Category: Nursing

NSG6430 Assignment Discussion iHuman Case Study-Adolescent Depression Case

Assignment 1: Discussion: iHuman Case Study-Adolescent Depression Case Discuss the questions that would be important to include when interviewing a patient with this issue. Describe the clinical findings that may be present in a patient with this issue. Are there any diagnostic studies that should be ordered on this patient? Why? List the primary diagnosis and three differential diagnoses for this patient. Explain your reasoning for each. Discuss your management plan for this patient, including pharmacologic therapies, tests, patient education, referrals, and follow-ups.

Financial Accountability and Nursing’s Role in Decision-Making Essay Paper

This Financial Accountability and Nursing’s Role in Decision-Making Essay Paper assignment broadens the students understanding and knowledge of the various roles financial management and nursing leaders play in the business of healthcare. Have you ever said to yourself “If we only did things this way, this department/unit would more efficiently and cost effective? Or, what about “I have an idea to improve care and save money?”

For this assignment, the student will identify a workplace/unit issue or concern. Create a plan related to the issue/concern that could help the unit become more efficient and cost effective. A major emphasis of this assignment is to focus upon on how to be more cost effective without compromising quality and safety. How can the plan improve the fiscalhealth of the department and/or unit?

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Areas and ideas to consider might include:

· Charge for procedures not previously charged for · Changing brands of items · Creating a new department · Outsourcing procedures or personnel · Buying new or different equipment · Hiring personnel · Eliminating procedures, departments, supplies, etc. · Redesigning procedures, department layout, policy

Financial Accountability and Nursing’s Role in Decision-Making Essay Paper Assignment Criteria

Develop a scholarly Financial Accountability and Nursing’s Role in Decision-Making Essay Paper that addresses the following criteria: 1. Identify and fully describe the problem or issue. 2. Describe in detail why this is a problem/issue and how it affects patients, nursing, and the organization in terms of fiscal management. Be specific. 3. Develop a plan or proposal related to the chosen problem on how to improve the fiscal health of the department/unit. 4. Include a literature review supporting the plan. · Describe how the literature/evidence describes the problem/issue or supports the plan/ideas to resolve the problem/issue · Discuss specific goals and objectives for implementing this plan/proposal 5. Identify specific strategies for solving this problem based on the readings and literature. 6. Include a proposed budget that shows the anticipated cost savings. · Discuss the return on investment expected (when, who, how, etc.) · This can be described in (a) narrative format within the Financial Accountability and Nursing’s Role in Decision-Making Essay Paper, (b) in a table within the paper, or (c) as an appendix 7. Include a proposed time line for implementation. 8. Describe how the proposal/plan effectiveness will be evaluated. 9. The scholarly paper should be six to eight (6-8) pages excluding the title page, reference page, and appendices. 10. Include level 1and 2 headings to organize the paper. 11. The paper should begin with an introductory paragraph that includes the purpose statement. 12. The paper should include a conclusion. 13. Write the paper in third person and a scholarly manner. To clarify: I, we, you, me, our may not be used. In addition, describing yourself as the researcher or the author should not be used. 14. Include a minimum of six (6) references from professional peer-reviewed nursing journals to support your paper.References should be from scholarly peer-reviewed journals (review in Ulrich Periodical Directory) and be less than five (5) years old. 15. APA format is required (attention to spelling/grammar, a title page, a reference page, and in-text citations). 16. Submit the assignment to TurnitinDirect prior to your final submission to the assignment drop box by the posted due date. Please be sure to review the originality report and make any needed changes prior to submitting to the assignment drop box. 17. Submit to the Financial Accountability and Nursing’s Role in Decision-Making Essay Paper assignment drop box by posted due date.

Financial Accountability and Nursing’s Role in Decision-Making Essay Paper Grading Rubric

Assignment Criteria 5 points 4 points 2 points 1 point All topics/criteria addressed and all questions fully answered. All topics/criteria addressed and most questions fully answered. All topics/criteria addressed and most questions partially answered. One or more topics/criteria not addressed or completely answered. Quality/Accuracy of Information 3 points 2 points 1 point 0 points Information clearly relates to the main topic/criteria. It includes several supporting details and/or examples. Financial Accountability and Nursing’s Role in Decision-Making Essay Paper. Information clearly relates to the main topic/criteria. It provides supporting details and/or examples. Information clearly relates to the main topic/criteria. A few details and/or examples are given. Information has little or nothing to do with the main topic/criteria. Organization 2 points 1 point 0.5 point 0.25 point Information is very organized with well-constructed paragraphs and levels of heading. Information organized with well-constructed paragraphs and levels of heading. There is an attempt at organization but errors exist. No levels of heading. The information or overall structure appears disorganized. Sources 2 points 1 point 0.5 point 0.25 point All references are from a relevant professional peer-reviewed scholarly journal, within a 5-year timeframe, or a classic/ historical source. Financial Accountability and Nursing’s Role in Decision-Making Essay Paper. The majority of references are from a relevantprofessional peer-reviewed scholarly journal, within a 5-year timeframe or a classic/historical source. Some references are from non-peer-reviewed scholarly sources or older than 5-years. Majority of references are from non-peer-reviewed scholarly sources or older than 5-years. Earned Points Up to 20% of the assigned points (total points of assignment) can be deducted from the earned points for errors in APA style [title page, introduction, purpose statement, level heading, conclusion, references, citations, and format], spelling, and/or grammar. Financial Accountability and Nursing’s Role in Decision-Making Essay Paper.

Assessment and Care of Patients With Cardiovascular Conditions

Many cardiac disorders such as myocardial infarctions are a common problem in the acute care setting. Thus it is essential for you, as the advanced practice nurse caring for acute patients, to identify potential signs and symptoms of complications. Although some cardiac disorders require outpatient treatment and management, other procedures such as CABGs or valve replacements are more common and frequently require major interventions. In your role with acute cardiac patients, you must evaluate symptoms and determine how to treat patients. For this Discussion, consider potential diagnoses, treatment, and/or referral options for the patients in the following 3 case studies. Assessment and Care of Patients With Cardiovascular Conditions.

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Case Study 1: Tom is 56-year-old African American male who presented to the ED with chest pain radiating to his back. The pain has been continuous for 1 hour. The patient complains of shortness of breath. The pain has not been relieved with rest. The patient’s vitals are: 99.1-98-18-198/110. The patient’s cardiac enzymes are negative. Labs results are as follows: Na 134 K 4.1 Cr 1.8 BUN 42 Glucose 248 WBC 13.1 Hbg 14.1 Hct 44.2 Plt 236 EKG sinus rhythm no ekg changes

Case Study 2: Liz is a 79-year-old female with a history of aortic stenosis and hypertension. The patient underwent elective aortic valve replacement yesterday. This AM during rounds, the patient is sitting up in the chair. Vital signs: 99.4-54-20-85/50. Pa 29/13, CVP10. Urine output 20 ml/hr for the last 3 hours. Cardiac output 3.9, cardiac index 1.8. Patient’s preop ef was 50%. Labs are as follows: K 4.0 Cr 1.5 BUN 42 Hgb 9.8 Hct 29.1 Plt 138 Postoperative chest X-ray normal

Case Study 3: Arvid is a 69-year-old male you are seeing in CCU 1 hour after he had a CABG × 4. The patient is intubated. VS: 97.1-78-14-90/50. PA 30/13, CVP 12. ABG 7.21-49-98-19.6-99%- -6 base deficit. Mixed venous O2 sat 68. Hgb 10.2, Hct 32.1. The patient is sedated. Vent settings FiO2 50%, IMV 12, PEEP 5, tidal volume 550. To prepare: Review and select 1 of the 3 case studies provided. Analyze the patient information. Consider a differential diagnosis for the patient in the case study you selected. Think about the most likely diagnosis for the patient. Think about a treatment and management plan for the patient. Be sure to consider appropriate dosages for any recommended pharmacologic and/or nonpharmacologic treatments. Consider strategies for educating patients and families on the treatment and management of the cardiac disorder. Post on or before Day 3 an explanation of the differential diagnosis for the patient in the case study you selected. Assessment and Care of Patients With Cardiovascular Conditions. Explain which is the most likely diagnosis for the patient and why. Include an explanation of unique characteristics of the disorder you identified as the primary diagnosis. Then, explain a treatment and management plan for the patient, including appropriate dosages for any recommended treatments. Finally, explain strategies for educating patients and families on the treatment and management of the cardiac disorder. Read a selection of your colleagues’ responses. Respond on or before Day 6 to at least two of your colleagues on 2 different days in both of the ways listed below. Respond to colleagues who selected different case studies from yours. Describe how a patient factor such as age, gender, ethnicity or culture might affect the diagnosis, management, and follow-up care of patients with the cardiac disorders your colleagues discussed. Based on your personal and/or professional experiences, expand on your colleagues’ postings by providing additional insights or different perspectives.? Discussion Part II: Pharmacology To prepare: Read the following article to enhance your knowledge of commonly prescribed medications: Kalil, A., & Bailey, K. L. (2014, October 20). Septic shock medication. Retrieved from http://emedicine.medscape.com/article/168402-medication All of the following groups of medications are commonly prescribed in the acute care setting. Choose one of the topics below to discuss. If it is a medication group, select a specific drug within that group. (This is a good way for you to prepare for clinical practice, because you will get to know the drugs you will prescribe for patients.). Focus your discussion on the hospital or ICU setting and IV usage. All of the following groups of medications are commonly prescribed in the acute care setting. This Discussion will focus on CABG patients. Choose one of the topics below to discuss in terms of management of a post-CABG patient. Focus your discussion on the hospital or ICU setting and IV usage. Amicar Epinephrine Vasopressin Nitroglycerin Cardene Insulin drip Dopamine Dobutamine Norepinephrine Phenylephrine. Assessment and Care of Patients With Cardiovascular Conditions.

Note: When sharing your initial post, select a drug that has not yet been discussed. If all drugs have been discussed, then you may select that drug again. For this Discussion, address 1 of the following options. Post by Day 3: Option 1: Post a description of a patient you have taken care of (inpatient as an RN, or as an NP student) who has been prescribed the medication you selected. Assessment and Care of Patients With Cardiovascular Conditions. Include the scenario, indication, dosing, complications, and outcome. Then explain whether or not you would have ordered the same drug and same dose. Option 2: Conduct an evidence-based drug search on the drug you selected and post an explanation of any possible issues. Are there any drug interactions? Any black box warnings? To what type of patient would you prescribe this medication? Option 3: Post an explanation of the properties of the drug you selected, including usages and dosing in the hospital or ICU. Describe a patient to whom you would prescribe this medication. Assessment and Care of Patients With Cardiovascular Conditions.

