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Please see the attached assignment details. – ## ProjectDraftPartTwoModuleFive.docx – ENG190ProjectGuidelinesandRubric.html2.zip **## ProjectDraftPartTwoModuleFive.docx** 2 **Eliminating College Tuition: A Bold Step Toward Equity, Economic Growth, and Social Progress** Melony Hadden Southern New Ham…

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Assignment Prompt & Instructions

Please see the attached assignment details.

– ## ProjectDraftPartTwoModuleFive.docx

– ENG190ProjectGuidelinesandRubric.html2.zip

**## ProjectDraftPartTwoModuleFive.docx**

2

**Eliminating College Tuition: A Bold Step Toward Equity, Economic Growth, and Social Progress**

Melony Hadden

Southern New Hampshire University

Instructor Heather Carroll

ENG 190 Research and Persuasion

**Introduction**

A college education today is even more crucial than at any other time. It also provides more promising employment, greater income, and self-enhancement. Nevertheless, college education is costly, thus locking many gifted students out of college. This issue of tuition fees impacts not only the individual's future but also undermines society. Education should not be viewed as a privilege of a few but a right of everybody. This is because making college tuition free would encourage equality of opportunity, reduce financial burden, and enhance the country's well-being.

**Thesis Statement:**

Free college would be essential in creating a more equal society on both social and economic levels, diminishing student debt, and creating a better and more educated community of workers.

**Social Equality**

Among the most significant advantages of free college tuition is the opportunity that all students, regardless of their financial background, have. Numerous students can collect a college degree but do not have the money to do so. Education will be more affordable to low-income and marginalised citizens when there is free tuition. It assists in introducing a more level playing field where people can win on merit, not income taxes(Butler et al.,2021). It also enables students who would otherwise be pre-determined to take up low-paying jobs immediately after high school to have a better life through education.

**Student Loan Relief**

The problem of student debt among young people is overwhelming. Thousands of students find themselves financing their college degrees out of school in thousands of dollars, with the loan having to be repaid within years or even decades. This debt may keep them out of house buying, starting families, or stalling over their future prosperity. College tuition would make student loans unnecessary or significantly decrease the amount of loans that must be taken out. Consequently, students could study worry-free most of the time about the problem of money. It would also help them have greater freedom to pursue careers they love, so they would not be guided to choose a job based solely on how remunerative it is. Eliminating the strain of debt allows graduates to face adulthood with confidence and financial relaxation.

**Developing a better workforce**

Education is one of the best ways to enhance a country's economy. Skills, innovation, and the ability to compete are enhanced in the workforce when a wider range of people can access college. The opportunity of free tuition would encourage more students to obtain degrees in sectors such as healthcare, education, science, and technology, where trained employees are in short supply. Businesses become more efficient with a better-educated citizenry, and the state would feel more equipped to face the times of globalization (LeBlanc,2021). Moreover, a society that has higher education displays fewer unemployment cases, reduced crime, and improved health. It benefits not only those who want to get free college tuition, but also the nation's benefit.

**Counterargument and Rebuttal**

The claim that full tuition in colleges is too expensive and will burden taxpayers has been made by some people. Although it is a correct issue, one should consider education as a long-term investment. The government would recycle the tax dollars used to fund free tuition by increasing tax revenues, saving on welfare expenditures, and creating a more efficient economy. Some fear free college will mean a crowded campus and a standard drop. Nonetheless, planning, judicious application of technology, and sustained provision of quality faculty can address these challenges. The pitfalls that the policy might face are insufficient to address the strong solutions to providing free college education.

**Conclusion**

Free college education is not a dream but a wise and right solution to most issues affecting young people and society today. It ensures level playing fields, relieves the oppressive weight of debt, and develops a better-educated workforce. Everyone should have access to education regardless of their financial capacity. Educating people is an investment in our typical store. The time has come to repeal the use of free tuition in colleges and allow every student to have an opportunity to excel, no matter how financially endowed.

References

Butler, L. M., Arya, V., Nonyel, N. P., & Moore, T. S. (2021). The Rx-HEART framework to address health equity and racism within pharmacy education.
_American Journal of Pharmaceutical Education_,
_85_(9), 8590.

LeBlanc, P. (2021).
_Students first: Equity, access, and opportunity in higher education_. Harvard Education Press.

Kanter, M. J., Armstrong, A., Cammack, A., & Blalock, C. (2016). College promise: Pathway to the 21st century.
_Change: The Magazine of Higher Learning_,
_48_(6), 6-15.

**ENG190ProjectGuidelinesandRubric.html2.zip**

This file is too large to display. [View in new window](https://www.sweetstudy.com/files/eng190projectguidelinesandrubric-html2-zip)

**ENG190ProjectGuidelinesandRubric.html2.zip**

This file is too large to display. [View in new window](https://www.sweetstudy.com/files/eng190projectguidelinesandrubric-html2-zip)

**## ProjectDraftPartTwoModuleFive.docx**

2

**Eliminating College Tuition: A Bold Step Toward Equity, Economic Growth, and Social Progress**

Melony Hadden

Southern New Hampshire University

Instructor Heather Carroll

ENG 190 Research and Persuasion

**Introduction**

A college education today is even more crucial than at any other time. It also provides more promising employment, greater income, and self-enhancement. Nevertheless, college education is costly, thus locking many gifted students out of college. This issue of tuition fees impacts not only the individual's future but also undermines society. Education should not be viewed as a privilege of a few but a right of everybody. This is because making college tuition free would encourage equality of opportunity, reduce financial burden, and enhance the country's well-being.

**Thesis Statement:**

Free college would be essential in creating a more equal society on both social and economic levels, diminishing student debt, and creating a better and more educated community of workers.

**Social Equality**

Among the most significant advantages of free college tuition is the opportunity that all students, regardless of their financial background, have. Numerous students can collect a college degree but do not have the money to do so. Education will be more affordable to low-income and marginalised citizens when there is free tuition. It assists in introducing a more level playing field where people can win on merit, not income taxes(Butler et al.,2021). It also enables students who would otherwise be pre-determined to take up low-paying jobs immediately after high school to have a better life through education.

