Tag: Clinical-Nursing

  • NURS 6501 Advanced Pathophysiology Module 2 week 3 Knowledge Check quizlet

    NURS 6501 Advanced Pathophysiology Module 2 week 3 Knowledge Check quizlet

    Review Test Submission: Module 2 Knowledge Check

    Content

    User

    xxxxx

    Course

    NURS-6501S-19/NURS-6501N-19-Advanced Pathophysiology2020 Fall Quarter 08/31-11/22-PT27

    Test

    Module 2 Knowledge Check

    Started

    9/20/20 3:12 AM

    Submitted

    9/20/20 4:38 AM

    Due Date

    9/21/20 1:59 AM

    Status

    Needs Grading

    Attempt Score

    Grade not available.

    Time Elapsed

    1 hour, 25 minutes

    Results Displayed

    Correct Answers

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    Question 1

    Needs Grading

    CC: “I have been having terrible chest and arm pain for the past 2 hours and I think I am having a heart attack.”

    HPI: Mr. Hammond is a 57-year-old African American male who presents to the Emergency Department with a chief complaint of chest pain that radiates down his left arm. He states that he started having pain several hours ago and says the pain “it feels like an elephant is sitting on my chest”. He rates the pain as 8/10. NURS 6501 Advanced Pathophysiology Module 2 week 3 Knowledge Check quizlet Nothing has made the pain better or worse. He denies any previous episode of chest pain. Denies nausea, dyspnea, or lightheadedness. He was given 0.4 mg nitroglycerine tablet sublingual x 1 which decreased, but not stopped the pain.

    Lipid panel reveals Total Cholesterol 324 mg/dl, high density lipoprotein (HDL) 31 mg/dl, Low Density Lipoprotein (LDL) 122 mg/dl, Triglycerides 402 mg/dl, Very Low-Density Lipoprotein (VLDL) 54 mg/dl

    His diagnosis is an acute inferior wall myocardial infarction.

    1 of 2 Questions:

    Why is HDL considered the “good” cholesterol?

    Correct Answer:

    HDL is considered the good cholesterol because it collects excess cholesterol in the body cells and transports it to the liver where it is excreted in the body cells and transports it to the liver where it is excreted in the body. HDL carries 20-25% of total plasma cholesterol. NURS 6501 Advanced Pathophysiology Module 2 week 3 Knowledge Check quizlet

    Question 2

    Needs Grading

    CC: “I have been having terrible chest and arm pain for the past 2 hours and I think I am having a heart attack.”

    HPI: Mr. Hammond is a 57-year-old African American male who presents to the Emergency Department with a chief complaint of chest pain that radiates down his left arm. He states that he started having pain several hours ago and says the pain “it feels like an elephant is sitting on my chest”. He rates the pain as 8/10. Nothing has made the pain better or worse. He denies any previous episode of chest pain. Denies nausea, dyspnea, or lightheadedness. He was given 0.4 mg nitroglycerine tablet sublingual x 1 which decreased, but not stopped the pain.

    Lipid panel reveals Total Cholesterol 324 mg/dl, high density lipoprotein (HDL) 31 mg/dl, Low Density Lipoprotein (LDL) 122 mg/dl, Triglycerides 402 mg/dl, Very Low-Density Lipoprotein (VLDL) 54 mg/dl NURS 6501 Advanced Pathophysiology Module 2 week 3 Knowledge Check quizlet

    His diagnosis is an acute inferior wall myocardial infarction.

    2 of 2 Questions:

    Explain the role inflammation has in the development of atherosclerosis.

    Correct Answer:

    Inflammation in the heart muscle caused by chronic inflammatory processes leads to mitochondrial damage that results in an increased free radical production that further activates the chronic inflammatory vicious cycle.

    Question 3

    Needs Grading

    A 45-year-old woman with a history of systemic lupus erythematosus (SLE) presents to the Emergency Room (ER) with complaints of sharp retrosternal chest pain that worsens with deep breathing or lying down. She reports a 3-day history of low-grade fever, listlessness and says she feels like she had the flu. Physical exam reveals tachycardia and a pleural friction rub. She was diagnosed with acute pericarditis. NURS 6501 Advanced Pathophysiology Module 2 week 3 Knowledge Check quizlet

     

    Question:

     

    What does the Advanced Practice Registered Nurse (APRN) recognize as the result of the pleural friction rub?

    Correct Answer:

    The inflammation of the pericardium, due to either the underlying autoimmune disease or a post viral syndrome, causes roughening of the pericardium. The roughening of the pericardium causes the classic “rub” which can best be heard at the apex of the heart and left sternal border.

    Question 4

    Needs Grading

    A 15-year-old adolescent male comes to the clinic with his parents with a chief complaint of fever, nausea, vomiting, poorly localized abdominal pain, arthralgias, and “swollen lymph nodes”. States he has felt “lousy” for a couple weeks. The fevers have been as high as 102 F. His parents thought he had the flu and took him to an Urgent Care Center. He was given Tamiflu® and sent home. He says the Tamiflu didn’t seem to work. States had a slight sore throat a couple weeks ago and attributed it to the flu. Physical exam revealed thin young man who appears to be uncomfortable but not acutely ill. Posterior pharynx reddened and tonsils 3+ without exudate. + anterior and posterior cervical lymphadenopathy. Tachycardic and a new onset 2/6 high-pitched, crescendo-decrescendo systolic ejection murmur auscultated at the left sternal border. Rapid strep +. The patient was diagnosed with acute rheumatic heart disease (RHD).

     

    Question:

     

    Explain how a positive strep test has caused the patient’s symptoms.

    Correct Answer:

    Rheumatic Heart Disease (RHD) only develops after a pharyngeal infection with Group A beta hemolytic streptococcus. It is an abnormal response to humoral and cell-mediated response to M proteins on the microorganisms. The intense inflammation caused by these reactions cause proliferative and exudative lesions in connective tissue. This inflammation causes scarring of the valve tissue. The inflammation usually affects the endocardium which contains the valves. Endocardial inflammation causes swelling of leaflets in the valves.

    Question 5

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    Needs Grading

    The APRN sees a 74-year-old obese female patient who is 2 days post-op after undergoing left total hip replacement. The patient has had severe post op nausea and vomiting and has been unable to go to physical therapy. Her mucus membranes are dry. The patient says she feels like the skin on her left leg is too tight. Exam reveals a swollen, tense, and red colored calf. The patient has a duplex ultrasound which reveals the presence of a deep venous thrombosis (DVT). NURS 6501 Advanced Pathophysiology Module 2 week 3 Knowledge Check quizlet

    Question:

    Describe the factors that could have contributed to the development of a DVT in this patient explain how each of the factors could cause DVT.

    Correct Answer:

    Virchow’s Triad caused damage to the walls of the vessels. When there is injury to the intimal layer of the vessel, antiplatelet substances such as nitric oxide and prostacyclin, along with the expression of collagen on the vessel wall, causes adherence of the platelets to the vessel wall. The platelets become activated then aggregate forming clots. Venous stasis as a result of obesity, patient’s advanced age and inability to go to physical therapy. NURS 6501 Advanced Pathophysiology Module 2 week 3 Knowledge Check quizlet

    Question 6

    Needs Grading

    A 45-year-old woman is 10 days status post partial small bowel resection for Crohn Disease and has been recuperating at home. She suddenly develops severe shortness of breath, becomes weak, and her blood pressure drops to 80/40 mmHg (previous readings ~130/80s mmHg). The pulse oximetry is 89% on room air. The APRN suspects the patient experienced a massive pulmonary embolus.

     

    Question:

     

    Explain why a large pulmonary embolus interferes with oxygenation.

    Correct Answer:

    The embolus lodges somewhere in the pulmonary circulation and causes a ventilation/perfusion mismatch (V/Q). NURS 6501 Advanced Pathophysiology Module 2 week 3 Knowledge Check quizlet.  Ventilation Perfusion mismatch or “V/Q defects” are defects in total lung ventilation perfusion ratio. It is a condition in which one or more areas of the lung receive oxygen but no blood flow, or they receive blood flow but no oxygen due to obstruction somewhere in the pulmonary circulation. This causes a decreased area for oxygen exchange.

    Question 7

    Needs Grading

    A 45-year-old woman is 10 days status post partial small bowel resection for Crohn Disease and has been recuperating at home. She suddenly develops severe shortness of breath, becomes weak, and her blood pressure drops to 80/40 mmHg (previous readings ~130/80s mmHg). The pulse oximetry is 89% on room air. NURS 6501 Advanced Pathophysiology Module 2 week 3 Knowledge Check quizlet While waiting for the Emergency Medical Service (EMS) to arrive, the APRN places EKG leads and the EKG demonstrates right ventricular strain.

     

    Question:

     

    Explain why a large pulmonary embolism causes right ventricular strain.

    Correct Answer:

    The V/Q mismatch causes release of neurohumeral substances and inflammatory mediators that cause vasoconstriction of the pulmonary vasculature further impeding oxygenation. Hemodynamically, this vasoconstriction results in pulmonary hypertension, making it difficult for the right ventricle to pump blood. The V/Q mismatch also causes decreased production of surfactant causing atelectasis that further decreases surface area available for oxygen exchange.

    Question 8

    Needs Grading

    A 12-year-old girl is brought to the Emergency Room (ER) by her mother with complaints of shortness of breath, wheezing, tachypnea, tachycardia, and a non-productive cough. The mother states they had just come from a fall festival where the entire family enjoyed a hayride. The symptoms began shortly after they left the festival but got better a couple hours after they returned home. The symptoms began again about 6 hours later and seem to be worse  NURS 6501 Advanced Pathophysiology Module 2 week 3 Knowledge Check quizlet. The mother states there is no history of allergies or frequent respiratory infections. The child is up to date on all vaccinations. The child was diagnosed with asthma. The nurse practitioner explained to the mother that her child was exhibiting symptoms of asthma, and probably had an early asthmatic response and a late asthmatic response.

     

    Question 1 of 2:

     

    Explain early asthmatic responses and the cells responsible for the responses.

    Correct Answer:

    When there is an initial airway exposure to an antigen, an innate and adaptive immune response is initiated. Cells that can initiate the inflammation of the bronchial mucosa and hyperresonance of the airways include dendritic cells, T helper 2 lymphocytes, B lymphocytes, mast cells, neutrophils, eosinophils, and basophils. Early asthmatic response is a phase of bronchospasm that peaks at about 30 minutes and usually resolves after about 3 hours NURS 6501 Advanced Pathophysiology Module 2 week 3 Knowledge Check quizlet.

    Question 9

    Needs Grading

    A 12-year-old girl is brought to the Emergency Room (ER) by her mother with complaints of shortness of breath, wheezing, tachypnea, tachycardia, and a non-productive cough. The mother states they had just come from a fall festival where the entire family enjoyed a hayride. The symptoms began shortly after they left the festival but got better a couple hours after they returned home. The symptoms began again about 6 hours later and seem to be worse. The mother states there is no history of allergies or frequent respiratory infections. The child is up to date on all vaccinations. The child was diagnosed with asthma. The nurse practitioner explained to the mother that her child was exhibiting symptoms of asthma, and probably had an early asthmatic response and a late asthmatic response.

    Question 2 of 2:

    Explain late asthmatic responses and the cells responsible for the responses.

    Correct Answer:

    Late asthmatic responses are mediated by earlier exposure in early phase that causes a latent release of inflammatory mediators. These mediators, leukotrienes and prostaglandin D, cause bronchospasm, edema, and mucus secretions that obstruct airflow. Airway obstruction creates resistance to airflow and causes air trapping. Continued air trapping increases intrapleural and alveolar gas pressure, decreases ventilation and perfusion leading to uneven and variable ventilation/perfusion in the lung

    Question 10

    Needs Grading

    A 64-year-old man with a 40 pack/year history of cigarette smoking has been diagnosed with emphysema.  He asks the APRN if this means he has COPD.

    Question 1 of 2:

    Explain the pathophysiology of emphysema and how it relates to COPD
    .

    Correct Answer:

    Emphysema is a disease of the airways that causes permanent enlargement of the gasexchange airways. It is accompanied by destruction of the alveolar walls do not appear to be fibrotic. Chronic exposure to irritants recruit neutrophils, macrophages, and lymphocytes to the lung resulting in progressive damage from inflammatory oxidative stress. Emphysema is characterized by destruction of alveoli leading to decreased surface area for gas exchange that causes significant ventilation/perfusion mismatch NURS 6501 Advanced Pathophysiology Module 2 week 3 Knowledge Check quizlet.

    Question 11

    Needs Grading

    A 64-year-old man with a 40 pack/year history of cigarette smoking has been diagnosed with emphysema.  He asks the APRN if this means he has COPD.

    Question 2 of 2:

    Explain the pathophysiology of chronic bronchitis and how it relates to COPD.

    Correct Answer:

    Chronic bronchitis is caused by inhalation of irritants that promote bronchial inflammation. This inflammation causes bronchial edema, increase in the size and number of mucus glands and goblet cells, smooth muscle hypertrophy with fibrosis and narrowing of the airway. Increased secretions of thick mucus happen, and the patient cannot cough it up due to impairment of ciliary function. As the disease, progresses, the smaller airways are involved as well as the large airways. These airways, due to hypertrophy, cause narrowing of the smooth muscle and obstruct airflow, especially during expiration. The obstruction can lead to VQ mismatches.

    Question 12

    Needs Grading

    Mr. Jones is a 78-year-old gentleman who presents to the clinic with a chief complaint of fever, chills and cough. He also reports some dyspnea. He has a history of right sided CVA, COPD, dyslipidemia, and HTN. Current medications include atorvastatin 40 mg po qhs, lisinopril, and fluticasone/salmeterol. He reports more use of his albuterol rescue inhaler.

     

    Vital signs Temp 101.8 F, pulse 108, respirations 21. PaO
    2
    on room air 86% and on O
    2
    4 L nasal canula 94%. CMP WNL, WBC 18.4. Physical exam reveals thin, anxious gentleman with mild hemiparesis on left side due to CVA. HEENT WNL except for diminished gag reflex and uneven elevation of the uvula, CV-HR 108 RRR without murmurs, rubs, or click, no bruits. Resp-coarse rhonchi throughout lung fields. CXR reveals consolidation in right lower lobe. He was diagnosed with community acquired pneumonia (CAP).

    Question:

     

    Patient was hypoxic as evidenced by the low PaO
    2
    . Explain the pathologic processes that caused this patient’s hypoxemia.

    Correct Answer:

    Arterial hypoxemia early in acute pneumococcal pneumonia is principally caused by persistence of pulmonary artery blood flow to be consolidated lung resulting in an intrapulmonary shunt, and by ventilation-perfusion mismatch later. Release of mediators cause widespread inflammation of the bronchial structures, especially the alveolarcapillary membrane NURS 6501 Advanced Pathophysiology Module 2 week 3 Knowledge Check quizlet. The alveoli collapse due to inactivation of surfactant and the alveoli fill with exudate, decreasing surface area for gas exchange.

    Question 13

    Needs Grading

    A 64-year-old woman with moderately severe COPD comes to the pulmonary clinic for her quarterly checkup. The APRN reviewing the chart notes that the patient has lost 5% of her body weight since her last visit. The APRN questions the patient and patient admits to not having much of an appetite and she also admits to missing some meals because it “takes too much work” to cook and consume dinner.

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    Question:

     

    The APRN recognizes that COPD has a deleterious effect on patients. NURS 6501 Advanced Pathophysiology Module 2 week 3 Knowledge Check quizlet. Explain why patients with COPD are at risk for malnutrition.

    Correct Answer:

    Many of the patients with severe COPD are lean, and frequently in a malnourished or undernourished state, which is characterized by loss of fat-free body mass causing muscle wasting. The muscle wasting in COPD not only leads to decreased skeletal muscle function associated with reduced exercise capacity but is also a major determinant of mortality in COPD. Patients with COPD require a low carbohydrate diet as increased CHO can lead to hypercapnia as the end products of CHO metabolism are CO2 and H2O. NURS 6501 Advanced Pathophysiology Module 2 week 3 Knowledge Check quizlet

  • NURS 6512

    Module 1: Comprehensive Health History

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    What’s Happening in This Module?

    This course is composed of four (4) separate modules. Each module consists of an overarching topic in which each week within the module includes specific subtopics for learning. As you work through each module, you will have an opportunity to draw upon the knowledge you gain in various Digital Clinical Experiences (DCE) and lab assignment components that will be due throughout each of the modules.

    Module 1: Comprehensive Health History
     
    is a 1-week module,
     
    Week 1 of the course, in which you will examine how social determinants of health such as age, gender, ethnicity, and environmental situations impact the health and risk assessment of the patients you serve. You will also consider how social determinants of health influence your interview and communication techniques as you work in partnership with a patient to gather data to build an accurate health history.

    What do I have to do?

    When do I have to do it?

    Review your Learning Resources

    Days 1–7, Week 1

    Discussion: Building a Comprehensive Health History

    Post by Day 3 of Week 1, and respond to your colleagues by Day 6 of Week 1.

    What’s Coming Up in Module 2: Looking Ahead

    Review the “Looking Ahead” section for this week. You are encouraged to further review the requirements for the Shadow Health registration process for your digital clinical experiences.

    Go to the Week’s Content

    Week 1: Building a Comprehensive Health History

    According to a 2011 Gallup poll, nurses are ranked as the most trusted professionals in the United States. One of the most admired nursing skills is the ability to put patients at ease. When patients enter into a healthcare setting, they are often apprehensive about sharing personal health information. Caring nurses can alleviate the hesitance of patients and encourage them to be forthcoming with this information.

    The initial health history interview can be an excellent opportunity to develop supportive relationships between patients and nurses. Nurses may employ a variety of communication skills and interview techniques to foster strong bonds with patients and to effectively facilitate the diagnostic process. In conducting interviews, advanced practice nurses must also take into account a range of patient-specific factors that may impact the questions they ask, how they ask those questions, and their complete assessment of the patient’s health.

    This week, you will consider how social determinants of health such as age, gender, ethnicity, and environmental situation impact the health and risk assessment of the patients you serve. You will also consider how social determinants of health influence your interview and communication techniques as you work in partnership with a patient to gather data to build an accurate health history.

    Learning Objectives

    Students will:

    Analyze communication techniques used to obtain patients’ health histories based upon social determinants of health

    Analyze health-related risk

    Apply concepts, theories, and principles related to patient interviewing, diagnostic reasoning, and recording patient information

    Learning Resources

    Required Readings
     (click to expand/reduce)

    Required Media
     (click to expand/reduce)

    Discussion: Building a Health History

    Effective communication is vital to constructing an accurate and detailed patient history. A patient’s health or illness is influenced by many factors, including age, gender, ethnicity, and environmental setting. As an advanced practice nurse, you must be aware of these factors and tailor your communication techniques accordingly. Doing so will not only help you establish rapport with your patients, but it will also enable you to more effectively gather the information needed to assess your patients’ health risks.

    For this Discussion, you will take on the role of a clinician who is building a health history for a particular new patient assigned by your Instructor.

    Photo Credit: Getty Images/Caiaimage

    To prepare:

    With the information presented in Chapter 1 of Ball et al. in mind, consider the following:

    By Day 1 of this week, you will be assigned a new patient profile by your Instructor for this Discussion. 
    Note
    : Please see the “Course Announcements” section of the classroom for your new patient profile assignment.

    How would your communication and interview techniques for building a health history differ with each patient?

    How might you target your questions for building a health history based on the patient’s social determinants of health?

    What risk assessment instruments would be appropriate to use with each patient, or what questions would you ask each patient to assess his or her health risks?

