Category: Nursing

Many nurses are very concerned about what lies in the future of their careers. Each generation has their challenges, but this generation will probably always remember COVID-19. As nurses, we had to reflect on what happened during those days and we needed to soul search because of what we had to confront as nurses. Some of you are on the front lines of this pandemic taking care of patients that are affected.
Instructions:
Go to the American Association of Critical-Care Nurses (AACN) https://www.aacn.org/clinical-resources/moral-distress website and read about moral distress.
Please share a couple of experiences that you may have had or that you may imagine that you would have caring for a patient with COVID-19
Example: It really disturbs me that a person that is dying cannot communicate with their family. As a proponent of palliative care and hospice and all the ideas connected to this I am adamantly against any person going through the dying process without family present. This has really disturbed me to the point that I am personally dealing with feelings of distress that I cannot come up with an answer.
Your post should:
Answer the questions as thoroughly and concisely as possible.
Be sure to reference any works that you utilize in answering the questions
Be sure that references are in APA Links to an external site. format.

In at least 2 paragraphs and in APA format explain how the image of nursing in Florence Nightengales time influenced nursing from the 18060’s through the 1940’s. You do not need a cover page for this assignment but you do need to cite your sources appropriately.

FOR ALTERNATIVE ASSIGNMENT THE UPLOADED FILES. All of the following are true:
● Alternative assignment describes the main points discussed in the Seminar.
● Assignment includes sub-topics and/or subsequent classroom discussion from the entire Seminar.
● Assignment includes points found of interest about the unit content and/or any additional reflections or questions about the unit content.
Note: Points may be adjusted by the instructor if specified criteria in the level are not met.

Using the following case study give the reason for prescribing, mechanism of action, and best prescription for the patient in the case study using the rubric.
TIPS for ALL Case Studies:
Please use Case Study Grading Sheet and adhere to the page limit.
Check multiple sources as references—your texts, Epocrates, and/or Sanford Guide, etc.
When explaining rationale, you may refer to evidence based guidelines.
An example of rationale: Pyelonephritis is caused by XXXXX pathogen and can be treated by XXXXX drug. XXXX drug is in the XXXXX class (then explain the MOA of the drug)
Tailor the case study to the particular patient. Don’t use generic information not pertinent to the case study. For example: Drug XXX is pregnancy category C and the patient in the case study is male or post-menopausal.
Books 1. Whalen, K. (2018). Lippincott’s illustrated reviews: Pharmacology. 7th ed. Philadelphia, PA: Lippincott Williams & Wilkins. ISBN 978-1496384133; ISBN-10 14-9638413. *This is your primary text text is available as a new and used text; available as an e-book and text can be rented—can be rented for $15.66
2. Woo, TM & Robinson, MV. [2020]. Pharmacotherapeutics for Advanced Practice Nurse Prescribers. 5th Edition. Philadelphia, PD: FA Davis. ISBN: 978-0-8036-6926-0. *This text has required materials on lifespan, prenatal, pediatrics and prescribing so it is also required If you opt to purchase your text direct from publisher see below: www.fadavis.com save 20% and get free shipping—search for text by ISBN, title or author; then use promo code PWEA7M82 for discount to be added. Text is available as a new and used text; it can also be rented—cost of rental text is $23.483. Suggested: Gilbert, D. N., Moellering, R. C., Eliopoulos, G. M., Chambers, H. F. & Saag, M. S. (2021). Sanford guide to antimicrobial therapy. 52nd Ed., Sperryville, VA, Antimicrobial Therapy Inc.
Women’s Health Case Study—Pharmacology
Sarah is a 28-year-old female who presents for birth control. Sarah says that she tried Skyla, but thinks it made her acne worse, so she had it removed about 6 months ago. She says she is healthy. She does not smoke or use alcohol in excess. She has no allergies. She has had an appendectomy. Her medical problems include acne. Medications include Doxycycline 50 mg. once daily for her acne. Sarah works as a CPA. She plays tennis for exercise.
On exam, she is 67 inches tall and weighs 140 pounds. She is well groomed. There are noticeable small papules and rare pustules [all smaller than 2 mm] on her cheeks and on her back—at the level of the scapula bilaterally. No other acne-form lesions. There is no evidence of hirsutism.
Cardiac and lung exams are normal; she has no lower extremity edema. Grade Sheet for Pharmacology Case Studies
The same grading criteria will be used for all cases. Please use this page for each case study. You may write in your answers and scan this page. Uses references as appropriate [no reference page required, put references used in the body of the work]. ***PAGE LIMIT: Limit ONE page of text, ONE page for prescription [if more than one Rx is given, one page per prescription is accepted], and ONE page for cover sheet [if desired]***
1. What drug and drug class would be the best choice in this scenario? State name of drug and its mechanism of action. If there is information from the patient’s history or exam that was important in choosing the agent [patient specific factors], cite those. 25 points
2. Cite any lab/diagnostic testing needed for before prescribing that are required and any needed for monitoring. State patient education/counseling or side effect education that should be included. Note pertinent any drug-drug interactions, Black Box warnings and life span considerations? 35 points
3. Write the patient the prescription(s) for the new medication(s) on the provided prescription(s). Include any special instructions if needed. Prescription(s) must be clear, legible, accurate, and complete.
40 points
Advanced Pharmacy Clinic
123 Pill Ave., Anywhere, TX 70001
(123) 456-7890
Name:_________________________________Date:_________
Address:_______________________________DOB:__________
℟
SIG
Refill_____times
______________________
A.B. Smart MD phone (123)456-7890 J.B. Jones, RN, ANP
123 Pill Ave, Anywhere, TX 70001 NPI ID#
DEA# AB12345 DPS# 112321 DEA# DPS#N5334
3
3
Advanced Pharmacy Clinic
123 Pill Ave., Anywhere, TX 70001
(123) 456-7890
Name:_________________________________Date:_________
Address:_______________________________DOB:__________
℟
SIG
Refill_____times
_____________________
A.B. Smart MD phone (123)456-7890 J.B. Jones, RN, ANP
123 Pill Ave, Anywhere, TX 70001 NPI ID#_____________
DEA# AB12345 DPS#112321 DEA# DPS#
Advanced Pharmacy Clinic
123 Pill Ave., Anywhere, TX 70001
(123) 456-7890
Name:_________________________________Date:_________
Address:_______________________________DOB:__________
℟
SIG
Refill_____times
______________________
A.B. Smart MD phone (123)456-7890 J.B. Jones ,RN, ANP
123 Pill Ave, Anywhere, TX 70001 NPI ID#
Prescription Writing Example Controlled Substances
Some APRN’s print Prescribing Authority /DEA/DPS number on the blank form but leave a space and fill in numbers when appropriate, which may be safer option.
If several physicians in the same facility delegate prescriptive authority to you then all their names must be on the form. You circle the name of the one who is delegating at the time the script is written. The physicians may also wish you write in their DEA, DPS#’s as appropriate. Your protocol or collaborative agreement requires the name and signature of your primary physician and in large practices may include names who may delegate to you in the absence of the primary. You do have to keep special documentation when using other than the primary delegating physician. This is a BOM requirement.
Abbreviations Effective January 2004!!!
Example:
Advanced Pharmacy Clinic
123 Pill Ave., Anywhere, TX 70001
(123) 456-7890
Name: John D. Smith___________________Date:mm/dd/yy_
Address:__street address at least____________DOB 4/1/1950_______
℟ Lunesta 2 mg tablet
dispense # 30 (thirty)
Sig: 1 tab po at HS Refill NONE times
J Jones RN, ANPA.B. Smart MD phone (123)456-7890 J.B. Jones ,RN, ANP
123 Pill Ave, Anywhere, TX 70001 NPI# 22002

