Category: Nursing

Purpose:
This discussion board content is intended to facilitate learning for students through engaging dialogues as they achieve the desired learning outcomes/competencies associated with their course in a manner that empowers them to organize, integrate, apply and critically appraise their knowledge to their selected field of practice.
The use of discussions provides students with opportunities to contribute graduate level-appropriate knowledge and experience to the topic in a safe, caring, and fluid environment that models professional and social interaction. The ebb and flow of a discussion is based upon the composition of student and faculty interaction in the quest for relevant scholarship.
Participation in the discussion generates opportunities for students to actively engage in the written ideas of others by carefully reading, researching, reflecting, and responding to the contributions of their peers and course faculty. Discussions foster the development of members into a community of learners as they share ideas and inquiries, consider perspectives that may be different from their own, and integrate knowledge from other disciplines.
Assignment: This week we are comparing and contrasting epidemiological methods of research; case-control and cohort study methods. Select either the case-control or cohort study method and compare its features, the methodology, to a randomized controlled trial using the following questions. Please format, organize, your responses using each question below:
What is the fundamental difference between the method you have chosen (either the case-control or cohort method) and the randomized controlled trial?
What are the advantages and disadvantages of the study method you chose (case-control or cohort study)?
What are the characteristics of a correlational study?
Where does the method you chose (case-control or cohort study) fall on the research pyramid? What does where it is on the research pyramid mean?
Your analysis should have in-text citations and utilize a scholarly voice with APA formatting.

Teri goes to see her PCP after feeling depressed last couple of months as well as experiencing a seizure earlier this week. The physician orders a few test, results are shown below:
Low hematocrit
Low levels of Vit B12
Low Oxygen levels
Presence of autoantibodies against the parietal cell
Peripheral blood smear shows abnormal RBC (large pale RBCs)
After viewing the results, Teri is diagnosed with Pernicious Anemia; a condition in which autoantibodies destroys the parietal cells found within the stomach.
Address each of the following regarding Teri’s case:
Since the parietal cell is destroyed, which substance(s) is Teri lacking as a consequence?
What is the correlation between destruction of parietal cells and Vit B12 deficiency?
Due to her condition, Teri lacks Pepsin. Explain why.
If Teri were healthy, explain what her RBCs would look like?
What is hematocrit?
Low oxygen levels stimulate her body to create new RBCs by stimulating which process? Explain that process in depth.
What protein transports oxygen in our body and explain its structure?
What cell secretes antibodies and explain the various functions of antibodies.
What are the different types of antibodies and give two characteristics for each?
Explain the structure of an immunoglobulin.
Specifics:
Support your opinions with evidence from your readings and research.
You must reference a minimum of three (3) scholarly sources in your paper, which includes one non-Internet source.
Use current APA Style to format your paper and to cite your sources.
Your paper/total responses must be 3– to 4-pages in length not including the title page, abstract, and reference pages.Title page: Case Title, Full Name, Section, Date, Instructor and Campus
Abstract: Summarize the case in a paragraph
Introduction: The physiological importance of the digestive system, immune system, and cardiovascular system for the proper functioning of the human body
Body: Organize your analysis with headings that thoroughly answer the prompts
Conclusion: Summarize the paper in a paragraph

A patient is ready for discharge when she spikes a fever of 101.3°F. A call to the physician results in an order for IV antibiotics to be administered every 12 hours for 48 hours. The patient’s family arrives to take her home, and they discover that she now has an IV and will not be discharged for 2 days. They ask, “What happened? Did our mother catch something in the hospital? We thought this is a place of healing.” How will you respond? Your response may have legal implications.
In one well-developed paragraphs (12-point font):
Describe one strategy you will incorporate in your practice to ensure that you are providing evidence-based care in the prevention of HAIs.
Cite your references in proper APA Style.
Review the rubric for more information on how your assignment will be graded.
Submit as an attachment in the assignment area. I NEED TWO SEPARATE VERSIONS OF THE SAME ASSIGNMENT

Advanced care planing Topic Submit a one-page, double-spaced paper addressing the following points:
Identify your chosen research topic
Create at least one problem statement to go along with your chosen research area
Identify your research question/s
Explain the significance of the research topic to nursing
Upon completion, your instructor will approve, deny, or make recommendations for modifications of your research topic, problem statement, or research question(s) to ensure successful completion of the research proposal project.
If you need some assistance creating a PICOT question, click here for a template provided by the AAACN.