    Identify any potential health-related risks based upon the patient’s age, gender, ethnicity, or environmental setting that should be taken into consideration.

    Select 
    one
     of the risk assessment instruments presented in Chapter 1 or Chapter 5 of the 
    Seidel’s Guide to Physical Examination
     text, or another tool with which you are familiar, related to your selected patient.

    Develop 
    at least five
     targeted questions you would ask your selected patient to assess his or her health risks and begin building a health history.

    By Day 3 of Week 1

    Post 
    a summary of the interview and a description of the communication techniques you would use with your assigned patient. Explain why you would use these techniques. Identify the risk assessment instrument you selected, and justify why it would be applicable to the selected patient. Provide at least five targeted questions you would ask the patient.

    Note:
     For this Discussion, you are required to complete your initial post before you will be able to view and respond to your colleagues’ postings. Begin by clicking on the “Post to Discussion Question” link, and then select “Create Thread” to complete your initial post. Remember, once you click on Submit, you cannot delete or edit your own posts, and you cannot post anonymously. Please check your post carefully before clicking on 
    Submit!

    Read a selection of your colleagues’ responses.

    By Day 6 of Week 1

    Respond 
    to 
    at least two
     of your colleagues 
    on 2 different days
     who selected a different patient than you, using one or more of the following approaches:

    Share additional interview and communication techniques that could be effective with your colleague’s selected patient.

    Suggest additional health-related risks that might be considered.

    Validate an idea with your own experience and additional research.

    Submission and Grading Information

    Grading Criteria

    To access your rubric:

    Week 1 Discussion Rubric

    Post by Day 3 of Week 1 and Respond by Day 6 of Week 1

    To Participate in this Discussion:

    Week 1 Discussion

    What’s Coming Up in Module 2?

    Photo Credit: Getty Images/iStockphoto

    In Module 2,
     you explore the impact of functional assessments, diversity, and sensitivity in conducting health assessments. You also examine various assessment tools and diagnostic tests used to gather information about patients’ conditions and examine their validity, reliability, and impact in conducting health assessments.

    Next week,
     you will specifically examine functional assessments as they relate to diversity and sensitivity

    Registration for Shadow Health

    Throughout this course, you will participate in digital clinical experiences using the online simulation tool Shadow Health. The Shadow Health digital clinical experience provides a dynamic, immersive experience designed to improve nursing skills and clinical reasoning through the examination of digital standardized patients. Using Shadow Health you will participate in health histories, focused exams, and a comprehensive assessment.

    There will be four Shadow Health assessment components that you will need to complete in Module’s 2 and 3:

    Health History Assessment (Week 3 & 4)

    Focused Exam: Cough (Week 5) for a pediatric patient presenting with cough

    Focused Exam: Chest Pain (Week 7) for an adult patient presenting with chest pain

    Comprehensive (Head-to-Toe) Physical Assessment (Week 9)

    Before you can participate in these simulations, you will need to register for a Shadow Health account. To do this:

    Go to the Walden Bookstore and purchase access to Shadow Health and the required texts.

    Once Shadow Health has been purchased, an access code will be emailed to you from the bookstore.

    Review this video explaining how to register in Shadow Health: 

    Use the Shadow Health link located in the navigation menu on the left in the Blackboard course.

    Follow the prompts to register in Shadow Health. You will need the access code provided from the bookstore to register. Once registered, Shadow Health should always be accessed via the link in Blackboard.

    Use only Google Chrome when accessing Shadow Health and make sure all other programs are turned off on your computer. Other browsers do not work well and will not allow the Shadow Health speech to text function to work.

     Once registered, complete the Shadow Health Orientation in the Shadow Health website/program and review the videos designed to assist with navigating and completing assignments.

    Read the Shadow Health Nursing Documentation Tutorial located in the Week 1 Learning Resources.

    Note
    : As nurses you typically use the word assessment to mean completing the physical exam. However, in the SOAP Note format, assessment means diagnosis so start getting in the habit of calling the physical exam exactly that.

    Week 2 Case Studies

    In Week 2, your Instructor will assign you a case study related to your Discussion by Day 1 of the week. Please make sure to review the “Course Announcements” area of the course to verify your assigned case study. Please plan ahead to ensure you have time to review your case study and your Learning Resources so that you can complete your Discussions and Assignments on time.

    Photo Credit: Getty Images/iStockphoto

    Next Module

    To go to the next module:

    Module 2

    Module 2: Functional Assessments and Assessment Tools

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    What’s Happening in This Module?

    Module 2: Functional Assessments and Assessment Tools
     
    is a 2-week module, Weeks 2 and 3. In this module, you consider the impact of functional assessments, diversity, and sensitivity in conducting health assessments. You also explore various assessment tools and diagnostic tests that are used to gather information about patients’ conditions and examine the validity and reliability of these tests and tools. Finally, you examine assessment techniques, health risks and concerns, and recommendations for care related to patient growth, weight, and nutrition.

    What do I have to do?

    When do I have to do it?

    Review your Learning Resources.

    Days 1–7, Weeks 2 and 3

    Discussion: Diversity and Health Assessments

    Post by Day 3 of Week 2, and respond to your colleagues by Day 6 of Week 2.

    Case Study Assignment: Assessment Tools and Diagnostic Tests in Adults and Children

    Submit your Case Study Assignment by Day 6 of Week 3.

    DCE: Health History Assessment

    You are encouraged to work on your DCE every week. However, this Assessment is not due until Day 7 of Week 4.

    Go to the Module’s Content

    Week 2: Functional Assessments and Cultural and Diversity Awareness in Health Assessment

    Diversity is not about how we differ. Diversity is about embracing one another’s uniqueness.

    —Ola Joseph

    Countless assessments can be conducted on patients, but they may not be useful. In order to ensure that health assessments result in the necessary care, health assessments should take into account the impact of factors such as cultures and developmental circumstances.

    Learning Objectives

    Students will:

    Analyze diversity considerations in health assessments

    Apply concepts, theories, and principles related to examination techniques, functional assessments, and cultural and diversity awareness in health assessment

    Learning Resources

    Required Readings
     (click to expand/reduce)

    Required Media
     (click to expand/reduce)

    Discussion: Diversity and Health Assessments

    May 2012, Alice Randall wrote an article for 
    The New York Times
     on the cultural factors that encouraged black women to maintain a weight above what is considered healthy. Randall explained—from her observations and her personal experience as a black woman—that many African-American communities and cultures consider women who are overweight to be more beautiful and desirable than women at a healthier weight. As she put it, “Many black women are fat because we want to be” (Randall, 2012).

    Photo Credit: Getty Images

    Randall’s statements sparked a great deal of controversy and debate; however, they emphasize an underlying reality in the healthcare field: different populations, cultures, and groups have diverse beliefs and practices that impact their health. Nurses and healthcare professionals should be aware of this reality and adapt their health assessment techniques and recommendations to accommodate diversity.

    In this Discussion, you will consider different socioeconomic, spiritual, lifestyle, and other cultural factors that should be taken into considerations when building a health history for patients with diverse backgrounds. Your Instructor will assign a case study to you for this Discussion.

    To prepare:

    Reflect on your experiences as a nurse and on the information provided in this week’s Learning Resources on diversity issues in health assessments.

    By Day 1 of this week, you will be assigned a case study by your Instructor. 
    Note
    : Please see the “Course Announcements” section of the classroom for your case study assignment.

    Reflect on the specific socioeconomic, spiritual, lifestyle, and other cultural factors related to the health of the patient assigned to you.

    Consider how you would build a health history for the patient. What questions would you ask, and how would you frame them to be sensitive to the patient’s background, lifestyle, and culture? Develop five targeted questions you would ask the patient to build his or her health history and to assess his or her health risks.

    Think about the challenges associated with communicating with patients from a variety of specific populations. What strategies can you as a nurse employ to be sensitive to different cultural factors while gathering the pertinent information?

    By Day 3 of Week 2

    Post
     an explanation of the specific socioeconomic, spiritual, lifestyle, and other cultural factors associated with the patient you were assigned. Explain the issues that you would need to be sensitive to when interacting with the patient, and why. Provide at least five targeted questions you would ask the patient to build his or her health history and to assess his or her health risks.

    Note:
     For this Discussion, you are required to complete your initial post before you will be able to view and respond to your colleagues’ postings. Begin by clicking on the “Post to Discussion Question” link, and then select “Create Thread” to complete your initial post. Remember, once you click on Submit, you cannot delete or edit your own posts, and you cannot post anonymously. Please check your post carefully before clicking on 
    Submit!

    Read
     a selection of your colleagues’ responses.

    By Day 6 of Week 2

    Respond on or before Day 6
     
    on 2 different days
     to at least
     two
     of your colleagues who were assigned a different patient than you. Critique your colleague’s targeted questions, and explain how the patient might interpret these questions. Explain whether any of the questions would apply to your patient, and why.

    Submission and Grading Information

    Grading Criteria

    To access your rubric:

    Week 2 Discussion Rubric

    Post by Day 3 of Week 2 and Respond by Day 6 of Week 2

    To Participate in this Discussion:

    Week 2 Discussion

    What’s Coming Up in Week 3?

    Photo Credit: Getty Images/iStockphoto

    Next week
    , you examine assessment techniques, health risks and concerns, and recommendations for care related to patient growth, weight, and nutrition. You will also begin your first 
    DCE: Health History Assessment 
    which will be due in Week 4. Plan your time accordingly.

    Overview of Digital Clinical Experiences (DCE) and Lab Components

    Throughout this course, you are required to not only complete your standard course assignments and discussions, but you will also complete DCE and Lab Components that are either structured as optional or required assignment submissions. Please take the time to review your DCEand Lab Components for this course that are required submissions. See the table below and the attached 
    table
     for specific DCE and Lab Components for the course.

    Note
    : Each Shadow Health Assessment may be attempted and reopened as many times as necessary prior to the due date to achieve a total score of 80% or better, but you must take all attempts by the Day 7 deadline. You must pass BOTH the Health History and Comprehensive (head-to-toe) Physical Exam of at least a total score of 80% in order to pass the course.

    Week

    Digital Clinical Experiences

    Lab Components

    Module 1:  Comprehensive Health History

    Week 1: Building a Comprehensive Health History

    Module 2: Functional Assessments and Assessment Tools

    Week 2: Functional Assessments and Cultural and Diversity Awareness in Health Assessment

    Week 3: Assessment Tools, Diagnostics, Growth, Measurement, and Nutrition in Adults and Children

    DCE: Health History Assessment (assigned in Week 3, due in Week 4)

    Case Study Assignment: Assessment Tools and Diagnostic Tests in Adults and Children

    Module 3: Approach to System Focused Advanced Health Assessments

    Week 4: Assessment of the Skin, Hair, and Nails

    DCE: Health History Assessment

    Lab Assignment: Differential Diagnosis for Skin Conditions (SOAP Note for differential diagnosis)

    Week 5: Assessment of Head, Neck, Eyes, Ears, Nose, and Throat

    DCE: Focused Exam: Cough

    Case Study Assignment: Assessing the Head, Eyes, Ears, Nose, and Throat (Episodic SOAP Note)

    Week 6: Assessment of the Abdomen and Gastrointestinal System

    Lab Assignment: Assessing the Abdomen (Analyze SOAP Note)

    Week 7: Assessment of the Heart, Lungs, and Peripheral Vascular System

    DCE: Focused Exam: Chest Pain

    Week 8: Assessment of the Musculoskeletal System

    Discussion: Assessing Musculoskeletal Pain (Episodic SOAP Note)

    Week 9: Assessment of Cognition and the Neurologic System

    DCE: Comprehensive (head-to-toe) Physical Assessment

    Case Study Assignment: Assessing Neurological Symptoms (Episodic SOAP Note)

    Week 10: Special Examinations—Breast, Genital, Prostate, and Rectal

    Lab Assignment: Assessing the Genitalia and Rectum (analyze SOAP Note)

    Module 4: Ethics in Assessment

    Week 11: The Ethics Behind Assessment

    Lab Assignment: Ethical Concerns

    Next Week

    To go to the next week:

    Week 3

     

    Week 3: Assessment Tools, Diagnostics, Growth, Measurement, and Nutrition in Adults and Children

    Many experts predict that genetic testing for disease susceptibility is well on its way to becoming a routine part of clinical care. Yet many of the genetic tests currently being developed are, in the words of the World Health Organization (WHO), of “questionable prognostic value.”

    —Leslie Pray, PhD

    Obesity remains one of the most common chronic diseases in the United States. As a leading cause of United States mortality, morbidity, disability, healthcare utilization and healthcare costs, the high prevalence of obesity continues to strain the United States healthcare system (Obesity Society, 2016).  More than one-third (39.8%) of U.S. adults have obesity (CDC, 2018). The estimated annual medical cost of obesity in the U.S. was $147 billion in 2008 U.S. dollars; the medical costs for people who are obese were $1,429 higher than those of normal weight (CDC, 2018).

    According to the Centers for Disease Control and Prevention (CDC), the rate of childhood obesity has tripled in the past 30 years, with an estimated 13.7 million children and adolescents considered obese (CDC, 2018). When seeking insights about a patient’s overall health and nutritional state, body measurements can provide a valuable perspective. This is particularly important with pediatric patients. Measurements such as height and weight can provide clues to potential health problems and help predict how children will respond to illness. Nurses need to be proficient at using assessment tools, such as the Body Mass Index (BMI) and growth charts, in order to assess nutrition-related health risks and pediatric development while being sensitive to other factors that may affect these measures. Body Mass Index is also used as a predictor for measurement of adult weight and health.

    Assessments are constantly being conducted on patients, but they may not provide useful information. In order to ensure that health assessments provide relevant data, nurses should familiarize themselves with test-specific factors that may affect the validity, reliability, and value of these tools.

    This week, you will explore various assessment tools and diagnostic tests that are used to gather information about patients’ conditions. You will examine the validity and reliability of these tests and tools. You will also examine assessment techniques, health risks and concerns, and recommendations for care related to patient growth, weight, and nutrition.

    Learning Objectives

    Students will:

    Evaluate validity and reliability of assessment tools and diagnostic tests

    Analyze diversity considerations in health assessments

    Apply concepts, theories, and principles related to examination techniques, functional assessments, and cultural and diversity awareness in health assessment

    Apply assessment skills to collect patient health histories

    Learning Resources

    Required Readings
     (click to expand/reduce)

    Required Media
     (click to expand/reduce)

    Assignment 1: Case Study Assignment: Assessment Tools and Diagnostic Tests in Adults and Children

    When seeking to identify a patient’s health condition, advanced practice nurses can use a diverse selection of diagnostic tests and assessment tools; however, different factors affect the validity and reliability of the results produced by these tests or tools. Nurses must be aware of these factors in order to select the most appropriate test or tool and to accurately interpret the results.

    Not only do these diagnostic tests affect adults, body measurements can provide a general picture of whether a child is receiving adequate nutrition or is at risk for health issues. These data, however, are just one aspect to be considered. Lifestyle, family history, and culture—among other factors—are also relevant. That said, gathering and communicating this information can be a delicate process.

    Photo Credit: Getty Images/Hero Images

    For this Assignment, you will consider the validity and reliability of different assessment tools and diagnostic tests. You will explore issues such as sensitivity, specificity, and positive and negative predictive values. You will also consider examples of children with various weight issues. You will explore how you could effectively gather information and encourage parents and caregivers to be proactive about their children’s health and weight.

    To Prepare

    Review this week’s Learning Resources and consider factors that impact the validity and reliability of various assessment tools and diagnostic tests. You also will review examples of pediatric patients and their families as it relates to BMI.

    By Day 1 of this week, you will be assigned to one of the following Assignment options by your Instructor: Adult Assessment Tools or Diagnostic Tests (option 1), or Child Health Case (Option 2). 
    Note:
     Please see the “Course Announcements” section of the classroom for your assignments from your Instructor.

    Search the Walden Library and credible sources for resources explaining the tool or test you were assigned. What is its purpose, how is it conducted, and what information does it gather?

    Also, as you search the Walden library and credible sources, consider what the literature discusses regarding the validity, reliability, sensitivity, specificity, predictive values, ethical dilemmas, and controversies related to the test or tool.

    If you are assigned Assignment Option 2 (Child), consider what health issues and risks may be relevant to the child in the health example.

    Based on the risks you identified, consider what further information you would need to gain a full understanding of the child’s health. Think about how you could gather this information in a sensitive fashion.

    Consider how you could encourage parents or caregivers to be proactive toward the child’s health.

    The Assignment

    Assignment
     (3–4 pages, not including title and reference pages)
    :

    Assignment Option 1: Adult Assessment Tools or Diagnostic Tests:

    Include the following:

    A description of how the assessment tool or diagnostic test you were assigned is used in healthcare.

    What is its purpose?

    How is it conducted?

    What information does it gather?

    Based on your research, evaluate the test or the tool’s validity and reliability, and explain any issues with sensitivity, reliability, and predictive values. Include references in appropriate APA formatting.

    Assignment Option 2: Child Health Case:

    Include the following:

    An explanation of the health issues and risks that are relevant to the child you were assigned.

    Describe additional information you would need in order to further assess his or her weight-related health.

    Identify and describe any risks and consider what further information you would need to gain a full understanding of the child’s health. Think about how you could gather this information in a sensitive fashion.

    Taking into account the parents’ and caregivers’ potential sensitivities, list at least three specific questions you would ask about the child to gather more information.

    Provide at least two strategies you could employ to encourage the parents or caregivers to be proactive about their child’s health and weight.

    By Day 6 of Week 3

    Submit
     your Assignment.

    Submission and Grading Information

    To submit your completed Assignment for review and grading, do the following:

    Please save your Assignment using the naming convention “WK3Assgn1+last name+first initial.(extension)” as the name.

    Click the 
    Week 3 Assignment 1 Rubric 
    to review the Grading Criteria for the Assignment.

    Click the 
    Week 3 Assignment 1 
    link. You will also be able to “View Rubric” for grading criteria from this area.

    Next, from the Attach File area, click on the 
    Browse My Computer
     button. Find the document you saved as “WK3Assgn1+last name+first initial.(extension)” and click 
    Open
    .

    If applicable: From the Plagiarism Tools area, click the checkbox for 
    I agree to submit my paper(s) to the Global Reference Database
    .

    Click on the 
    Submit
     button to complete your submission.

    Grading Criteria

    To access your rubric:

    Week 3 Assignment 1 Option 1 Rubric

    To access your rubric:

    Week 3 Assignment 1 Option 2 Rubric

    To check your Assignment draft for authenticity:

    Submit your Week 3 Assignment 1 draft and review the originality report.

    Submit Your Assignment by Day 6 of Week 3

    To participate in this Assignment:

    Week 3 Assignment 1

    Assignment 2: Digital Clinical Experience (DCE): Health History Assessment

    A comprehensive health history is essential to providing quality care for patients across the lifespan, as it helps to properly identify health risks, diagnose patients, and develop individualized treatment plans. To effectively collect these heath histories, you must not only have strong communication skills, but also the ability to quickly establish trust and confidence with your patients. For this DCE Assignment, you begin building your communication and assessment skills as you collect a health history from a volunteer “patient.”

    Photo Credit: Getty Images/Caiaimage

    To Prepare

    Review this week’s Learning Resources as well as the 
    Taking a Health History
     media program, and consider how you might incorporate these strategies. Download and review the Student Checklist: Health History Guide and the History Subjective Data Checklist, provided in this week’s Learning Resources, to guide you through the necessary components of the assessment.

    Access and login to Shadow Health using the link in the left-hand navigation of the Blackboard classroom.