**Student Loan Relief**

The problem of student debt among young people is overwhelming. Thousands of students find themselves financing their college degrees out of school in thousands of dollars, with the loan having to be repaid within years or even decades. This debt may keep them out of house buying, starting families, or stalling over their future prosperity. College tuition would make student loans unnecessary or significantly decrease the amount of loans that must be taken out. Consequently, students could study worry-free most of the time about the problem of money. It would also help them have greater freedom to pursue careers they love, so they would not be guided to choose a job based solely on how remunerative it is. Eliminating the strain of debt allows graduates to face adulthood with confidence and financial relaxation.

**Developing a better workforce**

Education is one of the best ways to enhance a country's economy. Skills, innovation, and the ability to compete are enhanced in the workforce when a wider range of people can access college. The opportunity of free tuition would encourage more students to obtain degrees in sectors such as healthcare, education, science, and technology, where trained employees are in short supply. Businesses become more efficient with a better-educated citizenry, and the state would feel more equipped to face the times of globalization (LeBlanc,2021). Moreover, a society that has higher education displays fewer unemployment cases, reduced crime, and improved health. It benefits not only those who want to get free college tuition, but also the nation's benefit.

**Counterargument and Rebuttal**

The claim that full tuition in colleges is too expensive and will burden taxpayers has been made by some people. Although it is a correct issue, one should consider education as a long-term investment. The government would recycle the tax dollars used to fund free tuition by increasing tax revenues, saving on welfare expenditures, and creating a more efficient economy. Some fear free college will mean a crowded campus and a standard drop. Nonetheless, planning, judicious application of technology, and sustained provision of quality faculty can address these challenges. The pitfalls that the policy might face are insufficient to address the strong solutions to providing free college education.

**Conclusion**

Free college education is not a dream but a wise and right solution to most issues affecting young people and society today. It ensures level playing fields, relieves the oppressive weight of debt, and develops a better-educated workforce. Everyone should have access to education regardless of their financial capacity. Educating people is an investment in our typical store. The time has come to repeal the use of free tuition in colleges and allow every student to have an opportunity to excel, no matter how financially endowed.

References

Butler, L. M., Arya, V., Nonyel, N. P., & Moore, T. S. (2021). The Rx-HEART framework to address health equity and racism within pharmacy education.
_American Journal of Pharmaceutical Education_,
_85_(9), 8590.

LeBlanc, P. (2021).
_Students first: Equity, access, and opportunity in higher education_. Harvard Education Press.

Kanter, M. J., Armstrong, A., Cammack, A., & Blalock, C. (2016). College promise: Pathway to the 21st century.
_Change: The Magazine of Higher Learning_,
_48_(6), 6-15.

**ENG190ProjectGuidelinesandRubric.html2.zip**

This file is too large to display. [View in new window](https://www.sweetstudy.com/files/eng190projectguidelinesandrubric-html2-zip)

**## ProjectDraftPartTwoModuleFive.docx**

2

**Eliminating College Tuition: A Bold Step Toward Equity, Economic Growth, and Social Progress**

Melony Hadden

Southern New Hampshire University

Instructor Heather Carroll

ENG 190 Research and Persuasion

**Introduction**

A college education today is even more crucial than at any other time. It also provides more promising employment, greater income, and self-enhancement. Nevertheless, college education is costly, thus locking many gifted students out of college. This issue of tuition fees impacts not only the individual's future but also undermines society. Education should not be viewed as a privilege of a few but a right of everybody. This is because making college tuition free would encourage equality of opportunity, reduce financial burden, and enhance the country's well-being.

**Thesis Statement:**

Free college would be essential in creating a more equal society on both social and economic levels, diminishing student debt, and creating a better and more educated community of workers.

**Social Equality**

Among the most significant advantages of free college tuition is the opportunity that all students, regardless of their financial background, have. Numerous students can collect a college degree but do not have the money to do so. Education will be more affordable to low-income and marginalised citizens when there is free tuition. It assists in introducing a more level playing field where people can win on merit, not income taxes(Butler et al.,2021). It also enables students who would otherwise be pre-determined to take up low-paying jobs immediately after high school to have a better life through education.

**Student Loan Relief**

The problem of student debt among young people is overwhelming. Thousands of students find themselves financing their college degrees out of school in thousands of dollars, with the loan having to be repaid within years or even decades. This debt may keep them out of house buying, starting families, or stalling over their future prosperity. College tuition would make student loans unnecessary or significantly decrease the amount of loans that must be taken out. Consequently, students could study worry-free most of the time about the problem of money. It would also help them have greater freedom to pursue careers they love, so they would not be guided to choose a job based solely on how remunerative it is. Eliminating the strain of debt allows graduates to face adulthood with confidence and financial relaxation.

**Developing a better workforce**

Education is one of the best ways to enhance a country's economy. Skills, innovation, and the ability to compete are enhanced in the workforce when a wider range of people can access college. The opportunity of free tuition would encourage more students to obtain degrees in sectors such as healthcare, education, science, and technology, where trained employees are in short supply. Businesses become more efficient with a better-educated citizenry, and the state would feel more equipped to face the times of globalization (LeBlanc,2021). Moreover, a society that has higher education displays fewer unemployment cases, reduced crime, and improved health. It benefits not only those who want to get free college tuition, but also the nation's benefit.

**Counterargument and Rebuttal**

The claim that full tuition in colleges is too expensive and will burden taxpayers has been made by some people. Although it is a correct issue, one should consider education as a long-term investment. The government would recycle the tax dollars used to fund free tuition by increasing tax revenues, saving on welfare expenditures, and creating a more efficient economy. Some fear free college will mean a crowded campus and a standard drop. Nonetheless, planning, judicious application of technology, and sustained provision of quality faculty can address these challenges. The pitfalls that the policy might face are insufficient to address the strong solutions to providing free college education.

