Discusssion

/in /by

Resources:

 Milstead, J. A., & Short, N. M. (2019). Health policy and politics: A nurse’s guide (6th ed.). Jones & Bartlett Learning.

 

To Prepare:

  • Review the Resources and reflect on the mission of state/regional boards of nursing as the protection of the public through the regulation of nursing practice.
  • Consider how key regulations may impact nursing practice.
  • Review key regulations for nursing practice of your state’s/region’s board of nursing and those of at least one other state/region and select at least two APRN regulations to focus on for this Discussion.

Post a comparison of at least two APRN board of nursing regulations in your state/region with those of at least one other state/region. Describe how they may differ. Be specific and provide examples. Then, explain how the regulations you selected may apply to Advanced Practice Registered Nurses (APRNs) who have legal authority to practice within the full scope of their education and experience. Provide at least one example of how APRNs may adhere to the two regulations you selected.

Nursing LEADERSHIP ASSIGNMENT

/in /by

A screenshot of a computer Description automatically generated

A close-up of a text Description automatically generated

A text on a page Description automatically generated
A close-up of a sign Description automatically generated

image1.png

image2.png

image3.png

image4.png

WHERE IN THE WORLD IS EVIDENCE-BASED PRACTICE?

/in /by

March 21, 2010, was not EBP’s date of birth, but it may be the date the approach “grew up” and left home to take on the world.

When the Affordable Care Act was passed, it came with a requirement of empirical evidence. Research on EBP increased significantly. Application of EBP spread to allied health professions, education, healthcare technology, and more. Health organizations began to adopt and promote EBP.

You will consider this adoption in the post. You will examine healthcare organization websites and analyze to what extent these organizations use EBP.

To Prepare:

  • Review the Resources and reflect on the definition and goal of EBP.
  • Choose a professional healthcare organization’s website (e.g., a reimbursing body, an accredited body, or a national initiative).
  • Explore the website to determine where and to what extent EBP is evident.

  • Write a description of the healthcare organization website you reviewed. Describe where, if at all, EBP appears (e.g., the mission, vision, philosophy, and/or goals of the healthcare organization, or in other locations on the website). Then, explain whether this healthcare organization’s work is grounded in EBP and why or why not. Finally, explain whether the information you discovered on the healthcare organization’s website has changed your perception of the healthcare organization. Be specific and provide examples. Reference 3 scholarly citations 

Healthcare Policy and Delivery Systems

/in /by

 

The purpose of learning the ropes of policy, politics and advocacy is to influence health care or broader social agendas that influence human health.  Discuss a time where you influence health care through advocacy.

The discussion must address the topic.

From week #2 and on, you are expected to post 400 words in your initial post by Wednesday 23:59 pm with 2 scholarly references. You must post two answers to your peers of 200 words by Saturday 23:59 pm. ****

EVIDENCE-BASED PROJECT, PART 1: IDENTIFYING RESEARCH METHODOLOGIES

/in /by

EVIDENCE-BASED PROJECT, PART 1: IDENTIFYING RESEARCH METHODOLOGIES

Is there a difference between “common practice” and “best practice”?

When you first went to work for your current organization, experienced colleagues may have shared with you details about processes and procedures. Perhaps you even attended an orientation session to brief you on these matters. As a “rookie,” you likely kept the nature of your questions to those with answers that would best help you perform your new role.

Over time and with experience, perhaps you recognized aspects of these processes and procedures that you wanted to question further. This is the realm of clinical inquiry.

Clinical inquiry is the practice of asking questions about clinical practice. To continuously improve patient care, all nurses should consistently use clinical inquiry to question why they are doing something the way they are doing it. Do they know why it is done this way, or is it just because we have always done it this way? Is it a common practice or a best practice?

In this Assignment, you will identify clinical areas of interest and inquiry and practice searching for research in support of maintaining or changing these practices. You will also analyze this research to compare research methodologies employed.

To Prepare:

· Review the Resources and identify a clinical issue of interest that can form the basis of a clinical inquiry. Keep in mind that the clinical issue you identify for your research will stay the same for the entire course. 

· Based on the clinical issue of interest and using keywords related to the clinical issue of interest, search at least four different databases in the Walden Library to identify at least four relevant peer-reviewed articles related to your clinical issue of interest. You should not be using systematic reviews for this assignment, select original research articles.

· Review the results of your peer-reviewed research and reflect on the process of using an unfiltered database to search for peer-reviewed research.

· Reflect on the types of research methodologies contained in the four relevant peer-reviewed articles you selected.

Part 1: Identifying Research Methodologies

After reading each of the four peer-reviewed articles you selected, use the Matrix Worksheet template to analyze the methodologies applied in each of the four peer-reviewed articles. Your analysis should include the following:

· The full citation of each peer-reviewed article in APA format.