    Review the 
    Shadow Health Student Orientation
     media program and the 
    Useful Tips and Tricks
     document provided in the week’s Learning Resources to guide you through Shadow Health.

    Review the Week 4 DCE Health History Assessment Rubric, provided in the Assignment submission area, for details on completing the Assignment.

    DCE Health History Assessment:

    Complete the following in Shadow Health:

    Orientation

    DCE Orientation (15 minutes)

    Conversation Concept Lab (50 minutes)

    Health History

    Health History of Tina Jones (180 minutes)

    Note
    : Each Shadow Health Assessment may be attempted and reopened as many times as necessary prior to the due date to achieve 80% or better, but you must take all attempts by the Week 4 Day 7 deadline.

    Submission and Grading Information

    No Assignment submission due this week but will be due Day 7, Week 4.

    Grading Criteria

    To access your rubric:

    Week 4 Assignment 2 DCE Rubric

    What’s Coming Up in Module 3?

    Photo Credit: Getty Images/iStockphoto

    In Module 3
    , you will examine advanced health assessments using a system focused approach.

    Next week,
     you will specifically explore how to assess the skin, hair, and nails, as well as how to evaluate abnormal skin findings while conducting health assessments. You will also complete your first Lab Assignment: Differential Diagnosis for Skin Conditions as well as complete your DCE: Health History Assessment in the simulation tool, Shadow Health.

    Week 4 Required Media

    Photo Credit: [fergregory]/[iStock / Getty Images Plus]/Getty Images

    Next week
    , you will need to view several videos and animations in 
    Seidel’s Guide to Physical Examination 
    as well as other media, as required, prior to completing your Lab Assignment. There are several videos in varied lengths. Please plan ahead to ensure you have time to view these media programs to complete your Assignment on time.

  • NURS 6051 – The Impact of Nursing Informatics on Patient Outcomes and Patient Care Efficiencies

    The Assignment: (4-5 pages)

    In a 4- to 5-page project proposal written to the leadership of your healthcare organization, propose a nursing informatics project for your organization that you advocate to improve patient outcomes or patient-care efficiency. Your project proposal should include the following:

    Describe the project you propose.

    Identify the stakeholders impacted by this project.

    Explain the patient outcome(s) or patient-care efficiencies this project is aimed at improving and explain how this improvement would occur. Be specific and provide examples.

    Identify the technologies required to implement this project and explain why.

    Identify the project team (by roles) and explain how you would incorporate the nurse informaticist in the project team.

     

    NURS_5051_Module02_Week04_Assignment_Rubric

    Grid View

    List View

    Excellent

    Good

    Fair

    Poor

    In a 4- to 5-page project proposal written to the leadership of your healthcare organization, propose a nursing informatics project for your organization that you advocate to improve patient outcomes or patient care efficiency. Your project proposal should include the following:

    ·   Describe the project you propose.

    ·   Identify the stakeholders impacted by this project.

    ·   Explain the patient outcome(s) or patient-care efficiencies this project is aimed at improving, and explain how this improvement would occur. Be specific and provide examples.

    ·   Identify the technologies required to implement this project and explain why.

    ·   Identify the project team (by roles) and explain how you would incorporate the nurse informaticist in the project team.

    77 
    (77%)
     – 85 
    (85%)

    The response accurately and thoroughly describes in detail the project proposed.

    The response accurately and clearly identifies the stakeholders impacted by the project proposed.

    The response accurately and thoroughly explains in detail the patient outcome(s) or patient-care efficiencies that the project proposed is aimed at improving, including an accurate and detailed explanation, with sufficient supporting evidence of how this improvement would occur.

    The response accurately and clearly identifies the technologies required to implement the project proposed with a detailed explanation why.

    The response accurately and clearly identifies the project team (by roles) and thoroughly explains in detail how to incorporate the nurse informaticist in the project team.

    Includes: 3 or more peer-reviewed sources and 2 or more course resources.

    68 
    (68%)
     – 76 
    (76%)

    The response describes the project proposed.

    The response identifies the stakeholders impacted by the project proposed.

    The response explains the patient outcome(s) or patient-care efficiencies that the project proposed is aimed at improving, including an explanation, with some supporting evidence of how this improvement would occur.

    The response identifies the technologies required to implement the project proposed with an explanation why.

    The response identifies the project team (by roles) and explains how to incorporate the nurse informaticist in the project team.

    Includes: 2 peer-reviewed sources and 2 course resources.

    60 
    (60%)
     – 67 
    (67%)

    The response describing the project proposed is vague or inaccurate.

    The response identifying the stakeholders impacted by the project proposed is vague or inaccurate.

    The response explaining the patient outcome(s) or patient-care efficiencies the project proposed is aimed at improving, including an explanation of how this improvement would occur, is vague or inaccurate, or includes little to no supporting evidence.

    The response identifying the technologies required to implement the project proposed with an explanation why is vague or inaccurate.

    The response identifying the project team (by roles) and an explanation of how to incorporate the nurse informaticist in the project team is vague or inaccurate.

    Includes: 1 peer-reviewed sources and 1 course resources.

    0 
    (0%)
     – 59 
    (59%)

    The response describing the project proposed is vague and inaccurate, or is missing.

    The response identifying the stakeholders impacted by the project proposed is vague and inaccurate, or is missing.

    The response explaining the patient outcome(s) or patient-care efficiencies the project proposed is aimed at improving, including an explanation of how this improvement would occur, is vague and inaccurate, includes no supporting evidence, or is missing.

    The response identifying the technologies required to implement the project proposed with an explanation why is vague and inaccurate, or is missing.

    The response identifying the project team (by roles) and an explanation of how to incorporate the nurse informaticist in the project team is vague and inaccurate, or is missing.

    Includes: 1 or fewer resources.

    Written Expression and Formatting – Paragraph Development and Organization:

    Paragraphs make clear points that support well developed ideas, flow logically, and demonstrate continuity of ideas. Sentences are carefully focused–neither long and rambling nor short and lacking substance.

    5 
    (5%)
     – 5 
    (5%)

    Paragraphs and sentences follow writing standards for flow, continuity, and clarity.

    4 
    (4%)
     – 4 
    (4%)

    Paragraphs and sentences follow writing standards for flow, continuity, and clarity 80% of the time.

    3.5 
    (3.5%)
     – 3.5 
    (3.5%)

    Paragraphs and sentences follow writing standards for flow, continuity, and clarity 60%- 79% of the time.

    0 
    (0%)
     – 3 
    (3%)

    Paragraphs and sentences follow writing standards for flow, continuity, and clarity < 60% of the time. Written Expression and Formatting – English writing standards: Correct grammar, mechanics, and proper punctuation 5  (5%)  – 5  (5%) Uses correct grammar, spelling, and punctuation with no errors. 4  (4%)  – 4  (4%) Contains a few (1-2) grammar, spelling, and punctuation errors. 3.5  (3.5%)  – 3.5  (3.5%) Contains several (3-4) grammar, spelling, and punctuation errors. 0  (0%)  – 3  (3%) Contains many (≥ 5) grammar, spelling, and punctuation errors that interfere with the reader’s understanding. Written Expression and Formatting – The paper follows correct APA format for title page, headings, font, spacing, margins, indentations, page numbers, running head, parenthetical/in-text citations, and reference list. 5  (5%)  – 5  (5%) Uses correct APA format with no errors. 4  (4%)  – 4  (4%) Contains a few (1-2) APA format errors. 3.5  (3.5%)  – 3.5  (3.5%) Contains several (3-4) APA format errors. 0  (0%)  – 3  (3%) Contains many (≥ 5) APA format errors. Total Points: 100   Module 2: The Role of the Informatics Specialist in Healthcare (Weeks 3-4) Laureate Education (Producer). (2018).  The Nurse Informaticist  [Video file]. Baltimore, MD: Author. Accessible player   –Downloads– Download Video w/CC Download Audio Download Transcript Learning Objectives Students will: Analyze interactions between nurse informaticists, data/technology specialists, and other professionals in healthcare organizations Recommend strategies to improve interactions between nurse informaticists and other professionals Analyze how nursing informatics as a specialty and new technologies impact interactions between nurse informaticists and members of healthcare teams Recommend nursing informatics projects to improve outcomes or efficiencies in healthcare organizations Identify stakeholders impacted by nursing informatics projects Analyze how nursing informatics projects improve outcomes or efficiencies in healthcare organizations Identify technologies required for implementation of nursing informatics projects Analyze the role of the nurse informaticist in nursing informatics project teams Due By Assignment Week 3, Days 1–2 Read/Watch/Listen to the Learning Resources. Compose your initial Discussion post. Week 3, Day 3 Post your initial Discussion post. Begin to compose your Assignment. Week 3, Days 4-5 Review peer Discussion posts. Compose your peer Discussion responses. Continue to compose your Assignment. Week 3, Day 6 Post at least two peer Discussion responses on two different days (and not the same day as the initial post). Week 3, Day 7 Wrap up Discussion. Deadline to submit your Assignment. Week 4, Days 1-6 Continue to compose your Assignment Week 4, Day 7 Deadline to submit your Assignment Learning Resources Note:  To access this module’s required library resources, please click on the link to the Course Readings List, found in the  Course Materials  section of your Syllabus. Required Readings McGonigle, D., & Mastrian, K. G. (2017). Nursing informatics and the foundation of knowledge (4th ed.). Burlington, MA: Jones & Bartlett Learning. Chapter 25, “The Art of Caring in Technology-Laden Environments” (pp. 525–535) Chapter 26, “Nursing Informatics and the Foundation of Knowledge” (pp. 537–551) Mosier, S., Roberts, W. D., & Englebright, J. (2019). A Systems-Level Method for Developing Nursing Informatics Solutions: The Role of Executive Leadership.  JONA: The Journal of Nursing Administration ,  49 (11), 543-548. Ng, Y. C., Alexander, S., & Frith, K. H. (2018). Integration of Mobile Health Applications in Health Information Technology Initiatives: Expanding Opportunities for Nurse Participation in Population Health.  CIN: Computers, Informatics, Nursing ,  36 (5), 209-213. Sipes, C. (2016). Project management: Essential skill of nurse informaticists.  Studies in Health Technology and Informatics, 225 , 252-256. Discussion: Interaction Between Nurse Informaticists and Other Specialists Nature offers many examples of specialization and collaboration. Ant colonies and bee hives are but two examples of nature’s sophisticated organizations. Each thrives because their members specialize by tasks, divide labor, and collaborate to ensure food, safety, and general well-being of the colony or hive. Of course, humans don’t fare too badly in this regard either. And healthcare is a great example. As specialists in the collection, access, and application of data, nurse informaticists collaborate with specialists on a regular basis to ensure that appropriate data is available to make decisions and take actions to ensure the general well-being of patients. In this Discussion, you will reflect on your own observations of and/or experiences with informaticist collaboration. You will also propose strategies for how these collaborative experiences might be improved. To Prepare: Review the Resources and reflect on the evolution of nursing informatics from a science to a nursing specialty. Consider your experiences with nurse Informaticists or technology specialists within your healthcare organization. By Day 3 of Week 3 Post  a description of experiences or observations about how nurse informaticists and/or data or technology specialists interact with other professionals within your healthcare organization. Suggest at least one strategy on how these interactions might be improved. Be specific and provide examples. Then, explain the impact you believe the continued evolution of nursing informatics as a specialty and/or the continued emergence of new technologies might have on professional interactions. By Day 6 of Week 3 Respond  to at least  two  of your colleagues * on two different days , offering one or more additional interaction strategies in support of the examples/observations shared or by offering further insight to the thoughts shared about the future of these interactions. *Note:  Throughout this program, your fellow students are referred to as colleagues. Submission and Grading Information Grading Criteria To access your rubric: Week 3 Discussion Rubric Post by Day 3 and Respond by Day 6 of Week 3 To participate in this Discussion: Week 3 Discussion Assignment: The Impact of Nursing Informatics on Patient Outcomes and Patient Care Efficiencies In the Discussion for this module, you considered the interaction of nurse informaticists with other specialists to ensure successful care. How is that success determined? Patient outcomes and the fulfillment of care goals is one of the major ways that healthcare success is measured. Measuring patient outcomes results in the generation of data that can be used to improve results. Nursing informatics can have a significant part in this process and can help to improve outcomes by improving processes, identifying at-risk patients, and enhancing efficiency. To Prepare: Review the concepts of technology application as presented in the Resources. Reflect on how emerging technologies such as artificial intelligence may help fortify nursing informatics as a specialty by leading to increased impact on patient outcomes or patient care efficiencies. The Assignment: (4-5 pages) In a 4- to 5-page project proposal written to the leadership of your healthcare organization, propose a nursing informatics project for your organization that you advocate to improve patient outcomes or patient-care efficiency. Your project proposal should include the following: Describe the project you propose. Identify the stakeholders impacted by this project. Explain the patient outcome(s) or patient-care efficiencies this project is aimed at improving and explain how this improvement would occur. Be specific and provide examples. Identify the technologies required to implement this project and explain why. Identify the project team (by roles) and explain how you would incorporate the nurse informaticist in the project team. By Day 7 of Week 4 Submit your completed Project Proposal. Submission and Grading Information To submit your completed Assignment for review and grading, do the following: Please save your Assignment using the naming convention “WK4Assgn+last name+first initial.(extension)” as the name. Click the  Week 4 Assignment Rubric  to review the Grading Criteria for the Assignment. Click the  Week 4 Assignment  link. You will also be able to “View Rubric” for grading criteria from this area. Next, from the Attach File area, click on the  Browse My Computer  button. Find the document you saved as “WK4Assgn+last name+first initial.(extension)” and click  Open . If applicable: From the Plagiarism Tools area, click the checkbox for  I agree to submit my paper(s) to the Global Reference Database . Click on the  Submit  button to complete your submission. Grading Criteria To access your rubric: Week 4 Assignment Rubric Check Your Assignment Draft for Authenticity To check your Assignment draft for authenticity: Submit your Week 4 Assignment draft and review the originality report. Submit Your Assignment by Day 7 of Week 4 To participate in this Assignment: Week 4 Assignment

  • NURS 6512 Discussion: Building a Health History

    Discussion: Building a Health History

    Effective communication is vital to constructing an accurate and detailed patient history. A patient’s health or illness is influenced by many factors, including age, gender, ethnicity, and environmental setting. As an advanced practice nurse, you must be aware of these factors and tailor your communication techniques accordingly. Doing so will not only help you establish rapport with your patients, but it will also enable you to more effectively gather the information needed to assess your patients’ health risks.

    For this Discussion, you will take on the role of a clinician who is building a health history for a particular new patient assigned by your Instructor.

    Photo Credit: Getty Images/Caiaimage

    To prepare:

    With the information presented in Chapter 1 of Ball et al. in mind, consider the following:

    By Day 1 of this week, you will be assigned a new patient profile by your Instructor for this Discussion. 
    Note
    : Please see the “Course Announcements” section of the classroom for your new patient profile assignment.

    How would your communication and interview techniques for building a health history differ with each patient?

    How might you target your questions for building a health history based on the patient’s social determinants of health?

    What risk assessment instruments would be appropriate to use with each patient, or what questions would you ask each patient to assess his or her health risks?

    Identify any potential health-related risks based upon the patient’s age, gender, ethnicity, or environmental setting that should be taken into consideration.

    Select 
    one
     of the risk assessment instruments presented in Chapter 1 or Chapter 5 of the 
    Seidel’s Guide to Physical Examination
     text, or another tool with which you are familiar, related to your selected patient.

    Develop 
    at least five
     targeted questions you would ask your selected patient to assess his or her health risks and begin building a health history.

    By Day 3 of Week 1

    Post 
    a summary of the interview and a description of the communication techniques you would use with your assigned patient. Explain why you would use these techniques. Identify the risk assessment instrument you selected, and justify why it would be applicable to the selected patient. Provide at least five targeted questions you would ask the patient.

    Note:
     For this Discussion, you are required to complete your initial post before you will be able to view and respond to your colleagues’ postings. Begin by clicking on the “Post to Discussion Question” link, and then select “Create Thread” to complete your initial post. Remember, once you click on Submit, you cannot delete or edit your own posts, and you cannot post anonymously. Please check your post carefully before clicking on 
    Submit!

    Read a selection of your colleagues’ responses.

    By Day 6 of Week 1

    Respond 
    to 
    at least two
     of your colleagues 
    on 2 different days
     who selected a different patient than you, using one or more of the following approaches:

    Share additional interview and communication techniques that could be effective with your colleague’s selected patient.

    Suggest additional health-related risks that might be considered.

    Validate an idea with your own experience and additional research.

     

    NURS_6512_Week_1_Discussion_Rubric

    Grid View

    List View

    Excellent

    Good

    Fair

    Poor

    Main Posting

    45 
    (45%)
     – 50 
    (50%)

    “Answers all parts of the Discussion question(s) with reflective critical analysis and synthesis of knowledge gained from the course readings for the module and current credible sources. Supported by at least three current, credible sources. Written clearly and concisely with no grammatical or spelling errors and fully adheres to current APA manual writing rules and style.

    40 
    (40%)
     – 44 
    (44%)

    “Responds to the Discussion question(s) and is reflective with critical analysis and synthesis of knowledge gained from the course readings for the module. At least 75% of post has exceptional depth and breadth. Supported by at least three credible sources. Written clearly and concisely with one or no grammatical or spelling errors and fully adheres to current APA manual writing rules and style.

    35 
    (35%)
     – 39 
    (39%)

    “Responds to some of the Discussion question(s). One or two criteria are not addressed or are superficially addressed. Is somewhat lacking reflection and critical analysis and synthesis. Somewhat represents knowledge gained from the course readings for the module. Post is cited with two credible sources. Written somewhat concisely; may contain more than two spelling or grammatical errors. Contains some APA formatting errors.

    0 
    (0%)
     – 34 
    (34%)

    “Does not respond to the Discussion question(s) adequately. Lacks depth or superficially addresses criteria. Lacks reflection and critical analysis and synthesis. Does not represent knowledge gained from the course readings for the module. Contains only one or no credible sources. Not written clearly or concisely. Contains more than two spelling or grammatical errors. Does not adhere to current APA manual writing rules and style.

    Main Post: Timeliness

    10 
    (10%)
     – 10 
    (10%)

    Posts main post by Day 3.

    0 
    (0%)
     – 0 
    (0%)

    N/A

    0 
    (0%)
     – 0 
    (0%)

    N/A

    0 
    (0%)
     – 0 
    (0%)

    Does not post main post by Day 3.

    First Response

    17 
    (17%)
     – 18 
    (18%)

    “Response exhibits synthesis, critical thinking, and application to practice settings. Provides clear, concise opinions and ideas that are supported by at least two scholarly sources. Demonstrates synthesis and understanding of Learning Objectives. Communication is professional and respectful to colleagues. Responses to faculty questions are fully answered, if posed. Response is effectively written in standard, edited English.

    15 
    (15%)
     – 16 
    (16%)

    “Response exhibits critical thinking and application to practice settings. Communication is professional and respectful to colleagues. Responses to faculty questions are answered, if posed. Provides clear, concise opinions and ideas that are supported by two or more credible sources. Response is effectively written in standard, edited English.

    13 
    (13%)
     – 14 
    (14%)

    “Response is on topic and may have some depth. Responses posted in the Discussion may lack effective professional communication. Responses to faculty questions are somewhat answered, if posed. Response may lack clear, concise opinions and ideas, and a few or no credible sources are cited.

    0 
    (0%)
     – 12 
    (12%)

    “Response may not be on topic and lacks depth. Responses posted in the Discussion lack effective professional communication. Responses to faculty questions are missing. No credible sources are cited.