**Conclusion**

Free college education is not a dream but a wise and right solution to most issues affecting young people and society today. It ensures level playing fields, relieves the oppressive weight of debt, and develops a better-educated workforce. Everyone should have access to education regardless of their financial capacity. Educating people is an investment in our typical store. The time has come to repeal the use of free tuition in colleges and allow every student to have an opportunity to excel, no matter how financially endowed.

References

Butler, L. M., Arya, V., Nonyel, N. P., & Moore, T. S. (2021). The Rx-HEART framework to address health equity and racism within pharmacy education.
_American Journal of Pharmaceutical Education_,
_85_(9), 8590.

LeBlanc, P. (2021).
_Students first: Equity, access, and opportunity in higher education_. Harvard Education Press.

Kanter, M. J., Armstrong, A., Cammack, A., & Blalock, C. (2016). College promise: Pathway to the 21st century.
_Change: The Magazine of Higher Learning_,
_48_(6), 6-15.

**ENG190ProjectGuidelinesandRubric.html2.zip**

This file is too large to display. [View in new window](https://www.sweetstudy.com/files/eng190projectguidelinesandrubric-html2-zip)

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November 5, 2026
[Solved] response

✓ Verified Academic Solution Available

Executive Solution Overview

– ## unit7resp.docx **## unit7resp.docx** **Peer Response** **Instructions:** **Review the plans posted by your peers from your advanced practice nursing role perspective (educator, leader or nurse practitioner). From this mindset, reflect upon a discussion you would like to have with your colleague…

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Assignment Prompt & Instructions

– ## unit7resp.docx

**## unit7resp.docx**

**Peer Response**

**Instructions:**

**Review the plans posted by your peers from your advanced practice nursing role perspective (educator, leader or nurse practitioner). From this mindset, reflect upon a discussion you would like to have with your colleagues about their plan.**

·
**For example – if you are a nurse educator (clinical or academic) what are your thoughts about the patient education provided in the plan, or do you want to comment on or add to the education provided?**

·
**If you a nurse leader what are your thoughts about the risk profile or cost effectiveness of the plan?**

·
**If you are a nurse practitioner did your peer develop a plan that aligns with evidence-based practice and current clinical guidelines? Etc.**

**Please be sure to validate your opinions and ideas with citations and references in APA format.**

[**Lucas Parenti**](https://herzing.instructure.com/courses/47762/users/95429)

Aug 20 4:44pm

Reply from Lucas Parenti

**Diagnosis**

The 52-year-old male has a past medical history and symptoms that points to erectile dysfunction as the diagnosis. The reduced ability to maintain and achieve an erection are key symptoms for erectile dysfunction (Leslie & Sooriyamoorthy, 2024) The patient's poorly controlled type 2 diabetes mellitus with an A1C of 8.2%, hypertension, obesity, sedentary lifestyle, and hyperlipidemia have been shown to be risk factors for erectile dysfunction.

**Management and Rationale**

The patient will need a comprehensive approach by implementing lifestyle changes and pharmacologic therapy as warranted. The first line treatment in erectile dysfunction is phosphodiesterase type-5 inhibitors that play a role in increasing the blood flow to the penis during sexual activity. Sildenafil, also known as Viagra, is a common prescription medication for patients experiencing ED (Burnett et al., 2018). The patient should also have blood work done for testosterone levels as low testosterone can have a negative impact on the patient's erectile dysfunction (Leslie & Sooriyamoorthy, 2024). As noted by Bhasin et al. (2018), managing the patient's weight, improving proper glycemic control, and increasing physical activity are important modifiable risk factors for ED.

**Prescription**

The patient will start taking Sildenafil 50mg orally one hour prior to sexual activity. The patient should not take this more than time per day and to take on an empty stomach. The patient will need to be educated on allowing the medication to take effect within 30-60 minutes. The patient will have ordered labs for monitoring total testosterone, CBC, TSH, HbA1C, and CMP to follow up on the diabetes control as well as evaluate further on the patient's fatigue.

**Patient Education**

The patient will be educated on ED and that it is a treatable condition and common that is influenced by nerves, hormones, and the patient's past medical history as it is not uncommon with men that have diabetes and hypertension. The patient will be educated on sildenafil, the newly prescribed medication and the importance of when to take it. Certain side effects can include headaches, mild visual changes, and nasal congestion (Leslie & Sooriyamoorthy, 2024). The patient will also be educated on lifestyle modifications such as walking 30 minutes per day, implementing proper dietary habits, and glycemic control.

**Follow-Up Plan**

The patient will follow up within 4 weeks to evaluate sildenafil and adjust the dose as needed. Labs will be reviewed, and an endocrinologist will need to be referred if the testosterone is low. The patient will also need a dietician referral to help make healthy eating habits.

**References**

Bhasin, S., Cunningham, G. R., Hayes, F. J., et al. (2018). Testosterone therapy in men with hypogonadism: An Endocrine Society clinical practice guideline. The Journal of Clinical Endocrinology & Metabolism, 103(5), 1715–1744.
[https://doi.org/10.1210/jc.2018-00229Links to an external site.](https://doi.org/10.1210/jc.2018-00229)

Burnett, A. L., Nehra, A., Breau, R. H., et al. (2018). Erectile dysfunction: AUA guideline. The Journal of Urology, 200(3), 633–641.
[https://doi.org/10.1016/j.juro.2018.05.004Links to an external site.](https://doi.org/10.1016/j.juro.2018.05.004)

Leslie, S. W., & Sooriyamoorthy, T. (2024, January 9).
_Erectile dysfunction_. StatPearls.
[https://www.ncbi.nlm.nih.gov/books/NBK562253/Links to an external site.](https://www.ncbi.nlm.nih.gov/books/NBK562253/)

· Reply to post from Lucas Parenti
**Reply**

· Mark as Unread
**Mark as Unread**

[**Mariam Lomashvili**](https://herzing.instructure.com/courses/47762/users/91090)

Aug 20 3:53pm

Reply from Mariam Lomashvili

**Diagnosis**

The most likely diagnosis for this 52-year-old male is erectile dysfunction (ED), predominantly vasculogenic, in the context of multiple cardiometabolic risk factors. His type 2 diabetes (A1C 8.2%), hypertension, hyperlipidemia, obesity (BMI 32), and sedentary lifestyle all contribute to endothelial dysfunction and impaired nitric oxide signaling, which are key mechanisms of ED. The diminished peripheral pulses further suggest vascular disease. Importantly, the patient maintains normal libido, making hypoactive sexual desire disorder less likely. The presence of mild nocturia could point toward lower urinary tract symptoms (LUTS) or benign prostatic hyperplasia (BPH), which may influence therapeutic decision-making. Diabetes is strongly associated with ED, and better glycemic control has been shown to improve outcomes (Defeudis et al., 2022; Wang et al., 2023).