· A brief (1-paragraph) statement explaining why you chose this peer-reviewed article and/or how it relates to your clinical issue of interest, including a brief explanation of the ethics of research related to your clinical issue of interest.

· A brief (1-2 paragraph) description of the aims of the research of each peer-reviewed article.

· A brief (1-2 paragraph) description of the research methodology used. Be sure to identify if the methodology used was qualitative, quantitative, or a mixed-methods approach. Be specific.

· A brief (1- to 2-paragraph) description of the strengths of each of the research methodologies used, including reliability and validity of how the methodology was applied in each of the peer-reviewed articles you selected.

n4t

/in /by

ARTHRITIS

This paper should integrate HP2030 and CDC information into your paper.

Link to HP2030Links to an external site.

1. Identify your target population (for instance, age or other demographic, aggregate population); this must be in your city or state.

2. Discuss population-based health education interventions for your target population that is aimed at reducing morbidity and mortality for the problem. Be sure to review the research literature and HP2030 for interventions.

3. Identify how and what data for interventions is being tracked.

4. In a four (4) page paper, address the following. Refer to rubric for expanded details related to grading expectations.

·

· Identify the problem in the introduction section.

· Provide an overview of the problem in your state/national.

· Review of descriptive epidemiological and demographic data on mortality/morbidity and risk.

· HP2030: Present the goal, overview and objectives of Healthy People 2030 for the paper topic.

· Population level prevention and health promotion review. Describe population and/or primary health care focused interventions. Use of scholarly literature and HP2030 is required. There should be direct correlation to evidence for all strategies.

Short Answer Pharm

/in /by

Assignment, you will review and apply your understanding of psychopharmacologic treatments for patients with multiple mental health disorders.

1. In 3 or 4 sentences, explain the appropriate drug therapy for a patient who presents with MDD and a history of alcohol abuse ( use an SSRI Sertraline and an alcohol cessation medication naltrexone). Which drugs are contraindicated, if any, and why? Be specific. What is the timeframe that the patient should see resolution of symptoms?

2. List 4 predictors of late onset generalized anxiety disorder.

3. List 4 potential neurobiology causes of psychotic major depression.

4. An episode of major depression is defined as a period of time lasting at least 2 weeks. List at least 5 symptoms required for the episode to occur. Be specific.

5. List 3 classes of drugs, with a corresponding example for each class, that precipitate insomnia. Be specific. 

References x 3 to include:

Morgenthaler, T. I., Kapur, V. K., Brown, T. M., Swick, T. J., Alessi, C., Aurora, R. N., Boehlecke, B., Chesson, A. L., Friedman, L., Maganti, R., Owens, J., Pancer, J., & Zak, R. (2007). Practice parameters for the treatment of narcolepsy and other hypersomnias of central origin. 


SLEEPLinks to an external site.


, 30(12), 1705–1711. https://j2vjt3dnbra3ps7ll1clb4q2-wpengine.netdna-ssl.com/wp-content/uploads/2017/07/PP_Narcolepsy.pdf

Sateia, M. J., Buysse, D. J., Krystal, A. D., Neubauer, D. N., & Heald, J. L. (2017). Clinical practice guideline for the pharmacologic treatment of chronic insomnia in adults: An American Academy of Sleep Medicine clinical practice guideline. 


Journal of Clinical Sleep MedicineLinks to an external site.


, 13(2), 307–349. https://jcsm.aasm.org/doi/pdf/10.5664/jcsm.6470

soap for brilliant

/in /by

Week 6: Problem-Focused SOAP Note

USE the template that I gave you before. Needs the 1st blank paper for cover sheet.

Some Rubric

Some Rubric

Criteria Ratings Pts

This criterion is linked to a
Learning Outcomes (Subjective)

10 pts
Accomplished

Symptom analysis is well organized, with C/C, OLD

CART, pertinent negatives, and pertinent positives. All

data needed to support the diagnosis & differential

are present. Is complete, concise, and relevant with

no extraneous data.

10 pts

This criterion is linked to a
Learning Outcome (Objective)

10 pts
Accomplished

Complete, concise, well organized, well written, and

includes pertinent positive and pertinent negative

physical findings. Organized by body system in list

format. No extraneous data.

10 pts

This criterion is linked to a
Learning Outcome
(Assessment)

10 pts
Accomplished

Diagnosis and differential dx are correct, include ICD

code, and are supported by subjective and objective

data.

10 pts

This criterion is linked to a
Learning Outcome (Plan) 10 pts

Accomplished

Plan is organized, complete and supported with 2

evidence-based references. Addresses each diagnosis

and is individualized to the specific patient and

includes medication teaching and all 5 components:

(Dx plan, Tx plan, patient education, referral/follow-

up, health maintenance).