Assessment and Care of Patients With Adrenal and Urogynecologic Conditions Essay Assignment Discussion

Many genitourinary (GU) disorders such as kidney disease start developing during adolescence (Johns Hopkins Children’s Center, 2010). This early onset of disease makes it essential for you, as the advanced practice nurse caring for adolescent patients, to identify potential signs and symptoms. Although some adolescent GU disorders require long-term treatment and management, other disorders such as urinary tract infections are more common and frequently require only minor interventions. In your role with adolescent patients, you must evaluate symptoms and determine whether to treat patients or refer them for specialized care. For this Discussion, consider potential diagnoses, treatment, and/or referral options for the patients in the following 3 case studies.

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Many genitourinary (GU) disorders such as kidney disease start developing during adolescence (Johns Hopkins Children’s Center, 2010). This early onset of disease makes it essential for you, as the advanced practice nurse caring for adolescent patients, to identify potential signs and symptoms. Although some adolescent GU disorders require long-term treatment and management, other disorders such as urinary tract infections are more common and frequently require only minor interventions. In your role with adolescent patients, you must evaluate symptoms and determine whether to treat patients or refer them for specialized care. For this Discussion, consider potential diagnoses, treatment, and/or referral options for the patients in the following 3 case studies.

Case Study 2: Mark is a 15-year-old male with a complaint of acute left scrotal pain with nausea. The pain began approximately 6 hours ago as a dull ache and gradually has worsened such that he can no longer stand without doubling over. He is afebrile and in marked pain. Physical exam results are negative except for elevation of the left testicle, diffuse scrotal edema, and the presence of a blue dot sign.

Case Study 3: Maya is a 16-year-old female who presents to the ER for urinary pain. She is a healthy adolescent with complaints of lower abdominal pain, low back pain, and burning with urination. She had a fever of 102°F at home. Physical examination results are normal. Routine urinalysis indicates 2+ proteinuria; specific gravity 1.020; negative for glucose, blood. Leukocytes are moderate and nitrites, moderate. Her blood pressure is normal, and she is at the 60th percentile for height and weight. Vitals are: temp 103.1°F, HR 116, RR 18, BP 100/58. P Ox is 98% (Johns Hopkins Children’s Center, 2010). Assessment and Care of Patients With Adrenal and Urogynecologic Conditions Essay Assignment Discussion.

To prepare: Review and select 1 of the 3 provided case studies. Analyze the patient information. Consider a differential diagnosis for the patient in the case study you selected. Think about the most likely diagnosis for the patient. Assessment and Care of Patients With Adrenal and Urogynecologic Conditions Essay Assignment Discussion. Think about a treatment and management plan for the patient. Be sure to consider appropriate dosages for any recommended pharmacologic and/or nonpharmacologic treatments. Consider strategies for educating patients and families on the treatment and management of the genitourinary disorder. Post on or before Day 3 an explanation of the differential diagnosis for the patient in the case study you selected. Explain which is the most likely diagnosis for the patient and why. Include an explanation of unique characteristics of the disorder you identified as the primary diagnosis. Then, explain a treatment and management plan for the patient, including appropriate dosages for any recommended treatments. Assessment and Care of Patients With Adrenal and Urogynecologic Conditions Essay Assignment Discussion. Finally, explain strategies for educating patients and families on the treatment and management of the genitourinary disorder. Read a selection of your colleagues’ responses. Respond on or before Day 6 to at least two of your colleagues on 2 different days in both of the ways listed below. Respond to colleagues who selected different case studies from yours. Describe how culture might affect the diagnosis, management, and follow-up care of patients with the genitourinary disorders your colleagues discussed. Based on your personal and/or professional experiences, expand on your colleagues’ postings by providing additional insights or different perspectives.? Discussion Part II: Pharmacology Read the following articles to enhance your knowledge of commonly prescribed medications: Daley, B. (2015, February 23). Peritonitis and abdominal sepsis. Retrieved from http://emedicine.medscape.com/article/180234-overview Shahedi, K., Chudasama, Y. N., Dea, S. K., & Cooperman, A. (2015, January 14). Diverticulitis treatment and management. Retrieved from http://emedicine.medscape.com/article/173388-treatment Tobias, J. D., & Leder, M. (2011). Procedural sedation: A review of sedative agents, monitoring, and management of complications. Saudi Journal of Anasthesia, 5(4), 395–410. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3227310/

All of the following groups of medications are commonly prescribed in the acute care setting. Choose one of the topics below to discuss. If it is a medication group, select a specific drug within that group. (This is a good way for you to prepare for clinical practice, because you will get to know the drugs you will prescribe for patients.). Focus your discussion on the hospital or ICU setting and IV usage. Sedation Diazepam Fentanyl Ketamine Lorazepam Midazolam Propofol Nonsedation Chlorpromazine Peritonitis—what antibiotics are chosen for peritonitis? Nerve blocks—what drugs are used with nerve blocks? Diverticulitis—what drugs are used with diverticulitis? Note: When sharing your initial post, select a topic that has not yet been discussed. If all topics have been discussed, then you may select that topic again, but select a different drug within the medication group. Assessment and Care of Patients With Adrenal and Urogynecologic Conditions Essay Assignment Discussion.

For this Discussion, address 1 of the following options. Post by Day 3: Option 1: Post a description of a patient you have taken care of (inpatient as an RN, or as an NP student) who has been prescribed the medication you selected. Include the scenario, indication, dosing, complications, and outcome. Then explain whether or not you would have ordered the same drug and same dose. Option 2: Conduct an evidence-based drug search on the drug you selected and post an explanation of any possible issues. Are there any drug interactions? Any black box warnings? To what type of patient would you prescribe this medication? Assessment and Care of Patients With Adrenal and Urogynecologic Conditions Essay Assignment Discussion. Option 3: Post an explanation of the properties of the drug you selected, including usages and dosing in the hospital or ICU. Describe a patient to whom you would prescribe this medication.

Neurologic and Orthopedic Conditions and Plastic/Reconstructive Surgery Case Studies

This week, you study neurologic and orthopedic conditions with plastic surgery considerations. Both neurologic and orthopedic conditions are seen in the trauma areas of the hospital. These conditions encompass cardiovascular, pulmonary, and metabolic aspects of care in the ICU. For this Discussion, focus on adolescent patients, and consider potential diagnoses, treatment, and/or referral options for the patients in the following 3 case studies.

Case Study 1: A 17-year-old male was celebrating his birthday with friends and alcohol. At one point he jumped into the hotel pool three stories below, hitting the side of the pool with his chest. EMS arrived and packaged him with spinal support. He arrives in the ER with breathing difficulty, chest pain, GCS 10, and O2 sat of 94%. You do initial assessment in the first 10 minutes and find that his chest is asymmetric for breathing and contusions are noted all over his chest. His CXR shows multiple rib fractures on both sides and pulmonary contusions. His cervical spine is stable in a collar. His thoracic and lumbar films are negative for fractures. In the next hours, what are your priorities, and what plan would you have for this patient as he moves to the ICU? At what stage of development is he, and how does that affect his care?

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Case Study 2: A 13-year-old female restrained passenger of a vehicle was involved in an MVA at 60 mph on the highway. The vehicle experienced a frontal impact. The patient arrived in the ER with closed fractures of the left tibia and fibula with angulation, dislocation of the right ankle, multiple pelvic fractures, and femur fracture on the left side. Her BP is 92/54 with pulse of 130. What is your plan for this patient, and what are the considerations to prevent further morbidity? At what stage of development is she, and how does that impact her care?

Case Study 3: A 19-year-old male private in the U.S. Air Force was driving with friends when they dared him to “surf the car.” He fell off the roof of the car while it was moving at a speed of approximately 40 mph. He landed face first. He is now in the ICU with a closed head injury. His intracranial pressure is elevated, and his pupillary response is slowing. At this time, what medications do you recommend, and what other medical treatments do you recommend? In addition, after the acute situation is controlled and the patient awakens, what medication do you use for his agitation?

To prepare: Review and select 1 of the 3 provided case studies. Analyze the patient information. Consider a differential diagnosis for the patient in the case study you selected. Think about the most likely diagnosis for the patient. Think about a treatment and management plan for the patient. Be sure to consider appropriate dosages for any recommended pharmacologic and/or nonpharmacologic treatments. Consider strategies for educating patients and families on the treatment and management of the trauma care. Neurologic and Orthopedic Conditions and Plastic/Reconstructive Surgery Case Studies Post on or before Day 3 an explanation of the differential diagnosis for the patient in the case study you selected. Explain which is the most likely diagnosis for the patient and why. Include an explanation of unique characteristics of the disorder you identified as the primary diagnosis. Then, explain a treatment and management plan for the patient, including appropriate dosages for any recommended treatments. Finally, explain strategies for educating patients and families on the treatment and management of neurologic and orthopedic conditions. Read a selection of your colleagues’ responses. Respond on or before Day 6 to at least two of your colleagues on 2 different days in both of the ways listed below. Respond to colleagues who selected different case studies from yours. Neurologic and Orthopedic Conditions and Plastic/Reconstructive Surgery Case Studies. Describe how culture might affect the diagnosis, management, and follow-up care of patients with the neurological, orthopedic, or plastics disorders your colleagues discussed. Based on your personal and/or professional experiences, expand on your colleagues’ postings by providing additional insights or different perspectives.?

Discussion Part II: Pharmacology To prepare: Read the following articles to enhance your knowledge of commonly prescribed medications: Family Practice Notebook. (2015). Neurologic and Orthopedic Conditions and Plastic/Reconstructive Surgery Case Studies. Nonsteroidal anti-inflammatory. Retrieved from http://www.fpnotebook.com/Pharm/Analgesic/NnstrdlAntInflmtry.htm Press, C. D. (2013, September 10). Infiltrative administration of local anesthetic agents. Retrieved from http://emedicine.medscape.com/article/149178-overview All of the following groups of medications are commonly prescribed in the acute care setting. Choose one of the topics below to discuss. If it is a medication group, select a specific drug within that group. (This is a good way for you to prepare for clinical practice, because you will get to know the drugs you will prescribe for patients.). Focus your discussion on the hospital or ICU setting and IV usage.

Glycopeptides Oxazolidinones (Bs) Monobactams Ansamycins Metronidazole Lincosamides (Bs) Tinidazole Lidocaine Marcaine NSAIDs

Note: When sharing your initial post, select a topic that has not yet been discussed. If all topics have been discussed, then you may select that topic again, but select a different drug within the medication group. For this Discussion, address 1 of the following options. Neurologic and Orthopedic Conditions and Plastic/Reconstructive Surgery Case Studies Post by Day 3:

Option 1: Post a description of a patient you have taken care of (inpatient as an RN, or as an NP student) who has been prescribed the medication you selected. Include the scenario, indication, dosing, complications, and outcome. Then explain whether or not you would have ordered the same drug and same dose.

Option 2: Conduct an evidence-based drug search on the drug you selected and post an explanation of any possible issues. Are there any drug interactions? Any black box warnings? To what type of patient would you prescribe this medication?

