Part 1: Art Creation
Select one of the visual art pieces from Chapters 1-6 or the lessons from Weeks 1-3 to use as a point of inspiration. Create a painting, sculpture, drawing, or work of architecture inspired by your selected art piece.

Part 2: Reflection
Write a reflection about the relationship between your art production and the inspiration piece. Include the following in the reflection paper:

• Introduction
• Inspiration Piece
  • Include image.
  • Record the title, artist, year, and place of origin.
  • Briefly explain the background of the inspiration piece.
• Your Art Piece
  • Include image.
  • Provide a title.
  • Explain the background of your piece.
• Connection
  • Explain the thematic connection between the two pieces.
  • How are they similar and different?
  • Are they the same medium? How does the medium impact what the viewer experiences?
  • How do the formal elements of design compare to one another?

Original Artwork Requirements

• Methods: paint, watercolor, pencil, crayon, marker, collage, clay, metal, or wood (Check with your instructor about other methods you have in mind.)
• No computer-generated pieces

Writing Requirements (APA format)

• Length: 1.5-2 pages (not including title page, references page, or image of artwork)
• 1-inch margins
• Double spaced
• 12-point Times New Roman font
• Title page
• References page (minimum of 1 scholarly source)

Grading
This activity will be graded based on the W3 Art Creation & Reflection Grading Rubric.

• Consider the community surrounding your school of nursing. Pick two environmental conditions and assess these conditions. Where do you think you could locate data to support your observations?
• Fort lauderdale, florida
• 1 page

Benchmark – Capstone Project Change Proposal  (Fall prevention strategies in hospitals.)

In this assignment, students will pull together the capstone project change proposal components they have been working on throughout the course to create a proposal inclusive of sections for each content focus area in the course. For this project, the student will apply evidence-based research steps and processes required as the foundation to address a clinically oriented problem or issue in future practice.

Develop a 1,250-1,500 written project that includes the following information as it applies to the problem, issue, suggestion, initiative, or educational need profiled in the capstone change proposal:

1. Background
2. Clinical problem statement.
3. Purpose of the change proposal in relation to providing patient care in the changing health care system.
4. PICOT question.
5. Literature search strategy employed.
6. Evaluation of the literature.
7. Applicable change or nursing theory utilized.
8. Proposed implementation plan with outcome measures.
9. Discussion of how evidence-based practice was used in creating the intervention plan.
10. Plan for evaluating the proposed nursing intervention.
11. Identification of potential barriers to plan implementation, and a discussion of how these could be overcome.
12. Appendix section, if tables, graphs, surveys, educational materials, etc. are created.

Review the feedback from your instructor on the Topic 3 assignment, PICOT Question Paper, and Topic 6 assignment, Literature Review. Use this feedback to make appropriate revisions to these before submitting.

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

You are required to submit this assignment to LopesWrite. Refer to the LopesWrite Technical Support articles for assistance.

Benchmark Information

This benchmark assignment assesses the following programmatic competencies:

RN to BSN

1.1:     Exemplify professionalism in diverse health care settings.

2.2:     Comprehend nursing concepts and health theories.

3.2:     Implement patient care decisions based on evidence-based practice.

I need a truthful person to work with through out my program.

N492 Assignment Mod 2:

Assignment:

Identify an older adult age 65 +, use a 1st and last initial. Execute a therapeutic assessment interview with them for at least two interview sessions assessing their self-identified:

• Demographics,      life time education and career/employment
• Two      most significant (positive) times in their lives
• What      past hardship or loss has the client successfully negotiated in the past?
• Two      personal strengths
• Engage      them in identifying what is healthy versus non-healthy coping skills
  • Inquire       of 2 healthy coping skills they have used in the past and/or now
• Three      (3) pieces of advice they would give to their younger self if they could?
• Support      the client in taking the Geriatric Depression Scale.pdf
• Support      the client in taking the Fulmer SPICES Assessment.pdf
• Perform      a Mini Mental State Exam.pdf and Patient_Stress_Questionnaire.pdf (attach here)
• Perform      a Hall, Hall, and Chapman Article.pdf
• Report      the findings from the Geriatric Depression Scale, Fulmer Spices, Patient      stress questionnaire and the mini mental status exam
• Discuss      your older adult’s level of ego integrity vs. despair as described by      psychoanalyst Erik Erikson. If you had to rate them on a scale of 1-10,      with 1 representing a full state of despair and 10 representing full ego      integrity, what rating would you give your older adult?
• Describe      at least two nursing diagnoses for this client.  
• Create      a plan of care for the client to include at least three nursing goals with      two nursing interventions each.