    Second Response

    16 
    (16%)
     – 17 
    (17%)

    “Response exhibits synthesis, critical thinking, and application to practice settings. Provides clear, concise opinions and ideas that are supported by at least two scholarly sources. Demonstrates synthesis and understanding of Learning Objectives. Communication is professional and respectful to colleagues. Responses to faculty questions are fully answered, if posed. Response is effectively written in standard, edited English.

    14 
    (14%)
     – 15 
    (15%)

    “Response exhibits critical thinking and application to practice settings. Communication is professional and respectful to colleagues. Responses to faculty questions are answered, if posed. Provides clear, concise opinions and ideas that are supported by two or more credible sources. Response is effectively written in standard, edited English.

    12 
    (12%)
     – 13 
    (13%)

    “Response is on topic and may have some depth. Responses posted in the Discussion may lack effective professional communication. Responses to faculty questions are somewhat answered, if posed. Response may lack clear, concise opinions and ideas, and a few or no credible sources are cited.

    0 
    (0%)
     – 11 
    (11%)

    “Response may not be on topic and lacks depth. Responses posted in the Discussion lack effective professional communication. Responses to faculty questions are missing. No credible sources are cited.

    Participation

    5 
    (5%)
     – 5 
    (5%)

    Meets requirements for participation by posting on three different days.

    0 
    (0%)
     – 0 
    (0%)

    N/A

    0 
    (0%)
     – 0 
    (0%)

    N/A

    0 
    (0%)
     – 0 
    (0%)

    Does not meet requirements for participation by posting on three different days.

    Total Points: 100

  • Application of Data to Problem-Solving discussion

    To Prepare:

    Reflect on the concepts of informatics and knowledge work as presented in the Resources.

    Consider a hypothetical scenario based on your own healthcare practice or organization that would require or benefit from the access/collection and application of data. Your scenario may involve a patient, staff, or management problem or gap.

    By Day 3 of Week 1

    Post
     a description of the focus of your scenario. Describe the data that could be used and how the data might be collected and accessed. What knowledge might be derived from that data? How would a nurse leader use clinical reasoning and judgment in the formation of knowledge from this experience?

    By Day 6 of Week 1

    Respond
     to at least 
    two
     of your colleagues
    * on two different days
    , asking questions to help clarify the scenario and application of data, or offering additional/alternative ideas for the application of nursing informatics principles.

     In my experience working in long term care and skilled nursing facilities I became aware of several issues that could have benefited greatly from improved collection of data. One such issue is the abundance of pressure ulcers developed during a patient’s admission within the skilled nursing facilities. According to Lavallée et al. (2019) patients who are admitted to nursing homes are at a greater risk of developing pressure ulcers that could lead to an increase in overall healthcare costs, an increase length of patient stays, and a potential for poor prognosis. Sweeney (2017) states nursing informatics integrates nursing and computer science in order to enhance the delivery of quality patient care in the health care setting. Fortunately, the skilled nursing facility that I was a part of was already equipped with an electronic health record system that could be utilized to collect, review, and apply data. Some of the data that could be collected in order to assist in reducing pressure ulcer development would include the raw overall number of pressure ulcer cases that were developed after admission. Additionally, the data would also need to include pre-admission pressure ulcers that have worsened. For example, a patient is admitted with a stage 1 pressure ulcer but during the patient stay it becomes a stage 2 pressure ulcer. Lastly, all patients receive a Braden assessment upon admission and this data could prove useful as well in analyzing data to help prevent pressure ulcer development.

    Some of the key information that could be obtained from analyzing the data would be the development of a baseline for the rate at which patients are acquiring pressure ulcers as well as the rate at which existing pressure ulcers are worsening. This data could be utilized by a nurse leader to develop a process improvement project that could prove beneficial in reducing the incidence of pressure ulcers in the long-term care facilities. Nagle, Sermeus, and Junger (2017) state that nursing leaders can make a major impact in the management of care through process improvements. A nurse leader could utilize this data to develop a process improvement project that would require the assistance of a leadership team, a nurse informaticist, and the staff nurses. Ideally, this team would utilize the data to follow trends and produce an improvement plan that would reduce pressure ulcers. This plan could include methods of better tracking patient repositioning, better use of available bed technology, additional skin assessments, and pressure ulcer prevention bundles. This is an ongoing issue that needs to be addressed in order improve overall quality of patient care.

    References

    Lavallée, J. F., Gray, T. A., Dumville, J., & Cullum, N. (2019). Preventing pressure ulcers in nursing homes using a care bundle: a feasibility study. 
    Health & Social Care in the Community
    , 
    27
    (4), e417-e427.

    Nagle, L., Sermeus, W., & Junger, A. (2017).  Evolving Role of the Nursing Informatics Specialist. In J. Murphy, W. Goosen, & P. Weber (Eds.), 
    Forecasting Competencies for Nurses in the Future of Connected Health
     (212-221). Clifton, VA: IMIA and IOS Press. Retrieved from https://serval.unil.ch/resource/serval:BIB_4A0FEA56B8CB.P001/REF

    Sweeney, J. (2017). Healthcare informatics. 
    Online Journal of Nursing Informatics, 21
    (1).

     
    Reply
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    Menard Tchatchou-Tchoubia

    Menard Tchatchou-Tchoubia

    Dec 1, 2022
    Dec 1, 2022 at 11:34am

    Manage Discussion Entry

    Discussion Response

     

     

    Menard Tchatchou

    Walden University

    NURS 6051 N

    Dr. Lynne Taylor

    12/01/2022

     

     

     

     

     

     

     

     

     

     

     

     

    Discussion Response

     

    Thanks for providing valuable insights on how the facilities you worked with could collect, review, and apply data to help reduce pressure ulcer development. I can see how Sweeney (2017) defines nursing informatics principles as integrating nursing and computer science to enhance the delivery of quality health care that could be applied in this situation. From your insights, I was impressed to learn that all ulcer patients would receive a Braden assessment upon admission. This data could prove helpful in preventing pressure ulcer development.  I would also note from your insights that the nurse leader would use the collected data from ulcer patients to develop a process improvement project in support of Nagle, Sermeus, and Junger (2017) that would be useful in reducing the incidence of pressure ulcers in long term care facilities with the help of other medics. However, I would like to know in more detail how the nurse leader and the team would use the data to follow trends to improve overall patient care quality.

    Lastly, I better understood how the nurse leader and health facility team can follow pressure ulcer trends and how nursing informatics principles could be applied. I agree that collecting and using data to reduce pressure ulcer development and identify areas for improvement, using data to develop evidence-based protocols/guidelines, and using data to educate staff and patients are all great ideas. Using data to improve resource utilization (e.g., staffing levels, supplies, etc.) would be another great way to apply nursing informatics principles. Do you have any other thoughts?

    References

    Nagle, L., Sermeus, W., & Junger, A. (2017).  Evolving Role of the Nursing Informatics Specialist. In J. Murphy, W. Goosen, & P. Weber (Eds.), Forecasting Competencies for Nurses in the Future of Connected Health (212-221). Clifton, VA: IMIA and IOS Press. Retrieved from https://serval.unil.ch/resource/serval:BIB_4A0FEA56B8CB.P001/REF

    Sweeney, J. (2017). Healthcare informatics. Online Journal of Nursing Informatics, 21(1).

     
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    Maxine A Lewis

    Maxine A Lewis

    Dec 1, 2022
    Dec 1, 2022 at 9:06pm

    Manage Discussion Entry

    Irvin with the collection and reviewing of the data (Braden score) at your facility how meaningful is the data? Is it being used to staff according to the acuity? I am curious of the percent increase or decrease in pressure ulcer  as well at deterioration of existing ones. My rational for asking is that so often the Braden scale and documentation is done but if the manpower is not available to do the frequent turns etc.  the electronic paperwork is meticulous but  the incident of pressure injuries remains the same or increases.

    Inadequate  staffing can be a contributing factor in pressure ulcer   studies have “shown a direct relationship between nurse staffing and patient outcomes such as PUs…” (Kim et.al 2022). Pressure injuries are preventable if the preventative measures are instituted however if there is no manpower to initiate evidence base practice then we are back to square one.

    Harrington et.al cites “nursing home 
    s
    taffing levels are highly variable and much lower on weekends than during the week.
    43
    Links to an external site.
     RN levels were 42% lower, LVN/LPN levels were 17% lower, and CNA levels were 9% lower on weekends in 2017 to 2018.” Furthermore ” based on resident acuity, 54% of nursing homes did not meet the total CMS expected staffing level 80%of the time. About 75% of nursing homes almost never met the CMS expected RN staffing level based on resident acuity in 2017 to 2018″ (Harrington et.al 2020). Kim et.al cites that  ” the higher the level of nurse staffing, the lower the risk for PU development” (Kim et.al 2022).

     

     

    Harrington, C., Dellefield, M. E., Halifax, E., Fleming, M. L., & Bakerjian, D. (2020). Appropriate Nurse Staffing Levels for U.S. Nursing Homes. 
    Health services insights
    , 
    13
    , 1178632920934785. https://doi.org/10.1177/1178632920934785

    Kim, J., Lee, J., & Lee, E. (2022). Risk factors for newly acquired pressure ulcer and the impact of nurse staffing on pressure ulcer incidence. 
    Journal of Nursing Management (John Wiley & Sons, Inc.)
    , 
    30
    (5), O1–O9. https://doi.org/10.1111/jonm.12928

     

     
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    Irvin Michael Jones

    Irvin Michael Jones

    Dec 3, 2022
    Dec 3, 2022 at 2:20pm

    Manage Discussion Entry

    Hi Maxine and Mernard,

    In my previous experience working in the nursing home, pressure ulcer development became such a major issue due to the federal survey team that came to do a full inspection of the facility. The facility was tagged with several areas of improvement in the appropriate prevention of pressure ulcers. During this time my team and I were responsible for collecting the data, reviewing the data, and developing project proposals. Some of the plans we came up with were to start weekly wound rounds where we contracted a physician assistant that would come each week to do assessments. This was a great help because the nurses could assess patients then submit a referral for the physician assistant to see them that week. Nurses were trained to submit referrals even at the sign of redness to coccyx to help provide treatment early. We also purchased additional pressure-relieving air mattresses to provide to patients immediately upon admission.

    We also increased the Braden assessment from weekly to BID and the unit managers were expected to review any changes or trends. According to Anaba-Wright and Kefas (2020) quality improvement projects to reduce pressure ulcers are beneficial when staff are able to buy-in. Through various trainings and meetings with the staff we were able to come up with additional improvements based on staff feedback. We initiated the use of the patient turning clock as well so that the nurses could assist the CNA’s in making sure the patient is repositioned every 2 hours. As you mentioned Maxine, with staffing being variable to low maintaining these initiatives proved difficult. We decided to have the entire leadership team rotate through the units daily to assist in any way that they could. We did see a reduction of pressure injuries when reviewing the data 3 months later and the facility was able to pass the inspection as well.

    Thank you all for your feedback.

    References

    Anaba-Wright, U., & Kefas, J. (2020). Reducing pressure ulcers in care homes in Barnet: a quality improvement project. 
    British Journal of Community Nursing
    , 
    25
    (Sup9), S33–S37. https://doi.org/10.12968/bjcn.2020.25.Sup9.S33

    Sweeney, J. (2017). Healthcare informatics. 
    Online Journal of Nursing Informatics, 21
    (1).

     
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    Christiana Nuworsoo

    Christiana Nuworsoo

    Dec 2, 2022
    Dec 2, 2022 at 2:59pm

    Manage Discussion Entry

    Irvine,

    I consider your topic of interest a hot topic of great importance and priority at all health facilities.  In the United States alone, approximately $2.5 million in hospitalizations are due to pressure ulcers (Afzali Borojeny et al., 2020). Surgical and ICU patients are at the greatest risk for pressure ulcers in the hospital setting due to bedrest and immobility (Truong et al., 2016).  What sets each facility apart are the standards and protocols in place to decrease the development of pressure ulcers.  I have had the privilege of working with 3 of the major hospital systems in Maryland, and only one has a rigorous approach to prevention.  This one hospital system I’ve worked with has a Pressure Ulcer Prevention Committee that includes, at minimum, two nurses from each unit, one for the day shift and the other for the night shift.  Each week they compile a list of all patients with a Braden Score of 18 or less. Using the electronic charting system information, they can tell who is being turned and who is not.  To confirm best practice, they must visit the patients with low Braden Scores to ensure that turns are indeed being done according to the charting and that the types of equipment needed are present in the rooms.  They do random checks to ensure that the charting matches the patient’s disposition.  If a patient is not turned, they turn the patient.  The list of patients with low Braden Scores and nurses not adhering to prevention tactics are then sent to the Unit Manager.

    Although I agree with you about determining a baseline Braden Score, one thing I have learned working at the hospital is that Braden Scores change by the day.  Therefore, the best practice should be to determine a daily or shift Braden Score because it indicates whether a patient is declining or recovering.  A patient with a decreasing Braden Score will need to be turned more.  A program that automatically sends a list of low Braden Score patients to the Unit Managers daily for analysis can be written.

     

    References

    Afzali Borojeny, L., Albatineh, A. N., Hasanpour Dehkordi, A., & Ghanei Gheshlagh, R. (2020). The Incidence of Pressure Ulcers and its Associations in Different Wards of the Hospital: A 
    Systematic Review and Meta-Analysis. International journal of preventive medicine,
     11, 171. 
    https://doi.org/10.4103/ijpvm.IJPVM_182_19
    Links to an external site.

    Truong, B., Grigson, E., Patel, M., & Liu, X. (2016). Pressure Ulcer Prevention in the Hospital Setting Using Silicone Foam Dressings. Cureus, 8(8), e730. 
    https://doi.org/10.7759/cureus.730
    Links to an external site.

     
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    Bertina Boma Soh

    Bertina Boma Soh

    Dec 2, 2022
    Dec 2, 2022 at 9:33pm

    Manage Discussion Entry

    Hello Irvine,

    Pressure ulcers, primarily in-house-acquired, are a real issue for every facility. While working at a nursing home, I found a pressure ulcer as a clinical priority. Pressure ulcers can lead to significant health conditions and increase the patient’s morbidity and mortality. A pressure ulcer is important because patients come to the healthcare facility to cure their disease. However, patients suffer from pressure ulcers that can lead to life-threatening conditions such as infection of the wound, osteomyelitis, sepsis, and the reimbursement system to the health care organization. Residents in long-term and skilled care facilities have impaired mobility due to chronic illness; these residents are at increased risk for further disability due to pressure injuries. It is our responsibility to prevent this from occurring. Most nursing homes cure pressure ulcers in nursing homes using a care bundle (Lavallee et al., 2019). Routine assessment of skin, nutritional assessment, hydration, repositioning, and pressure ulcer care bundle. The nursing evidence-based practice committee should focus its next research project on this nursing practice problem. Pressure ulcers can be the gateway to many life-threatening health conditions and increase the patient’s mortality risk (Lavallee et al., 2019).

    Reference

    Lavallee et al., 2019. Preventing pressure ulcers in nursing homes using a care bundle: A

    feasibility study. Health &Social Care in the Community. 27(4). Permalink https://chamberlainuniversity.

    idm.oclc.org/login?url=https://search.ebscohost.com/login.aspx?

    direct=true&db=her&AN=137037259&site=eds-live&scope=site

     
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    Olufunke Ajayi-Festus

    Olufunke Ajayi-Festus

    Dec 4, 2022
    Dec 4, 2022 at 11:13am

    Manage Discussion Entry

    Irvin,

    I enjoyed reading your post, I will like to say that nursing informatics has helped us with data collection, unlike before, when collecting data was strenuous work and most of the data were not accurate. The problem is what we do with the data collected which is a topic for another day. Braden score, for example, is a way to know how the skin integrity of a patient is either improving or worsening, what we don’t do is turn the patient frequently, get them out of bed when appropriate, or walk them as the case may be.

     

    Reference

    Lavallee et al., 2019. Preventing pressure ulcers in nursing homes using a care bundle: A

    feasibility study. Health &Social Care in the Community. 27(4). Permalink https://chamberlainuniversity.

    idm.oclc.org/login?url=https://search.ebscohost.com/login.aspx?

    direct=true&db=her&AN=137037259&site=eds-live&scope=site

     
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    Remi Oluremi Ojo

    Remi Oluremi Ojo

    Dec 4, 2022
    Dec 4, 2022 at 11:46pm

    Manage Discussion Entry

    Hi Irvin,

    I agree that pressure ulcers (PU) are a serious, frequent, and costly complication in health care settings and are commonly used as a quality indicator for nursing care. The prevalence of PU in healthcare settings is high, especially in hospitalized patients or in a nursing facilities. As a result, there is a huge need to continually measure the incidence and prevalence in health care (Gunningberg, et al., 2009). The impact of health information technology (HIT) should be widely noted in the development of standardized documentation practices for pressure ulcer prevention and care. Adverse occurrences such as healthcare-acquired pressure ulcers (HAPUs) are being enhanced through the application of HITs. An example is the risk assessment tools in Kaiser Permanente (KP) HealthConnect. KP completed the execution of an organization-wide EHR known as KP HealthConnect in March 2010 which improved practitioner prescribing, increased efficiencies in organizations, improved communication, and improved quality of care and outcomes. KP HealthConnect is used to calculate an overall risk score of PU, identify patients that are a high risk of developing a pressure ulcer, and alert nurses to implement preventative measures. For HAPUs, KP incorporated Ascension Health’s SKIN care bundle into the KP HealthConnect build and provide education for the nursing employees. The EHR system was designed to provide flowsheets that prompt nurses to implement proper actions related to skin care by turning the patent that is at a high risk of pressure ulcers regularly. The implementation of this EHR has contributed to improvements in the nursing care outcome and processes (Dowding et al., 2012).

    References

    Dowding, D. W., Turley, M., & Garrido, T. (2012). The impact of an electronic health record on nurse-sensitive patient outcomes: an interrupted time series analysis. 
    Journal of the American Medical Informatics Association: JAMIA
    , 
    19
    (4), 615–620. https://doi.org/10.1136/amiajnl-2011-000504

    Gunningberg, L., Fogelberg-Dahm, M., & Ehrenberg, A. (2009). Improved quality and comprehensiveness in nursing documentation of pressure ulcers after implementing an electronic health record in hospital care. 
    Journal of clinical nursing
    , 
    18
    (11), 1557–1564. https://doi.org/10.1111/j.1365-2702.2008.02647.x

     
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    Mansong Ntekim

    Mansong Ntekim

    Nov 29, 2022
    Nov 29, 2022 at 2:06am

    Manage Discussion Entry

    Healthcare Information and Management Systems Society (HIMSS), (2022) defines nursing informatics as “the specialty that integrates nursing science with multiple information and analytical sciences to identify, define, manage and communicate data, information, knowledge and wisdom in nursing practice.” Nursing as a profession has benefited immensely from the paper charting to electronic medical record (EMR) in terms of availability of information, accessibility of information, and patient safety.

    I started nursing about 22 years ago, when paper charting was the norm, any information sought had to be found in books, if such books were available at the point of care. Information and data were hard to obtain, mostly, while on the job as one had to go and search for the information/data in the books available at the care location. With nursing informatics, needed information and data are within the finger reach.

    I practice in an acute care mental health setting with a high patient turn-over ratio, which also means, a high admission rate. The facility uses EPIC, this system provides the nurse with data and current information about the patient’s previous care information. When a patient’s personal information is logged into the system, the patient’s past admissions, diagnosis, medications, progress and nursing notes are accessible from all facilities that the patient has been to the uses EPIC. The availability of these information/data helps in speeding up the admission process, medication reconciliation, and giving the nurse information about the patient’s behavior on the unit during prior admissions. The past behavior pattern can help to determine future behavior and help in housing location for the safety of other patients and staff. Having adequate information about past treatment is strategic to the treatment and safety of the patient and staff.

