Category: Nursing

OLDCARTS

B.J., a 70-year-old black female has been seen in the clinic several times. The last time she was in for a check-up was 6 months ago to get her prescriptions refilled. She has returned to the clinic today because she “ran out of blood pressure medicine” and would like to get her prescriptions renewed. She has not taken any prescription medicine in approximately 6 months

Background:

The patient indicates that she has noticed shortness of breath, especially when she is playing with her grandchildren. But, it goes away once she sits down to rest. She reports that she is also bothered by shortness of breath that wakes her up at night, but it resolves after sitting upright on 3 pillows. She also tells you that “I noticed over the last week that my legs and ankles have been swollen”. She also indicates that she often feels light headed and faint while going up the stairs, but it subsides after sitting down to rest. OLDCARTS

PMH:

Hypertension

Previous history of MI in 2010

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Current medications:

Coreg 6.25 mg PO BID

Colace 100 mg PO BID

K-dur 20 mEq PO QD

Furosemide 40 mg PO QD

Surgeries:

2010-Left Anterior Descending (LAD) cardiac stent placement

Allergies
: Amoxicillin

Vaccination History:

She receives an annual flu shot. Last flu shot was this year

Has never had a Pneumovax

Has not had a Td in over 20 years

Has not had the herpes zoster vaccine

Other:

Last colorectal screening was 11 years ago

Last mammogram was 5 years ago

Has never had a DEXA/Bone Density Test

Last dilated eye exam was 4 years ago

Labs from last year’s visit: Hgb 12.2, Hct 37%, K+ 4.2,

Na+140 Cholesterol 186, Triglycerides 188, HDL 37, LDL 190, TSH 3.7

Blood pressure on day of visit: 150/90

Social history:

She graduated from high school, and thought about college, but got married right away and then had kids a short time later. Her son lives in another state. OLDCARTS

Family history:

Both parents are deceased. Father died of a heart attack; mother died of natural causes. She had one brother who died of a heart attack 20 years ago at the age of 52.

Habits:

She drinks one 4-ounce glass of red wine daily. She is a former smoker that stopped 20 years ago.

Discussion Part One:

• Summarize the important data from the patient’s history and reason for the visit today.

• Provide a minimum of three differential diagnoses (DD) with rationale for the chief complaint.

• Include OLDCARTS and additional ROS questions needed to develop DD.

• Based on the LDL level above, indicate if you need to order a statin for this patient? Provide a rationale for your decision based on evidence based clinical guidelines.

• What other patient risk factors put the patient at risk for arteriosclerotic coronary vascular disease (ASCVD)? Reference the guidelines in your response.

• Based on the patient data provided, choose two geriatric assessment tools that would be appropriate to use in conducting a thorough geriatric assessment. Provide a rationale on why you are choosing these particular tools. OLDCARTS.

NR 601 SOAP note

Week 2: Discussion Part Two8 8 unread replies. 34 34 replies. Physical examination:

Vital Signs

Height: 5 feet 2 inches Weight: 163 pounds BMI: 29.8 BP 150/86 T 98.0 po P 100 R 22, non-labored

HEENT: normocephalic, symmetric. Bilateral cataracts; PERRLA, EOMI; Upper and lower dentures in place a fitting well. No tinnitus. NR 601 SOAP note

NECK: Neck supple; non-palpable lymph nodes; no carotid bruits. Thyroid non-palpable

LUNGS: inspiratory crackles

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HEART: Normal S1 with S2 split during expiration. An S4 is noted at the apex; systolic murmur noted at the right upper sternal border without radiation to the carotids.

ABDOMEN: Normal contour; active bowel sounds all four quadrants; no palpable masses.

PV: Pulses are 2+ in upper extremities and 1+ in pedal pulses bilaterally. 2+ pitting edema to her knees noted bilaterally

GENITOURINARY: no CVA tenderness; not examined

MUSCULOSKELETAL: Heberden’s nodes at the DIP joints of all fingers and crepitus of the bilateral knees on flexion and extension with tenderness to palpation medially at both knees. Kyphosis and gait slow, but steady.