The assignment should be written in an APA-formatted essay. The essay should be at least 1500 words in length and include at least two scholarly sources other than provided materials.

Record the time you spend interviewing the client and writing the assessment report as practice experience hours in Project Concert as ‘Older Adult Interview’ for Module 2. (Discussion Board work does not apply). It is expected to take you between 2-4 hours. Access Project Concert. Minimum required hours must be entered into Project Concert for Module 2. Some states/entities require hour logs for certification or employment. It is the student’s professional responsibility to ensure all hours are entered correctly in order to meet these requirements. Please see the Project Concert directions document in the Learning Materials on how to enter hours.

1. What is a workaround? Identify a workaround (specific to technology  used in a hospital setting) that you have used or perhaps seen someone  else use, and analyze why you feel this risk-taking behavior was chosen  over behavior that conforms to a safety culture. What are the risks? Are  there benefits? Why or why not?
2. Discuss the current patient safety characteristics used by your  current workplace or clinical site. Identify at least three aspects of  your workplace or clinical environment that need to be changed with  regard to patient safety (including confidentiality), and then suggest  strategies for change.

Bipolar Therapy
Client of Korean Descent/Ancestry

BACKGROUND INFORMATION

The client is a 26-year-old woman of Korean descent who presents to her first appointment following a 21-day hospitalization for onset of acute mania. She was diagnosed with bipolar I disorder. 

Upon arrival in your office, she is quite “busy,” playing with things on your desk and shifting from side to side in her chair. She informs you that “they said I was bipolar, I don’t believe that, do you? I just like to talk, and dance, and sing. Did I tell you that I liked to cook?”

She weights 110 lbs. and is 5’ 5” 

SUBJECTIVE

Patient reports “fantastic” mood. Reports that she sleeps about 5 hours/night to which she adds “I hate sleep, it’s no fun.” 

You reviewed her hospital records and find that she has been medically worked up by a physician who reported her to be in overall good health. Lab studies were all within normal limits. You find that the patient had genetic testing in the hospital (specifically GeneSight testing) as none of the medications that they were treating her with seemed to work. 

Genetic testing reveals that she is positive for CYP2D6*10 allele. 

Patient confesses that she stopped taking her lithium (which was prescribed in the hospital) since she was discharged two weeks ago. 

MENTAL STATUS EXAM

The patient is alert, oriented to person, place, time, and event. She is dressed quite oddly- wearing what appears to be an evening gown to her appointment. Speech is rapid, pressured, tangential. Self-reported mood is euthymic. Affect broad. Patient denies visual or auditory hallucinations, no overt delusional or paranoid thought processes readily apparent. Judgment is grossly intact, but insight is clearly impaired. She is currently denying suicidal or homicidal ideation.

The Young Mania Rating Scale (YMRS) score is 22

RESOURCES

§ Chen, R., Wang, H., Shi, J., Shen, K., & Hu, P. (2015). Cytochrome P450 2D6 genotype affects the pharmacokinetics of controlled-release paroxetine in healthy Chinese subjects: comparison of traditional phenotype and activity score systems. European Journal of Clinical Pharmacology, 71(7), 835-841. doi:10.1007/s00228-015-1855-6

Decision Point One

Select what the PMHNP should do:

Begin Lithium 300 mg orally BID

Begin Risperdal 1 mg orally BID

Begin Seroquel XR 100 mg orally at HS

Examine Case Study: An Asian American Woman With Bipolar Disorder. You will be asked to make three decisions concerning the medication to prescribe to this client. Be sure to consider factors that might impact the client’s pharmacokinetic and pharmacodynamic processes.