Option 3: Post an explanation of the properties of the drug you selected, including usages and dosing in the hospital or ICU. Describe a patient you would prescribe this medication to. Neurologic and Orthopedic Conditions and Plastic/Reconstructive Surgery Case Studies.

NURS 6560 Advanced Practice Care of Adults in Acute Care Settings II all weeks assignments discussions

Week 1 discussion

Discussion Part I: Scope of Practice, Credentialing, and Negotiation

Note: In this course, some Discussions will have two parts: Part I will consist of a specific topic related to the week’s content. Part II will consist of a pharmacology review of approximately 250 words. Please submit each posting separately but within the same Discussion thread. You will be assessed on your posting and responses to both parts.

As medical care evolves, so does the role and scope of practice of the advanced practice nurse in acute care settings. When providing patient care, however, you, as an advanced practice nurse, must always ensure that you are working within the scope of practice outlined by your state’s laws and institution’s regulations. For this Discussion, you examine these laws and regulations and consider how they might affect your future clinical practice, consider the credentialing process for your area, and discuss negotiation techniques you may use in a job search.

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To prepare: Locate a collaborative practice agreement. Based on this agreement, consider the scope of practice of an advanced practice nurse in your state. Locate and select at least two hospitals where you would be interested in working at once you obtain your licensure. Locate the hospitals’ credentialing documents and investigate the scope of practice at each hospital. Note: All hospitals do not have the same scope of practice even if they are located within the same city and state. Consider how the laws and regulations of the state and hospitals might affect your practice with medical and surgical patients in acute care settings. Think about how you would negotiate your first Advanced Practice role. Consider issues such as salary range, Continueing Medical Education (CME), license and DEA costs, insurance, hours, on call requirements, etc.

Post on or before Day 3 an explanation of the scope of practice of advanced practice nurses, as outlined in the collaborative practice agreement. Then, identify the two hospitals of interest that you selected. Based on the credentialing documents, explain the scope of practice for acute care advanced practice nurses at each hospital. Explain how this might affect your practice in terms of caring for medical and surgical patients in acute care settings (i.e., medical treatments, procedures you can perform, interpreting diagnostics, etc.). Finally, describe job negotiation considerations. NURS 6560 Advanced Practice Care of Adults in Acute Care Settings II all weeks assignments discussions.

Note: To support your Discussion post, you must include references (with URL links) from the state and the hospitals you selected. Read a selection of your colleagues’ responses. Respond on or before Day 6 to at least two of your colleagues on 2 different days who selected a different state or hospital from yours. Share additional insights or alternative perspectives.

Discussion Part II: Pharmacology

Note: To access this week’s required library resources, please click on the link to the Course Readings List, found in the Course Materials section of your Syllabus.

To prepare: Read the following articles to enhance your knowledge of commonly prescribed medications: Chalikonda, S. A. (2009). Alpha2-adrenergic agonists and their role in the prevention of perioperative adverse cardiac events. AANA Journal, 77(2), 103–108. Retrieved from the Walden Library databases. Frankenstein, L., Katus, H. A., Grundtvig, M., Hole, T., de Blois, J., Schellberg, D., … Agewall, S. (2013). Association between spironolactone added to beta-blockers and ACE inhibition and survival in heart failure patients with reduced ejection fraction: A propensity score-matched cohort study. European Journal of Clinical Pharmacology, 69(10), 1747–1755. Retrieved from the Walden Library databases. Hao, G., Wang, Z., Guo, R., Chen, Z., Wang, X., Zhang, L., & Li, W. (2014). Effects of ACEI/ARB in hypertensive patients with type 2 diabetes mellitus: A meta-analysis of randomized controlled studies. BMC Cardiovascular Disorders, 14, 148. Retrieved from the Walden Library databases. Levy, P. D., Laribi, S., & Mebazaa, A. (2014). Vasodilators in acute heart failure: Review of the latest studies. Current Emergency and Hospital Medicine Reports, 2(2), 126–132. Shi, C. (2013). Blood pressure lowering efficacy of alpha blockers for primary hypertension. International Journal of Evidence-Based Healthcare, 11(3), 204–205. Retrieved from the Walden Library databases. Tocci, G., Battistoni, A., Passerini, J., Musumeci, M. B., Francia, P., Ferrucci, A., & Volpe, M. (2015). Calcium channel blockers and hypertension. Journal of Cardiovascular Pharmacology and Therapeutics, 20(2), 121–130. Retrieved from the Walden Library databases. Toppen, W., Sareh, S., Satou, N., Shemin, R., Hunter, C., Buch, E., & Benharash, P. (2014). Do preoperative ?-blockers improve postoperative outcomes in patients undergoing cardiac surgery? Challenging societal guidelines. American Surgeon, 80(10), 1018–1021. Retrieved from the Walden Library databases. Wang, A. (2012). Efficacy of class III antiarrhythmics and magnesium combination therapy for atrial fibrillation. Pharmacy Practice, 10(2), 65–71. Retrieved from the Walden Library databases. NURS 6560 Advanced Practice Care of Adults in Acute Care Settings II all weeks assignments discussions. All of the following groups of medications are commonly prescribed in the acute care setting. Choose one of the topics below to discuss. If it is a medication group, select a specific drug within that group. (This is a good way to prepare for clinical practice, because you will get to know the drugs you will prescribe for patients.). Focus your discussion on the hospital or ICU setting and IV usage. Alpha agonists Alpha blockers Beta blockers Antiarrhythmics Calcium channel Vasodilators ACE versus BBlocker with spironolactone in CHF ACE versus ARB

Note: When sharing your initial post, select a topic that has not yet been discussed. If all topics have been discussed, then you may select that topic again, but select a different drug within the medication group. For this Discussion, address 1 of the following options. Post by Day 3: Option 1: Post a description of a patient you have taken care of (inpatient as an RN, or as an NP student) who has been prescribed the medication you selected. Include the scenario, indication, dosing, complications, and outcome. Then explain whether or not you would have ordered the same drug and same dose. Option 2: Conduct an evidence-based drug search on the drug you selected and post an explanation of any possible issues. Are there any drug interactions? Any black box warnings? NURS 6560 Advanced Practice Care of Adults in Acute Care Settings II all weeks assignments discussions. To what type of patient would you prescribe this medication? Option 3: Post an explanation of the properties of the drug you selected, including usages and dosing in the hospital or ICU. Describe a patient to whom you would prescribe this medication.

NURS 6560 Advanced Practice Care of Adults in Acute Care Settings II all weeks assignments discussions – Week 2 discussion

Discussion Part I: Limitations and Challenges

From providing ongoing assessments to monitoring for complications and facilitating recovery, advanced practice nurses who care for patients in perioperative environments experience a unique set of limitations and challenges. Reflecting on your experiences in this complex and critical environment will help you develop your professional competency and prepare you for your future role as an advanced practice nurse. In this week’s Discussion, you consider limitations and challenges of clinical practice in perioperative care settings. NURS 6560 Advanced Practice Care of Adults in Acute Care Settings II all weeks assignments discussions.

To prepare: Reflect on this week’s clinical experiences. Consider one limitation or challenge you encountered. Think about how you overcame this limitation or challenge and how this might affect your future practice in pre- and post-operative care settings. Post on or before Day 3 a description of at least one limitation or challenge you encountered during your clinical experience this week. Explain how you overcame this limitation or challenge and how this might affect your future practice. NURS 6560 Advanced Practice Care of Adults in Acute Care Settings II all weeks assignments discussions. Note: If you refer to a patient in your Discussions or Assignments, be sure to use a pseudonym or other false form of identification. This is to ensure the privacy and protection of the patient. Read a selection of your colleagues’ responses. Respond on or before Day 6 to two colleagues by sharing additional insights or alternative perspectives.

Discussion Part II: Pharmacology

Note: To access this week’s required library resources, please click on the link to the Course Readings List, found in the Course Materials section of your Syllabus.

To prepare: Read the following articles to enhance your knowledge of commonly prescribed medications: Ando, S., Yasugi, D., Matsumoto, T., Kanata, S., & Kasai, K. (2014). Serious outcomes associated with overdose of medicines containing barbiturates for treatment of insomnia. Psychiatry Clinical Neuroscience, 68(9), 721. Dassanayake, T. L., Jones, A. L., Michie, P. T., Carter, G. L., McElduff, P., Stokes, B. J., & Whyte, I. M. (2012). Risk of road traffic accidents in patients discharged following treatment for psychotropic drug overdose: A self-controlled case series study in Australia. CNS Drugs 26(3), 269–276. Retrieved from the Walden Library databases. Kulick, D., & Deen, D. (2011). Specialized nutrition support. American Family Physician, 83(2), 173–183. Retrieved from http://www.aafp.org/afp/2011/0115/p173.html Martini, D. I., Nacca, N., Haswell, D., Cobb, T., & Hodgman, M. (2015). Serotonin syndrome following metaxalone overdose and therapeutic use of a selective serotonin reuptake inhibitor. Clinical Toxicology 53(3), 185–187. Robinson, A., & Wermeling, D. P. (2014). Intranasal naloxone administration for treatment of opioid overdose. American Journal of Health-System Pharmacy, 71(24), 2129–2135. Retrieved from the Walden Library databases. Thomas, D. R. (2013). Total parenteral nutrition (TPN). In The Merck Manual Professional Edition. Retrieved from http://www.merckmanuals.com/professional/nutritional_disorders/nutritional_support/total_parenteral_nutrition_tpn.html All of the following groups of medications are commonly prescribed in the acute care setting. Choose one of the topics below to discuss. If it is a medication group, select a specific drug within that group. (This is a good way for you to prepare for clinical practice, because you will get to know the drugs you will prescribe for patients.). Focus your discussion on the hospital or ICU setting and IV usage. KPhos, bicarb, calcium, magnesium Iron, folic acid, B12 Diamox Macrolides Muinolones/mluoroquinolone Cephalosporins, 4th and 5th generation Aminoglycosides Carbapenems Lipopeptide Tigecycline Note: When sharing your initial post, select a topic that has not yet been discussed. If all topics have been discussed, then you may select that topic again, but select a different drug within the medication group. For this Discussion, address 1 of the following options. Post by Day 3: Option 1: Post a description of a patient you have taken care of (inpatient as an RN, or as an NP student) who has been prescribed the medication you selected. Include the scenario, indication, dosing, complications, and outcome. Then explain whether or not you would have ordered the same drug and same dose. NURS 6560 Advanced Practice Care of Adults in Acute Care Settings II all weeks assignments discussions. Option 2: Conduct an evidence-based drug search on the drug you selected and post an explanation of any possible issues. Are there any drug interactions? Any black box warnings? To what type of patient would you prescribe this medication? Option 3: Post an explanation of the properties of the drug you selected, including usages and dosing in the hospital or ICU. Discuss a patient to whom you would prescribe this medication.NURS 6560 Advanced Practice Care of Adults in Acute Care Settings II all weeks assignments discussions.