**Management and Rationale**

Initial evaluation should include laboratory studies such as fasting glucose, repeat A1C, morning total testosterone, lipid panel, and renal function tests. If testosterone is low, further hormonal evaluation with luteinizing hormone, follicle-stimulating hormone, and prolactin would be warranted. Screening for depression, obstructive sleep apnea, and atherosclerotic cardiovascular disease (ASCVD) is also important, given that ED can serve as an early marker of vascular disease (Wang et al., 2023). Additionally, prostate-specific antigen (PSA) testing may be considered in the setting of nocturia after shared decision-making.

The first-line treatment for this patient is a phosphodiesterase-5 inhibitor (PDE5i). PDE5 inhibitors are effective in improving erectile function, including in men with diabetes, though response rates may be lower compared to the general population. Tadalafil is a particularly suitable option in this case because daily dosing of 5 mg not only improves erectile function but also reduces LUTS associated with BPH, thereby addressing both of the patient’s concerns (Defeudis et al., 2022; Wang et al., 2023). If the patient prefers an on-demand regimen instead of daily therapy, sildenafil 50 mg to 100 mg as needed 30–60 minutes before sexual activity is an alternative. Both options are safe with his current medications, though caution should always be taken to avoid concurrent nitrate use.

Lifestyle and cardiometabolic optimization are also essential. Structured exercise, weight reduction, a Mediterranean-style diet, and improved sleep can enhance erectile function and improve glycemic control. Targeting an A1C closer to 7%, ensuring blood pressure control, and optimizing lipid management are important for both sexual and cardiovascular health (Defeudis et al., 2022).

**Prescription**

The prescription for this patient would be:

1. Tadalafil 5 mg orally once daily. Take one tablet by mouth at the same time each day, with or without food. Do not exceed one tablet in 24 hours. Dispense 30 tablets. Refills: 2.

If the patient prefers on-demand dosing instead of daily therapy:

1. Sildenafil 50 mg orally as needed. Take one tablet by mouth 30–60 minutes prior to sexual activity. May increase to 100 mg or decrease to 25 mg based on response and tolerability. Do not exceed one dose in 24 hours. Avoid taking with high-fat meals. Dispense 6–10 tablets. Refills: 2.

**Patient Education**

Patient education should emphasize that PDE5 inhibitors require sexual stimulation to be effective. The patient should be informed about common side effects, including headache, flushing, nasal congestion, dyspepsia, and—specifically with tadalafil—back pain or myalgias. He should be instructed to seek urgent medical attention for chest pain, sudden vision or hearing changes, or an erection lasting longer than four hours.

Equally important is counseling on lifestyle changes. The patient should aim for at least 150 minutes of moderate aerobic activity per week, combined with resistance training twice weekly. Weight reduction of 5–10% can significantly improve both glycemic control and erectile function. Alcohol should be limited, and tobacco should be avoided. Sleep hygiene should also be addressed. Patients should also be cautioned against using over-the-counter “male enhancement” supplements, as many of these products are adulterated or lack reliable efficacy data (Petre et al., 2023).

**Follow-up and Referral**

The patient should follow up in 4–6 weeks to evaluate the effectiveness and tolerability of the prescribed PDE5 inhibitor, review adherence to lifestyle modifications, and assess laboratory results such as A1C and testosterone. If the initial therapy proves ineffective, options include dose titration, switching PDE5 inhibitors, or adding second-line interventions such as vacuum erection devices or alprostadil. If laboratory evaluation reveals hypogonadism, referral to endocrinology would be indicated for further management. Referral to urology should also be considered if the patient fails first-line therapies. Finally, given the diminished peripheral pulses and known cardiometabolic disease, a referral to cardiology may be warranted to evaluate for systemic vascular disease, since ED is often an early indicator of cardiovascular pathology (Wang et al., 2023).

**References**

Defeudis, G., Mazzilli, R., Tenuta, M., Rossini, G., Zamponi, V., Olana, S., Faggiano, A., Pozzilli, P., Isidori, A. M., & Gianfrilli, D. (2022). Erectile dysfunction and diabetes: A melting pot of circumstances and treatments.
_Diabetes/Metabolism Research and Reviews_,
_38_(2), e3494.
[https://doi.org/10.1002/dmrr.3494Links to an external site.](https://doi.org/10.1002/dmrr.3494)

Feng, H., Peng, W., Deng, Z., Liu, J., & Wang, T. (2023). Erectile dysfunction and exosome therapy.
_Frontiers in Endocrinology_,
_14_, 1123383.
[https://doi.org/10.3389/fendo.2023.1123383Links to an external site.](https://doi.org/10.3389/fendo.2023.1123383)

Petre, G. C., Francini-Pesenti, F., Vitagliano, A., Grande, G., Ferlin, A., & Garolla, A. (2023). Dietary supplements for erectile dysfunction: Analysis of marketed products, systematic review, meta-analysis and rational use.
_Nutrients_,
_15_(17), 3677.
[https://doi.org/10.3390/nu15173677Links to an external site.](https://doi.org/10.3390/nu15173677)

Wang, C.-M., Wu, B.-R., Xiang, P., Xiao, J., & Hu, X.-C. (2023). Management of male erectile dysfunction: From the past to the future.
_Frontiers in Endocrinology_,
_14_, 1148834.
[https://doi.org/10.3389/fendo.2023.1148834](https://doi.org/10.3389/fendo.2023.1148834)