At each decision point stop to complete the following:

• Decision #1
  • Which decision did you select?
  • Why did you select this decision? Support your response with evidence and references to the Learning Resources.
  • What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.
  • Explain any difference between what you expected to achieve with Decision #1 and the results of the decision. Why were they different?
• Decision #2
  • Why did you select this decision? Support your response with evidence and references to the Learning Resources.
  • What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.
  • Explain any difference between what you expected to achieve with Decision #2 and the results of the decision. Why were they different?
• Decision #3
  • Why did you select this decision? Support your response with evidence and references to the Learning Resources.
  • What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.
  • Explain any difference between what you expected to achieve with Decision #3 and the results of the decision. Why were they different?

Also include how ethical considerations might impact your treatment plan and communication with clients.

Choice one: I choose to start Seroquel

Decision Point One

Begin Seroquel XR 100 mg orally at HS

RESULTS OF DECISION POINT ONE

• Client returns to clinic in four weeks
• Client is reporting that she sleeps a bit more at bedtime
• Client states that she has gained about 2 or 3 pounds, which she does not like
• Client also reports that she has been constipated since starting this medication
• Client is also complaining of dry mouth which she does not like.
• Client’s score on the Young Mania Rating Scale has decreased from a 22 to an 18
• Client is reporting really good mood, but is asking for a different medication because of the weight gain

Decision Point Two

Select what the PMHNP should do next:

Increase Seroquel XR to 300 mg orally daily 

Discontinue Seroquel and start Geodon 40 mg orally BID. Administer with 500 calorie meal 

Continue same dose of Seroquel and counsel client regarding ways to prevent constipation

I choose to discontinue Seroquel and start Geodon 40 mg orally BID. ADminister with 500 calorie meal

Discontinue Seroquel and start Geodon 40 mg orally BID. Administer with 500 calorie meal 

RESULTS OF DECISION POINT TWO

• Client returns to clinic in four weeks
• Client demonstrates a 50% decrease in score on the Young Mania Rating Scale (from 22 to 11)
• Client denies any additional weight gain and denies any additional side effects

Decision Point Three

Select what the PMHNP should do next:

Continue same dose and reassess in 4 weeks 

Increase Geodon to 60 mg orally BID with a 500 calorie meal 

Augment with Lithium sustained release 300 mg orally BID

I now choose to continue same dose and reassess in 4 weeks

Decision Point Three

Continue same dose and reassess in 4 weeks 

Guidance to Student
The PMHNP should provide counseling to the client about this side effect and encourage increased fluids and fiber in the diet to combat constipation. Hard candies or gum can be used to prevent dry mouth. This is another issue as the drug can cause dental problems as a result of dry mouth.

Changing to Geodon clearly helped with symptoms and arrested weight gain in this client. The PMHNP could wait 4 weeks and see if any changes in Young Mania Rating Scale are noted, or increasing to 60 mg orally BID in an attempt to hasten symptom improvement. Increasing dose may be associated with side effects.

Augmentation with Lithium may be appropriate if the goal of therapy is to discontinue antipsychotic therapy and treat with Lithium monotherapy. Lithium was problematic for this client but changing formulation to the extended release may overcome the difficulties she was experiencing with side effects. The PMHNP would need to educate client regarding side effects of medication and need to maintain compliance. 

You are admitting a 19-year old female college student to the hospital for fevers.  Using the patient information provided, choose a culture unfamiliar to you and describe what would be important to remember while you interview this patient. Discuss the health care support systems available in your community for someone of this culture. If no support systems are available in your community, identify a national resource.

how this aligns with Haught’s in Prophetic Religions; how Islamic spirituality described here aligns/diverges Models of Spiritual Care & Feminist Spirituality

CAHIIM Competencies Assessed: 

Subdomain VI.D. Human Resources Management

1. Create and implement staff orientation and training programs (Blooms 6)

Instructions:  You are an HIM Supervisor at a hospital and you have been asked to create a new staff training on data compliance rules.  Assume that the new staff has a wide variety of background, with some new staff knowing nothing about data compliance at all.  The training should be basic and introductory.

Create an outline for your training.

Requirements:

1. Include an introduction and summary within your outline
2. Length of outline should be 3-4 pages
3. It should be an annotated outline.  This means that it should include citations within the outline and a reference page.
4. Your training should include the topics of HIPAA and The Joint Commission and other data compliance topics that affect hospital staff