Category: Nursing

Desсrіption of what a Basal Cell Carcinoma is, how many types of basal cell carcinomas there are. Most common areas found nose cheek periorbital scalp periauricular. What is the incidence of people affected in the United States per year, 3.3 million(incidence increases 10% each year). Superficial Basal Cell Carcinoma (BCC) begins in the basal keratinocytes of the interfollicular epidermis, or the hair follicle stem cells (nodular BCC). What the causes are.Ultraviolet rays, sun exposure. UVB causes most malignant changes and stumulates changes in cellular DNA of the stratum basale and UVA enhances the carcinogenic effects of UVB. Types of basal cell 1) nodular 2) pigmented 3) superficial 4) scarring (sclerotic). What the treatments are. What causes them, how we can diagnose them. How can we avoid them. Differential diagnosis for 1)nodular sebaceous hyperplasia, flesh colored nevus , molluscum contagiosum, merkel cell, trichoepithelioma, fibrous papule, Squamous cell carcinoma, 2) seborheic keratosis , pigmented nevus, ,malignant melanoma, 3)superficial, dermatitis, lichenoid keratosis, squamous cell carcinoma, 4) scar, scarring Lab and biopsy, shave or punch biopsy should be done. treament- varies on location and individual.mscalpel incision, curettage and electrodessication, radiation, cryosurgery, and topical 5-fluorouracil and imiqimod. Excision with primary suture closure. Moh′s micrographic surgery has the highest cure rate and preserves normal skin. Mainly used on face and neck and for recuuent BCC′s. Vismodegib and sonidegib are hedgehog pathway inhibitors targets smoothened skin. Used for locally advaned, multiple or metatastic bcc. Initial treatment is excision, curettage and electrodessication , moh′s surgery. Alternative treatment radiation, cryosurgery, 5 flurouracil or imiquimod topically for multiple surperficial BCC and Vismodegib, sonidegib. Extrinsic Environmental Factors causes related to BCC are UVB exposure most common, tanning bed use, chemical exposures such as arsenic,Methoxsalen, exposure to occupational chemicals and exposure to the World Trade Center during 9/11. Intrinsic factors genetic predisposition, fair skinned blue eyes, green eyes, blonde or red heads.Rare genetic disorders Gorlin syndrome (Basal cell nevus syndroe) Albinism, xeroderma pigmentosa, Talk about basal cell growth and cellular characteristics.how in can grow into cartilahe bone and muscle in rare incidences. nodular most commondescribe what they look likeadenoid BCC, Custic BCC, superficial BCC, Morpheaform BCC, Infiltrating BCC,Micronodular BCC,Diffuse BCC, American Acadamy of Dermatology guidelines, management and prevention. APA format 7 professional please site Please use books and American academy of dermatology and the following books. Books used are 1. Bolognia, J. et al. (2017) Dermatology: 2-Volume Set 4th Edition Elsevier ISBN-13: 978-0702062759 ISBN-10: 0702062758 2. Wolverton, S., & Wu, J. (2020) Comprehensive Dermatologic Drug Therapy 4th Ed. Philadelphia, Missouri: Elsevier ISBN-13: 978-0323612111 ISBN-10: 0323612113 3. Marks Jr. J.& Miller. J. (2018). Lookingbill and Marks′ Principles of Dermatology 6th edition ISBN-13: 978-0323430401 ISBN-10: 9780323430401 Optional: Micheletti, R. et Al. (2023) Andrews′ Diseases of the Skin Clinical Atlas 2nd Edition ISBN-13: 978-
0323790130 ISBN-10: 0323790135 Please use APA 7 professional format. This is a group project and I′m starting off with Basal Cell Carcinoma. I picked out the powerpoint design already and I will attach the file so please continue with the same design. 20 slides would be perfect.

Complete a health history, including allergies, medications, current medical problems, and reason for the visit. Determine whether any problems are related and set priorities.
Please include 500 words in your post and a scholarly reference. APA STYLE.

Care of specific populations in the community is an important part of community health nursing. For example, the elderly community may need specific interventions or nursing care. Write a 3-4 page paper addressing the gerontology population. Utilize at least three professional references in APA format.
-Discuss professional attitudes, values, and expectations about physical and mental aging in the provision of patient centered care for older adults and their families
-Assess barriers for older adults in receiving, understanding, and giving information
-How assessment of the living environment as it relates to functional, physical, cognitive, psychological, and social needs can affect the nursing care of the elderly population
-How the community health nurse can appropriately utilize resources/programs to promote functional physical and mental wellness in older adults.
-How the community health nurse can intervene to assist older adults and their support network to achieve personal goals based on the analysis of the living environment and availability of community resources.

Liebler and McConnell (2017), “Planning is the process of deciding in the present what to do to bring about an outcome in the future.” So, what happens when Managers fail to plan when problems are not identified and meaningful strategies are not developed? What is the impact on productivity, staff morale, and trust?

Write a post about your experiences concerning the above questions and how things might have been done differently.
ANA Standard 4: Planning: The registered nurse develops a plan that prescribes strategies and alternatives to
attain expected outcomes.
I cannot think of one. You may use a scenario a nurse manager may encounter for the purpose of this discussion post. You may contact me with your ideas for the assignment.
References should be no older than five years, please.