**## unit7resp.docx**

**Peer Response**

**Instructions:**

**Review the plans posted by your peers from your advanced practice nursing role perspective (educator, leader or nurse practitioner). From this mindset, reflect upon a discussion you would like to have with your colleagues about their plan.**

·
**For example – if you are a nurse educator (clinical or academic) what are your thoughts about the patient education provided in the plan, or do you want to comment on or add to the education provided?**

·
**If you a nurse leader what are your thoughts about the risk profile or cost effectiveness of the plan?**

·
**If you are a nurse practitioner did your peer develop a plan that aligns with evidence-based practice and current clinical guidelines? Etc.**

**Please be sure to validate your opinions and ideas with citations and references in APA format.**

[**Lucas Parenti**](https://herzing.instructure.com/courses/47762/users/95429)

Aug 20 4:44pm

Reply from Lucas Parenti

**Diagnosis**

The 52-year-old male has a past medical history and symptoms that points to erectile dysfunction as the diagnosis. The reduced ability to maintain and achieve an erection are key symptoms for erectile dysfunction (Leslie & Sooriyamoorthy, 2024) The patient's poorly controlled type 2 diabetes mellitus with an A1C of 8.2%, hypertension, obesity, sedentary lifestyle, and hyperlipidemia have been shown to be risk factors for erectile dysfunction.

**Management and Rationale**

The patient will need a comprehensive approach by implementing lifestyle changes and pharmacologic therapy as warranted. The first line treatment in erectile dysfunction is phosphodiesterase type-5 inhibitors that play a role in increasing the blood flow to the penis during sexual activity. Sildenafil, also known as Viagra, is a common prescription medication for patients experiencing ED (Burnett et al., 2018). The patient should also have blood work done for testosterone levels as low testosterone can have a negative impact on the patient's erectile dysfunction (Leslie & Sooriyamoorthy, 2024). As noted by Bhasin et al. (2018), managing the patient's weight, improving proper glycemic control, and increasing physical activity are important modifiable risk factors for ED.

**Prescription**

The patient will start taking Sildenafil 50mg orally one hour prior to sexual activity. The patient should not take this more than time per day and to take on an empty stomach. The patient will need to be educated on allowing the medication to take effect within 30-60 minutes. The patient will have ordered labs for monitoring total testosterone, CBC, TSH, HbA1C, and CMP to follow up on the diabetes control as well as evaluate further on the patient's fatigue.

**Patient Education**

The patient will be educated on ED and that it is a treatable condition and common that is influenced by nerves, hormones, and the patient's past medical history as it is not uncommon with men that have diabetes and hypertension. The patient will be educated on sildenafil, the newly prescribed medication and the importance of when to take it. Certain side effects can include headaches, mild visual changes, and nasal congestion (Leslie & Sooriyamoorthy, 2024). The patient will also be educated on lifestyle modifications such as walking 30 minutes per day, implementing proper dietary habits, and glycemic control.

**Follow-Up Plan**

The patient will follow up within 4 weeks to evaluate sildenafil and adjust the dose as needed. Labs will be reviewed, and an endocrinologist will need to be referred if the testosterone is low. The patient will also need a dietician referral to help make healthy eating habits.

**References**

Bhasin, S., Cunningham, G. R., Hayes, F. J., et al. (2018). Testosterone therapy in men with hypogonadism: An Endocrine Society clinical practice guideline. The Journal of Clinical Endocrinology & Metabolism, 103(5), 1715–1744.
[https://doi.org/10.1210/jc.2018-00229Links to an external site.](https://doi.org/10.1210/jc.2018-00229)

Burnett, A. L., Nehra, A., Breau, R. H., et al. (2018). Erectile dysfunction: AUA guideline. The Journal of Urology, 200(3), 633–641.
[https://doi.org/10.1016/j.juro.2018.05.004Links to an external site.](https://doi.org/10.1016/j.juro.2018.05.004)

Leslie, S. W., & Sooriyamoorthy, T. (2024, January 9).
_Erectile dysfunction_. StatPearls.
[https://www.ncbi.nlm.nih.gov/books/NBK562253/Links to an external site.](https://www.ncbi.nlm.nih.gov/books/NBK562253/)

· Reply to post from Lucas Parenti
**Reply**

· Mark as Unread
**Mark as Unread**

[**Mariam Lomashvili**](https://herzing.instructure.com/courses/47762/users/91090)

Aug 20 3:53pm

Reply from Mariam Lomashvili

**Diagnosis**

The most likely diagnosis for this 52-year-old male is erectile dysfunction (ED), predominantly vasculogenic, in the context of multiple cardiometabolic risk factors. His type 2 diabetes (A1C 8.2%), hypertension, hyperlipidemia, obesity (BMI 32), and sedentary lifestyle all contribute to endothelial dysfunction and impaired nitric oxide signaling, which are key mechanisms of ED. The diminished peripheral pulses further suggest vascular disease. Importantly, the patient maintains normal libido, making hypoactive sexual desire disorder less likely. The presence of mild nocturia could point toward lower urinary tract symptoms (LUTS) or benign prostatic hyperplasia (BPH), which may influence therapeutic decision-making. Diabetes is strongly associated with ED, and better glycemic control has been shown to improve outcomes (Defeudis et al., 2022; Wang et al., 2023).

**Management and Rationale**

Initial evaluation should include laboratory studies such as fasting glucose, repeat A1C, morning total testosterone, lipid panel, and renal function tests. If testosterone is low, further hormonal evaluation with luteinizing hormone, follicle-stimulating hormone, and prolactin would be warranted. Screening for depression, obstructive sleep apnea, and atherosclerotic cardiovascular disease (ASCVD) is also important, given that ED can serve as an early marker of vascular disease (Wang et al., 2023). Additionally, prostate-specific antigen (PSA) testing may be considered in the setting of nocturia after shared decision-making.