PSYCH: normal affect; her Mini-Cog Score is 3. Her PHQ-9 score is 22. NR 601 SOAP note

SKIN: Sparse hair noted on lower legs and feet bilaterally with dry skin on her ankles and feet.

NR 601 SOAP note Discussion Questions Part Two:

Post your SOAP note for this patient’s encounter.

Review the SOAP note format for the course. Summarize the history and results of the physical exam. Include one evidence-based journal article that supports your rationale for all diagnoses with ICD 10 codes and include a complete treatment plan that include medications, further diagnostics, patient education, referral and plan for follow-up. Each step of the plan must include an in-text citation to a scholarly source. Review the Reference Guidelines document in Course Resources. NR 601 SOAP note

Research Critique Guidelines

Qualitative Study Research Critique Guidelines

Background of Study:

Identify the clinical problem and research problem that led to the study. What was not known about the clinical problem that, if understood, could be used to improve health care delivery or patient outcomes? This gap in knowledge is the research problem.

How did the author establish the significance of the study? In other words, why should the reader care about this study? Look for statements about human suffering, costs of treatment, or the number of people affected by the clinical problem.

Identify the purpose of the study. An author may clearly state the purpose of the study or may describe the purpose as the study goals, objectives, or aims.

List research questions that the study was designed to answer. If the author does not explicitly provide the questions, attempt to infer the questions from the answers.

Were the purpose and research questions related to the problem? Research Critique Guidelines

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Method of Study:

Were qualitative methods appropriate to answer the research questions?

Did the author identify a specific perspective from which the study was developed? If so, what was it?

Did the author cite quantitative and qualitative studies relevant to the focus of the study? What other types of literature did the author include?

Are the references current? For qualitative studies, the author may have included studies older than the 5-year limit typically used for quantitative studies. Findings of older qualitative studies may be relevant to a qualitative study. Research Critique Guidelines

Did the author evaluate or indicate the weaknesses of the available studies?

Did the literature review include adequate information to build a logical argument?

When a researcher uses the grounded theory method of qualitative inquiry, the researcher may develop a framework or diagram as part of the findings of the study. Was Was a framework developed from the study findings?

Research Critique Guidelines

 

Results of Study

What were the study findings?

What are the implications to nursing?

Explain how the findings contribute to nursing knowledge/science. Would this impact practice, education, administration, or all areas of nursing? Research Critique Guidelines

Ethical Considerations

Was the study approved by an Institutional Review Board?

Was patient privacy protected?

Were there ethical considerations regarding the treatment or lack of?

Conclusion

Emphasize the importance and congruity of the thesis statement.

Provide a logical wrap-up to bring the appraisal to completion and to leave a lasting impression and take-away points useful in nursing practice.

Incorporate a critical appraisal and a brief analysis of the utility and applicability of the findings to nursing practice.

Integrate a summary of the knowledge learned.

Research Critique Guidelines

Quantitative Study Research Critique Guidelines

Background of Study:

Identify the clinical problem and research problem that led to the study. What was not known about the clinical problem that, if understood, could be used to improve health care delivery or patient outcomes? This gap in knowledge is the research problem.

How did the author establish the significance of the study? In other words, why should the reader care about this study? Look for statements about human suffering, costs of treatment, or the number of people affected by the clinical problem.

Identify the purpose of the study. An author may clearly state the purpose of the study or may describe the purpose as the study goals, objectives, or aims.

List research questions that the study was designed to answer. If the author does not explicitly provide the questions, attempt to infer the questions from the answers.

Were the purpose and research questions related to the problem?

 Methods of Study

Identify the benefits and risks of participation addressed by the authors. Were there benefits or risks the authors do not identify?

Was informed consent obtained from the subjects or participants?

Did it seem that the subjects participated voluntarily in the study?

Was institutional review board approval obtained from the agency in which the study was conducted?

Are the major variables (independent and dependent variables) identified and defined? What were these variables? Research Critique Guidelines

How were data collected in this study?

What rationale did the author provide for using this data collection method?

Identify the time period for data collection of the study.

Describe the sequence of data collection events for a participant.