NURS 6560 Advanced Practice Care of Adults in Acute Care Settings II all weeks assignments discussions – Week 4 discussion

Discussion Part I: Assessment and Care of Patients With Cardiovascular Conditions

Many cardiac disorders such as myocardial infarctions are a common problem in the acute care setting. Thus it is essential for you, as the advanced practice nurse caring for acute patients, to identify potential signs and symptoms of complications. Although some cardiac disorders require outpatient treatment and management, other procedures such as CABGs or valve replacements are more common and frequently require major interventions. In your role with acute cardiac patients, you must evaluate symptoms and determine how to treat patients. For this Discussion, consider potential diagnoses, treatment, and/or referral options for the patients in the following 3 case studies. Case Study 1: Tom is 56-year-old African American male who presented to the ED with chest pain radiating to his back. The pain has been continuous for 1 hour. The patient complains of shortness of breath. The pain has not been relieved with rest. The patient’s vitals are: 99.1-98-18-198/110. The patient’s cardiac enzymes are negative. Labs results are as follows: Na 134 K 4.1 Cr 1.8 BUN 42 Glucose 248 WBC 13.1 Hbg 14.1 Hct 44.2 Plt 236 EKG sinus rhythm no ekg changes Case Study 2: Liz is a 79-year-old female with a history of aortic stenosis and hypertension. The patient underwent elective aortic valve replacement yesterday. This AM during rounds, the patient is sitting up in the chair. Vital signs: 99.4-54-20-85/50. Pa 29/13, CVP10. Urine output 20 ml/hr for the last 3 hours. Cardiac output 3.9, cardiac index 1.8. Patient’s preop ef was 50%. Labs are as follows: K 4.0 Cr 1.5 BUN 42 Hgb 9.8 Hct 29.1 Plt 138 Postoperative chest X-ray normal Case Study 3: Arvid is a 69-year-old male you are seeing in CCU 1 hour after he had a CABG × 4. The patient is intubated. VS: 97.1-78-14-90/50. PA 30/13, CVP 12. ABG 7.21-49-98-19.6-99%- -6 base deficit. Mixed venous O2 sat 68. Hgb 10.2, Hct 32.1. The patient is sedated. Vent settings FiO2 50%, IMV 12, PEEP 5, tidal volume 550. To prepare: Review and select 1 of the 3 case studies provided. Analyze the patient information. Consider a differential diagnosis for the patient in the case study you selected. Think about the most likely diagnosis for the patient. Think about a treatment and management plan for the patient. Be sure to consider appropriate dosages for any recommended pharmacologic and/or nonpharmacologic treatments. Consider strategies for educating patients and families on the treatment and management of the cardiac disorder. Post on or before Day 3 an explanation of the differential diagnosis for the patient in the case study you selected. Explain which is the most likely diagnosis for the patient and why. Include an explanation of unique characteristics of the disorder you identified as the primary diagnosis. NURS 6560 Advanced Practice Care of Adults in Acute Care Settings II all weeks assignments discussions, Then, explain a treatment and management plan for the patient, including appropriate dosages for any recommended treatments. Finally, explain strategies for educating patients and families on the treatment and management of the cardiac disorder. Read a selection of your colleagues’ responses. Respond on or before Day 6 to at least two of your colleagues on 2 different days in both of the ways listed below. Respond to colleagues who selected different case studies from yours. Describe how a patient factor such as age, gender, ethnicity or culture might affect the diagnosis, management, and follow-up care of patients with the cardiac disorders your colleagues discussed. NURS 6560 Advanced Practice Care of Adults in Acute Care Settings II all weeks assignments discussions. Based on your personal and/or professional experiences, expand on your colleagues’ postings by providing additional insights or different perspectives.? Discussion Part II: Pharmacology To prepare: Read the following article to enhance your knowledge of commonly prescribed medications: Kalil, A., & Bailey, K. L. (2014, October 20). Septic shock medication. Retrieved from http://emedicine.medscape.com/article/168402-medication All of the following groups of medications are commonly prescribed in the acute care setting. Choose one of the topics below to discuss. If it is a medication group, select a specific drug within that group. (This is a good way for you to prepare for clinical practice, because you will get to know the drugs you will prescribe for patients.). Focus your discussion on the hospital or ICU setting and IV usage. All of the following groups of medications are commonly prescribed in the acute care setting. This Discussion will focus on CABG patients. Choose one of the topics below to discuss in terms of management of a post-CABG patient. NURS 6560 Advanced Practice Care of Adults in Acute Care Settings II all weeks assignments discussions. Focus your discussion on the hospital or ICU setting and IV usage. Amicar Epinephrine Vasopressin Nitroglycerin Cardene Insulin drip Dopamine Dobutamine Norepinephrine Phenylephrine Note: When sharing your initial post, select a drug that has not yet been discussed. If all drugs have been discussed, then you may select that drug again. For this Discussion, address 1 of the following options. Post by Day 3: Option 1: Post a description of a patient you have taken care of (inpatient as an RN, or as an NP student) who has been prescribed the medication you selected. Include the scenario, indication, dosing, complications, and outcome. Then explain whether or not you would have ordered the same drug and same dose. Option 2: Conduct an evidence-based drug search on the drug you selected and post an explanation of any possible issues. Are there any drug interactions? Any black box warnings? To what type of patient would you prescribe this medication? Option 3: Post an explanation of the properties of the drug you selected, including usages and dosing in the hospital or ICU. NURS 6560 Advanced Practice Care of Adults in Acute Care Settings II all weeks assignments discussions. Describe a patient to whom you would prescribe this medication.

NURS 6560 Advanced Practice Care of Adults in Acute Care Settings II all weeks assignments discussions – Week 9 discussion

Discussion Part I: Assessment and Care of Patients With Adrenal and Urogynecologic Conditions

Many genitourinary (GU) disorders such as kidney disease start developing during adolescence (Johns Hopkins Children’s Center, 2010). This early onset of disease makes it essential for you, as the advanced practice nurse caring for adolescent patients, to identify potential signs and symptoms. Although some adolescent GU disorders require long-term treatment and management, other disorders such as urinary tract infections are more common and frequently require only minor interventions. In your role with adolescent patients, you must evaluate symptoms and determine whether to treat patients or refer them for specialized care. For this Discussion, consider potential diagnoses, treatment, and/or referral options for the patients in the following 3 case studies. Case Study 1: Alicia is an 18-year-old female who is brought into urgent care by her mother. She is complaining of dizziness. She recently started to lift weights for softball season. She has been healthy up to this point. Vitals are: temp 101.9°F, HR 120, RR 24, BP 90/54. She has lower extremity edema and decreased skin turgor. She states that her shoulders, thighs, and lower back hurt. She is having trouble moving her arms and legs. She also complains of vague abdominal pain, with nausea and vomiting. Labs came back with CK 10,000, uric acid 40 mg/dl, WBC 14.3, BUN:creatinine ratio 6:1, K 5.8. Urinalysis shows a presence of myoglobin of more than 25. Case Study 2: Mark is a 15-year-old male with a complaint of acute left scrotal pain with nausea. The pain began approximately 6 hours ago as a dull ache and gradually has worsened such that he can no longer stand without doubling over. He is afebrile and in marked pain. Physical exam results are negative except for elevation of the left testicle, diffuse scrotal edema, and the presence of a blue dot sign. Case Study 3: Maya is a 16-year-old female who presents to the ER for urinary pain. She is a healthy adolescent with complaints of lower abdominal pain, low back pain, and burning with urination. She had a fever of 102°F at home. Physical examination results are normal. Routine urinalysis indicates 2+ proteinuria; specific gravity 1.020; negative for glucose, blood. Leukocytes are moderate and nitrites, moderate. Her blood pressure is normal, and she is at the 60th percentile for height and weight. Vitals are: temp 103.1°F, HR 116, RR 18, BP 100/58. P Ox is 98% (Johns Hopkins Children’s Center, 2010). To prepare: Review and select 1 of the 3 provided case studies. Analyze the patient information. Consider a differential diagnosis for the patient in the case study you selected. Think about the most likely diagnosis for the patient. Think about a treatment and management plan for the patient. Be sure to consider appropriate dosages for any recommended pharmacologic and/or nonpharmacologic treatments. Consider strategies for educating patients and families on the treatment and management of the genitourinary disorder. Post on or before Day 3 an explanation of the differential diagnosis for the patient in the case study you selected. Explain which is the most likely diagnosis for the patient and why. Include an explanation of unique characteristics of the disorder you identified as the primary diagnosis. Then, explain a treatment and management plan for the patient, including appropriate dosages for any recommended treatments. Finally, explain strategies for educating patients and families on the treatment and management of the genitourinary disorder. Read a selection of your colleagues’ responses. Respond on or before Day 6 to at least two of your colleagues on 2 different days in both of the ways listed below. Respond to colleagues who selected different case studies from yours. Describe how culture might affect the diagnosis, management, and follow-up care of patients with the genitourinary disorders your colleagues discussed. Based on your personal and/or professional experiences, expand on your colleagues’ postings by providing additional insights or different perspectives.? Discussion Part II: Pharmacology Read the following articles to enhance your knowledge of commonly prescribed medications: Daley, B. (2015, February 23). Peritonitis and abdominal sepsis. Retrieved from http://emedicine.medscape.com/article/180234-overview Shahedi, K., Chudasama, Y. N., Dea, S. K., & Cooperman, A. (2015, January 14). Diverticulitis treatment and management. Retrieved from http://emedicine.medscape.com/article/173388-treatment Tobias, J. D., & Leder, M. (2011). Procedural sedation: A review of sedative agents, monitoring, and management of complications. Saudi Journal of Anasthesia, 5(4), 395–410. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3227310/ All of the following groups of medications are commonly prescribed in the acute care setting. Choose one of the topics below to discuss. If it is a medication group, select a specific drug within that group. (This is a good way for you to prepare for clinical practice, because you will get to know the drugs you will prescribe for patients.). Focus your discussion on the hospital or ICU setting and IV usage. Sedation Diazepam Fentanyl Ketamine Lorazepam Midazolam Propofol Nonsedation Chlorpromazine Peritonitis—what antibiotics are chosen for peritonitis? Nerve blocks—what drugs are used with nerve blocks? Diverticulitis—what drugs are used with diverticulitis? Note: When sharing your initial post, select a topic that has not yet been discussed. NURS 6560 Advanced Practice Care of Adults in Acute Care Settings II all weeks assignments discussions. If all topics have been discussed, then you may select that topic again, but select a different drug within the medication group. For this Discussion, address 1 of the following options. Post by Day 3: Option 1: Post a description of a patient you have taken care of (inpatient as an RN, or as an NP student) who has been prescribed the medication you selected. NURS 6560 Advanced Practice Care of Adults in Acute Care Settings II all weeks assignments discussions. Include the scenario, indication, dosing, complications, and outcome. Then explain whether or not you would have ordered the same drug and same dose. Option 2: Conduct an evidence-based drug search on the drug you selected and post an explanation of any possible issues. Are there any drug interactions? Any black box warnings? To what type of patient would you prescribe this medication? Option 3: Post an explanation of the properties of the drug you selected, including usages and dosing in the hospital or ICU. Describe a patient to whom you would prescribe this medication.NURS 6560 Advanced Practice Care of Adults in Acute Care Settings II all weeks assignments discussions.