The first-line treatment for this patient is a phosphodiesterase-5 inhibitor (PDE5i). PDE5 inhibitors are effective in improving erectile function, including in men with diabetes, though response rates may be lower compared to the general population. Tadalafil is a particularly suitable option in this case because daily dosing of 5 mg not only improves erectile function but also reduces LUTS associated with BPH, thereby addressing both of the patient’s concerns (Defeudis et al., 2022; Wang et al., 2023). If the patient prefers an on-demand regimen instead of daily therapy, sildenafil 50 mg to 100 mg as needed 30–60 minutes before sexual activity is an alternative. Both options are safe with his current medications, though caution should always be taken to avoid concurrent nitrate use.

Lifestyle and cardiometabolic optimization are also essential. Structured exercise, weight reduction, a Mediterranean-style diet, and improved sleep can enhance erectile function and improve glycemic control. Targeting an A1C closer to 7%, ensuring blood pressure control, and optimizing lipid management are important for both sexual and cardiovascular health (Defeudis et al., 2022).

**Prescription**

The prescription for this patient would be:

1. Tadalafil 5 mg orally once daily. Take one tablet by mouth at the same time each day, with or without food. Do not exceed one tablet in 24 hours. Dispense 30 tablets. Refills: 2.

If the patient prefers on-demand dosing instead of daily therapy:

1. Sildenafil 50 mg orally as needed. Take one tablet by mouth 30–60 minutes prior to sexual activity. May increase to 100 mg or decrease to 25 mg based on response and tolerability. Do not exceed one dose in 24 hours. Avoid taking with high-fat meals. Dispense 6–10 tablets. Refills: 2.

**Patient Education**

Patient education should emphasize that PDE5 inhibitors require sexual stimulation to be effective. The patient should be informed about common side effects, including headache, flushing, nasal congestion, dyspepsia, and—specifically with tadalafil—back pain or myalgias. He should be instructed to seek urgent medical attention for chest pain, sudden vision or hearing changes, or an erection lasting longer than four hours.

Equally important is counseling on lifestyle changes. The patient should aim for at least 150 minutes of moderate aerobic activity per week, combined with resistance training twice weekly. Weight reduction of 5–10% can significantly improve both glycemic control and erectile function. Alcohol should be limited, and tobacco should be avoided. Sleep hygiene should also be addressed. Patients should also be cautioned against using over-the-counter “male enhancement” supplements, as many of these products are adulterated or lack reliable efficacy data (Petre et al., 2023).

**Follow-up and Referral**

The patient should follow up in 4–6 weeks to evaluate the effectiveness and tolerability of the prescribed PDE5 inhibitor, review adherence to lifestyle modifications, and assess laboratory results such as A1C and testosterone. If the initial therapy proves ineffective, options include dose titration, switching PDE5 inhibitors, or adding second-line interventions such as vacuum erection devices or alprostadil. If laboratory evaluation reveals hypogonadism, referral to endocrinology would be indicated for further management. Referral to urology should also be considered if the patient fails first-line therapies. Finally, given the diminished peripheral pulses and known cardiometabolic disease, a referral to cardiology may be warranted to evaluate for systemic vascular disease, since ED is often an early indicator of cardiovascular pathology (Wang et al., 2023).

**References**

Defeudis, G., Mazzilli, R., Tenuta, M., Rossini, G., Zamponi, V., Olana, S., Faggiano, A., Pozzilli, P., Isidori, A. M., & Gianfrilli, D. (2022). Erectile dysfunction and diabetes: A melting pot of circumstances and treatments.
_Diabetes/Metabolism Research and Reviews_,
_38_(2), e3494.
[https://doi.org/10.1002/dmrr.3494Links to an external site.](https://doi.org/10.1002/dmrr.3494)

Feng, H., Peng, W., Deng, Z., Liu, J., & Wang, T. (2023). Erectile dysfunction and exosome therapy.
_Frontiers in Endocrinology_,
_14_, 1123383.
[https://doi.org/10.3389/fendo.2023.1123383Links to an external site.](https://doi.org/10.3389/fendo.2023.1123383)

Petre, G. C., Francini-Pesenti, F., Vitagliano, A., Grande, G., Ferlin, A., & Garolla, A. (2023). Dietary supplements for erectile dysfunction: Analysis of marketed products, systematic review, meta-analysis and rational use.
_Nutrients_,
_15_(17), 3677.
[https://doi.org/10.3390/nu15173677Links to an external site.](https://doi.org/10.3390/nu15173677)

Wang, C.-M., Wu, B.-R., Xiang, P., Xiao, J., & Hu, X.-C. (2023). Management of male erectile dysfunction: From the past to the future.
_Frontiers in Endocrinology_,
_14_, 1148834.
[https://doi.org/10.3389/fendo.2023.1148834](https://doi.org/10.3389/fendo.2023.1148834)

November 5, 2026
[Solved] ploi

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November 5, 2026
[Solved] PICOT new

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November 5, 2026
[Solved] Prof Double R

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Prompt Imagine you have been contracted to consult on the recent developments at the Featherfall Medical Center. Featherfall has been struggling of late; it has had a series of problems that have prompted your hiring. It has faced the following issues: 1. Featherfall has recently violated several go…