here is often the requirement to evaluate descriptive statistics for data within the organization or for health care information. Every year the National Cancer Institute collects and publishes data based on patient demographics. Understanding differences between the groups based upon the collected data often informs health care professionals towards research, treatment options, or patient education.
Using the data on the “National Cancer Institute Data” Excel spreadsheet, calculate the descriptive statistics indicated below for each of the Race/Ethnicity groups. Refer to your textbook and the topic Resources, as needed, for assistance in with creating Excel formulas.
Provide the following descriptive statistics:
Measures of Central Tendency: Mean, Median, and Mode
Measures of Variation: Variance, Standard Deviation, and Range (a formula is not needed for Range).
Once the data is calculated, provide a 150-250 word analysis of the descriptive statistics on the spreadsheet. This should include differences and health outcomes between groups.
APA style is not required, but solid academic writing is expected.
This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

Post a publish of your cultural and ethical inquiry paper for peer review. You should also post your level 1 and level 2 research questions. Identify any questions or challenges you faced with the assignment, or mention something new you learned about the research question and inquiry paper process. Pose specific questions you would like your peers to address.
In your responses, provide your peers with specific feedback, constructive criticism, suggestions for improvement, and ideas for resources or support. Comment to a minimum of two peers. Remember that your feedback and support are important!