Describe the data management and analysis methods used in the study.

Did the author discuss how the rigor of the process was assured? For example, does the author describe maintaining a paper trail of critical decisions that were made during the analysis of the data? Was statistical software used to ensure accuracy of the analysis?

What measures were used to minimize the effects of researcher bias (their experiences and perspectives)? For example, did two researchers independently analyze the data and compare their analyses? Research Critique Guidelines

Results of Study

What is the researcher’s interpretation of findings?

Are the findings valid or an accurate reflection of reality? Do you have confidence in the findings?

What limitations of the study were identified by researchers?

Was there a coherent logic to the presentation of findings?

What implications do the findings have for nursing practice? For example, can the findings of the study be applied to general nursing practice, to a specific population, or to a specific area of nursing?

What suggestions are made for further studies? Research Critique Guidelines

Ethical Considerations

Was the study approved by an Institutional Review Board?

Was patient privacy protected?

Were there ethical considerations regarding the treatment or lack of?

Research Critique Guidelines

Conclusion

Emphasize the importance and congruity of the thesis statement.

Provide a logical wrap-up to bring the appraisal to completion and to leave a lasting impression and take-away points useful in nursing practice.

Incorporate a critical appraisal and a brief analysis of the utility and applicability of the findings to nursing practice.

Integrate a summary of the knowledge learned.

Research Critique Guidelines

Reference

Burns, N., & Grove, S. (2011).
Understanding nursing research
(5th ed.). St. Louis, MO: Elsevier.

DDBA 8300 Essay Assignments Papers and Discussions – Qualitative and Quantitative Methodology for Applied Business Research

Week 1 Discussion 1 Research Philosophies Methodologies

Week 1 Discussion 2 Ethical Considerations in Practice

Week 2 Assignment Conducting a Literature Review on a Research Problem – Phenomenon

Week 2 Discussion Critical Analysis in a Literature Review

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Week 3 Assignment Conducting a Literature Review on a Theoretical Conceptual Framework

Week 3 Discussion The Importance of Theoretical Conceptual Framework in Research

Week 4 Assignment Revised Problem Statement

Week 4 Discussion Peer Critique of Revised Problem Statements

Week 5 Assignment Draft Quantitative Prospectus

Week 5 Discussion Alignment Within Quantitative Studies

Week 6 Assignment Draft Qualitative Prospectus

Week 6 Discussion Alignment Within Qualitative Studies

Week 7 Assignment Draft Doctoral Study Prospectus

Week 7 Discussion Understanding the Research Process

Week 8 Discussion 1 Judging Research Quality

Week 8 Discussion 2 Use and Misuse of Research Studies for Social Change

DDBA 8300 Essay Assignments Papers and Discussions – Qualitative and Quantitative Methodology for Applied Business Research

Annotated Bibliography Research Paper

Develop an Annotated Bibliography for Use in Your Research Paper

 
Include the following in your annotated bibliography:

about 3 peer reviewed references

APA citations and annotations for three (3) sources you deem relevant to your problem statement (thesis).

For each source:

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Cite the source in proper APA format. The citations should be organized in alphabetical order by author as in an APA References page.

Follow with a brief annotation that summarizes the source (approximately 3–5 sentences). You may quote from the source, but do not copy and paste from the abstract.

In 1 or 2 sentences, explain and evaluate the source’s relevance and significance to your research.

Use an academic tone and style.

It is a requirement that you include a copy of your working thesis statement at the top of your assignment.

annotated bibliography-malignancy in adult patients

annotated bibliography antipilectic drugs and breastfeeding

bliography immunosuppresive drugs and fertility

Annotated Bibliography Research Paper

Copertino, M., Bua, J., Zanelli, E., Davanzo, R., Dal Bo, S., & Matarazzo, L. (2013). Antiepileptic drugs and breastfeeding. 
Italian Journal of Pediatrics,
 
39
(1), 1-11. doi:10.1186/1824-7288-39-50

Rigot, J., Le Mapihan, K., Parent, A., Leroy, C., Decanter, C., Yakoub-Agha, I., . . . Dharancy, S. (2015). Immunosuppressive drugs and fertility. 
Orphanet Journal of Rare Diseases,
 