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Prompt
Imagine you have been contracted to consult on the recent developments at the Featherfall Medical Center. Featherfall has been struggling of late; it has had a series of problems that have prompted your hiring. It has faced the following issues:
1. Featherfall has recently violated several government regulations regarding the current state of its technology and how it is being used. The technology system is vastly out of date, and staff are not always using the technology that is in place or they are using the technology inappropriately. These problems have lost the institution lots of money for not meeting government regulations and have caused operational and ethical problems from inefficient and ineffective use of technology.
2. The staff at Featherfall are not well-trained on the use of technology and do not communicate appropriately about technology use. The roles that pertinent to your consult are the health information management team, the clinical staff (doctors, nurses, etc.), and administrative staff. The health information management team uses proper coding practices, and the current technology system serves them well, despite its age. However, other roles in the hospital have had issues with the system. Clinical staff, for instance, have had record-keeping issues both due to lack of training on the system and the system itself being out of date. Administrative staff within the organization have taken issue with the lack of communication about the technology and its use between the various roles. When the current technology system was chosen many years ago, the needs of these various roles were not considered.
You will begin by preparing for your consultation. You will analyze the history of the field as well as determine standard guidelines for technology use and standard technologies used in the field. You will also prepare information for Feather fall regarding the ramifications for violating health laws and regulations. Finally, you will use this information to review [technology options](https://learn.snhu.edu/content/enforced/1958382-HIM-500-10870.202557-1/him500_technology_information.pdf?isCourseFile=true&ou=1958382) that could be implemented at the institution.
Specifically, the following **critical elements** must be addressed:
1. **Preparation for Consult**: In this section of your final project, you will prepare for your consultation on the organization’s technology choice. To prepare, you will analyze the field of health information management for determining standard technologies and guidelines related to technology use in order to inform your technology selection.
1. Analyze **key historical events** in the field of health informatics for how technology has been used that could inform the management of health information. Be sure to support your response with appropriate examples.
2. Determine **guidelines** for technology use in the field of health information management that Featherfall could implement. Be sure to support your response with research.
3. Determine the **standard technologies** currently used in the field of health information management. Be sure to support your response with research. For example, what record-keeping technologies are typically used in the field?
4. Develop an overview of how the pertinent **roles** described at Feather fall would interact with technology.
5. Describe the process you would use to **evaluate** new health information technology systems. Be sure that your process will evaluate new systems based on how they meet the needs of the organization and how they are compliant with health regulations and laws.
2. **Health Regulations and Laws Ramifications**: In this section of your final project, you will finish your preparation by reviewing and explaining the ramifications for the organization if it decides to wait on addressing its recent violations regarding technology use.
1. Determine how violating health regulations and laws regarding technology could impact the **finances** of the institution if these violations are not addressed. Be sure to support your response with examples.
2. Determine how violating health regulations and laws regarding technology could impact the **daily operations** of the institution if these violations are not addressed. Be sure to support your response with examples.
3. Determine how violating health regulations and laws regarding technology could impact the **security** of the health information in the institution if these violations are not addressed. Be sure to support your response with examples.
3. **Technology System Recommendations:** In this final section of your final project, you will review the [provided technology options](https://learn.snhu.edu/content/enforced/1958382-HIM-500-10870.202557-1/him500_technology_information.pdf?isCourseFile=true&ou=1958382) and make informed recommendations to the organization regarding which technology it should choose.
1. Determine the **needs** of the various roles of the organization in a new technology.
2. Recommend a new health information technology system that meets the following criteria. Be sure to justify how your recommendations meet the criteria. The new health technology must:
1. Abide by provided health **regulations and laws**
2. Align with the needs of all **staff** members of the previously described organization
3. Ensure the **ethical** management and use of health information
3. Determine how the organization could more effectively invest its **financial resources** into the recommended technology system. Be sure to justify your response.
4. Determine how the organization could **monitor** the use of the new health information system. Be sure to justify your response.
5. Determine how the organization could effectively invest its **time** into the implementation of the new health information technology system. Be sure to justify your response.

November 5, 2026
[Solved] Discussion week 5 Advanced Decision Making

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Remember that problem owners and stakeholders often like to have choices. By developing several alternatives and modeling each of them, you can present a balanced yet comprehensive view of the problem and its solutions. Section 10.16.3 of the BABOK® Guide details decision analysis. Using a company y…

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Remember that problem owners and stakeholders often like to have choices. By developing several alternatives and modeling each of them, you can present a balanced yet comprehensive view of the problem and its solutions. Section 10.16.3 of the BABOK® Guide details decision analysis. Using a company you have worked for (or would like to work for) as an example, share how a decision tree could be used to show possible solutions. What other tools could be beneficial in the enterprise analysis? In addition to peer-reviewed academic journal articles, back up all opinions with foundation knowledge from the BABOK Guide and in-class lessons

November 5, 2026
[Solved] Can someone do my Week 5 discussion in MHA 605 Business Intelligence?

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– Read Chapter 9 from your textbook, _An Overview of Business Intelligence, Analytics, Data Science, and AI_ – Read the following articles: – [_Using big data and data analytics for better business decisions_Links to an external site.](https://www.forbes.com/sites/forbesbusinessdevelopmentcouncil/20…

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– Read Chapter 9 from your textbook, _An Overview of Business Intelligence, Analytics, Data Science, and AI_
– Read the following articles:
– [_Using big data and data analytics for better business decisions_Links to an external site.](https://www.forbes.com/sites/forbesbusinessdevelopmentcouncil/2022/08/29/using-big-data-and-data-analytics-for-better-business-decisions/?sh=4ea00de27778)
– [_Big data analytics impact on business decision-making and strategy_Links to an external site.](https://intellectdata.com/big-data-analytics-impact-on-business-decision-making-and-strategy/)
– Review the video: [_Big data analytics transform how businesses make decisions_Links to an external site.](https://www.youtube.com/watch?v=CuWkC11Z2iE)
It is important for healthcare leaders to make informed decisions for the organization and their patients. Collecting data is only part of the picture. After the information has been collected, the work begins to analyze the data for meaning or themes. The quantity of data can be overwhelming to a single researcher, but machine-based algorithms can process data that is vast in quantity (big data). In the healthcare delivery system, data scientists use big data to improve patient experiences, provide more positive healthcare outcomes, and reduce costs for the healthcare organization and patients. Additionally, big data can be used to make predictions regarding possible epidemics, improve decision-making policies, and reduce mortality-morbidity rates.
According to Delen, Sharda, and Turban (2023), “Big data and analytics instigate new ways to transform processes, organizations, entire industries, and even society altogether” (p.369). By incorporating and analyzing big data, caregivers can improve their diagnostic accuracy through the identification of treatment actions and outcomes.
In this week’s discussion address the following prompts in a minimum of 500 words:
– Discuss the importance of big data and its contribution to improving health care outcomes for patients.
– Describe how big data is changing the decision-making processes for administrative and clinical care.
– Explain stream analytics and how it differs from regular analytics.
– Describe the motivations for using stream analytics.
– Discuss three problems that can be addressed or improved with big data analytics. Examples: Regulatory Compliance, Risk Management, Improved Customer Experience, Enhanced Security Efficiency.