For this assessment, develop a solution to a specific ethical dilemma faced by a health care professional. In your assessment:
Access the Ethical Case Studies media piece to review the case studies you will be using for this assessment.
Select the case most closely related to your area of interest and use it to complete the assessment.
Note: The case study may not supply all of the information you need. In such cases, you should consider a variety of possibilities and infer potential conclusions. However, please be sure to identify any assumptions or speculations you make.
Include the selected case study in your reference list, using proper APA style and format. Refer to the Evidence and APA section of the Writing Center for guidance.
Summarize the facts in a case study and use the three components of an ethical decision-making model to analyze an ethical problem or issue and the factors that contributed to it.
Identify which case study you selected and briefly summarize the facts surrounding it. Identify the problem or issue that presents an ethical dilemma or challenge and describe that dilemma or challenge.
Identify who is involved or affected by the ethical problem or issue.
Access the Ethical Decision-Making Model media piece and use the three components of the ethical decision-making model (moral awareness, moral judgment, and ethical behavior) to analyze the ethical issues.
Apply the three components outlined in the Ethical Decision-Making Model media.
Analyze the factors that contributed to the ethical problem or issue identified in the case study.
Describe the factors that contributed to the problem or issue and explain how they contributed.
Apply academic peer-reviewed journal articles relevant to an ethical problem or issue as evidence to support an analysis of the case.
In addition to the readings provided, use the Capella library to locate at least one academic peer-reviewed journal article relevant to the problem or issue that you can use to support your analysis of the situation. The NHS-FPX4000: Developing a Health Care Perspective Library Guide will help you locate appropriate references.
Cite and apply key principles from the journal article as evidence to support your critical thinking and analysis of the ethical problem or issue.
Review the Think Critically About Source Quality resource.
Assess the credibility of the information source.
Assess the relevance of the information source.
Discuss the effectiveness of the communication approaches present in a case study.
Describe how the health care professional in the case study communicated with others.
Assess instances where the professional communicated effectively or ineffectively.
Explain which communication approaches should be used and which ones should be avoided.
Describe the consequences of using effective and non-effective communication approaches.
Discuss the effectiveness of the approach used by a professional to deal with problems or issues involving ethical practice in a case study.
Describe the actions taken in response to the ethical dilemma or issue presented in the case study.
Summarize how well the professional managed professional responsibilities and priorities to resolve the problem or issue in the case.
Discuss the key lessons this case provides for health care professionals.
Apply ethical principles to a possible solution to an ethical problem or issue described in a case study.
Describe the proposed solution.
Discuss how the approach makes this professional more effective or less effective in building relationships across disciplines within his or her organization.
Discuss how likely it is the proposed solution will foster professional collaboration.
Write clearly and logically, with correct use of spelling, grammar, punctuation, and mechanics.
Apply the principles of effective composition.
Determine the proper application of the rules of grammar and mechanics.
Write using APA style for in-text citations, quotes, and references.
Determine the proper application of APA formatting requirements and scholarly writing standards.
Integrate information from outside sources into academic writing by appropriately quoting, paraphrasing, and summarizing, following APA style.
Case study topic: Incident 2: Emergency Department Report Admissions-A Question of Resource Use
Case study scenario:
Matt Losinski finished reading an article that provided grim details of a study of the overuse of emergency services in hospitals in central Texas. He smiled that sardonic half smile that meant there was a strong possibility that County General Hospital (CGH) might have the same problem. As chief executive office (CEO), Losinski always saw the problems of other hospitals as potential problems at CGH, a 300–bed, acute care hospital in a mixed urban and suburban service area in the south central United States. CGH was established as a county–owned hospital; however, 10 years ago the county wanted to get out of the hospital business and the assets were donated to a not–for–profit hospital system. The new owner has continued a strong public service orientation, even though CGH no longer receives the tax subsidy it did when it was county owned; it must look to itself for fiscal health.
The study data showed that nine residents of a central Texas community had been seen in emergency departments (EDs) a total of 2,678 times over 6 years. One resident had been seen in an ED 100 times each year for the past 4 years. Given that an ED visit can cost $1,000 or more, the nine residents had consumed $2.7 million in resources. These high users of ED services were middle age, spoke English, and were split between male and female. To Losinski, the problem seemed like a manifestation of Wilfredo Pareto’s classic 80/20 rule.
Losinski forwarded the article on a priority basis to Mary Scott, his chief financial officer (CFO), and asked her to see him after she read it. Scott stopped by Losinski’s office late the next day and began the conversation by asking him why he thought the article was a priority. Scott reminded Losinski that Medicaid paid 75% of costs for eligible ED users and that the cross subsidy from privately insured and self–pay ED admissions covered most of the unpaid additional costs. Losinski had a good working relationship with Scott, but he was a bit annoyed by her rather indifferent response.
Losinksi wanted details on use of the ED at CGH. He asked the administrative resident, Aniysha Patel, to gather data to identify use rates for persons repeatedly admitted to the ED. The findings that Patel gave to Losinski two weeks later were not as extreme as those reported from central Texas; however, they did show that a few persons were repeatedly admitted to the ED and accounted for hundreds of visits in the past year. The clinical details were not immediately available, but a superficial review of the admitting diagnoses suggested that most admissions involved persons with minor, nonspecific medical problems—persons commonly known as the “worried well.” Although Scott was correct that Medicaid covered the majority of costs, the fact remained that over $200,000 each year was not reimbursed to CGH. Were that money available, it could go directly to the bottom line and could be used for enhancements to health initiatives for the community. In addition, repeated admissions to the ED contributed to crowding, treatment delays, and general dissatisfaction for other patients.
Losinski presented the data to his executive committee, which includes all vice presidents, the director of development, and the elected president of the medical staff. The responses ran the gamut from “So what?” to “Wow, this is worse than I imagined.” Losinski was bemused by the disparity of views. He had thought there would have been an almost immediate consensus that this was a problem needing a solution. The financial margins for CGH were already very thin, and the future for higher reimbursement was not bright. A concern echoed by several at the meeting was the requirement of the federal Emergency Medical Treatment and Active Labor Act (EMTALA) that all persons who present at an ED that receives federal reimbursement for services must be treated and stabilized.
Losinski asked his senior management team for recommendations to address the problem of ED overuse.