INITIAL POST
Answer the following questions and provide rationales with supporting evidence for your choices using APA formatting. Integrate two evidence-based resources to include clinical practice guidelines as well as the course textbook.
Jason Ferguson is a 15-year-old boy who weighs 110 pounds. Jason is seeking treatment for a very itchy rash consisting of linear streaks of papules, vesicles, as well as blisters on his arms, legs, and face. He tells you he was hiking in the woods two days ago on trails that were lined with patches of shiny weeds that had three leaves. He tried using calamine lotion and over-the-counter hydrocortisone cream but has had no relief from the itching.
Diagnosis: Contact Dermatitis (Poison Ivy)
List specific goals of treatment for J. F.
What drug therapy would you prescribe? Why?
What are the parameters for monitoring the success of the therapy?
Discuss specific patient education based on the prescribed therapy.
List one or two adverse reactions for the selected agent that would cause you to change therapy.
What would be the choice for second-line therapy?
What over-the-counter and alternative medications would be appropriate for J. F.?
What lifestyle changes would you recommend to J. F.?
Describe one or two drug–drug or drug–food interactions for the selected.
R
REPLY POSTS
Reply to at least two of your classmates, in a well-developed paragraph (300–350 words) to each peer integrating an evidence-based resource that is different than the one you used for the initial post.
Respectfully agree and disagree with your peers’ responses and explain your reasoning by including your rationales in your explanation.
classmate 1: Samantha
The case scenario describes a 15-year-old boy who is experiencing the symptoms of allergic contact dermatitis (ACD), which involves skin contact with an allergen producing redness, papules, and/or vesicles (Woo & Robinson, 2020, pp. 984). Common causes of ACD are exposure to metals, topical medications, cosmetics, personal care products, preservatives, and some plants (Brod, 2023). Plants of certain species, such as anacardiaceae, compositae, alliaceae, and myrtaceae, all which contain resins and oils can cause symptoms in sensitized individuals (Brod, 2023). J.F. states that he may have had contact with a three-leaved shiny plant in the woods two days ago. This plant sounds like a description of poison ivy and if J.F. is having a reaction to it 2 days after exposure, this would be a subsequent exposure to the plant as a reaction can only occur after an initial exposure creating sensitization (Prok & McGovern, 2022, Woo & Robinson, 2020). Treatment goals for J.F. should include decrease of inflammation and discomfort including pruritis, treatment of papules, vesicles, and blisters, prevention of secondary bacterial infection, and restoration of skin barrier (Prok & McGovern, 2022).
Since J.F’s case of ACD has extended to his arms, legs, and face, and first-line pharmacological treatment for face and flexural areas is low-medium potency topical corticosteroids 1-2 times daily for 1-2 weeks then tapered dosing over the following two weeks (Brod, 2023). Seeing as J.F. has already used over-the-counter hydrocortisone cream without relief from itching, prescription of a 0.025% topical triamcinolone cream used on affected areas 1-2 times daily for 1-2 weeks is warranted and should be tapered to application every other day for 2 weeks after the first 1-2 weeks os use (Brod, 2023, Lexicomp, n.d.b). An oral antihistamines like Benadryl is not proven to help J.F. as poison ivy ACD is not caused by a histamine response (Brod, 2023). The parameters to monitor success of first-line therapy are resolution of papules, vesicles, and blisters on J.F.’s arms, legs, and face, relief from itching, no signs of secondary bacterial infection, and restoration of skin barrier (Prok & McGovern, 2022). Some education that should be shared with J.F. regarding this therapy should include use of therapy as prescribed, avoidance of re-exposure to the allergen poison ivy, avoid scratching, utilization of cold, wet cloths on affected areas, notify provider is rash spreads or severity of rash increases, avoid use of antihistamine creams, numbing products, and antibiotic ointments, as they all can cause an increase in skin or rash irritation (Lexicomp, n.d.b, UpToDate Doctors and Editors, n.d.). Possible drug-drug and drug-food interactions for triamcinolone mainly occur with concurrent use of CYPD4A3 inhibitors including many antifungals, antivirals, macrolides, and grapefruit, all which will increase the serum concentration of triamcinolone (Lexicomp, n.d.b).
If J.F. experienced an adverse reaction to the 0.023% triamcinolone cream such as application site burning, application site irritation, or application site pruritus I would change treatment therapy (Lexicomp, n.d.b). Topical tacrolimus is an alternative therapy to topical corticosteroids and 0.03% tacrolimus ointment can be applied as a thin layer to the affected areas twice daily for ACD (Lexicomp, n.d.a). A systemic corticosteroid can also be prescribed, especially if J.F.’s case of ACD worsens (Brod, 2023). An oral prednisone of 50 mg/day should be taken for 5 days, then decreased to 25 mg/day for 5 days, then decreased to 10 mg/day, then discontinued (Prok & McGovern, 2022). Some over-the-counter and alternative treatment options for J.F. include oatmeal baths, cool, wet compresses applied to affected areas, aluminum acetate solution and menthol and phenol containing lotions, however J.F. has already stated that calamine lotion was not helpful for him (Prok & McGovern, 2022). Some lifestyle changes for J.F. include avoidance of poison ivy plants, wearing gloves, long sleeves and pants to avoid risk of contact when working near allergens, washing these clothes and any exposed areas as soon as possible, do not burn poison ivy plants, and use of emollients to maintain skin hydration (Prok & McGovern, 2022).
Classmate 2: Sara
1. List specific goals of treatment for J. F.