10 pts

Total Points: 40

Patient initial: R. R

DOB: June/1991 Sex: F

Encounter Date: 08/08/2023

SUBJECTIVE:

Chief Complaint:

History Of Present Illness:

appt is requested for URI

Medical History:

#. COVID 1/2022

#. hemorrhoids

#. Postpartum Depression, Anxiety, panic attacks

#. ADD

#. Insomnia

#. Allergic rhinitis

#. Psoriasis

#. Onychymycosis

Surgical History:

none

Gynecological History:

G2 P2 A0

Family History:

M: living, arrhythmia, palpitations

F: living, healthy

S: asthma

Social History:

-Married

-Lives with husband, 2 kids, and grandparents

-Authorization coordiinator at USC Keck, also student in digital marketing

-Denies tobacco use

-etoh use: Socially

-Denies illicit drug use

Smoking Status: Never Smoked

Allergies:

No known allergies

Current Medications:

———————————-

Paxil 10 mg po qd

xanax 0.25 mg prn panic attacks

Adderall 20mg bid prn

———————————

Review of System:

Constitutional: Patient denies weight change, fever, chills, weakness, fatigue, sleep

changes, appetite changes.

Head: Patient denies headache.

Neck: Patient denies abnormal masses, neck stiffness.

Eyes: Patient denies vision loss, blurring, discharge, excessive tearing, dryness.

Ears: Patient denies hearing loss, tinnitus, vertigo, discharge, pain

Nose: #sinus congestion#

Mouth: Patient denies ulcers, bleeding gums, taste problems.

Throat: #sore throat#

Cardiovascular: Patient denies chest pain, chest pressure, palpitations, DOE,

orthopnea.

Respiratory: #dry cough#

Patient denies shortness of breath, increased sputum, hemoptysis.

Gastrointestinal: #looser stools, frequency, occ incontinence#

Patient denies nausea, vomiting, heartburn, dysphagia, constipation, melena,

abdominal pain, jaundice, hemorrhoids.

Genitourinary: #urinary urgency and frequency, occasional incontinence#

Patient denies abnormal hesitancy, hematuria, dysuria, nocturia, stones.

Musculoskeletal: Patient denies arthralgias, joint stiffness, myalgias, muscle

weakness, instability and abnormal range of motion

Integumentary (Skin and/or Breast): Patient denies rash, lesions, changes in hair,

changes in nail, pruritus

Neurological: Patient denies headache, syncope, seizures, vertigo, ataxia, diplopia,

tremor, numbness, tingling.

Psychiatric: #depression, anxiety, ADD#

Patient denies mood abnormalities, memory loss, difficulty sleeping, appetite

changes

Endocrine: Patient denies sensitivity to cold or heat, polyuria, polydipsia.

Hematologic/Lymphatic: Patient denies bleeding, bruising, lymphadenopathy.

GYN: #menorrhagia#

Patient denies changes in menstrual cycle, hot flashes.

OBJECTIVE:

Physical Exam:

Constitutional: #last exam done on 7/10/23 showed#

WD, WN, Alert, Oriented X3 in NAD. Affect appropriate. Gait normal.

Eye: PERRLA, EOMI, nl conjunctiva

Ear: No pinnea/tragal tenderness. Drums are visualized, no wax in canals

Nose: N1 mucosa. N1 Nasal septal walls and turbinates.

Mouth: N1 bucal mucosa, no lesions noted.

Throat: Clear, no erythema or exudates.

Neck: #thyroid fullness R#

supple, no masses. Trachea is midline. N1 carotid auscultation. No JVD

Cardiovascular: RRR, N1 S1 and S2, No cardiac murmurs, rubs or gallops.

Lungs: ctab, no wheezes, rhonchi or crackles

Chest/Breasts: deferred

Gastrointestinal (Abdomen): soft, nt, nd, bs(+). No palpable masses.

Genitourinary: #negative CVAT#

deferred

Lymphatic: -No LAN noted

Musculoskeletal: good ROM. Strength symmetrical and wnl. No muscle weakness or

stiffness. No joint effusion or ttp.

Skin: Normal color and texture. No lesions seen.

Extremities: Warm, no clubbing, cyanosis or edema. N1 DP/PT pulses bilaterally

Neurological/Psychiatric: CN I-XII intact, neurosensory wnl, strength (5/5), (2+) DTR

UE/LE bilaterally -Judgment and insight intact

ASSESSMENT:

Diagnosis:

ICD-10 Codes:

1)J069; Upper respiratory infection, unspecified

PLAN:

Procedures (CPT code):

1) 99213; Detailed

2) 99401; 15 min

Medications:

Promethazine-DM 6.25-15 MG/5ML Oral Syrup; Take 5 ml orally every 4 hours Take

as needed for dry cough; Qty: 120; Refills: 0

Care Plan:

.***URI- x4 days, sore throat, sinus congestion, dry cough, headache. took

tylenol/cough syrup, claritin with not much relief. sent home today from work, COVID

test today from work pending results. sisters also similar sxs, but has tested

negative for COVID.