    Reference

    Healthcare Information and Management Systems Society (HIMSS) (2022)
    . 
    What is Nursing Informatics? 
    Retrieved from 
    https://www.himss.org/resources/what-nursing-informatics
    Links to an external site.

     

     
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    Irvin Michael Jones

    Irvin Michael Jones

    Nov 30, 2022
    Nov 30, 2022 at 2:45pm

    Manage Discussion Entry

    Hi Mansong,

    You mentioned using paper charting during your career as a nurse. While I have spent most of my career utilizing electronic health record systems, I certainly understand the importance of nursing informatics in our evolving health care system. In my current position as a mental health nurse, we continue to do paper charting which has proven to be very time consuming. Time management in nursing is of great importance and when we are spending several hours documenting on paper that could be improved using an electronic health record, it highlights the importance of using nursing informatics. Trout et al. (2022) states that the use of electronic health record systems is associated with an increase in overall patient safety as well as documentation efficiency. Fortunately, the facility that I am currently a part of has recognized the need to utilize an electronic health record system. They are planning on launching EPIC early next year and I hope to see similar improvements as you mentioned in your facility.

    -Irvin

    References

    Sweeney, J. (2017). Healthcare informatics. 
    Online Journal of Nursing Informatics, 21
    (1).

    Trout, K. E., Chen, L.-W., Wilson, F. A., Tak, H. J., & Palm, D. (2022). The Impact of Meaningful Use and Electronic Health Records on Hospital Patient Safety. 
    International Journal of Environmental Research and Public Health
    , 
    19
    (19). https://doi.org/10.3390/ijerph191912525

     
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    Barkisu Fortenberry

    Barkisu Fortenberry

    Nov 30, 2022
    Nov 30, 2022 at 7:39pm

    Manage Discussion Entry

    Hi Mansong,

    Wow! Your discussion is truly reflective of your career as a nurse. Since I have spent most of my career using electronic record systems, I am fascinated by the significance of nursing informatics within the changing healthcare system. In my current role as a nurse, we continuously do paper charting, which is indeed time-consuming (Alexandru,  Radu & Bizon, 2018). Besides, time management remains essential in nursing; thus, when we use several hours in the documentation of a paper, which could be enhanced using electronic health records, it underscores the significance of using nursing informatics. The use of electronic health record systems has been related to a general increase in relation to patient safety and documentation effectiveness. However, does this spell doom for facilities that fail to adopt electronic records? However, our facility projects to have improved services as a result of launching EPIC.

    Reference:

    Alexandru, A. G., Radu, I. M., & Bizon, M. L. (2018). Big Data in Healthcare-Opportunities and Challenges. 
    Informatica economica
    , 
    22
    (2).

     
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    Andrea M Allen

    Andrea M Allen

    Nov 30, 2022
    Nov 30, 2022 at 7:40pm

    Manage Discussion Entry

    Hi Monsong,

    Unfortunately, I too work in mental health where most of our charting are done by writing on paper.  The hospital has started certain aspects of charting via computer such as doctors dictation, labs and medication administration.  Coming from previous hospitals where writing was a thing of the past can be very challenging and really time consuming.  For example, if someone documents an error, they have to draw a straight line through the error, sign, time and date the error before moving on plus the charts become quite heavy quickly.  Another issue I observed is the older nurses who worked there for many years are very resistance to using a computer.  Prior attempts to change the system by other administrators have failed.  Administering medication via computer has made significant improvement so far.  I am hoping that advancement will continue where technology will continue to prove that its safer and saves time.

     

    Healthcare Information and Management Systems Society (HIMSS) (2022). 
    What is Nursing Informatics?
     Retrieved from 
    https://www.himss.org/resource/what-nursing-informatics
    Links to an external site.

     
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    Bertina Boma Soh

    Bertina Boma Soh

    Nov 30, 2022
    Nov 30, 2022 at 11:03pm

    Manage Discussion Entry

    Hello Mansong,

    Thank you so much for the detailed work. I agree that Healthcare Information and Management Systems Society defines nursing informatics as “the specialty that integrates nursing science with multiple information and analytical sciences to identify, define, manage and communicate data, information, knowledge, and wisdom in nursing practice. You are correct that Nursing has benefited immensely from paper charting to electronic medical records (EMR) in terms of availability of information, accessibility of information, and patient safety.

    Over the past few decades, our medical knowledge has increased. More investigative and treatment options are available; as a result, our patients are living longer, and we are dealing with more chronic conditions. Family physicians cannot “know all things,” nor can we be “all things to all patients.” To adequately address our patients’ complex needs, we need good sources of information and good relationships, including access to a multidisciplinary team of professionals and other specialists. We need tools that improve access to information and relationships. We have had to transform how we practice, and the EMR, with its associated information technology, has facilitated that transformation.

     
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    Dawn Lorde

    Dawn Lorde

    Dec 1, 2022
    Dec 1, 2022 at 10:43pm

    Manage Discussion Entry

    Hi Mansong,

    Thank you for your post.  I currently work in the emergency room (ER), and we see a lot of patients with mental health issues.  We also use EPIC charting system, and it is very helpful in collecting all the data on past medical history, medications, and the previous hospital stays.  We often have patients arrive under a temporary custody order (TDO).  Often, these patients are not forthcoming in giving any medical history because they are unhappy about being in the emergency room against their will.

    In the hospital where I work, there is no mental health unit.  Therefore, those patients requiring inpatient mental health treatment may be in the ER for an extended time until placement is found.  We collaborate with doctors, psychiatrists, and community service board (CSB) using telecommunication every day.  Therefore, current electronic health records (EHR)  are crucial for accurately recording and sharing critical patient health information with other medical professionals (Alenezi & Alghamdi, 2022).

     Reference:

    A. Alenezi & A. A. Alghamdi, “Progress of Nursing Informatics for Mental Health Initiatives,” 
    2022 Second International Conference on Interdisciplinary Cyber Physical Systems (ICPS)
    , 2022, pp. 152-158, DOI: 10.1109/ICPS55917.2022.00036.

     

     

     
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    Jodian Walford

    Jodian Walford

    Dec 2, 2022
    Dec 2, 2022 at 2:02am

    Manage Discussion Entry

    Hi colleague,

    You have made noticeable points regarding informatics and the electronic medical record (EMR). It has contributed positively to the healthcare profession. On the island I am from, we only had paper charting, which was stored in folders. Often Papers would be misplaced, which delays patient care. Now upgrading to the use of EMR has solved that problem. EMR provides easy access for authorized users and allows for the flow of information specific to the patient treatment, from the nurse at the bedside to the physician prescribing treatment to the pharmacy (Cipriano, 2011).

    Nurses are uniquely positioned to be leaders in how this technology is organized and implemented for the patient’s betterment (Huston, 2013). With the experience of paper charting and EHR, I have experienced benefits and drawbacks. The benefits of EHR, however, outweigh the negatives. The world is evolving, and as professionals, it is vital to equip ourselves with the needed knowledge and skills as it saves time and lives.

     

    References

    Cipriano, P. E. & Murphy, J. (2011). Nursing informatics. The future of nursing and health IT: The quality elixir. Nursing Economic$, 29(5), 282, 286-289

    Huston, C. (2013). The impact of emerging technology on nursing care: Warp speed ahead. The online Journal of Issues in Nursing, 18(2)

     
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    Menard Tchatchou-Tchoubia

    Menard Tchatchou-Tchoubia

    Dec 2, 2022
    Dec 2, 2022 at 7:44am

    Manage Discussion Entry

    Discussion Response

     

     

     

     

    Menard Tchatchou

    Walden University

    NURS 6051 N

    Dr. Lynne Taylor

    12/02/2022

     

     

     

     

     

     

     

     

     

    Discussion Response

    Hi Mansong, after carefully reading your post, I came up with the following questions that need clarification.

    How did hospitals transition from paper charts to nursing informatics?

    How much training was needed for the transition from paper charts to nursing informatics?

    What challenges were faced during the transition from paper charts to nursing informatics?

    In case the book that contains information at the time of care was not available, what were the procedures to care for the patients?

    Did the transition from paper charts to nursing informatics lead to job losses or lower demand for nurses?

    What were some of the difficulties encountered during the transition to nursing informatics?

    What was the noticeable difference between the use of paper charts and nursing informatics?

    How has nursing informatics affected the treatment and care of patients, and in what way?

    How did you respond to the emergence of an unknown case during the paper chart era?

    How do you obtain records for a patient who visited a hospital that didn’t use the EPIC system, and what is the procedure?

    Who regulates and authorizes access to patient information to ensure patient confidentiality?

    In case of unavailability of data, what is the procedure for admission, diagnosis, medication, and care of the patient?

    How do you handle a case where the patient information captured in the system is incomplete and inaccurate?

    What is the procedure for determining which patients require treatment and which do not?

    In cases of misdiagnosis, how do you handle the patient’s treatment?

    Is the EPIC system friendly to the user?

    In the event of an EPIC system failure, how do you access information for patient care?

    In this, I would like to give an alternative. The alternative use of the nursing informatics principle can be used in ideas such as aligning nursing practices with workflow and care, helping reduce medical errors, helping formulate training and learning based on the data collected, improving the quality of medical protocols, policies, or procedures, and helping achieve continuity of care.

     

     

     
    Reply
    Reply to Comment

    Collapse Subdiscussion
    Guoming Feng

    Guoming Feng

    Dec 3, 2022
    Dec 3, 2022 at 10:59pm

    Manage Discussion Entry

    Hi Mansong,

    When we’re talking about nursing informatics, most of the time, we’re talking about data storage. Yes, electronic health records have significantly made our routine work more convenient. I haven’t worked in a healthcare setting with paper charting, so I didn’t know how a medical surgical unit was run, until recently when there was an unexpected power outage, the doctors were struggling to write paper orders, the nurses were struggling with where to find the doctors orders and where and how to chart, and all the professional struggling to communicating to each other without the EHRs.  But EHRs should not only store information but also support the delivery of better care. Rudin et al. (2020) point out that despite the widespread adoption of electronic health records (EHRs), healthcare in the United States remains low-value, and the expected improvement includes better clinical decisions, better triage decisions, better collaboration, and automation of tasks. I believe nursing informatics will continue to improve the quality of our nursing care.

     

    Rudin, R. S., Corporation, R. A. N. D., Friedberg, M. W., Blue Cross Blue Shield of Massachusetts, Shekelle, P., Shah, N., T.H. Harvard Chan School of Public Health, Bates, D. W., Hospital, B. and W., & Auerbach, A. (n.d.). 
    Getting value from electronic health records: Research needed to improve practice
    . Annals of Internal Medicine. Retrieved December 2, 2022, from https://www.acpjournals.org/doi/full/10.7326/M19-0878

    Submission and Grading Information

    Grading Criteria

    To access your rubric:

    Week 1 Discussion Rubric

    Post by Day 3 and Respond by Day 6 of Week 1

    To participate in this Discussion:

    Week 1 Discussion

    NURS_5051_Module01_Week01_Discussion_Rubric

    Grid View

    List View

    Excellent

    Good

    Fair

    Poor

    Main Posting

    45 
    (45%)
     – 50 
    (50%)

    Answers all parts of the discussion question(s) expectations with reflective critical analysis and synthesis of knowledge gained from the course readings for the module and current credible sources.

    Supported by at least three current, credible sources.

    Written clearly and concisely with no grammatical or spelling errors and fully adheres to current APA manual writing rules and style.

    40 
    (40%)
     – 44 
    (44%)

    Responds to the discussion question(s) and is reflective with critical analysis and synthesis of knowledge gained from the course readings for the module.

    At least 75% of post has exceptional depth and breadth.

    Supported by at least three credible sources.

    Written clearly and concisely with one or no grammatical or spelling errors and fully adheres to current APA manual writing rules and style.

    35 
    (35%)
     – 39 
    (39%)

    Responds to some of the discussion question(s).

    One or two criteria are not addressed or are superficially addressed.

    Is somewhat lacking reflection and critical analysis and synthesis.

    Somewhat represents knowledge gained from the course readings for the module.

    Post is cited with two credible sources.

    Written somewhat concisely; may contain more than two spelling or grammatical errors.

    Contains some APA formatting errors.

    0 
    (0%)
     – 34 
    (34%)

    Does not respond to the discussion question(s) adequately.

    Lacks depth or superficially addresses criteria.

    Lacks reflection and critical analysis and synthesis.

    Does not represent knowledge gained from the course readings for the module.

    Contains only one or no credible sources.

    Not written clearly or concisely.

    Contains more than two spelling or grammatical errors.

    Does not adhere to current APA manual writing rules and style.

    Main Post: Timeliness

    10 
    (10%)
     – 10 
    (10%)

    Posts main post by day 3.

    0 
    (0%)
     – 0 
    (0%)

    0 
    (0%)
     – 0 
    (0%)

    0 
    (0%)
     – 0 
    (0%)

    Does not post by day 3.

    First Response

    17 
    (17%)
     – 18 
    (18%)

    Response exhibits synthesis, critical thinking, and application to practice settings.

    Responds fully to questions posed by faculty.

    Provides clear, concise opinions and ideas that are supported by at least two scholarly sources.

    Demonstrates synthesis and understanding of learning objectives.

    Communication is professional and respectful to colleagues.

    Responses to faculty questions are fully answered, if posed.

    Response is effectively written in standard, edited English.

    15 
    (15%)
     – 16 
    (16%)

    Response exhibits critical thinking and application to practice settings.

    Communication is professional and respectful to colleagues.

    Responses to faculty questions are answered, if posed.

    Provides clear, concise opinions and ideas that are supported by two or more credible sources.

    Response is effectively written in standard, edited English.

    13 
    (13%)
     – 14 
    (14%)

    Response is on topic and may have some depth.

    Responses posted in the discussion may lack effective professional communication.

    Responses to faculty questions are somewhat answered, if posed.

    Response may lack clear, concise opinions and ideas, and a few or no credible sources are cited.

    0 
    (0%)
     – 12 
    (12%)

    Response may not be on topic and lacks depth.

    Responses posted in the discussion lack effective professional communication.

    Responses to faculty questions are missing.

    No credible sources are cited.

    Second Response

    16 
    (16%)
     – 17 
    (17%)

    Response exhibits synthesis, critical thinking, and application to practice settings.

    Responds fully to questions posed by faculty.

    Provides clear, concise opinions and ideas that are supported by at least two scholarly sources.

    Demonstrates synthesis and understanding of learning objectives.

    Communication is professional and respectful to colleagues.

    Responses to faculty questions are fully answered, if posed.

    Response is effectively written in standard, edited English.

    14 
    (14%)
     – 15 
    (15%)

    Response exhibits critical thinking and application to practice settings.

    Communication is professional and respectful to colleagues.

    Responses to faculty questions are answered, if posed.

    Provides clear, concise opinions and ideas that are supported by two or more credible sources.

    Response is effectively written in standard, edited English.

    12 
    (12%)
     – 13 
    (13%)

    Response is on topic and may have some depth.

    Responses posted in the discussion may lack effective professional communication.

    Responses to faculty questions are somewhat answered, if posed.

    Response may lack clear, concise opinions and ideas, and a few or no credible sources are cited.

    0 
    (0%)
     – 11 
    (11%)

    Response may not be on topic and lacks depth.

    Responses posted in the discussion lack effective professional communication.

    Responses to faculty questions are missing.

    No credible sources are cited.

    Participation

    5 
    (5%)
     – 5 
    (5%)

    Meets requirements for participation by posting on three different days.

    0 
    (0%)
     – 0 
    (0%)

    0 
    (0%)
     – 0 
    (0%)

    0 
    (0%)
     – 0 
    (0%)

    Does not meet requirements for participation by posting on 3 different days.

    Total Points: 100

    Discussion: The Application of Data to Problem-Solving

    In the modern era, there are few professions that do not to some extent rely on data. Stockbrokers rely on market data to advise clients on financial matters. Meteorologists rely on weather data to forecast weather conditions, while realtors rely on data to advise on the purchase and sale of property. In these and other cases, data not only helps solve problems, but adds to the practitioner’s and the discipline’s body of knowledge.

    Of course, the nursing profession also relies heavily on data. The field of nursing informatics aims to make sure nurses have access to the appropriate date to solve healthcare problems, make decisions in the interest of patients, and add to knowledge.

    In this Discussion, you will consider a scenario that would benefit from access to data and how such access could facilitate both problem-solving and knowledge formation.

    To Prepare:

    Reflect on the concepts of informatics and knowledge work as presented in the Resources.

    Consider a hypothetical scenario based on your own healthcare practice or organization that would require or benefit from the access/collection and application of data. Your scenario may involve a patient, staff, or management problem or gap.

    By Day 3 of Week 1

    Post
     a description of the focus of your scenario. Describe the data that could be used and how the data might be collected and accessed. What knowledge might be derived from that data? How would a nurse leader use clinical reasoning and judgment in the formation of knowledge from this experience?

    By Day 6 of Week 1

    Respond
     to at least 
    two
     of your colleagues
    * on two different days
    , asking questions to help clarify the scenario and application of data, or offering additional/alternative ideas for the application of nursing informatics principles.

    *Note:
     Throughout this program, your fellow students are referred to as colleagues.

    Submission and Grading Information

  • routine shaving of the surgical site

    For this assessment, you will select a nursing admission/assessment or patient care/preparation process or procedure (e.g., routine shaving of the surgical site) that is commonly found in your practice setting that you and your colleagues question. You will gather evidence to determine the basis for this process or procedure, provide suggestions based on evidence on how this process or procedure should be changed, and determine possible barriers to implementation of a revised clinical practice guideline.

    Requirements:

    A. Describe a nursing admission/assessment or patient care/preparation process or procedure currently found in your practice setting.

    Note: You must choose a process or procedure that was already in place and you can recommend changes to.

    1. Discuss why the present process or procedure needs to be changed, based on the evidence you have gathered.

    2. Based on your initial investigation of the situation, do the following:

    Note: You may need to ask workplace personnel to complete the following.

    a. Explain who determined the basis for the current process or procedure in your practice setting.

    b. Explain the decision makers’ rationale for instituting or supporting the current process or procedure.

    c. Explain why the decision makers decided to implement the current process or procedure.

    3. Recommend a practice change for the process or procedure you selected.

    a. List five relevant and credible sources to support your suggested practice change.

    Note: Credible sources are less than five years old and may include professional journals, research reports, professional websites, governmental reports, current texts less than five years old, and presentations from professional meetings.

    4. Explain the clinical implications your recommended change might have on patients, based on the relevant and credible sources you listed in part A3a.

    5. Explain the implications your recommended change might have on the practice setting, based on the relevant and credible sources you listed in part A3a.

    6. Discuss how you would involve key stakeholders in the decision to change the process or procedure or to comply with the recommended change.

    B. Write an essay (suggested length of 2–3 pages) in which you do the following:

    1. Discuss the specific barriers you may encounter in applying research to processes and procedures in your practice setting.

    Note: You should distinguish between difficulties you would have interpreting what the research says and synthesizing it into a practice guideline or procedure, rather than just the outside barriers to change.

    2. Identify at least two strategies that you and your team could use to overcome the barriers you discussed in part B1.

    3. Explain how you would implement your recommended process or procedure based on research findings.

    C. When you use sources, include all in-text citations and references in APA format.

    Note: For definitions of terms commonly used in the rubric, see the Rubric Terms web link included in the Evaluation Procedures section.