From the description of the plant Jason came into contact with recently, it sounds as though he is suffering from contact dermatitis from poison ivy. Poison ivy is a type IV hypersensitivity allergic reaction caused by penetration of the epidermis by the plant’s oleoresin urushiol that causes symptoms within 12-18 hours after contact (Prok et al., 2022). Specific goals for Jason’s treatment would be quick reduction of symptoms including the severe pruritis. Itching the rash puts Jason at a higher risk for infection so appropriate and effective treatment options should be initiated in a timely manner. Treatment goals also include resolution of the papules, vesicles, and blisters, no signs of a secondary infection, and complete restoration of the skin barrier.
2. What drug therapy would you prescribe? Why?
An oral corticosteroid is recommended for widespread cases of dermatitis especially when involving the face or genital area. Dermatitis that covers 20 percent or more of the skin surface and/or involving the face, oral steroids are preferred (Levy et al., 2022). To treat Jason’s contact dermatitis related to poison ivy exposure, I would prescribe prednisone which should be initiated at 1mg/kg/day then tapered over 2-3 weeks (Prok et al., 2022). Jason weights 110 pounds which means his dosage of prednisone should be 50mg po daily; however, 40mg/day is the maximum amount recommended for children (Woo & Robinson, 2020). Jason would be prescribed 40mg po daily x5 days, then 20mg po daily x5 days, then 10mg po daily x5 days, then discontinue the medication. Patients placed on short courses of oral steroids, such as a week or less, have a higher risk of rebound dermatitis; therefore, treatment over 2-3 weeks is suggested.
3. What are the parameters for monitoring the success of the therapy?
Parameters for monitoring the success of the therapy include assessing the effectiveness of the medical treatment. Lessening of symptoms, healing of the lesions, and absence of secondary infection are signs of successful therapy (Prok et al., 2022). Jason’s ability to tolerate the prednisone, lessening of a need for adjunctive treatments, and a lack of adverse side effects are also signs of successful treatment (Levy et al., 2022).
4. Discuss specific patient education based on the prescribed therapy.
Jason and his guardian(s) should be educated on the treatment plan concerning prednisone and the importance of adhering to the prescription as directed. Jason should not stop the medication abruptly even if symptoms and the rash have resolved before finishing the medication course. This could result in rebound dermatitis (Lexicomp, n.d.). It should be explained that prednisone needs to be taken with food or milk to decrease gastrointestinal disturbances. Side effects including behavioral changes, weight gain, gastrointestinal disturbances, infections, or visual disturbances warrants contact of the health care provider.
5. List one or two adverse reactions for the selected agent that would cause you to change therapy.
One adverse reaction of prednisone that may cause a change in therapy for Jason would be psychiatric disturbances such as anxiety, agitation, fear, insomnia, mania, restlessness, or tearfulness (Lexicomp, n.d.). If these mood changes are severe and interfering with Jason’s daily activities, a change in therapy would be recommended. Most cases of adverse behavioral reactions occur early on in treatment (usually within the first week), with an average of 11.5 days.
6. What would be the choice for second-line therapy?
Second-line therapy for Jason would include a low-mid potency topical corticosteroid. Triamcinolone acetonide ointment 0.025% applied 3-4 times a day until healing is complete would be another option for Jason if he is unable to take oral prednisone (Lexicomp, n.d.). This ointment will allow for enhanced medication absorption and is semi-occlusive; however, adherence to this treatment may be low as the ointments are greasy and sticky. Jason’s rash is on his arms, legs, and face so using the ointment on larger surface areas could be difficult and should be used with caution on the face.
7. What over-the-counter and alternative medications would be appropriate for J. F.?
Over-the-counter and alternative medications that would be appropriate for Jason would include the topical astringent aluminum acetate (Burow’s solution) which can be used to dry up the lesions caused by the poison ivy exposure (Prok et al., 2022). Utilization of an oral antihistamine at night, such as Benadryl 25 to 50mg po qhs, can be beneficial for increased pruritis in the evening and can be helpful allowing for sleep to occur undisturbed. Application of cool, wet dressings can help soothe the itching, decrease the erythema, debride the dried discharge from weeping lesions, and provide a skin barrier (Levy et al., 2022). Oatmeal baths can also provide soothing relief for pruritis.
8. What lifestyle changes would you recommend to J. F.?
Lifestyle change for Jason would include identification of poisonous plants to avoid while hiking (Prok et al., 2022). Wearing protective clothing while hiking such as long sleeve tops, pants, and boots. Minimizing skin exposure while in areas of toxic plants is a smart decision to avoid allergy potential. Jason should also know that urushiol can be on clothing and pets for days; therefore, washing clothing and giving pets a bath should be performed as soon as possible after hiking. If there is a known exposure, washing of contaminated clothing with hot water should be done as soon as possible, and showering the entire body with mild soap and hot water while wiping in one direction should be done immediately.
9. Describe one or two drug–drug or drug–food interactions for the selected agent.
Triamcinolone and CYP3A4 inhibitors may cause the concentration of the steroid to be increased (Lexicomp, n.d.). Therefore, avoidance of CYP3A4 inhibitors such as many antifungals, antivirals, and macrolides should be considered. Systemic effects of steroids such as Cushing syndrome or adrenal suppression can be initiated through coadministration of CYP3A4 inhibitors and triamcinolone. Alternative corticosteroids should be considered if long-term use of triamcinolone is expected.
Requirements: 3-4 pages