-off work this week

-Rx promethazine/DM 5mL prn cough, r/b d/w pt

-sudafed and tylenol prn

-f/u 1 week, if no improvement and covid neg, come back in office for exam

***urinary incontinence- h/o occasional stress incontinence, however over last 1 mo,

c/o increasing urengency, frequency and 2 episodes of incontinence, which occured

with only minimal alcohol use. denies hematuria, dysuria. c/o menorrhagia

worsening after delivering her 2 yo. denies LBP/trauma/saddle paresthesia

-pelvic floor PT ordered

-UA/UCx ordered

-referred to uro gyn

-ordered transvaginal u/s r/o uterine fibroids

-counseled on wt loss. keep voiding journal

-avoid irritants such as caffeine/ETOH

***diarrhea- c/o looser stools, 4-5xd and few episodes of incontinence. c/o abd

cramping after bm, othewise no abd pain, fever, melena, wt loss. has had h/o abd

pain and cramping which we ordered stool studies, CRP, ESR but pt never did.

denies LBP/trauma/saddle paresthesia. abd exam normal today

-ordered stool studies, ESR, CRP

-referred to GI

-ER precautions

***Hyperlipidemia, lipoprotein deficiency- On 1/16/23, FLP showed 237/47/182/156.

Has lost 6 lbs intentionally since last visit.

-Rec low fat, low carb diet

-FLP with next annual

***obesity- BMI 31.37, wt 221 lbs, Has lost 6 lbs intentionally since last visit.

-counseled

***thyroid fullness- noted on exam. 1/16/23, TSH wnl.

-ordered thyroid u/s 11/8/22, pt has not done yet

Plan Notes Continued: .

***trigger finger- unsure of duration, ono/off. R ring finger locks. Pt has seen hand

specialist in the past for another issue

-Rx ibuprofen as noted above, r/b d/w pt

-pt rec to f/u with hand specialist

***Vitamin D deficiency- On 1/16/23, Vitamin D level was 24. not supplementing.

-Rec Vitamin D 4000 IU qd

-Vitamin D level with next annual

***Onychymycosis- b/l feet on PEX on 2/1/23. pt is interested in tx.

-given the interactions between terbinafine and her psychiatric meds, I rec she

checked with them first before we start

***Depression, Anxiety- F/b psychiatrist, Dr. Askins and psychologist, Dr. Tricia

Duncan Hassle. Takes Paxil 10 mg po qd and xanax 0.25 mg prn panic attacks.

Denies SI/HI.

-mgmt per psych

***ADD- F/b psychiatrist, Dr. Askins. Takes Adderall 20mg bid prn.

-mgmt per psych

Patient Instructions: .

.

-Pt has been instructed to take medications as prescribed

-Pt received education on compliance with medications and recommendations

-Pt received counseling regarding Medication Side Effects

-Pt received counseling on following a well-balanced healthy diet with veg, fruit and

fiber.

-Pt was instructed to do CV exercise at least 3-4 times every week for 30 minutes.

PHCM: .

.

31 y/o F:

-Annual physical: done 2/1/23- next due 2/1/24

-Annual labs: done 1/16/23- next due 1/16/24

-Cervical CA screening: managed by GYN

-Skin CA screening; Referred to derm on 3/30/22

Immunizations:

Tetanus: doen 2021- next due 2031

Influenza: Fall 2022

COVID19: Pfizer in 7/1/21, bivalent booster Pfizer 1/14/23

HPV: will check records

  • Week 6: Problem-Focused SOAP Note

ALSP 01

/in /by

 Review the resources and clinical skills in the PMHNP Clinical Skills List document. It is recommended that you print out this document to serve as a guide throughout your practicum. 

Review the “Developing SMART Goals” resource on how to develop goals and objectives that follow the SMART framework.

Review the resources on nursing competencies and nursing theory and consider how these inform your practice.

Download the Clinical Skills Self-Assessment Form to complete this Assignment.  

Clinical Skills Self-Assessment Form to complete the following:   

Rate yourself according to your confidence level performing the skills identified on the Clinical Skills Self-Assessment Form.  

Based on your ratings, summarize your strengths and opportunities for improvement.   

Based on your self-assessment and theory of nursing practice, develop 3–4 measurable goals and objectives for this practicum experience. Include them on the designated area of the form