    Note: When using sources to support ideas and elements in an assessment, the submission MUST include APA formatted in-text citations with a corresponding reference list for any direct quotes or paraphrasing. It is not necessary to list sources that were consulted if they have not been quoted or paraphrased in the text of the assessment.

    Note: No more than a combined total of 30% of a submission can be directly quoted or closely paraphrased from outside sources, even if cited correctly. For tips on using APA style, please refer to the APA Handout web link included in the APA Guidelines section

  • Keirsey Temperament personality test

    For this assessment, you will navigate areas of focus that include professional presence, mindfulness practice, and healing environments. These areas of focus will help you to create a professional presence plan that has both personal and professional application. You will be analyzing your inner world (thoughts, beliefs, and values) and your outer world (activities, relationships, and experiences). Each section of this assessment will gauge how you use and interact with those two worlds. To aid you in understanding your inner and outer worlds, you will take the Keirsey Temperament Sorter-II, an online personality test. With the test’s results, you will better understand your strengths and weaknesses and how you can be an effective individual and leader. Authentic leadership requires as much care and understanding for yourself as for those you will serve and lead. Your professional presence plan will integrate your insights, goals, and beliefs into a coherent whole.

    Requirements:

    Note: Be sure to cover each prompt in sufficient detail and support.

    A. Professional Presence

    1. Discuss with substantial details the differences between two models of health and healing (e.g., physical body, body-mind, body-mind-spirit/bio-psycho-social,) as they relate to what it means to be human.

    2. Provide plausible analysis, with substantial support, of the differences between one of the models discussed in part A1 and your professional presence (i.e., current beliefs, attitudes, and actions regarding health and healing).

    3. Provide logical discussion with details of how your professional presence (mindful or distracted) influences your nursing practice.

    B. Personality Preferences

    1. Submit your results from the Keirsey Temperament personality test.

    (myKeirsey Temperament personality test result indicate that my personality type is that of: Guardian).

    For questions 2a and 2b: Please go to Keirsey.com, and under 4 temperaments, read on “Guardian” to help with questions 2a, 2b.

    2a. Provide plausible analysis with substantial details of your test results, including areas that may or may not align with how you view yourself.

    b. Evaluate how the preferences identified by the test align with your relationships, favorite activities, and career choices.

    c. Discuss two potential challenges or barriers (e.g., barriers in communication, decision-making) that could be minimized by your enhanced self-awareness when working with opposite personality types.

    C. Mindfulness Practice

    1. Develop a mindfulness practice plan consistent with your interests, goals, and beliefs by doing the following:

    a. Create two specific goals for each of the four Aspects of your whole person (physical, vital/rhythmic, mental/emotional, and biographical/spiritual body) to maintain balance.

    b. Discuss how you will achieve each of the goals created in part C1a, including how you will adjust to the changing of your whole person.

    D. Healing Environments

    1. Analyze two optimal healing environments in healthcare to identify the common elements of internal, interpersonal, behavioral, and external environments.

    2. Discuss how you intend to apply self-awareness and insights gained from part D1 to promote professional presence in your current healthcare setting.

    E. When you use sources, include all in-text citations and references in APA format.

    Note: When using sources to support ideas and elements in a performance assessment, the submission MUST include APA formatted in-text citations with a corresponding reference list for any direct quotes or paraphrasing. It is not necessary to list sources that were consulted if they have not been quoted or paraphrased in the text of the performance assessment.

    Note: No more than a combined total of 30% of a submission can be directly quoted or closely paraphrased from outside sources, even if cited correctly.

  • Mr. and Mrs. Newcomb

    Ethical Principle Application Nursing Assignment Paper

    Scenario:

    You have been working as a nurse in the adult oncology unit for the past year. You have developed a close relationship with many of your patients, but Mr. Newcomb has a special place in your heart. He has been diagnosed with stage 4 pancreatic cancer and has undergone aggressive chemotherapy. Each day his wife has come to the unit to be with her husband. They have been married for over 40 years and share a deep love. Ethical Principle Application Nursing Assignment Paper

    Mr. and Mrs. Newcomb have made the decision to no longer continue with treatment and have decided that hospice care is needed. Over the past few days, you have watched Mr. Newcomb’s health decline, and you can tell from your experience that he does not have much time left to live. Mr. Newcomb has been very open about discussing his death, and you have had the opportunity to learn about his life and the legacy he will leave behind.Ethical Principle Application Nursing Assignment Paper

    While you are completing your rounds, you stop in Mr. Newcomb’s room to see how he is doing. You ask, “Is there anything else I can do for you?” Mr. Newcomb has rarely asked for anything, but today he has one request. Mr. Newcomb states, “Before I die, I would like to see my mistress one more time. Mrs. Newcomb is always here. Do you think you could tell her that I will be busy for a few hours tomorrow so I can make arrangements to see my mistress one more time?”

    Reflect on the following questions before you begin working on this task:

    ●   What would you do in this scenario?

    ●   How can your knowledge of ethical principles be utilized to determine your response to Mr. Newcomb?

    ●   How would this affect you as a nurse and direct provider of care for Mr. Newcomb?Ethical Principle Application Nursing Assignment Paper

    Requirements:

    Your submission must be your original work. No more than a combined total of 30% of the submission and no more than a 10% match to any one individual source can be directly quoted or closely paraphrased from sources, even if cited correctly. Use the Turnitin Originality Report available in Taskstream as a guide for this measure of originality.

    You must use the rubric to direct the creation of your submission because it provides detailed criteria that will be used to evaluate your work. Each requirement below may be evaluated by more than one rubric aspect. The rubric aspect titles may contain hyperlinks to relevant portions of the course.

    A.  Summarize how the principles of beneficence, non-maleficence, autonomy, and justice apply to the scenario by doing the following:

    1.  Describe how you would respond to Mr. Newcomb’s request.

    2.  Evaluate how you applied the principles of beneficence, non-maleficence, autonomy, and justice to the scenario.

    3.  Examine how personal beliefs and values influenced your response to the scenario.Ethical Principle Application Nursing Assignment Paper

    4.  Describe 
    three
     strategies to promote self-care.

    B.  Acknowledge sources, using in-text citations and references, for content that is quoted, paraphrased, or summarized.

    C.  Demonstrate professional communication in the content and presentation of your submission.Ethical Principle Application Nursing Assignment Paper

  • r. J is a 72-year-old retired rabbi with a diagnosis of mild dementia

    734.3.1: Principles of Leadership – The graduate applies principles of leadership to promote high-quality healthcare in a variety of settings through the application of sound leadership principles.

    734.3.2: Interdisciplinary Collaboration – The graduate applies theoretical principles necessary for effective participation in an interdisciplinary team.

    734.3.3: Quality and Patient Safety – The graduate applies quality improvement processes intended to achieve optimal healthcare outcomes, contributing to and supporting a culture of safety.

    734.3.4: Healthcare Utilization and Finance – The graduate analyzes financial implications related to healthcare delivery, reimbursement, access, and national initiatives.

    Introduction:

    National initiatives driven by the American Nurses Association have determined nursing-sensitive outcome indicators that are intended to focus plans and programs to increase quality and safety in patient care. The following outcomes are commonly used nursing-sensitive indicators:

    � Complications such as urinary tract infections, pressure ulcers, hospital acquired pneumonia, and DVT

    � Patient falls

    � Surgical patient complications, including infection, pulmonary failure, and metabolic derangement

    � Length of patient hospital stay

    � Restraint prevalence

    � Incidence of failure to rescue, which could potentially result in increased morbidity or mortality

    � Patient satisfaction

    � Nurse satisfaction and staffing

    Scenario:

    Mr. J is a 72-year-old retired rabbi with a diagnosis of mild dementia. He was admitted for treatment of a fractured right hip after falling in his home. He has received pain medication and is drowsy, but he answers simple questions appropriately.

    A week after Mr. J was admitted to the hospital, his daughter, who lives eight hours away, came to visit. She found him restrained in bed. While Mr. J was slightly sleepy, he recognized his daughter and was able to ask her to remove the restraints so he could be helped to the bathroom. His daughter went to get a certified nursing assistant (CNA) to remove the restraints and help her father to the bathroom. When the CNA was in the process of helping Mr. J sit up in bed, his daughter noticed a red, depressed area over Mr. J�s lower spine, similar to a severe sunburn. She reported the incident to the CNA who replied, �Oh, that is not anything to worry about. It will go away as soon as he gets up.� The CNA helped Mr. J to the bathroom and then returned him to bed where she had him lie on his back so she could reapply the restraints.

    The diet order for Mr. J was �regular, kosher, chopped meat.� The day after his daughter arrived, Mr. J was alone in his room when his meal tray was delivered. The nurse entered the room 30 minutes later and observed that Mr. J had eaten approximately 75% of the meal. The meal served was labeled, �regular, chopped meat.� The tray contained the remains of a chopped pork cutlet.

    The nurse notified the supervisor, who said, �Just keep it quiet. It will be okay.� The nursing supervisor then notified the kitchen supervisor of the error. The kitchen supervisor told the staff on duty what had happened.

    When the patient�s daughter visited later that night, she was not told of the incident.

    The next night, the daughter was present at suppertime when the tray was delivered by a dietary worker. The worker said to the patient�s daughter, �I�m so sorry about the pork cutlet last night.� The daughter asked what had happened and was told that there had been �a mix up in the order.� The daughter then asked the nurse about the incident. The nurse, while confirming the incident, told the daughter, �Half a pork cutlet never killed anyone.�

    The daughter then called the physician, who called the hospital administrator. The physician, who is also Jewish, told the administrator that he has had several complaints over the past six months from his hospitalized Jewish patients who felt that their dietary requests were not taken seriously by the hospital employees.

    The hospital is a 65-bed rural hospital in a town of few Jewish residents. The town�s few Jewish members usually receive care from a Jewish hospital 20 miles away in a larger city.

    Task:

    Analyze the scenario (suggested length of 2�3 pages) by doing the following:

    A. Discuss how an understanding of nursing-sensitive indicators could assist the nurses in this case in identifying issues that may interfere with patient care.

    B. Analyze how hospital data on specific nursing-sensitive indicators (such as incidence of pressure ulcers and prevalence of restraints) could advance quality patient care throughout the hospital.

    C. Analyze the specific system resources, referrals, or colleagues that you, as the nursing shift supervisor, could use to resolve the ethical issue in this scenario.

    D. When you use sources to support ideas and elements in a paper or project, provide acknowledgement of source information for any content that is quoted, paraphrased or summarized. Acknowledgement of source information includes in-text citation noting specifically where in the submission the source is used and a corresponding reference, which includes:

    � Author

    � Date

    � Title

    � Location of information (e.g., publisher, journal, or website URL)

  • NURS 6521: Advanced Pharmacology Discussions, Assignments and Exams

    Week 1: Basic Pharmacotherapeutic Concepts/Ethical and Legal Aspects of Prescribing

    How do beta-blockers work? What exactly do antibiotics do to the bacteria they target? What effects does an anti-depressant have on blood flow?

    Questions like these are related to the underlying pharmacokinetic and pharmacodynamic processes of pharmacotherapeutics. As an advanced practice nurse, understanding these fundamental pharmacotherapeutic concepts is important to ensure that the prescription drugs you recommend for your patients will be safe and effective to treat and/or manage their symptoms. Additionally, as the advanced practice nurse, it is your responsibility to ensure that when prescribing prescription drugs, you adhere to the ethical and legal principles set forth for prescribing drugs as an added layer of protection and safety for the patients you will treat.

    This week, you will analyze factors that may influence pharmacokinetic and pharmacodynamics processes of a patient and assess the details of a personalized plan of care that you develop based on influencing factors and patient history. You will also evaluate and analyze ethical and legal implications and practices related to prescribing drugs, including disclosure and nondisclosure, and analyze the process of writing prescriptions to avoid medication errors.

    Learning Objectives

    Students will:

    Analyze factors that influence pharmacokinetic and pharmacodynamic processes in patients

    Assess patient factors and history to develop personalized plans of care

    Evaluate ethical and legal implications related to prescribing drugs

    Analyze ethical and legal practices of prescribing drugs

    Analyze strategies to address disclosure and nondisclosure

    Justify advanced practice nurse strategies to guide prescription drug decision-making

    Analyze the process of writing prescriptions to avoid medication errors

    Learning Resources

    Required Readings
     (click to expand/reduce)

    Required Media
     (click to expand/reduce)

    Discussion: Pharmacokinetics and Pharmacodynamics

    As an advanced practice nurse assisting physicians in the diagnosis and treatment of disorders, it is important to not only understand the impact of disorders on the body, but also the impact of drug treatments on the body. The relationships between drugs and the body can be described by pharmacokinetics and pharmacodynamics.

    Pharmacokinetics describes what the body does to the drug through absorption, distribution, metabolism, and excretion, whereas pharmacodynamics describes what the drug does to the body.

    Photo Credit: Getty Images/Ingram Publishing

    When selecting drugs and determining dosages for patients, it is essential to consider individual patient factors that might impact the patient’s pharmacokinetic and pharmacodynamic processes. These patient factors include genetics, gender, ethnicity, age, behavior (i.e., diet, nutrition, smoking, alcohol, illicit drug abuse), and/or pathophysiological changes due to disease.

    For this Discussion, you reflect on a case from your past clinical experiences and consider how a patient’s pharmacokinetic and pharmacodynamic processes may alter his or her response to a drug.

    To Prepare

    Review the Resources for this module and consider the principles of pharmacokinetics and pharmacodynamics.

    Reflect on your experiences, observations, and/or clinical practices from the last 5 years and think about how pharmacokinetic and pharmacodynamic factors altered his or her anticipated response to a drug.

    Consider factors that might have influenced the patient’s pharmacokinetic and pharmacodynamic processes, such as genetics (including pharmacogenetics), gender, ethnicity, age, behavior, and/or possible pathophysiological changes due to disease.

    Think about a personalized plan of care based on these influencing factors and patient history in your case study.

    By Day 3 of Week 1

    Post
     a description of the patient case from your experiences, observations, and/or clinical practice from the last 5 years. Then, describe factors that might have influenced pharmacokinetic and pharmacodynamic processes of the patient you identified. Finally, explain details of the personalized plan of care that you would develop based on influencing factors and patient history in your case. Be specific and provide examples.

    By Day 6 of Week 1

    Read
     a selection of your colleagues’ responses and 
    respond
     to 
    at least two
     of your colleagues on 
    two different days
     by suggesting additional patient factors that might have interfered with the pharmacokinetic and pharmacodynamic processes of the patients they described. In addition, suggest how the personalized plan of care might change if the age of the patient were different and/or if the patient had a comorbid condition, such as renal failure, heart failure, or liver failure.

    Note:
     For this Discussion, you are required to complete your initial post before you will be able to view and respond to your colleagues’ postings. Begin by clicking on the “Post to Discussion Question” link, and then select “Create Thread” to complete your initial post. Remember, once you click on Submit, you cannot delete or edit your own posts, and you cannot post anonymously. Please check your post carefully before clicking on 
    Submit!

    Submission and Grading Information

    Grading Criteria

    To access your rubric:

    Week 1 Discussion Rubric

    Post by Day 3 of Week 1 and Respond by Day 6 of Week 1

    To Participate in this Discussion:

    Week 1 Discussion

    Assignment: Ethical and Legal Implications of Prescribing Drugs

    What type of drug should you prescribe based on your patient’s diagnosis? How much of the drug should the patient receive? How often should the drug be administered? When should the drug not be prescribed? Are there individual patient factors that could create complications when taking the drug? Should 
    you
     be prescribing drugs to 
    this 
    patient? How might different state regulations affect the prescribing of this drug to this patient?

    These are some of the questions you might consider when selecting a treatment plan for a patient.

    Photo Credit: Getty Images/Caiaimage

    As an advanced practice nurse prescribing drugs, you are held accountable for people’s lives every day. Patients and their families will often place trust in you because of your position. With this trust comes power and responsibility, as well as an ethical and legal obligation to “do no harm.” It is important that you are aware of current professional, legal, and ethical standards for advanced practice nurses with prescriptive authority. Additionally, it is important to ensure that the treatment plans and administration/prescribing of drugs is in accordance with the regulations of the state in which you practice. Understanding how these regulations may affect the prescribing of certain drugs in different states may have a significant impact on your patient’s treatment plan. In this Assignment, you explore ethical and legal implications of scenarios and consider how to appropriately respond.

    To Prepare

    Review the Resources for this module and consider the legal and ethical implications of prescribing prescription drugs, disclosure, and nondisclosure.

    Review the scenario assigned by your Instructor for this Assignment.

    Search specific laws and standards for prescribing prescription drugs and for addressing medication errors for your state or region, and reflect on these as you review the scenario assigned by your Instructor.

    Consider the ethical and legal implications of the scenario for all stakeholders involved, such as the prescriber, pharmacist, patient, and patient’s family.

    Think about two strategies that you, as an advanced practice nurse, would use to guide your ethically and legally responsible decision-making in this scenario, including whether you would disclose any medication errors.

    By Day 7 of Week 1

    Write a 2- to 3-page paper that addresses the following:

    Explain the ethical and legal implications of the scenario you selected on all stakeholders involved, such as the prescriber, pharmacist, patient, and patient’s family.

    Describe strategies to address disclosure and nondisclosure as identified in the scenario you selected. Be sure to reference laws specific to your state.

    Explain two strategies that you, as an advanced practice nurse, would use to guide your decision making in this scenario, including whether you would disclose your error. Be sure to justify your explanation.

    Explain the process of writing prescriptions, including strategies to minimize medication errors.

    Reminder:
     The College of Nursing requires that all papers submitted include a title page, introduction, summary, and references. The College of Nursing Writing Template with Instructions provided at the Walden Writing Center offers an example of those required elements (available at 
    https://academicguides.waldenu.edu/writingcenter/templates/general#s-lg-box-20293632
    ). All papers submitted must use this formatting.

    Submission and Grading Information

    To submit your completed Assignment for review and grading, do the following:

    Please save your Assignment using the naming convention “WK1Assgn+last name+first initial.(extension)” as the name.

    Click the 
    Week 1 Assignment Rubric 
    to review the Grading Criteria for the Assignment.

    Click the 
    Week 1 Assignment 
    link. You will also be able to “View Rubric” for grading criteria from this area.

    Next, from the Attach File area, click on the 
    Browse My Computer
     button. Find the document you saved as “WK1Assgn+last name+first initial.(extension)” and click 
    Open
    .

    If applicable: From the Plagiarism Tools area, click the checkbox for 
    I agree to submit my paper(s) to the Global Reference Database
    .

    Click on the 
    Submit
     button to complete your submission.

    Grading Criteria

    To access your rubric:

    Week 1 Assignment Rubric

    Check Your Assignment Draft for Authenticity

    To check your Assignment draft for authenticity:

    Submit your Week 1 Assignment draft and review the originality report.

    Submit Your Assignment by Day 7 of Week 1

    To participate in this Assignment:

    Week 1 Assignment

    What’s Coming Up in Module 2?

    Photo Credit: [BrianAJackson]/[iStock / Getty Images Plus]/Getty Images

    In the next module,
     you will examine the impact of changes in pharmacokinetic and pharmacodynamic processes on patient drug therapy for cardiovascular disorders and the types of drugs prescribed to patients with respiratory disorders.

    Looking Ahead: Week 2 Assignment

    In Week 2, your Instructor will assign you a case study related to Assignment 1 by Day 1 of the week. Please make sure to review the “Course Announcements” area of the course to verify your assigned case study. Please plan ahead to ensure you have time to review your case study and Learning Resources in order to complete your Assignment on time.