Telehealth visit was completed. Client was alert and oriented x4, verbalized stability, denied skin bruise, cut, and no discoloration, no pain. Last medical appointment was last two weeks ago. Client stated he is homeless and sometime secure resting place in a friends house. He showers and dress daily in a friends house. He verbalized desire to secure a sleeping place in a shelter. Client spend food stamp to meet daily needs in term of foods. Client verbalized his cousin died two weeks ago and really affected his condition. During last medical appointment his blood pressure was reported 142/96. Client report he drinks alcohol daily and could not indicate number of bottles per day. Detail not should explain course of blood pressure, client educations.

Scenario 2: A 65-year-old patient is 8 days post op after a total knee replacement. Patient suddenly complains of shortness of breath, pleuritic chest pain, and palpitations. On arrival to the emergency department, an EKG revealed new onset atrial fibrillation and right ventricular strain pattern – T wave inversions in the right precordial leads (V1-4) ± the inferior leads (II, III, aVF)
In your Case Study Analysis related to the scenario provided, explain the following:
The cardiovascular and cardiopulmonary pathophysiologic processes that result in the patient presenting these symptoms.
Any racial/ethnic variables that may impact physiological functioning.
How these processes interact to affect the patient
The Assignment
In your Case Study Analysis related to the scenario provided, explain the following
The cardiovascular and cardiopulmonary pathophysiologic processes that result in the patient presenting these symptoms.
Any racial/ethnic variables that may impact physiological functioning.
How these processes interact to affect the patient.
Please write the assignment in APA format
Use subheadings to indicate which part of the Question is being answered.
Include an introduction (with thesis statement and the purpose of the paper), plus a conclusion.
Make sure to use a minimum of five current (less than 5 years old) resources: at least 3 from the school materials and 2 from outside.
LEARNING RESOURCES
Required Readings
McCance, K. L. & Huether, S. E. (2019). Pathophysiology: The biologic basis for disease in adults and children (8th ed.). St. Louis, MO: Mosby/Elsevier.Chapter 32: Structure and Function of the Cardiovascular and Lymphatic Systems; Summary Review
Chapter 33: Alterations of Cardiovascular Function (stop at Dysrhythmias); Summary Review
Chapter 35: Structure and Function of the Pulmonary System; Summary Review
Chapter 36: Alterations of Pulmonary Function (stop at Disorders of the chest wall and pleura); (obstructive pulmonary diseases) (stop at Pulmonary artery hypertension); Summary Review
Note: The above chapters were first presented in the Week 3 resources. If you read them previously you are encouraged to review them this week.
Required Media Alterations in the Cardiovascular and Respiratory Systems – Week 4 (15m)

Online Media from Pathophysiology: The Biologic Basis for Disease in Adults and Children

Evidence-Based Paper (EBP) Guidelines for Concept Map Presentation
“A Sentinel Event is defined by The Joint Commission (TJC) as any unanticipated event in a healthcare setting resulting in death or serious physical or psychological injury to a patient or patients, not related to the natural course of the patient’s illness.”
Two sentinel events happened in a hospital in 1 month.
A. 50 year old male in ICU passed away after suffering from Ventilator associated Pneumonia. Patient was vented after surgical removal of right lung lobe. It was post op day #9.
B. 45 year old female passed away from overdose of patient controlled analgesic (PCA). Patient was placed on PCA after laparoscopic bowel resection. It was post op day #3.
Write 1000 word paper on how to prevent any future such sentinel events. Please follow the Grading Rubric below to write your paper.
A hardcopy of EBP with attached Turnitin Report showing Similarity Index of 15% or less must be submitted to your Clinical Instructor.
ONLY DO SECIONS NAMED MECHANISMS AND ROOT CAUSE ANALYSIS
1 page for each of those sections
remaining of paper is done so do not change other sections