NURS 6560 Advanced Practice Care of Adults in Acute Care Settings II all weeks assignments discussions  – Week 10 discussion

Discussion Part I: Neurologic and Orthopedic Conditions and Plastic/Reconstructive Surgery

This week, you study neurologic and orthopedic conditions with plastic surgery considerations. Both neurologic and orthopedic conditions are seen in the trauma areas of the hospital. These conditions encompass cardiovascular, pulmonary, and metabolic aspects of care in the ICU. For this Discussion, focus on adolescent patients, and consider potential diagnoses, treatment, and/or referral options for the patients in the following 3 case studies. Case Study 1: A 17-year-old male was celebrating his birthday with friends and alcohol. At one point he jumped into the hotel pool three stories below, hitting the side of the pool with his chest. EMS arrived and packaged him with spinal support. He arrives in the ER with breathing difficulty, chest pain, GCS 10, and O2 sat of 94%. You do initial assessment in the first 10 minutes and find that his chest is asymmetric for breathing and contusions are noted all over his chest. His CXR shows multiple rib fractures on both sides and pulmonary contusions. His cervical spine is stable in a collar. His thoracic and lumbar films are negative for fractures. In the next hours, what are your priorities, and what plan would you have for this patient as he moves to the ICU? At what stage of development is he, and how does that affect his care? Case Study 2: A 13-year-old female restrained passenger of a vehicle was involved in an MVA at 60 mph on the highway. The vehicle experienced a frontal impact. The patient arrived in the ER with closed fractures of the left tibia and fibula with angulation, dislocation of the right ankle, multiple pelvic fractures, and femur fracture on the left side. Her BP is 92/54 with pulse of 130. What is your plan for this patient, and what are the considerations to prevent further morbidity? At what stage of development is she, and how does that impact her care? Case Study 3: A 19-year-old male private in the U.S. Air Force was driving with friends when they dared him to “surf the car.” He fell off the roof of the car while it was moving at a speed of approximately 40 mph. He landed face first. He is now in the ICU with a closed head injury. His intracranial pressure is elevated, and his pupillary response is slowing. At this time, what medications do you recommend, and what other medical treatments do you recommend? In addition, after the acute situation is controlled and the patient awakens, what medication do you use for his agitation? To prepare: Review and select 1 of the 3 provided case studies. Analyze the patient information. Consider a differential diagnosis for the patient in the case study you selected. Think about the most likely diagnosis for the patient. Think about a treatment and management plan for the patient. NURS 6560 Advanced Practice Care of Adults in Acute Care Settings II all weeks assignments discussions. Be sure to consider appropriate dosages for any recommended pharmacologic and/or nonpharmacologic treatments. Consider strategies for educating patients and families on the treatment and management of the trauma care. Post on or before Day 3 an explanation of the differential diagnosis for the patient in the case study you selected. Explain which is the most likely diagnosis for the patient and why. Include an explanation of unique characteristics of the disorder you identified as the primary diagnosis. Then, explain a treatment and management plan for the patient, including appropriate dosages for any recommended treatments. Finally, explain strategies for educating patients and families on the treatment and management of neurologic and orthopedic conditions. NURS 6560 Advanced Practice Care of Adults in Acute Care Settings II all weeks assignments discussions. Read a selection of your colleagues’ responses. Respond on or before Day 6 to at least two of your colleagues on 2 different days in both of the ways listed below. Respond to colleagues who selected different case studies from yours. Describe how culture might affect the diagnosis, management, and follow-up care of patients with the neurological, orthopedic, or plastics disorders your colleagues discussed. Based on your personal and/or professional experiences, expand on your colleagues’ postings by providing additional insights or different perspectives.? Discussion Part II: Pharmacology To prepare: Read the following articles to enhance your knowledge of commonly prescribed medications: Family Practice Notebook. (2015). Nonsteroidal anti-inflammatory. Retrieved from http://www.fpnotebook.com/Pharm/Analgesic/NnstrdlAntInflmtry.htm Press, C. D. (2013, September 10). Infiltrative administration of local anesthetic agents. Retrieved from http://emedicine.medscape.com/article/149178-overview All of the following groups of medications are commonly prescribed in the acute care setting. Choose one of the topics below to discuss. If it is a medication group, select a specific drug within that group. (This is a good way for you to prepare for clinical practice, because you will get to know the drugs you will prescribe for patients.). Focus your discussion on the hospital or ICU setting and IV usage. Glycopeptides Oxazolidinones (Bs) Monobactams Ansamycins Metronidazole Lincosamides (Bs) Tinidazole Lidocaine Marcaine NSAIDs NURS 6560 Advanced Practice Care of Adults in Acute Care Settings II all weeks assignments discussions. Note: When sharing your initial post, select a topic that has not yet been discussed. If all topics have been discussed, then you may select that topic again, but select a different drug within the medication group. For this Discussion, address 1 of the following options. Post by Day 3: Option 1: Post a description of a patient you have taken care of (inpatient as an RN, or as an NP student) who has been prescribed the medication you selected. Include the scenario, indication, dosing, complications, and outcome. Then explain whether or not you would have ordered the same drug and same dose. Option 2: Conduct an evidence-based drug search on the drug you selected and post an explanation of any possible issues. Are there any drug interactions? Any black box warnings? To what type of patient would you prescribe this medication? Option 3: Post an explanation of the properties of the drug you selected, including usages and dosing in the hospital or ICU. Describe a patient you would prescribe this medication to. NURS 6560 Advanced Practice Care of Adults in Acute Care Settings II all weeks assignments discussions.

NURS561 Ethical Health Promotion Paper

Find a scholarly, peer-reviewed article no more than four years old that discusses an ethical health promotion-related issue. Use the WCU library databases to search for appropriate articles.

In your NURS561 Ethical Health Promotion Paper paper:

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Briefly summarize the presented issue. Describe your thoughts on the role health care professionals should play in resolving the ethical issue. Provide specific theories and refer to specific ethical codes to support your position.

Your paper should be 2–3 pages long. Use APA to cite and reference the article and any other optional sources you use. Adhere to APA formatting throughout your NURS561 Ethical Health Promotion paper.

NUR409 contemporary issues analysis paper

CONTEMPORARY ISSUES ANALYSIS Using APA Style 6th Edition, develop a paper, 8 – 10 pages maximum including references, which delineates and analyzes one contemporary health related issue.

PART I

From the current news media, select a contemporary health related issue or trend or chronic illness by the second week of class and follow it for the next four consecutive weeks. v Select one report on your topic from each of the four weeks. v Write a brief summary of each of the four news reports. v Analyze these four news reports: o What is the trend or issue that they represent? o In what way does this issue or trend relate to primary & community health care? o How does the media represent the issue in each report? o How does this representation shape public opinion on this issue or trend?

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PART II

Conduct a professional scholarly literature search (CINAHL or MEDLINE) on this issue or trend within a historical context. v Analyze the issue in relation to any of these perspectives philosophical/ethical perspectives, social/political concerns, economic considerations, and historical change. v Identify your own points of agreement or disagreement with these perspectives (listed in previous bullet). v Does this issue or trend hold any significance for the profession of nursing? NUR409 contemporary issues analysis paper.

PART III

Compare your analysis of this issue in the media reports with your analysis of this issue in the professional nursing literature (if this is available). v Identify the similarities and differences v Based on your findings in this comparative analyses identify the implications for nurses or nursing students, health care policy, and/or health care delivery systems. DUE DATE: November 14, 2017-Tuesday Section /November 15, 2017-Wednesday Section

CONTEMPORARY ISSUES ANALYSIS – GRADING CRITERIA

PART I

1. Identification of contemporary health related issue. 5% 2. Summaries of four reports and relevance. 10% 3. Analysis of the four reports (Include all four components) 15%

PART II

4. Conduct a professional literature search within an historical context Submits a copy of literature search 15% 5. Analyze the issue or trend (Include all the necessary components) include in this analysis a discussion of your own points of agreement and/or disagreement (Include all the necessary components) 15% 6. Significance to contemporary nursing 5%

PART III

7. Comparison of the analysis of issue as presented in the media reports with your analysis of the issue or trend in the professional nursing literature. Include in this analysis the identification of similarities and differences. 15% 8. Implications for nursing profession or students, health care delivery system, etc 10% 9. Scholarly writing and adherence to APA format (6th edition) 10%. NUR409 contemporary issues analysis paper.

NR508 Midterm Exam Questions and Answers

NR 508 Week 4 Mid-Term

Question 12 pts Osteopenia is diagnosed in a 55-year-old woman who has not had a period in 15 months. She has a positive family history of breast cancer. The primary care NP should recommend: testosterone therapy. estrogen-only therapy. nonhormonal drugs for osteoporosis. estrogen-progesterone therapy for 1 to 2 years.

Question 22 pts A woman is in her first trimester of pregnancy. She tells the primary care nurse practitioner (NP) that she continues to have severe morning sickness on a daily basis. The NP notes a weight loss of 1 pound from her previous visit 2 weeks prior. The NP should consult an obstetrician and prescribe: aprepitant (Emend). ondansetron (Zofran). scopolamine transdermal. prochlorperazine (Compazine).

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Question 32 pts A 75-year-old patient who has cardiovascular disease reports insomnia and vomiting for several weeks. The primary care NP orders thyroid function tests. The tests show TSH is decreased and T4 is increased. The NP should consult with an endocrinologist and order: thyrotropin. methimazole. levothyroxine. propylthiouracil.

Question 42 pts A 55-year-old patient with no prior history of hypertension has a blood pressure greater than 140/90 on three separate occasions. The patient does not smoke, has a body mass index of 24, and exercises regularly. The patient has no known risk factors for cardiovascular disease. The primary care NP should: prescribe a thiazide diuretic and an angiotensin-converting enzyme inhibitor. perform a careful cardiovascular physical assessment. counsel the patient about dietary and lifestyle changes. order a urinalysis and creatinine clearance and begin therapy with a ?-blocker.

Question 52 pts A patient reports fatigue, weight loss, and dry skin. The primary care nurse practitioner (NP) orders thyroid function tests. The patient’s thyroid stimulating hormone (TSH) is 40 microunits/mL, and T4 is 0.1 ng/mL. The NP should refer the patient to an endocrinologist and prescribe: methimazole. liothyronine. levothyroxine. propylthiouracil.