    Photo Credit: Getty Images/iStockphoto

    Next Week

    To go to the next week:

    Week 2: Cardiovascular System

    Alterations of the cardiovascular system can cause serious adverse events and may lead to death when not treated in a timely and safe manner. Unfortunately, many patients with cardiovascular disorders are unaware until complications appear. In clinical settings, patients often present with symptoms of several cardiovascular disorders, making it essential for you, as the advanced practice nurse, to be able to recognize these symptoms and recommend appropriate drug treatment options.

    This week, you examine the impact of patient factors that may lead to changes in pharmacokinetic and pharmacodynamic processes on patient drug therapy for cardiovascular disorders. You also explore ways to improve drug therapy plans for cardiovascular disorders based on patient factors and overall health needs.

    Learning Objectives

    Students will:

    Analyze the influence of patient factors on pharmacokinetic and pharmacodynamic processes

    Analyze the impact of changes in pharmacokinetic and pharmacodynamic processes on patient drug therapies

    Evaluate drug therapy plans for cardiovascular disorders

    Learning Resources

    Required Readings
     (click to expand/reduce)

    Required Media
     (click to expand/reduce)

    Assignment: Pharmacotherapy for Cardiovascular Disorders

    …heart disease remains the No. 1 killer in America; nearly half of all Americans have high blood pressure, high cholesterol, or smoke—some of the leading risk factors for heart disease…

    —Murphy et al., 2018

    Despite the high mortality rates associated with cardiovascular disorders, improved treatment options do exist that can help address those risk factors that afflict the majority of the population today.

    Photo Credit: Getty Images/Science Photo Library RF

    As an advanced practice nurse, it is your responsibility to recommend appropriate treatment options for patients with cardiovascular disorders. To ensure the safety and effectiveness of drug therapy, advanced practice nurses must consider aspects that might influence pharmacokinetic and pharmacodynamic processes such as medical history, other drugs currently prescribed, and individual patient factors.

    Reference: Murphy, S. L., Xu, J., Kochanek, K. D., & Arias, E. (2018). Mortality in the United States, 2017. Retrieved from https://www.cdc.gov/nchs/products/databriefs/db328.htm

    To Prepare

    Review the Resources for this module and consider the impact of potential pharmacotherapeutics for cardiovascular disorders introduced in the media piece.

    Review the case study assigned by your Instructor for this Assignment.

    Select one the following factors: genetics, gender, ethnicity, age, or behavior factors.

    Reflect on how the factor you selected might influence the patient’s pharmacokinetic and pharmacodynamic processes.

    Consider how changes in the pharmacokinetic and pharmacodynamic processes might impact the patient’s recommended drug therapy.

    Think about how you might improve the patient’s drug therapy plan based on the pharmacokinetic and pharmacodynamic changes. Reflect on whether you would modify the current drug treatment or provide an alternative treatment option for the patient.

    By Day 7 of Week 2

    Write
     a 2- to 3-page paper that addresses the following:

    Explain how the factor you selected might influence the pharmacokinetic and pharmacodynamic processes in the patient from the case study you were assigned.

    Describe how changes in the processes might impact the patient’s recommended drug therapy. Be specific and provide examples.

    Explain how you might improve the patient’s drug therapy plan and explain why you would make these recommended improvements.

    Reminder:
     The College of Nursing requires that all papers submitted include a title page, introduction, summary, and references. The College of Nursing Writing Template with Instructions provided at the Walden Writing Center offers an example of those required elements (available at https://academicguides.waldenu.edu/writingcenter/templates/general#s-lg-box-20293632). All papers submitted must use this formatting.

    Submission and Grading Information

    To submit your completed Assignment for review and grading, do the following:

    Please save your Assignment using the naming convention “WK2Assgn+last name+first initial.(extension)” as the name.

    Click the 
    Week 2 Assignment Rubric 
    to review the Grading Criteria for the Assignment.

    Click the 
    Week 2 Assignment 
    link. You will also be able to “View Rubric” for grading criteria from this area.

    Next, from the Attach File area, click on the 
    Browse My Computer
     button. Find the document you saved as “WK2Assgn+last name+first initial.(extension)” and click 
    Open
    .

    If applicable: From the Plagiarism Tools area, click the checkbox for 
    I agree to submit my paper(s) to the Global Reference Database
    .

    Click on the 
    Submit
     button to complete your submission.

    Grading Criteria

    To access your rubric:

    Week 2 Assignment Rubric

    Check Your Assignment Draft for Authenticity

    To check your Assignment draft for authenticity:

    Submit your Week 2 Assignment draft and review the originality report.

    Submit Your Assignment by Day 7 of Week 2

    To participate in this Assignment:

    Week 2 Assignment

    What’s Coming Up in Week 3?

    Photo Credit: [BrianAJackson]/[iStock / Getty Images Plus]/Getty Images

    Next week,
     you will examine strategies for the treatment and management of respiratory disorders, including asthma. You will analyze asthma and stepwise management and consider the impact of this approach for patient health.

    Next Week

    To go to the next week:

    Week 3: Respiratory System

    Asthma and chronic obstructive pulmonary disease (COPD) are significant public health burdens. Currently, more than 25 million people in the United States have asthma (HealthyPeople.gov, 2019). As an advanced practice nurse, you will likely encounter patients who will present with respiratory disorders, including asthma or COPD. Understanding specific treatment protocols as well as the types of pharmacotherapeutics used to treat respiratory disorders is important to ensure the effective and safe delivery of advanced nursing practice.

    This week, you will evaluate drug therapy plans for patients who present with asthma and analyze the stepwise approach to asthma treatment and management from a patient in your professional practice.

    Reference: HealthyPeople.gov. (2019). Respiratory diseases. Retrieved from 
    https://www.healthypeople.gov/2020/topics-objectives/topic/respiratory-diseases

    Learning Objectives

    Students will:

    Evaluate drug therapy plans for asthma

    Assess the impact of asthma treatments on patients

    Analyze the stepwise approach to asthma treatment and management

    Learning Resources

    Required Readings
     (click to expand/reduce)

    Optional Resources
     (click to expand/reduce)

    Assignment: Asthma and Stepwise Management

    Asthma is a respiratory disorder that affects children and adults. Advanced practice nurses often provide treatment to patients with these disorders. Sometimes patients require immediate treatment, making it essential that you recognize and distinguish minor asthma symptoms from serious, life-threatening ones. Since symptoms and attacks are often induced by a trigger, advanced practice nurses must also help patients identify their triggers and recommend appropriate management options. Like many other disorders, there are various approaches to treating and managing care for asthmatic patients depending on individual patient factors.

    Photo Credit: Getty Images

    One method that supports the clinical decision making of drug therapy plans for asthmatic patients is the stepwise approach, which you explore in this Assignment.

    To Prepare

    Reflect on drugs used to treat asthmatic patients, including long-term control and quick relief treatment options for patients. Think about the impact these drugs might have on patients, including adults and children.

    Consider how you might apply the stepwise approach to address the health needs of a patient in your practice.

    Reflect on how stepwise management assists health care providers and patients in gaining and maintaining control of the disease.

    By Day 7 of Week 3

    Create
     a 5- to 6-slide PowerPoint presentation that can be used in a staff development meeting on presenting different approaches for implementing the stepwise approach for asthma treatment. Be sure to address the following:

    Describe long-term control and quick relief treatment options for the asthma patient from your practice as well as the impact these drugs might have on your patient.

    Explain the stepwise approach to asthma treatment and management for your patient.

    Explain how stepwise management assists health care providers and patients in gaining and maintaining control of the disease. Be specific.

    Submission and Grading Information

    To submit your completed Assignment for review and grading, do the following:

    Please save your Assignment using the naming convention “WK3Assgn+last name+first initial.(extension)” as the name.

    Click the 
    Week 3 Assignment Rubric 
    to review the Grading Criteria for the Assignment.

    Click the 
    Week 3 Assignment 
    link. You will also be able to “View Rubric” for grading criteria from this area.

    Next, from the Attach File area, click on the 
    Browse My Computer
     button. Find the document you saved as “WK3Assgn+last name+first initial.(extension)” and click 
    Open
    .

    If applicable: From the Plagiarism Tools area, click the checkbox for 
    I agree to submit my paper(s) to the Global Reference Database
    .

    Click on the 
    Submit
     button to complete your submission.

    NOTE:
     SafeAssign does not accept files over 10MB in size. Please attempt to keep your files under 10MB.

    Grading Criteria

    To access your rubric:

    Week 3 Assignment Rubric

    Check Your Assignment Draft for Authenticity

    To check your Assignment draft for authenticity:

    Submit your Week 3 Assignment draft and review the originality report.

    Submit Your Assignment by Day 7 of Week 3

    To participate in this Assignment:

    Week 3 Assignment

    What’s Coming Up in Module 3?

    Photo Credit: [BrianAJackson]/[iStock / Getty Images Plus]/Getty Images

    In the next module, 
    you will examine diagnoses for patients with potential GI and hepatobiliary disorders. You will also develop a drug therapy plan based on patient history and diagnosis.

    Next Week

    To go to the next week:

    Week 4: Gastrointestinal and Hepatobiliary Disorders

    As an advanced practice nurse, you will likely encounter patients who will present with symptoms affecting the gastrointestinal (GI) tract. Of special note, is the consideration that most symptoms concerning the GI tract are non-specific and therefore, diagnosing diagnoses of the GI tract require thoughtful and careful investigation. Similarly, hepatobiliary disorders may also mirror many of the signs and symptoms that patients present when suffering from GI disorders.

    How might you tease out the specific signs and symptoms between these potential disorders and body systems? What drug therapy plans will best address these disorders for your patients?

    This week, you examine GI and hepatobiliary disorders. You will review a patient case study and consider those factors in recommending and prescribing a drug therapy plan fo your patient.

    Learning Objectives

    Students will:

    Evaluate diagnoses for patients with gastrointestinal and hepatobiliary disorders

    Justify drug therapy plans based on patient history and diagnosis

    Learning Resources

    Required Readings
     (click to expand/reduce)

    Assignment: Pharmacotherapy for Gastrointestinal and Hepatobiliary Disorders

    Photo Credit: Getty Images/iStockphoto

    Gastrointestinal (GI) and hepatobiliary disorders affect the structure and function of the GI tract. Many of these disorders often have similar symptoms, such as abdominal pain, cramping, constipation, nausea, bloating, and fatigue. Since multiple disorders can be tied to the same symptoms, it is important for advanced practice nurses to carefully evaluate patients and prescribe a treatment that targets the cause rather than the symptom.

    Once the underlying cause is identified, an appropriate drug therapy plan can be recommended based on medical history and individual patient factors. In this Assignment, you examine a case study of a patient who presents with symptoms of a possible GI/hepatobiliary disorder, and you design an appropriate drug therapy plan.

    To Prepare

    Review the case study assigned by your Instructor for this Assignment

    Reflect on the patient’s symptoms, medical history, and drugs currently prescribed.

    Think about a possible diagnosis for the patient. Consider whether the patient has a disorder related to the gastrointestinal and hepatobiliary system or whether the symptoms are the result of a disorder from another system or other factors, such as pregnancy, drugs, or a psychological disorder.

    Consider an appropriate drug therapy plan based on the patient’s history, diagnosis, and drugs currently prescribed.

    By Day 7 of Week 4

    Write
     a 1-page paper that addresses the following:

    Explain your diagnosis for the patient, including your rationale for the diagnosis.

    Describe an appropriate drug therapy plan based on the patient’s history, diagnosis, and drugs currently prescribed.

    Justify why you would recommend this drug therapy plan for this patient. Be specific and provide examples.

    Reminder:
     The College of Nursing requires that all papers submitted include a title page, introduction, summary, and references. The Sample Paper provided at the Walden Writing Center offers an example of those required elements (available at 
    http://writingcenter.waldenu.edu/57.htm
    ). All papers submitted must use this formatting.

    Submission and Grading Information

    To submit your completed Assignment for review and grading, do the following:

    Please save your Assignment using the naming convention “WK4Assgn+last name+first initial.(extension)” as the name.

    Click the 
    Week 4 Assignment Rubric 
    to review the Grading Criteria for the Assignment.

    Click the 
    Week 4 Assignment 
    link. You will also be able to “View Rubric” for grading criteria from this area.

    Next, from the Attach File area, click on the 
    Browse My Computer
     button. Find the document you saved as “WK4Assgn+last name+first initial.(extension)” and click 
    Open
    .

    If applicable: From the Plagiarism Tools area, click the checkbox for 
    I agree to submit my paper(s) to the Global Reference Database
    .

    Click on the 
    Submit
     button to complete your submission.

    Grading Criteria

    To access your rubric:

    Week 4 Assignment Rubric

    Check Your Assignment Draft for Authenticity

    To check your Assignment draft for authenticity:

    Submit your Week 4 Assignment draft and review the originality report.

    Submit Your Assignment by Day 7 of Week 4

    To participate in this Assignment:

    Week 4 Assignment

    What’s Coming Up in Module 4?

    Photo Credit: [BrianAJackson]/[iStock / Getty Images Plus]/Getty Images

    In the next module, 
    you will examine types of drugs prescribed to patients with endocrine disorders, such as diabetes, and you will consider the impact of patient factors on the effects of these drugs.

    Next Week

    To go to the next week:

    Week 5: Endocrine System Disorders and the Treatment of Diabetes

    The endocrine system includes eight major glands throughout the body which affect such things as growth and development, metabolism, sexual function, and mood (National Institutes of Health). Some of the most commonly diagnosed endocrine disorders include hypothyroidism, diabetes, and Hashimoto’s disease. Not surprisingly, treating any one endocrine disorder may have effects on other body systems or their functions. As an advanced practice nurse, treating patients who may suffer from endocrine disorders requires an acute understanding of the structure and function of the endocrine system. Additionally, a solid understanding of patient factors and behaviors will assist in developing the best drug therapy plans possible to treat your patients. Some of most commonly diagnosed endocrine disorders include

    This week, you differentiate the types of diabetes and examine the impact of diabetes drugs on patients. You also evaluate alternative drug treatments and patient education strategies for diabetes management.

    Reference: National Institutes of Health. (n. d.). National Institute of Diabetes and Digestive and Kidney Disorders. Endocrine diseases. Retrieved July 3, 2019 from 
    https://www.niddk.nih.gov/health-information/endocrine-diseases

    Learning Objectives

    Students will:

    Differentiate types of diabetes

    Evaluate the impact of diabetes drugs on patients

    Evaluate alternative drug treatments and patient education strategies for diabetes management

    Learning Resources

    Required Readings
     (click to expand/reduce)

    Discussion: Diabetes and Drug Treatments

    Photo Credit: [Mark Hatfield]/[iStock / Getty Images Plus]/Getty Images

    Each year, 1.5 million Americans are diagnosed with diabetes (American Diabetes Association, 2019). If left untreated, diabetic patients are at risk for several alterations, including heart disease, stroke, kidney failure, neuropathy, and blindness. There are various methods for treating diabetes, many of which include some form of drug therapy. The type of diabetes as well as the patient’s behavior factors will impact treatment recommendations.

    For this Discussion, you compare types of diabetes, including drug treatments for type 1, type 2, gestational, and juvenile diabetes.

    Reference: American Diabetes Association. (2019). Statistics about diabetes. Retrieved from http://diabetes.org/diabetes-basics/statistics/

    To Prepare

    Review the Resources for this module and reflect on differences between types of diabetes, including type 1, type 2, gestational, and juvenile diabetes.

    Select one type of diabetes to focus on for this Discussion.

    Consider one type of drug used to treat the type of diabetes you selected, including proper preparation and administration of this drug. Then, reflect on dietary considerations related to treatment.

    Think about the short-term and long-term impact of the diabetes you selected on patients, including effects of drug treatments.

    By Day 3 of Week 5

    Post
     a brief explanation of the differences between the types of diabetes, including type 1, type 2, gestational, and juvenile diabetes. Describe one type of drug used to treat the type of diabetes you selected, including proper preparation and administration of this drug. Be sure to include dietary considerations related to treatment. Then, explain the short-term and long-term impact of this type of diabetes on patients. including effects of drug treatments. Be specific and provide examples.

    By Day 6 of Week 5

    Read
     a selection of your colleagues’ responses and 
    respond 
    to 
    at least two
     of your colleagues on 
    two different days
     who selected a different type of diabetes than you did. Provide recommendations for alternative drug treatments and patient education strategies for treatment and management.

    Note:
     For this Discussion, you are required to complete your initial post before you will be able to view and respond to your colleagues’ postings. Begin by clicking on the “Post to Discussion Question” link, and then select “Create Thread” to complete your initial post. Remember, once you click on Submit, you cannot delete or edit your own posts, and you cannot post anonymously. Please check your post carefully before clicking on 
    Submit!

    Submission and Grading Information

    Grading Criteria

    To access your rubric:

    Week 5 Discussion Rubric

    Post by Day 3 of Week 5 and Respond by Day 6 of Week 5

    To Participate in this Discussion:

    Week 5 Discussion

    What’s Coming Up in Module 5?

    Photo Credit: [BrianAJackson]/[iStock / Getty Images Plus]/Getty Images

    In the next module, 
    you will examine diagnoses for patients with neurologic and musculoskeletal disorders, and you will complete your Midterm Exam.

    Looking Ahead: Midterm Exam

    Please review the Resources and content in the previous modules in preparation for your Midterm Exam in Module 5.

    Next Week

    To go to the next week:

    Week 6: Neurologic and Musculoskeletal Disorders

    Sabrina is a 26 year old female who has just been diagnosed with multiple sclerosis. She has scheduled an appointment for a follow up with her physician but has several questions about her diagnosis and is calling the Nurse Helpline for her hospital network. As she talks with the advanced practice nurse, she learns that her diagnosis also impacts her neurologic and musculoskeletal systems. Although multiple sclerosis is an autoimmune disorder, both the neurologic and musculoskeletal systems will be affected by adverse symptoms that Sabrina needs to be aware of and for which specific drug therapy plans and other treatment options need to be decided on.

    As an advanced practice nurse, what types of drugs will best address potential neurologic and musculoskeletal symptoms Sabrina might experience?

    This week, you will evaluate patients for the treatment of neurologic and musculoskeletal disorders by focusing on specific patient case studies through a decision tree exercise. You will analyze the decisions you will make in the decision tree exercise and reflect on your experiences in proposing the recommended actions to address the health needs in the patient case study.

    Learning Objectives

    Students will:

    Evaluate patients for treatment of neurologic and musculoskeletal disorders

    Analyze decisions made throughout the diagnosis and treatment of patients with neurologic and musculoskeletal disorders

    Justify decisions made throughout the diagnosis and treatment of patients with neurologic and musculoskeletal disorders

    Learning Resources

    Required Readings
     (click to expand/reduce)

    Required Media
     (click to expand/reduce)

    Assignment: Decision Tree for Neurological and Musculoskeletal Disorders

    For your Assignment, your Instructor will assign you one of the decision tree interactive media pieces provided in the Resources. As you examine the patient case studies in this module’s Resources, consider how you might assess and treat patients presenting symptoms of neurological and musculoskeletal disorders.

    Photo Credit: Getty Images/Science Photo Library RF

    To Prepare

    Review the interactive media piece assigned by your Instructor.

    Reflect on the patient’s symptoms and aspects of the disorder presented in the interactive media piece.

    Consider how you might assess and treat patients presenting with the symptoms of the patient case study you were assigned.

    You will be asked to make three decisions concerning the diagnosis and treatment for this patient. Reflect on potential co-morbid physical as well as patient factors that might impact the patient’s diagnosis and treatment.