10
(1), 1-15. doi:10.1186/s13023-015-0332-8

Simon, T. A., Thompson, A., Gandhi, K. K., Hochberg, M. C., & Suissa, S. (2015). Incidence of malignancy in adult patients with rheumatoid arthritis: A meta-analysis.
 Arthritis Research & Therapy, 17
 Retrieved from
https://search-proquest-com.westcoastuniversity.idm.oclc.org/docview/1772399081?accountid=162765

Annotated Bibliography Research Paper

DDBA 8300 – Qualitative and Quantitative Methodology for Applied Business Research Papers

In this course, independent scholars are introduced to quantitative and qualitative frameworks for inquiry. Quantitative designs covered include correlation, experimental and quasi-experimental, survey, and causal-comparative designs; qualitative designs include case study, phenomenology, grounded theory, and ethnography. Independent scholars work toward acquiring substantive, foundational knowledge of the philosophy of science as they construct, use, and critique concepts and theories. They learn to produce knowledge for practice as they examine ethical, social, and political aspects of conducting research. Demonstrating knowledge and the ability to solve problems, independent scholars engage in course assignments that emphasize the practical application of writing and critical-thinking skills and the integration of professional practice at the doctoral level. DDBA 8300 – Qualitative and Quantitative Methodology for Applied Business Research Papers

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DDBA 8300 – Qualitative and Quantitative Methodology for Applied Business Research Papers 
Course Readings

After clicking on a citation below, enter your myWalden user name and password at the prompt.

Please Ask a Librarian if you have any questions about the links.

Bartholet, E. (2014). Creating a child-friendly child welfare system: The use and misuse of research. Whittier Journal of Child and Family Advocacy, 13(1), 1–19. doi:10.2139/ssrn.2282037

Fedina, L. (2015). Use and misuse of research in books on sex trafficking: Implications for interdisciplinary researchers, practitioners, and advocates. Trauma, Violence, & Abuse, 16(2), 188–198. doi:10.1177/1524838014523337

Heale, R., & Twycross, A. (2015). Validity and reliability in quantitative studies. Evidence Based Nursing, 18(3), 66–67. doi:10.1136/eb-2015-102129

Lewis-Beck, M. S., Bryman, A., & Liao, F. T. (Eds.). (2004). The SAGE encyclopedia of social science research methods. Thousand Oaks, CA: SAGE Publications. doi:10.4135/9781412950589

Morse, J. M. (2015). Critical analysis of strategies for determining rigor in qualitative inquiry. Qualitative Health Research, 25(9), 1212–1222. doi:10.1177/1049732315588501

O’Connor, D. (2013). The apomediated world: Regulating research when social media has changed research. Journal of Law, Medicine & Ethics, 41(2), 470–483. doi:10.1111/jlme.12056

Onwuegbuzie, A. J., & Leech, N. L. (2005). Taking the “Q” out of research: Teaching research methodology courses without the divide between quantitative and qualitative paradigms. Quality and Quantity, 39(3), 267–295. doi:10.1007/s11135-004-1670-0

DDBA 8300 – Qualitative and Quantitative Methodology for Applied Business Research Papers

Evidenced based Practice and Population Health Essay Assignment Paper

Answer this question.

A) In thinking about levels of prevention, choose a data based publication that represents each level and takes a position about which level of prevention is the most complex to put into action in order to advanced health and wellness. Evidenced based Practice and Population Health Essay Assignment Paper

B). Critique behavioral changes from the perspective of measuring the change after a health promotion in their diet intervention has been Implemented (e.g., teaching communities to decrease saturated fats in their diet

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2-Research Methadology.

-An assessment of baseline knowledge, attitudes, and practices among healthcare providers in the community regarding pneumococcal vacination to identify barrierd to providing pneumoccal vacination

-An  assessment of baseline  knowledge, attitudes, and  beleifs among community residents aged 65 years or older to determine barriers to receiving pneumococcal vaccination.