Question 62 pts When prescribing a medication for a chronic condition, the primary care NP should tell the patient: to contact the pharmacy whenever refills are needed. that it is necessary to return to the clinic for each monthly refill of the medication. about the frequency of clinic visits necessary for the number of refills authorized. to ask the pharmacist to supply several months’ worth of the medication at a time.

Question 72 pts A child who has congenital hypothyroidism takes levothyroxine 75 mcg/day. The child weighs 15 kg. The primary care NP sees the child for a 3-year-old check-up. The NP should consult with a pediatric endocrinologist to discuss: increasing the dose to 90 mcg/day. decreasing the dose to 30 mcg/day. stopping the medication and checking TSH and T4 in 4 weeks. discussing the need for lifetime replacement therapy with the child’s parents.

Question 82 pts A patient who has IBS experiences diarrhea, bloating, and pain but does not want to take medication. The primary care NP should recommend: 25 g of fiber each day. avoiding gluten and lactose in the diet. increasing water intake to eight to ten glasses per day. beginning aerobic exercise, such as running, every day.

Question 92 pts A woman who uses a transdermal contraceptive calls the primary care NP to report that while dressing that morning she discovered that the patch had come off and she was unable to find the patch. The NP should tell her to apply a new patch and: take one cycle of COCPs. take a home pregnancy test. use condoms for the next 7 days. contact the clinic if she misses a period.

Question 102 pts A patient has been diagnosed with IBS and tells the primary care NP that symptoms of diarrhea and cramping are worsening. The patient asks about possible drug therapy to treat the symptoms. The NP should prescribe: mesalamine (Asacol). dicyclomine (Bentyl). simethicone (Phazyme). metoclopramide (Reglan).

Question 112 pts A patient wants to know why a cheaper version of a drug cannot be used when the primary care NP writes a prescription for a specific brand name of the drug and writes, “Dispense as Written.” The NP should explain that a different brand of this drug: may cause different adverse effects. does not necessarily have the same therapeutic effect. is likely to be less safe than the brand specified in the prescription. may vary in the amount of drug that reaches the site of action in the body.

Question 122 pts A patient comes to the clinic with a history of syncope and weakness for 2 to 3 days. The primary care NP notes thready, rapid pulses and 3-second capillary refill. An ECG reveals a heart rate of 198 beats per minute with a regular rhythm. The NP should:(PSVT) administer intravenous fluids and obtain serum electrolytes. administer amiodarone in the clinic and observe closely for response. order digoxin and verapamil and ask the patient to return for a follow-up examination in 1 week. send the patient to an emergency department for evaluation and treatment.

Question 132 pts An adolescent girl has chosen Depo-Provera as a contraceptive method and tells the primary care NP that she likes the fact that she won’t have to deal with pills or periods. The primary care NP should tell her that she: should consider another form of contraception after 1 year. may have irregular bleeding, especially in the first month or so. will need to take calcium and vitamin D every day while using this method. will have to take oral contraceptive pills in addition to Depo-Provera when she takes antibiotics.

Question 142 pts A patient who is taking nifedipine develops mild edema of both feet. The primary care NP should contact the patient’s cardiologist to discuss: changing to amlodipine. ordering renal function tests. increasing the dose of nifedipine. evaluation of left ventricular function.

Question 152 pts A patient who is taking trimethoprim-sulfamethoxazole for prophylaxis of urinary tract infections tells the primary care NP that a sibling recently died from a sudden cardiac arrest, determined to be from long QT syndrome. The NP should: schedule a treadmill stress test. order genetic testing for this patient. discontinue the trimethoprim-sulfamethoxazole. refer the patient to a cardiologist for further evaluation.

Question 162 pts A patient has three consecutive blood pressure readings of 140/95 mm Hg. The patient’s body mass index is 24. A fasting plasma glucose is 100 mg/dL. Creatinine clearance and cholesterol tests are normal. The primary care NP should order: a ?-blocker. an angiotensin-converting enzyme inhibitor. a thiazide diuretic. dietary and lifestyle changes.

Question 172 pts A male patient tells the primary care NP he is experiencing decreased libido, lack of energy, and poor concentration. The NP performs an examination and notes increased body fat and gynecomastia. A serum testosterone level is 225 ng/dL. The NP’s next action should be to: order LH and FSH levels. order a serum prolactin level. prescribe testosterone replacement. obtain a morning serum testosterone level. Question 182 pts A woman has severe IBS and takes hyoscyamine sulfate (Levsin), simethicone (Phazyme), and a TCA. She reports having continued severe diarrhea. The primary care NP should: order diphenoxylate (Lomotil). prescribe alosetron after ruling out pregnancy. refer her to a gastroenterologist for endoscopy. increase the fiber in her diet to 30 g per day. Question 192 pts A patient is given a diagnosis of peptic ulcer disease. A laboratory test confirms the presence of Helicobacter pylori. The primary care NP orders a proton pump inhibitor (PPI) before meals twice daily, clarithromycin, and amoxicillin. After 14 days of treatment, H. pyloriis still present. The NP should order: continuation of the PPI for 4 to 8 weeks. a PPI, amoxicillin, and metronidazole for 14 days. a PPI, clarithromycin, and amoxicillin for 14 more days. a PPI, bismuth subsalicylate, tetracycline, and metronidazole. Question 202 pts A patient is taking drug A and drug B. The primary care NP notes increased effects of drug B. The NP should suspect that in this case drug A is a cytochrome P450 (CYP450) enzyme: inhibitor. substrate. inducer. metabolizer.

Question 212 pts The primary care NP sees a new patient who has diabetes and hypertension and has been taking a thiazide diuretic for 6 months. The patient’s blood pressure at the beginning of treatment was 150/95 mm Hg. The blood pressure today is 138/85 mm Hg. The NP should: order a ?-blocker. add an angiotensin-converting enzyme inhibitor. continue the current drug regimen. change to an aldosterone antagonist medication.

Question 222 pts A patient has been taking antibiotics to treat recurrent pneumonia. The patient is in the clinic after having diarrhea for 5 days with six to seven liquid stools each day. The primary care NP should: obtain a stool specimen and order vancomycin. order testing for Clostridium difficile and consider metronidazole therapy. prescribe diphenoxylate (Lomotil) to provide symptomatic relief. reassure the patient that diarrhea is a common side effect of antibiotic therapy.

Question 232 pts The primary care NP has referred a child who has significant gastrointestinal reflux disease to a specialist for consideration for a fundoplication and gastrostomy tube placement. The child’s weight is 80% of what is recommended for age, and a recent swallow study revealed significant risk for aspiration. The child’s parents do not want the procedure. The NP should: compromise with the parents and order a nasogastric tube for feedings. initiate a discussion with the parents about the potential outcomes of each possible action. refer the family to a case manager who can help guide the parents to the best decision. understand that the child’s parents have a right to make choices that override those of the medical team.

Question 242 pts The primary care NP prescribes an extended-cycle monophasic pill regimen for a young woman who reports having multiple partners. Which statement by the patient indicates she understands the regimen? “I have to take a pill only every 3 months.” “I should expect to have only four periods each year.” “I will need to use condoms for only 7 more days.” “This type of pill has fewer side effects than other types.”

Question 252 pts The primary care NP prescribes an inhaled corticosteroid for a patient who has asthma. The third-party payer for this patient denies coverage for the brand that comes in the specific strength the NP prescribes. The NP should: provide pharmaceutical company samples of the medication for the patient. inform the patient that the drug must be paid for out of pocket because it is not covered. order the closest formulary-approved approximation of the drug and monitor effectiveness. write a letter of medical necessity to the insurer to explain the need for this particular medication.

Question 262 pts A patient with primary hypercholesterolemia is taking an HMG-CoA reductase inhibitor. All of the patient’s baseline LFTs were normal. At a 6-month follow-up visit, the patient reports occasional headache. A lipid profile reveals a decrease of 20% in the patient’s LDL cholesterol. The NP should: order LFTs. order CK-MM tests. consider decreasing the dose of the medication. reassure the patient that this side effect is common.

Question 272 pts A patient who takes a thiazide diuretic will begin taking an ACE inhibitor. The primary care NP should counsel the patient to: report wheezing and shortness of breath, which may occur with these drugs. take care when getting out of bed or a chair after the first dose of the ACE inhibitor. discuss taking an increased dose of the thiazide diuretic with the cardiologist. minimize fluid intake for several days when beginning therapy with the ACE inhibitor.

Question 282 pts A thin 52-year-old woman who has recently had a hysterectomy tells the primary care NP she is having frequent hot flashes and vaginal dryness. A recent bone density study shows early osteopenia. The woman’s mother had CHD. She has no family history of breast cancer. The NP should prescribe: estrogen-only HT now. estrogen-only HT in 5 years. estrogen-progesterone HT now. estrogen-progesterone HT in 5 years.

Question 292 pts A patient who will begin using nitroglycerin for angina asks the primary care NP how the medication works to relieve pain. The NP should tell the patient that nitroglycerin acts to: dissolve atheromatous lesions. relax vascular smooth muscle. prevent catecholamine release. reduce C-reactive protein levels.

Question 302 pts A patient is in the clinic complaining of nausea and vomiting that has lasted 2 to 3 days. The patient has dry oral mucous membranes, a blood pressure of 90/56 mm Hg, a pulse of 96 beats per minute, and a temperature of 38.8° C. The primary care NP notes a capillary refill of greater than 3 seconds. The NP should: obtain a complete blood count and serum electrolytes. prescribe a rectal antiemetic medication. admit to the hospital for intravenous (IV) rehydration. encourage the patient to take small, frequent sips of Gatorade.

Question 312 pts A patient who has severe arthritis and who takes nonsteroidalantiinflammatory drugs (NSAIDs) daily develops a duodenal ulcer. The patient has tried a cyclooxygenase-2 selective NSAID in the past and states that it is not as effective as the current NSAID. The primary care nurse practitioner (NP) should: prescribe cimetidine (Tagamet). prescribe omeprazole (Prilosec). teach the patient about a bland diet. change the NSAID to a corticosteroid.

Question 322 pts A patient who has stable angina and uses sublingual nitroglycerin tablets is in the clinic and begins having chest pain. The primary care NP administers a nitroglycerin tablet and instructs the patient to lie down. The NP’s next action should be to: obtain an electrocardiogram. administer oxygen at 2 L/minute. give 325 mg of chewable aspirin. call EMS.

Question 332 pts A primary care NP sees a patient who is being treated for heart failure with digoxin, a loop diuretic, and an ACE inhibitor. The patient reports having nausea. The NP notes a heart rate of 60 beats per minute and a blood pressure of 100/60 mm Hg. The NP should: decrease the dose of the diuretic to prevent further dehydration. obtain a serum potassium level to assess for hyperkalemia. hold the ACE inhibitor until the patient’s blood pressure stabilizes. obtain a digoxin level before the patient takes the next dose of digoxin. Question 342 pts A patient who is taking an oral anticoagulant is in the clinic in the late afternoon and reports having missed the morning dose of the medication because the prescription was not refilled. The primary care NP should counsel this patient to: avoid foods that are high in vitamin K for several days. take a double dose of the medication the next morning. refill the prescription and take today’s dose immediately. skip today’s dose and resume a regular dosing schedule in the morning.