November 5, 2026
[Solved] Prof Double R

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During the implementation of a CIS, what is the impact on stakeholders across the organization? How does it impact staff? Patients? Support your answer with relevant sources.

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During the implementation of a CIS, what is the impact on stakeholders across the organization? How does it impact staff? Patients?
Support your answer with relevant sources.

November 5, 2026
[Solved] journal

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November 5, 2026
[Solved] Business Finance – Operations Management Can someone do my Week 6 assignment in MHA 605 Business Intelligence?

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Prior to beginning work on this assignment, – Read Chapter 10 of your textbook, _Business Intelligence, Analytics, Data Science, and AI_. – Read the following article and webpages: – [_How to make a successful BI strategy roadmap_Links to an external site.](https://www.thoughtspot.com/data-trends/bu…

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Prior to beginning work on this assignment,
– Read Chapter 10 of your textbook, _Business Intelligence, Analytics, Data Science, and AI_.
– Read the following article and webpages:
– [_How to make a successful BI strategy roadmap_Links to an external site.](https://www.thoughtspot.com/data-trends/business-intelligence/how-to-make-a-bi-strategy-roadmap)
– [_How data mining helps in business intelligence_Links to an external site.](https://appinventiv.com/blog/data-mining-in-business-intelligence/)
– [_7 steps to create a modern business intelligence strategy_Links to an external site.](https://www.techtarget.com/searchbusinessanalytics/tip/7-key-steps-to-deploy-a-modern-business-intelligence-strategy)
– Review the video, [_Create a winning business intelligence strategy: Google career certificates_Links to an external site.](https://www.youtube.com/watch?v=w65itR6nFT0)
A business intelligence (BI) plan, or roadmap, is derived from data sets encompassing a multitude of factors in a healthcare organization. The BI plan, with data mining and statistics, measures a healthcare organization’s performance and seeks to determine the organization’s competitive advantage among a service demographic, such as cardiac care, orthopedic care, renal care, and long-term care. According to Delen, Sharda, and Turban (2023), “BI cannot simply be a technical exercise for the information systems department. It has to serve as a way to change the manner in which the company conducts business by improving its business processes and transforming decision making processes to be more data driven” (p. 20).
Imagine, you are the lead manager of the information systems department at Green Valley Hospital Center. The hospital is an 800-bed comprehensive facility that specializes in orthopedic surgery for older patients. The hospital is committed to bringing state-of-the-art healthcare services with a focus on diversity, equity, and quality of care to their patients. You and your team will be working with administrative staff, including all C-Suite administrators and officers. You are tasked with developing and presenting a PowerPoint presentation on the development process for a healthcare organization’s BI plan.
In your presentation,
– Define Business Intelligence (BI) and its applicability to the healthcare delivery system.
– Explain how data mining techniques can be implemented and what information can be derived from these techniques.
– Discuss how BI is clearly linked to an organizational strategy and the execution of an organization’s strategic plans.
– Define descriptive analytics, predictive analytics, and prescriptive analytics.
– Discuss how the five tenets of healthcare are implemented into a healthcare organization’s business intelligence plan.
– Analyze technology and architecture and how they impact the development of a business intelligence plan.
– Explain the four primary steps that will be used in creating your team’s successful BI plan (road map).
– Discuss the possible legal issues related to privacy and ethics regarding the implementation of analytics.
The Business Intelligence Plan final presentation
– must be 10 to 12 slides in length (not including title and references slides and formatted according to [_APA Style_Links to an external site.](https://writingcenter.uagc.edu/apa-style) as outlined in the Writing Center’s [_How to Make a PowerPoint Presentation_Links to an external site.](https://writingcenter.uagc.edu/how-make-powerpoint-presentation) resource.
– must include a separate title slide with the following in title case:
– title of presentation in bold font
– Space should appear between the title and the rest of the information on the title page.
– student’s name
– name of institution (The University of Arizona Global Campus)
– course name and number
– instructor’s name
– due date
– must utilize academic voice. Review the [_Academic Voice_Links to an external site.](https://writingcenter.uagc.edu/academic-voice) resource for additional guidance.
– must include an introduction and conclusion paragraph.
– Your introduction paragraph needs to end with a clear thesis statement that indicates the purpose of your presentation.
– For assistance on writing [_Introductions & Conclusions_Links to an external site.](https://writingcenter.uagc.edu/introductions-conclusions) and [_Writing a Thesis Statement_Links to an external site.](https://writingcenter.uagc.edu/writing-a-thesis), refer to the Writing Center resources.
– must use at least 6 scholarly, peer-reviewed, credible sources in addition to the course text.
– The [_Scholarly, Peer-Reviewed, and Other Credible Sources_Links to an external site.](https://content.bridgepointeducation.com/curriculum/file/e5359309-7d3c-4a21-a410-44d59303ccef/1/Scholarly%20Peer-Reviewed%20and%20Other%20Credible%20Sources.pdf) table offers additional guidance on appropriate source types. If you have questions about whether a specific source is appropriate for this assignment, please contact your instructor. Your instructor has the final say about the appropriateness of a specific source.
– To assist you in completing the research required for this assignment, review [_Quick and Easy Library Research_Links to an external site.](https://ashford.mediaspace.kaltura.com/media/Ashford+University+Library+Quick+%27n%27+Dirty/0_bcsbcjee) tutorial, which introduces the University of Arizona Global Campus Library and the research process, and provides some library search tips.
– must document any information used from sources in APA Style as outlined in the Writing Center’s [_APA: Citing Within Your Paper_Links to an external site.](https://writingcenter.uagc.edu/apa-citing-within-your-paper) guide.
– must include a separate reference slide that is formatted according to APA Style as outlined in the Writing Center.
– Review the [_APA: Formatting Your References List_Links to an external site.](https://writingcenter.uagc.edu/format-your-reference-list) resource in the Writing Center for specifications.

November 5, 2026