    By Day 7 of Week 8

    Write a 1- to 2-page summary paper that addresses the following:

    Briefly summarize the patient case study you were assigned, including each of the three decisions you took for the patient presented.

    Based on the decisions you recommended for the patient case study, explain whether you believe the decisions provided were supported by the evidence-based literature. Be specific and provide examples. Be sure to support your response with evidence and references from outside resources.

    What were you hoping to achieve with the decisions you recommended for the patient case study you were assigned? Support your response with evidence and references from outside resources.

    Explain any difference between what you expected to achieve with each of the decisions and the results of the decision in the exercise. Describe whether they were different. Be specific and provide examples.

    You will submit this Assignment in Week 8.

    Submission and Grading Information

    To submit your completed Assignment for review and grading, do the following:

    Please save your Assignment using the naming convention “WK8Assgn+last name+first initial.(extension)” as the name.

    Click the 
    Week 8 Assignment Rubric 
    to review the Grading Criteria for the Assignment.

    Click the 
    Week 8 Assignment 
    link. You will also be able to “View Rubric” for grading criteria from this area.

    Next, from the Attach File area, click on the 
    Browse My Computer
     button. Find the document you saved as “WK8Assgn+last name+first initial.(extension)” and click 
    Open
    .

    If applicable: From the Plagiarism Tools area, click the checkbox for 
    I agree to submit my paper(s) to the Global Reference Database
    .

    Click on the 
    Submit
     button to complete your submission.

    Grading Criteria

    To access your rubric:

    Week 8 Assignment Rubric

    Check Your Assignment Draft for Authenticity

    To check your Assignment draft for authenticity:

    Submit your Week 8 Assignment draft and review the originality report.

    Submit Your Assignment by Day 7 of Week 8

    To participate in this Assignment:

    Week 8 Assignment

    What’s Coming Up in Week 7?

    Photo Credit: [BrianAJackson]/[iStock / Getty Images Plus]/Getty Images

    Next week, 
    you will continue working on your Assignment started in Week 6, and you will complete your Midterm Exam.

    Next Week

    To go to the next week:

    Week 7: Midterm Exam

    This week, you will continue working on your Assignment started in Week 6, and you will complete your Midterm Exam.

    Learning Objectives

    Students will:

    Identify key terms, concepts, and principles related to prescribing drugs to treat patient disorders

    Midterm Exam

    The Exam covers the content you have explored throughout the first 6 weeks of this course.

    This exam is a test of your knowledge in preparation for your certification exam. 
    No outside resources
    —including books, notes, websites, or any other type of resource—are to be used to complete this quiz. You are not allowed to take screenshots or record the exam questions in any other format while taking the exam. You are expected to 
    comply with Walden University’s Code of Conduct
    .

    Photo Credit: Getty Images/Hero Images

    By Day 7 of Week 7

    Complete
     the Midterm Exam. You have 120 minutes to complete the exam. You may only attempt this exam once.

    Submission and Grading Information

    Complete the Exam by Day 7 of Week 7

    To Complete this Exam:

    Week 7 Exam

    What’s Coming Up in Module 6?

    Photo Credit: [BrianAJackson]/[iStock / Getty Images Plus]/Getty Images

    In the next module, 
    you will examine types of drugs prescribed to patients who present with psychological disorders.

    In the next module, 
    you will examine types of drugs prescribed to patients who present with psychological disorders.

    Next Week

    To go to the next week:

    Week 8: Pharmacology for Psychological Disorders

    How does an advanced practice nurse determine the best treatment option or pharmacotherapeutic to recommend for patients with psychological disorders?

    Much like assessing or recommending pharmacotherapeutics for other conditions or disorders, as an advanced practice nurse, you may encounter a patient who presents with a psychological disorder. Understanding the guiding principles related to treating patients with psychological disorders as well as the effects of pharmacotherapeutics on a patient’s overall health and well-being is critical for the safe and effective delivery of care.

    This week, you examine types of drugs prescribed to patients with psychological disorders. You also examine potential impacts of pharmacotherapeutics used to treat psychological disorders on a patient’s pathophysiology.

    Learning Objectives

    Students will:

    Evaluate patients for treatment of psychological disorders

    Analyze decisions made throughout the diagnosis and treatment of patients with psychological disorders

    Analyze impacts of pharmacotherapeutics for psychological disorders on patient pathophysiology

    Evaluate patients for treatment of neurological and musculoskeletal disorders

    Analyze decisions made throughout the diagnosis and treatment of patients with neurological and musculoskeletal disorders

    Justify decisions made throughout the diagnosis and treatment of patients with neurological and musculoskeletal disorders

    Learning Resources

    Required Readings
     (click to expand/reduce)

    Required Media
     (click to expand/reduce)

    Discussion: Decision Making When Treating Psychological Disorders

    Psychological disorders, such as depression, bipolar, and anxiety disorders can present several complications for patients of all ages. These disorders affect patients physically and emotionally, potentially impacting judgment, school and/or job performance, and relationships with family and friends. Since these disorders have many drastic effects on patients’ lives, it is important for advanced practice nurses to effectively manage patient care. With patient factors and medical history in mind, it is the advanced practice nurse’s responsibility to ensure the safe and effective diagnosis, treatment, and education of patients with psychological disorders.

    Photo Credit: Getty Images/iStockphoto

    For this Discussion, you will select an interactive media piece to practice decision making when treating patients with psychological disorders. You will recommend the most effective pharmacotherapeutic to treat the psychological disorder presented and examine potential impacts of pharmacotherapeutics on a patient’s pathophysiology.

    To Prepare

    Review this week’s interactive media pieces and select one to focus on for this Discussion.

    Reflect on the decision steps in the interactive media pieces, and consider the potential impacts from the administration of the associated pharmacotherapeutics on the patient’s pathophysiology.

    By Day 3 of Week 8

    Post
     a brief explanation of the psychological disorder presented and the decision steps you applied in completing the interactive media piece for the psychological disorder you selected. Then, explain how the administration of the associated pharmacotherapeutics you recommended may impact the patient’s pathophysiology. How might these potential impacts inform how you would suggest treatment plans for this patient? Be specific and provide examples.

    By Day 6 of Week 8

    Read
     a selection of your colleagues’ responses and 
    respond 
    to 
    at least two
     of your colleagues on 
    two different days
     who selected a different interactive media piece on a psychological disorder, and provide recommendations for alternative drug treatments to address the patient’s pathophysiology.

    Note:
     For this Discussion, you are required to complete your initial post before you will be able to view and respond to your colleagues’ postings. Begin by clicking on the “Post to Discussion Question” link, and then select “Create Thread” to complete your initial post. Remember, once you click on Submit, you cannot delete or edit your own posts, and you cannot post anonymously. Please check your post carefully before clicking on 
    Submit!

    Submission and Grading Information

    Grading Criteria

    To access your rubric:

    Week 8 Discussion Rubric

    Post by Day 3 of Week 8 and Respond by Day 6 of Week 8

    To Participate in this Discussion:

    Week 8 Discussion

    Assignment: Decision Tree for Neurological and Musculoskeletal

    By Day 7 of Week 8

    Submit
     your Assignment, started in Week 6.

    Reminder:
     The Collegeof Nursing requires that all papers submitted include a title page, introduction, summary, and references. The Sample Paper provided at the Walden Writing Center offers an example of those required elements (available at 
    http://writingcenter.waldenu.edu/57.htm
    ). All papers submitted must use this formatting.

    Photo Credit: Getty Images/Science Photo Library RF

    Submission and Grading Information

    To submit your completed Assignment for review and grading, do the following:

    Please save your Assignment using the naming convention “WK8Assgn+last name+first initial.(extension)” as the name.

    Click the 
    Week 8 Assignment Rubric 
    to review the Grading Criteria for the Assignment.

    Click the 
    Week 8 Assignment 
    link. You will also be able to “View Rubric” for grading criteria from this area.

    Next, from the Attach File area, click on the 
    Browse My Computer
     button. Find the document you saved as “WK8Assgn+last name+first initial.(extension)” and click 
    Open
    .

    If applicable: From the Plagiarism Tools area, click the checkbox for 
    I agree to submit my paper(s) to the Global Reference Database
    .

    Click on the 
    Submit
     button to complete your submission.

    Grading Criteria

    To access your rubric:

    Week 8 Assignment Rubric

    Check Your Assignment Draft for Authenticity

    To check your Assignment draft for authenticity:

    Submit your Week 8 Assignment draft and review the originality report.

    Submit Your Assignment by Day 7 of Week 8

    To participate in this Assignment:

    Week 8 Assignment

    What’s Coming Up in Module 7?

    Photo Credit: [BrianAJackson]/[iStock / Getty Images Plus]/Getty Images

    In the next module, 
    you will examine types of drugs prescribed to address women’s and men’s health, infections, and disorders of the hematologic system.

    Next Week

    To go to the next week:

    Week 9: Women’s and Men’s Health/Infections and Hematologic Systems, Part I

    As an advanced practice nurse, you will likely encounter many disorders associated with women’s and men’s health, such as hormone deficiencies, cancers, and other functional and structural abnormalities. Disorders such as these not only result in physiological consequences but also psychological consequences, such as embarrassment, guilt, or profound disappointment for patients. For these reasons, the provider-patient relationship must be carefully managed. During evaluations, patients must feel comfortable answering questions so that you, as a key health-care provider, will be able to diagnose and recommend appropriate treatment options. Advanced practice nurses must be able to educate patients on these disorders and help relieve associated stigmas and concerns.

    This week, you examine women’s and men’s health concerns as well as the types of drugs used to treat disorders that affect women’s and men’s health. You also explore how to treat aspects of these disorders on other health systems.

    Learning Objectives

    Students will:

    Evaluate patients for treatment of complex health issues

    Evaluate patients for treatment of infections

    Evaluate patients for treatment of hematologic disorders

    Analyze patient education strategies for the management and treatment of complex comorbidities

    Learning Resources

    Required Readings
     (click to expand/reduce)

    Required Media
     (click to expand/reduce)

    Discussion: Women’s and Men’s Health, Infectious Disease, and Hematologic Disorders

    As an advanced practice nurse, you will likely experience patient encounters with complex comorbidities. For example, consider a female patient who is pregnant who also presents with hypertension, diabetes, and has a recent tuberculosis infection. How might the underlying pathophysiology of these conditions affect the pharmacotherapeutics you might recommend to help address your patient’s health needs? What education strategies might you recommend for ensuring positive patient health outcomes?

    For this Discussion, you will be assigned a patient case study and will consider how to address the patient’s current drug therapy plans. You will then suggest recommendations on how to revise these drug therapy plans to ensure effective, safe, and quality patient care for positive patient health outcomes.

    Photo Credit: Getty Images

    To Prepare

    Review the Resources for this module and reflect on the different health needs and body systems presented.

    Your Instructor will assign you a complex case study to focus on for this Discussion.

    Consider how you will practice critical decision making for prescribing appropriate drugs and treatment to address the complex patient health needs in the patient case study you selected.

    By Day 3 of Week 9

    Post
     a brief description of your patient’s health needs from the patient case study you assigned. Be specific. Then, explain the type of treatment regimen you would recommend for treating your patient, including the choice or pharmacotherapeutics you would recommend and explain why. Be sure to justify your response. Explain a patient education strategy you might recommend for assisting your patient with the management of their health needs. Be specific and provide examples.

    You will respond to your colleagues’ posts in Week 10.

    Note:
     For this Discussion, you are required to complete your initial post before you will be able to view and respond to your colleagues’ postings. Begin by clicking on the “Post to Discussion Question” link, and then select “Create Thread” to complete your initial post. Remember, once you click on Submit, you cannot delete or edit your own posts, and you cannot post anonymously. Please check your post carefully before clicking on 
    Submit!

    Submission and Grading Information

    Grading Criteria

    To access your rubric:

    Week 9 Discussion Rubric

    Post by Day 3 of Week 9 and Respond by Day 6 of Week 10

    To Participate in this Discussion:

    Week 9 Discussion

    What’s Coming Up in Week 10?

    Photo Credit: [BrianAJackson]/[iStock / Getty Images Plus]/Getty Images

    Next week, 
    you will continue working on your Discussion assigned in Week 9, as you examine the types of drugs used to treat infections and disorders of the hematologic system.

    Next Week

    To go to the next week:

    Week 10: Women’s and Men’s Health/Infections and Hematologic Systems, Part II

    Bacterial and viral infections may spread through the direct contact of bodily fluids such as blood or through vectors, who help to spread infections via the blood. When you think of infections and the hematologic system, what comes to mind?

    Infectious diseases, such as malaria, dengue, or other hemorrhagic fevers are some examples of infections that impact the hematologic system. However, disorders of the hematologic system, such as anemia or blood clotting factor disorders, can also have a deleterious effect on a patient’s health and well-being. As an advanced practice nurse, you will need to understand the different types of pharmacotherapeutics used to treat infections and disorders of the hematologic system as you work to enhance patient-centered approaches for safe, quality, and effective care.

    This week, you will examine infections and hematologic disorders, as well as the types of drugs used to treat aspects of these disorders or health systems.

    Learning Objectives

    Students will:

    Evaluate patients for treatment of complex health issues

    Evaluate patients for treatment of infections

    Evaluate patients for treatment of hematologic disorders

    Analyze patient education strategies for the management and treatment of complex comorbidities

    Learning Resources

    Required Readings
     (click to expand/reduce)

    Required Media
     (click to expand/reduce)

    Discussion: Women’s and Men’s Health, Infectious Disease, and Hematologic Disorders

    To Prepare

    Review the resources for this module and reflect on the different health needs and body systems presented.

    Review your peers case studies from Week 9.

    Consider how you will practice critical decision making for prescribing appropriate drugs and treatment to address the complex patient health needs in the patient case study you selected.

    Photo Credit: Getty Images

    By Day 6 of Week 10

    Read
     a selection of your colleagues’ responses from Week 9 and 
    respond 
    to 
    at least two
     of your colleagues on 
    two different days
     who were assigned a different patient case study, and provide recommendations for alternative drug treatments to address the patient’s pathophysiology. Be specific and provide examples.

    Note:
     For this Discussion, you are required to complete your initial post before you will be able to view and respond to your colleagues’ postings. Begin by clicking on the “Post to Discussion Question” link, and then select “Create Thread” to complete your initial post. Remember, once you click on Submit, you cannot delete or edit your own posts, and you cannot post anonymously. Please check your post carefully before clicking on 
    Submit!

    Submission and Grading Information

    Grading Criteria

    To access your rubric:

    Week 9 Discussion Rubric

    Post by Day 3 of Week 9 and Respond by Day 6 of Week 10

    To Participate in this Discussion:

    Week 9 Discussion

    What’s Coming Up in Module 8?

    Photo Credit: [BrianAJackson]/[iStock / Getty Images Plus]/Getty Images

    In the next module, 
    you will examine prescribing drugs and the off-label use of drugs to treat pediatric patients. You will also complete your Final Exam.

    Looking Ahead: Final Exam

    Please review the Resources and content in the previous modules in preparation for your Final Exam in Module 8.

    Next Week

    To go to the next week:

    Week 11: Pediatrics

    Children, like adults, deal with variety of health issues, but they also have issues that are more prevalent within their population. One issue that significantly impacts children is the prescription of drugs for off-label use. As an advanced practice nurse, how do you determine the appropriate use of off-label drugs in pediatrics? Are there certain drugs that should be avoided with pediatric patients?

    This week, you examine the practice of prescribing off-label drugs to children. You also explore strategies for making off-label drug use safer for children from infancy to adolescence, as it is essential that you are prepared to make drug-related decisions for pediatric patients in clinical settings.

    Learning Objectives

    Students will:

    Evaluate the practice of prescribing off-label drugs to children

    Analyze strategies to make the off-label use of drugs safer for children

    Identify key terms, concepts, and principles related to prescribing drugs to treat patient disorders

    Learning Resources

    Required Readings
     (click to expand/reduce)

    Required Media
     (click to expand/reduce)

    Assignment: Off-Label Drug Use in Pediatrics

    The unapproved use of approved drugs, also called off-label use, with children is quite common. This is because pediatric dosage guidelines are typically unavailable, since very few drugs have been specifically researched and tested with children.

    When treating children, prescribers often adjust dosages approved for adults to accommodate a child’s weight. However, children are not just “smaller” adults. Adults and children process and respond to drugs differently in their absorption, distribution, metabolism, and excretion.

    Photo Credit: Getty Images

    Children even respond differently during stages from infancy to adolescence. This poses potential safety concerns when prescribing drugs to pediatric patients. As an advanced practice nurse, you have to be aware of safety implications of the off-label use of drugs with this patient group.

    To Prepare

    Review the interactive media piece in this week’s Resources and reflect on the types of drugs used to treat pediatric patients with mood disorders.

    Reflect on situations in which children should be prescribed drugs for off-label use.

    Think about strategies to make the off-label use and dosage of drugs safer for children from infancy to adolescence. Consider specific off-label drugs that you think require extra care and attention when used in pediatrics.

    By Day 5 of Week 11

    Write 
    a 1-page narrative in APA format that addresses the following:

    Explain the circumstances under which children should be prescribed drugs for off-label use. Be specific and provide examples.

    Describe strategies to make the off-label use and dosage of drugs safer for children from infancy to adolescence. Include descriptions and names of off-label drugs that require extra care and attention when used in pediatrics.

    Reminder:
     The College of Nursing requires that all papers submitted include a title page, introduction, summary, and references. The Sample Paper provided at the Walden Writing Center offers an example of those required elements (available at 
    http://writingcenter.waldenu.edu/57.htm
    ). All papers submitted must use this formatting.

    Submission and Grading Information

    To submit your completed Assignment for review and grading, do the following:

    Please save your Assignment using the naming convention “WK11Assgn+last name+first initial.(extension)” as the name.

    Click the 
    Week 11 Assignment Rubric 
    to review the Grading Criteria for the Assignment.

    Click the 
    Week 11 Assignment 
    link. You will also be able to “View Rubric” for grading criteria from this area.

    Next, from the Attach File area, click on the 
    Browse My Computer
     button. Find the document you saved as “WK11Assgn+last name+first initial.(extension)” and click 
    Open
    .

    If applicable: From the Plagiarism Tools area, click the checkbox for 
    I agree to submit my paper(s) to the Global Reference Database
    .

    Click on the 
    Submit
     button to complete your submission.

    Grading Criteria

    To access your rubric:

    Week 11 Assignment Rubric

    Check Your Assignment Draft for Authenticity

    To check your Assignment draft for authenticity:

    Submit your Week 11 Assignment draft and review the originality report.

    Submit Your Assignment by Day 5 of Week 11

    To participate in this Assignment:

    Week 11 Assignment

    Final Exam

    This Exam covers the content you have explored throughout this course.

    This exam is a test of your knowledge in preparation for your certification exam. 
    No outside resources
    —including books, notes, websites, or any other type of resource—are to be used to complete this exam. You are not allowed to take screenshots or record the exam questions in any other format while taking the exam. You are expected to 
    comply with Walden University’s Code of Conduct
    .

    Photo Credit: Getty Images

    By Day 7 of Week 11

    Complete
     the Final Exam.

    Submission and Grading Information

    Complete the Exam by Day 7 of Week 11

    To Complete this Exam:

    Week 11 Exam

    Module in Review

    In this module,
     you evaluated the practice and circumstances of prescribing off-label drugs to children and analyzed the strategies used to make their use and dosage safer for children. After you have completed the Discussion and the Final Exam for this week, you have finished the course. Congratulations! 
    Please complete the Course Evaluation form and submit by Day 7.

    Congratulations! After you have finished all of the assignments for this week, you have completed the course. Please submit your Course Evaluation by Day 7.