Question 352 pts A primary care NP has prescribed phentermine for a patient who is obese. The patient loses 10 lb in the first month but reports that the drug does not seem to be suppressing appetite as much as before. The NP should: discontinue the phentermine. increase the dose of phentermine. continue the phentermine at the same dose. change to a combination of phentermine and topiramate.

Question 362 pts A 45-year-old patient who has a positive family history but no personal history of coronary artery disease is seen by the primary care NP for a physical examination. The patient has a body mass index of 27 and a blood pressure of 130/78 mm Hg. Laboratory tests reveal low-density lipoprotein, 110 mg/dL; high-density lipoprotein, 70 mg/dL; and triglycerides, 120 mg/dL. The patient does not smoke but has a sedentary lifestyle. The NP should recommend: 30 minutes of aerobic exercise daily. taking 81 to 325 mg of aspirin daily. beginning therapy with a statin medication. starting a thiazide diuretic to treat hypertension.

Question 372 pts A patient has heart failure. A recent echocardiogram reveals decreased compliance of the left ventricle and poor ventricular filling. The patient takes low-dose furosemide and an ACE inhibitor. The primary care NP sees the patient for a routine physical examination and notes a heart rate of 92 beats per minute and a blood pressure of 100/60 mm Hg. The NP should: order serum electrolytes. obtain renal function tests. consider prescribing a ?-blocker. call the patient’s cardiologist to discuss adding digoxin to the patient’s regimen.

Question 382 pts A patient takes an antispasmodic and an occasional antidiarrheal medication to treat IBS. The patient comes to the clinic and reports having dry mouth, difficulty urinating, and more frequent constipation. The primary care NP notes a heart rate of 92 beats per minute. The NP should: prescribe a TCA. discontinue the antidiarrheal medication. encourage the patient to increase water intake. lower the dose of the antispasmodic medication.

Question 392 pts A patient who has had four to five liquid stools per day for 4 days is seen by the primary care NP. The patient asks about medications to stop the diarrhea. The NP tells the patient that antidiarrheal medications are: not curative and may prolong the illness. useful in cases of acute infection with elevated temperature. most beneficial when symptoms persist longer than 2 weeks. useful when other symptoms, such as hematochezia, develop.

Question 402 pts A patient who has angina is taking nitroglycerin and long-acting nifedipine. The primary care NP notes a persistent blood pressure of 90/60 mm Hg at several follow-up visits. The patient reports lightheadedness associated with standing up. The NP should consult with the patient’s cardiologist about changing the medication to: amlodipine (Norvasc). isradipine (DynaCirc). verapamil HCl (Calan). short-acting nifedipine (Procardia).

Question 412 pts A patient who has been taking digoxin 0.25 mg daily for 6 months reports that it is not working as well as it did initially. The primary care NP should: recommend a reduced potassium intake. increase the dose of digoxin to 0.5 mg daily. hold the next dose of digoxin and obtain a serum digoxin level. contact the patient’s pharmacy to ask if generic digoxin was dispensed.

Question 422 pts A patient is taking spironolactone and comes to the clinic complaining of weakness and tingling of the hands and feet. The primary care NP notes a heart rate of 62 beats per minute and a blood pressure of 100/58 mm Hg. The NP should: obtain a serum drug level. order an electrocardiogram (ECG) and serum electrolytes. change the medication to a thiazide diuretic. question the patient about potassium intake.

Question 432 pts The primary care nurse practitioner (NP) sees a patient in the clinic who has a blood pressure of 130/85 mm Hg. The patient’s laboratory tests reveal high-density lipoprotein, 35 mg/dL; triglycerides, 120 mg/dL; and fasting plasma glucose, 100 mg/dL. The NP calculates a body mass index of 29. The patient has a positive family history for cardiovascular disease. The NP should: prescribe a thiazide diuretic. consider treatment with an angiotensin-converting enzyme inhibitor. reassure the patient that these findings are normal. counsel the patient about dietary and lifestyle changes.

Question 442 pts A patient who has primary hyperlipidemia and who takes atorvastatin (Lipitor) continues to have LDL cholesterol of 140 mg/dL after 3 months of therapy. The primary care NP increases the dose from 10 mg daily to 20 mg daily. The patient reports headache and dizziness a few weeks after the dose increase. The NP should: change the atorvastatin dose to 15 mg twice daily. change the patient’s medication to cholestyramine (Questran). add ezetimibe (Zetia) and lower the atorvastatin to 10 mg daily. recommend supplements of omega-3 along with the atorvastatin.

Question 452 pts The primary care NP is seeing a patient for a hospital follow-up after the patient has had a first myocardial infarction. The patient has a list of the prescribed medications and tells the NP that “no one explained anything about them.” The NP’s initial response should be to: ask the patient to describe the medication regimen. ask the patient to make a list of questions about the medications. determine what the patient understands about coronary artery disease. give the patient information about drug effects and any adverse reactions.

Question 462 pts ???? A primary care NP sees a 5-year-old child who is morbidly obese. The child has an elevated hemoglobin A1c and increased lipid levels. Both of the child’s parents are overweight but not obese, and they tell the NP that they see nothing wrong with their child. They both state that it is difficult to refuse their child’s requests for soda or ice cream. The NP should: suggest that they give the child diet soda and low-fat frozen yogurt. understand and respect the parents’ beliefs about their child’s self-image. initiate a dialogue with the parents about the implications of the child’s laboratory values. suggest family counseling to explore ways to improve parenting skills and limits.

Question 472 pts A primary care NP is developing a handout to give to patients who will begin self-administering insulin. When developing this handout, the NP should: provide detailed descriptions of each step in the process of injecting insulin. use correct medical terminology when describing insulin self-administration. provide as much factual information as possible about insulin administration. address one or two educational objectives that describe what the patient will learn.

Question 482 pts A patient reports having occasional acute constipation with large, hard stools and pain and asks the primary care NP about medication to treat this condition. The NP learns that the patient drinks 1500 mL of water daily; eats fruits, vegetables, and bran; and exercises regularly. The NP should recommend: a daily bulk laxative. long-term docusate sodium. a saline laxative as needed. glycerin suppositories as needed.

Question 492 pts A patient who has heart failure has been treated with furosemide and an ACE inhibitor. The patient’s cardiologist has added digoxin to the patient’s medication regimen. The primary care NP who cares for this patient should expect to monitor: serum electrolytes. blood glucose levels. serum thyroid levels. complete blood counts (CBCs).

Question 502 pts A 55-year-old woman has not had menstrual periods for 5 years and tells the primary care nurse practitioner (NP) that she is having increasingly frequent vasomotor symptoms. She has no family history or risk factors for coronary heart disease (CHD) or breast cancer but is concerned about these side effects of hormone therapy (HT). The NP should: tell her that starting HT now may reduce her risk of breast cancer. advise a short course of HT now that may decrease her risk for CHD. tell her that HT will not help control her symptoms during postmenopause. recommend herbal supplements for her symptoms to avoid HT side effects.

Question 512 pts A primary care NP is performing a previsit health history on a new patient. The patient reports taking vitamins every day. The NP should: ask the patient to bring all vitamin bottles to the clinic appointment. recommend natural vitamin products over synthetic vitamin products. reassure the patient that vitamins that are high in folic acid are safe to take. tell the patient that some vitamins, such as vitamin C, are safe in large doses.

Question 522 pts An 80-year-old patient asks a primary care NP about OTC antacids for occasional heartburn. The NP notes that the patient has a normal complete blood count and normal electrolytes and a slight elevation in creatinine levels. The NP should recommend: calcium carbonate (Tums). aluminum hydroxide (Amphojel). sodium bicarbonate (Alka-Seltzer). magnesium hydroxide (Milk of Magnesia).

Question 532 pts A 50-year-old woman with a family history of CHD is experiencing occasional hot flashes and is having periods every 3 to 4 months. She asks the primary care NP about HT to relieve her symptoms. The NP should: prescribe estrogen-only therapy. initiate oral contraceptive pills now. discuss using bioidentical HT. plan to use estrogen-progesterone therapy when menopause begins.

Question 542 pts A patient who has breast cancer has been taking toremifene for 2 weeks. She tells her primary care NP that she thinks her tumor has grown larger. The NP should: schedule her for a breast ultrasound. reassure her that this is common and will subside. tell her she may need an increased dose of this medication. contact her oncologist to discuss adding another medication.

Question 552 pts A patient reports having episodes of dizziness, nausea, and lightheadedness and describes a sensation of the room spinning when these occur. The primary care NP will refer the patient to a specialist who, after diagnostic testing, is likely to prescribe: meclizine. ondansetron. scopolamine. dimenhydrinate.

Question 562 pts The primary care NP sees a patient who has a history of hypertension and alcoholism. The patient is not taking any medications. The NP auscultates crackles in both lungs and palpates the liver 2 cm below the costal margin. Laboratory tests show an elevated creatinine level. The NP will refer this patient to a cardiologist and should prescribe: albuterol metered-dose inhaler. furosemide (Lasix). spironolactone (Aldactone). chlorthalidone (Zaroxolyn).

Question 572 pts A perimenopausal woman tells the primary care NP that she is having hot flashes and increasingly severe mood swings. The woman has had a hysterectomy. The NP should prescribe: estrogen-only HT. low-dose oral contraceptive therapy. selective serotonin reuptake inhibitor therapy until menopause begins. estrogen-progesterone HT.

Question 582 pts A primary care NP prescribes a COCP for a woman who is taking them for the first time. After teaching, the woman should correctly state the need for using a backup form of contraception if she: is having vomiting or diarrhea. delays taking a pill by 5 or 6 hours. takes nonsteroidalantiinflammatory drugs several days in a row. has recurrent headaches or insomnia.

Question 592 pts A patient who has had a new onset of AF the day prior will undergo cardioversion that day. The primary care NP will expect the cardiologist to: give clopidogrel after administering cardioversion. administer cardioversion without using anticoagulants. give warfarin and aspirin before attempting cardioversion. give low-dose aspirin before administering cardioversion.

Question 602 pts A patient in the clinic reports frequent episodes of bloating, abdominal pain, and loose stools to the primary care nurse practitioner (NP). An important question the NP should ask about the abdominal pain is: the relation of the pain to stools. what time of day the pain occurs. whether the pain is sharp or diffuse. the age of the patient when the pain began.