A)What research methods do the nurse use to perform these assessment? How would you go about gathering the data for those assessment ? Evidenced based Practice and Population Health Essay Assignment Paper

3-Implementing nursing practice in community setting

Identify the driving and restraining forces in a forces in a field analysis to help plan change to reduce binge drinking on collage campus.

a. Which restraining forces would you want to strengthen? What approach would you use to accomplish this. Why?

b. Which restraining forces would you want to decrease? What approach would you use. Why?

4–family assessment

Consider a family from your clinical practice that is different in some way from your own.  Discuss the challenges of working with the family and describe how you were able to support them. Write a short paragraph about something you learned from that experience.  Include an action that you might approach differently, if you were in a similar situations. Evidenced based Practice and Population Health Essay Assignment Paper

Trident Res603 module 1 SLP -SCALING AND EXPLORATORY FACTOR

The enclosed dataset (wiscsem.sav) is an SPSS file containing the subscale scores for the Weschler Intelligence Scale for Children. The first two columns are subject code and age. The rest include scores on different areas of the exam.

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1. Run exploratory factor analysis (principal components, no rotation) on the data. How many meaningful factors will you retain? Interpret them and give them names. 2. Run exploratory factor analysis (principal components, WITH Varimax rotation) on the data. How many meaningful factors will you retain? Interpret them and give them names. Trident Res603 module 1 SLP -SCALING AND EXPLORATORY FACTOR

3. Run exploratory factor analysis (principal components, WITH Promax rotation) on the data. How many meaningful factors will you retain? What is the correlation between the factors? Interpret them and give them names. SLP Assignment Expectations 1. Be able to run different variants of EFA 2. Develop critical thinking regarding EFA.

Trident Res603 module 1 SLP -SCALING AND EXPLORATORY FACTOR

Diabetes Essay – Connie Rodrigues, overweight woman, increasing dyspnea and chest discomfort on exertion, fatigue, and weight gain

 

Connie Rodrigues, a 47-year-old overweight woman, has gradually increasing dyspnea and mild chest discomfort on exertion, fatigue, and weight gain. She has no children and is not now pregnant. Further history reveals a family history of diabetes.

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Answer the following questions about Ms. Rodrigues and diabetes.

1. In addition to questions about her chest discomfort, what other assessment questions should you ask Ms. Rodrigues? Why?

2.Ms. Rodrigues has polyuria, paresthesias in her feet, an itching rash in her groin, and blurry vision. Why is it important to measure her blood pressure and the pain and vibration sensation in her hands and feet?

3. Her nurse practitioner ordered blood tests for glucose and HbA1C. What do you expect these values to be if Ms. Rodrigues has type 2 diabetes?

4.What information does HbA1C provide that the blood glucose level does not?

5.Ms. Rodrigues’s evaluation reveals Candida infection and mild coronary artery disease. Why does diabetes increase the risk of infection?

6.Which physiological mechanisms contribute to peripheral neuropathy in type 2 diabetes?

Diabetes Essay – Connie Rodrigues, overweight woman, increasing dyspnea and chest discomfort on exertion, fatigue, and weight gain

HLT308V Week 5 Reflective Analysis: Risk Management

Throughout this course, you have identified, examined, and provided individual as well as collaborative analysis on multiple facets of risk management in the health care setting.

Addressing the knowledge you have gained, and building on that knowledge to add your evaluation of the role that the managed care organization (MCO) plays in today’s health care environment, develop a 250-500 word reflection to incorporate the following:

What is a health care organization’s administrative role regarding oversight of risk management policies and ensuring compliance with managed care organization (MCOs) standards?

What is your assessment of the value provided to an organization that stems from the regulatory statutes of a typical MCO? Consider the establishment of conflict resolution and risk management strategies within the health care organization from the employer/employee perspective as well as in regards to patient conflict circumstances.

What MCO responsibilities pertain to the Patient Protection and Affordable Care Act (PPACA) and Center for Medicare and Medicaid Services (CMS) focus on fraud, waste, and abuse laws?

Prepare this assignment according to the guidelines found in the APA Style Guide

HLT308V Week 5 Reflective Analysis: Risk Management