situations where a patient’s wishes about his or her health conflict with evidence, your own experience, or a family’s wishes. This may create an ethical dilemma. What do you do when these situations occur?
In this Lab Assignment, you will explore evidence-based practice guidelines and ethical considerations for specific scenarios.
WRITE THIS UP LIKE A PAPER IN PARAGRAPHS
CASE STUDY B
A 57-year-old man who was diagnosed with motor neuron disease 2 years ago is
experiencing a rapid decline in his condition. He prefers to be admitted to the in-patient
unit at a hospice to receive end-of-life care, but his wife wants him to remain at home.
Select one scenario from above, and reflect on the material presented throughout this
course.
What necessary information would need to be obtained about the patient through health assessments and diagnostic tests?
Consider how you would respond as an advanced practice nurse. Review evidence-based practice guidelines and ethical considerations applicable to the scenarios you selected.
The Lab Assignment
Write a detailed one-page narrative (not a formal paper) explaining the health assessment information required for a diagnosis of your selected patient (include the scenario number). Explain how you would respond to the scenario as an advanced practice nurse using evidence-based practice guidelines and applying ethical considerations. Justify your response using at least three different references from current evidence-based literature.

For this week’s discussion, you are asked to research a technological or human induced disaster.
(This not the same as in Weeks 3 and 4 where you might have discussed hostage situations, mass shootings, multiple-vehicle or mass transit accidents with multiple critical injuries, bioterrorism, and disease outbreaks.) Here you want to look at situations such as radiological, nuclear accidents, technological disasters (electromagnetic pulse), and hazardous material spills.
In your post, provide the name of the incident you have chosen, and support your answers with evidence/examples. Please provide a working link and a citation for your source(s).
Select 2 of the items below to discuss:
At what point does a technological or man made event become labeled a disaster?
Name and explain the impact categories associated with your disaster.
How well do you think the United States is prepared for a disaster like the one you selected?
Discuss the factors that can influence the effects a disaster may have on a community or region.
What nursing interventions would be a priority for these victims?
What community resources should be provided to the victims for follow up needs?

The dietitian discusses that you “eat to live, not live to eat.” She describes that 80/20 rule of eating. What percentage of “empty calories” do you think you consume in a day, and what results mentioned in the video do you experience when you eat “too many” empty calories?
What interventions can you apply to help meet the ratio of good calories/empty calories?
Mindful rest
Mindful Eating
Mindful Movement
Reflection
Reflection
(24 points/10%)
24 points
20 points
19 points
7 points
0 Points
Required Criteria
1.Answers the weekly reflection questions.
2.Uses two specific examples from the video(s) to support writing.
3.Uses Standard English grammar and sentence structure.
4.Contains no more than 3 spelling or typographical errors.
5.Writing demonstrates original thought without an over-reliance on the works of others.
Includes all 5
Includes 4
Includes 3
Includes 1-2
Includes 0
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Hello,
Thank you for your help with this assignment. I am working on an assignment for my Global and Population Health. I have attached the template, the rubric and web links for this assignment. You are able to use other sources too. For this assignment in-text citation is required and a reference page. I live in Orange County, California. In section A it asked you to describe a local town, city, or county and a subpopulation.
Thank you again for your help.

You have formed a primary partnership with your liaison during your clinical experience in this class. For this discussion question, you are asked to evaluate one of the partnerships formed.
LIAISON/FACILITE-HANUMAN MANDIR OF GREATER CHICAGO FOR HAND HYGEINE Please complete the following steps for your discussion post and response.
Discuss your partnership with your liaison from your clinical experience.
How was the partnership was formed?
Who are the Key stakeholders invested in the success of your project?
What is the mission of your partnership?
Considering the literature, what could be done to strengthen the partnership?
Please be sure to validate your opinions and ideas with citations and references in APA format.