NR701 Critique of Quantitative and Qualitative Research Articles

Critique of Quantitative and Qualitative Research Articles Guidelines Purpose The student will compare quantitative and qualitative research articles to determine how theory and research are linked, and how they are utilized for nursing science. Course Outcomes This NR701 Critique of Quantitative and Qualitative Research Articles assignment enables the student to meet the following course outcomes:

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CO 4: Compare and contrast the difference and similarities with selected characteristics of quantitative research designs. (PO#3) CO 5: Evaluate appropriateness of qualitative research design for a specific clinical practice question. (PO#3) CO 6: Evaluate appropriateness of quantitative research design for a specific clinical practice question. (PO#3) Due Date: Submit by Sunday of the end Week 5 at 11:59 p.m. MT. Points: This NR701 Critique of Quantitative and Qualitative Research Articles assignment is worth a total of 200 points. NR701 Critique of Quantitative and Qualitative Research Articles.

Requirements 1. Review the three categories below (highlighted), which include one quantitative and one qualitative article. Select one category you are most interested in and use the assigned articles under that category to complete your assignment. Note the articles below may be found within the CCN library by clicking on the links below each article. If you need further instructions/help, visit the “Need Help” or the “Ask a Librarian” sections of the library page associated with NR-701 Application of Analytic Methods”. Category 1: Pressure Ulcers Coyer, F., Gardner, A., Doubrovsky, A., Cole, R., Ryan, F., Allen, C., & McNamara, G. (2015). Reducing pressure ulcer injuries in critically ill patients by using a patient skin integrity care bundle (InSPiRE). American Journal of Critical Care, 24(3), 199-209. http://dx.doi.org/10.4037/ajcc2015930 Roberts, S., McInnes, E., Wallis, M., Bucknall, T., Banks, M., & Chaboyer, W. (2016). Nurses’ perceptions of a pressure ulcer prevention care bundle: A qualitative descriptive study. BMC Nursing, 15, 1-10. doi:10.1186/s12912-016-0188-9 Category 2: Compassion Fatigue Berg, G., Harshbarger, J., Ahlers-Schmidt, C., & Lippoldt, D. (2016, January-February). Exposing compassion fatigue and burnout syndrome in a trauma team: A qualitative study. Journal of Trauma Nursing, 23(1), 3-10. doi:10.1097/JTN.0000000000000172 Kelly, L., & Lefton, C. (2017, November). Effect of meaningful recognition on critical care nurses’ compassion fatigue. American Journal of Critical Care, 26(6), 438-444. https://doi.org/10.4037/ajcc2017471 Category 3: End- of-Life Care Holms, N., Milligan, S., & Kydd, A. (2014). A study of the lived experiences of registered nurses who have provided end-of-life care within an intensive care unit. International Journal of Palliative Nursing, 20(11), 549-556. doi:10.12968/ijpn.2014.20.11.549 Potash, J., HY Ho, A., Chan, F., Wang, X., & Cheng, C. (2014). Can art therapy reduce death anxiety and burnout in end-of-life care workers? A quasi-experimental study. International Journal of Palliative Nursing, 20(5), 233-240. doi:10.12968/ijpn.2014.20.5.233 2. NR701 Critique of Quantitative and Qualitative Research Articles.

Submit a 6 page APA-formatted paper (note a template for this assignment can be found in Course Resources): a. Include an Introduction section entitled, Critique of Quantitative and Qualitative Articles (centered, not bolded), that indicates the purpose of your paper b. Compare and contrast the articles with respect to (headings should be centered and bolded): 1. Research Design 2. Research Question(s) 3. Sampling Process and Sample Size 4. Methods for Data Analysis 5. Adhering to Ethical Standards 6. Reliability and Validity (Rigor) 7. Generalizability and Transferability of Findings c. Summarization (centered and bolded); share your own thoughts regarding the usefulness and value of quantitative vs. qualitative research. Provide a rationale for your opinions and explain how each research methodology can be used to support a change in practice. Be sure to avoid the use of 1st person terminology by referring to yourself as the DNP student or the DNP learner, etc. Directions and Grading Criteria Category Points % Description Introduction 10 5% Introduction paragraph is concise (approximately 5 sentences). A brief introduction is provided for each article being critiqued. The purpose of the paper is clearly conveyed/expressed through use of a formal purpose statement. Research Design 20 10% Compare and contrast the research designs from each article. Critique appropriateness of the design used in relation to the research questions being asked in each article. Provide evidence to support research design appropriateness. Research Questions 20 10% Compare and contrast the research questions from the standpoint of a quantitative versus a qualitative inquiry. How do they differ? Sampling Process and Sample Size 20 10% Compare and contrast the sampling process and size for each article. For example, what type of population was used? How were subjects recruited? What were inclusion and exclusion criteria, if any? Were the sample sizes for each article sufficient? Why or why not? Methods for Data Analysis 25 12.5% Compare and contrast the methods for data analysis for each article. For example, what statistical tests were performed by the quantitative researchers and for what purpose where they used? How did the qualitative researchers analyze the data they collected? Were the tests appropriate for the type of data collected? Ethical standards 20 10% Compare and contrast the ethical standards described or implied in each article. For example, what were the protections put into place to protect human subjects or personal demographic data? Did the researchers adhere to the standards, or were there any potential ethical considerations? Reliability and validity (rigor) 20 10% Compare and contrast the reliability/validity and rigor of the methods reported in each article. For example, was the reliability/validity of the quantitative instruments addressed? NR701 Critique of Quantitative and Qualitative Research Articles. What did the qualitative researchers do to ensure rigor in their study? Generalizability, Transferability of findings 25 12.5% Examine the generalizability of the findings from the quantitative article. Were they any threats to external validity or internal validity? Were they acknowledged? For the qualitative article, address the transferability of the findings. Are the findings credible? Why or why not? Summarization 20 10% Summarize your own thoughts regarding the usefulness of quantitative and quantitative research when making a change in practice. APA formatting, scholarly writing 20 10% Adheres to the rules of APA formatting, scholarly writing, spelling, and grammar. Maintain paper within length requirements Met/Not Met (Up to 10 points deducted if not met) Up to 10% if Not Met Adheres to the minimum/maximum page requirements of 4-6 pages (excluding title and reference pages). Note up to 10 points can be deducted for going over or under the page requirements for the assignment. Total 200 100% A quality paper will meet or exceed all of the above requirements. Grading Rubric NR701 Critique of Quantitative and Qualitative Research Articles Assignment Criteria A Outstanding or highest level of performance B Very good or high level of performance C Competent or satisfactory level of performance D/F Poor or failing or unsatisfactory level of performance Introduction 10 points Fully introduces both articles. Remains clear and concise and includes formal purpose statement. 9-10 points Mostly introduces both articles. Mostly remains clear and concise and includes formal purpose statement.

NR701 Critique of Quantitative and Qualitative Research Articles. 8 points Minimally introduces both articles. Formal purpose statement is included. 7 points Fails to introduce both articles. Introduction is unclear and formal purpose statement is not included. 0-6 points Research Design 20 points Fully compares and contrasts the research design for each article. 18-20 points Mostly compares and contrasts the research design for each article. 16-17 points Minimally compares and contrasts the research design for each article. 14-15 points Fails to compare and contrast the research design for each article. 0-13 points Research Questions 20 points Fully compares and contrasts the research questions for each article in the context of their methodology. 18-20 points Mostly compares and contrasts the research questions for each article in the context of their methodology. 16-17 points Minimally compares and contrasts research questions for each article in the context of their methodology. 14-15 points Fails to compare and contrast the research questions for each article in the context of their methodology. 0-13 points Sampling Process and Sample Size 20 points Fully compares and contrasts the sample selection and size for each article. 18-20 points Mostly compares and contrasts the sample selection and size for each article. 16-17 points Minimally compares and contrasts the sample selection and size for each article. 14-15 points Fails to compare and contrast the sample selection and size for each article. 0-13 points Methods for Data Analysis 25 points Fully compares and contrasts the methods of data analysis for each article. 23 – 25 points Mostly compares and contrasts the methods of data analysis for each article. 21-22 points Minimally compares and contrasts the methods of data analysis for each article. NR701 Critique of Quantitative and Qualitative Research Articles.

NR701 Critique of Quantitative and Qualitative Research Articles. 19-20 points Fails to compare and contrast the methods of data analysis for each article. 0-18 points Ethical standards 20 points Fully compares and contrasts the ethical standards for each article. 18-20 points Mostly compares and contrasts the ethical standards for each article. 16-17 points Minimally compares and contrasts the ethical standards for each article. 14-15 points Fails to compare and contrast the ethical standards for each article. NR701 Critique of Quantitative and Qualitative Research Articles. 0-13 points Reliability and validity (rigor) 20 points Fully compares and contrasts the reliability and validity (rigor) for each article. 18-20 points Mostly compares and contrasts the reliability and validity (rigor) for each article. 16-17 points Minimally compares and contrasts the reliability and validity (rigor) for each article. 14-15 points Fails to compare and contrast the reliability and validity (rigor) for each article. 0-13 points Generalizability, Transferability of findings 25 points Fully compares and contrasts the generalizability and transferability of findings for each article. 23-25 points Mostly compares and contrasts the generalizability and transferability of findings for each article. 21-22 points Minimally compares and contrasts the generalizability and transferability of findings for each article. 19-20 points Fails to compare and contrast the generalizability and transferability of findings for each article. 0-18 points Summarization 20 points Described in detail thoughts regarding qualitative and quantitative research including rationale. 18-20 points Described thoughts regarding qualitative and quantitative research but provides little rationale. NR701 Critique of Quantitative and Qualitative Research Articles. 16-17 points Described thoughts regarding research but does not discriminate between qualitative and quantitative, or gives weak rationale. 14-15 points Failed to describe thoughts regarding qualitative and quantitative research and gives no rationale. 0-13 points APA formatting, scholarly writing 20 points Writes in a scholarly manner with no grammar, spelling, or syntax errors. NR701 Critique of Quantitative and Qualitative Research Articles. Follows the rules of APA formatting. 18-20 points Writes in a scholarly manner with minimal grammar, spelling, or syntax errors. Follows the rules of APA formatting. 16-17 points Writes in a scholarly manner with several grammar, spelling, or syntax errors. Breaks minor rules of rules of APA formatting. 14-15 points Does not write in a scholarly manner. Has many errors in grammar, spelling and syntax. Does not follow rules for APA formatting. 0-13 points Maintains paper within length requirements (Up to 10 points deducted if not met) Adheres to the minimum/maximum page requirements of 4-6 pages (excluding title and reference pages). No point deduction Met Paper is up to 1 page under or over the minimum/maximum page requirements of 4-6 pages (excluding title and reference pages). 4-5 point deduction per faculty discretion Not Met Paper is 2 pages under or over the minimum/maximum page requirements of 4-6 pages (excluding title and reference pages). 6-8 point deduction per faculty discretion Not Met Paper is 3 pages under or over the minimum/maximum page requirements of 4-6 pages (excluding title and reference pages). 9-10 point deduction per faculty discretion Not Met Total Points Possible = 200 points. NR701 Critique of Quantitative and Qualitative Research Articles.