****ONLY SCHOLORY RESOURCES CAN BE USED****
1. Describe how learning in this course helped you to meet Program Outcome 5: Advocates for positive health outcomes through compassionate, evidence-based, collaborative advanced nursing practice (Extraordinary Nursing).
2. Describe how course assignments or activities will help you achieve ONE of the advanced-level nursing education competencies from AACN Essentials Domain 9
*This is what you will use to answer question number 2
Comply with relevant laws, policies, and regulations 9.4d Advocate for polices that enable nurses to practice to the full extent of their education.
9.4e Assess the interaction between regulatory agency requirements and quality, fiscal, and value based indicators.
9.4f Evaluate the effect of legal and regulatory policies on nursing practice and healthcare outcomes.
9.4g Analyze efforts to change legal and regulatory policies that improve nursing practice and health outcomes.
9.4h Participate in the implementation of policies and regulations to improve the professional practice environment and healthcare outcomes.
3. Describe how course assignments or activities will help you achieve ONE NONPF Independent Practice CompetencyLinks to an external site. listed below.
Functions as a licensed independent practitioner.
Demonstrates the highest level of accountability for professional practice.
Practices independently managing previously diagnosed and undiagnosed patients.
Provides patient-centered care recognizing cultural diversity and the patient or designee as a full partner in decision-making.
Educates professional and lay caregivers to provide culturally and spiritually sensitive, appropriate care.
Collaborates with both professional and other caregivers to achieve optimal care outcomes.
Coordinates transitional care services in and across care settings.
Participates in the development, use, and evaluation of professional standards and evidence-based care.
****IMPORTANT INFORMATION****
SOME OF THE ASSIGNMENTS THAT WE DID IN THE CLASS ARE
APEA TESTING TO PREPARE OF FOR BOARDS
WEEKLY APEA QUIZES
IHUMAN (VITALS ASSESSMENTS)
VISE CALL (A CALL WITH THE PROFESSEOR WHO GIVES US A PATIENT SCENARIO THAT WE HAVE TO STATE DX AND TREATMENT PLAN.

Part 1 : The threaded discussion topic for Week 1 is the “The Public Image of Nursing”.
Discuss the challenges that have been created by the media and are generally present in American society.
Describe any actions to promote the public image of nursing.
Discussion post: The post will have a minimum of 200 words.
It is your responsibility to formulate your own ideas in a meaningful way that advances your professional knowledge while stimulating the thinking of your peers. Your comments should demonstrate in-depth analysis, critical thinking, and practical application of theory.
Part 2: Responses: Each student will then respond to two different students’ initial posts. The responses must be substantial – a minimum of 100 words and have 2 different sources cited
* Response and citation/ reference must all be in APA format * I will attach multiple discussion posts from classmate, you pick two and response to them

Details:
Topic is bedside reporting on patients
While
the implementation plan prepares students to apply their research to
the problem or issue they have identified for their capstone change
proposal project, the literature review enables students to map out and
move into the active planning and development stages of the project.
A
literature review analyzes how current research supports the PICOT, as
well as identifies what is known and what is not known in the evidence.
Students will use the information from the earlier PICOT Statement Paper
and Literature Evaluation Table assignments to develop a 750-1,000 word
review that includes the following sections:
1. Title page
2. Introduction section
3. A comparison of research questions
4. A comparison of sample populations
5. A comparison of the limitations of the study
6. A conclusion section, incorporating recommendations for further research
Prepare
this assignment according to the guidelines found in the APA Style
Guide, located in the Student Success Center. An abstract is not
required.
This
assignment uses a rubric. Please review the rubric prior to beginning
the assignment to become familiar with the expectations for successful
completion.
You are required to submit this assignment to Turnitin. Please refer to the directions in the Student Success Center.
Please
Note: Assignment will not be submitted to the faculty member until the
“Submit” button under “Final Submission” is clicked.
New Attempt
Title Attached Documents Turnitin Report Similarity Index Final Submission
Click ‘New Attempt’ to start assignment or attach documents
Literature Review
1
Unsatisfactory
0.00% 2
Less than Satisfactory
75.00% 3
Satisfactory
79.00% 4
Good
89.00% 5
Excellent
100.00%
80.0 %Content
10.0
%Introduction An introduction is not present. An introduction is
present, but it does not relate to the body of the paper. An
introduction is present, and it relates to the body of the paper. There
is nothing in the introduction to entice the reader to continue reading.
An introduction is present, and it relates to the body of the paper.
Information presented in the introduction provides incentive for the
reader to continue reading. An introduction is present, and it relates
to the body of the paper. Information presented in the introduction is
intriguing and encourages the reader to continue reading.
20.0
%Comparison of Research Questions No comparison of research questions
is presented. A comparison of research questions is presented, but it is
not valid. A cursory though valid comparison of research questions is
presented. A moderately thorough and valid comparison of research
questions is presented. A reflective and insightful comparison of
research questions is presented.
20.0
%Comparison of Sample Populations No comparison of sample populations
is presented. A comparison of sample populations is presented, but it is
not valid. A cursory though valid comparison of sample populations is
presented. A moderately thorough and valid comparison of sample
populations is presented. A reflective and insightful comparison of
sample populations is presented.
20.0
%Comparison of the Limitations of the Study No comparison of the
limitations of the study is presented. A comparison of the limitations
of the study is presented, but it is not valid. A cursory though valid
comparison of the limitations of the study is presented. A moderately
thorough and valid comparison of the limitations of the study is
presented. A reflective and insightful comparison of the limitations of
the study is presented.
10.0
%Conclusion and Recommendations for Further Research No conclusion and
recommendations for further research are presented. A conclusion and
recommendations for further research are presented, but they are not
valid. A conclusion and recommendations for further research are valid,
but they are cursory. A conclusion and recommendations for further
research are valid and moderately thorough. A conclusion and
recommendations for further research are reflective and insightful.
15.0 %Organization and Effectiveness
5.0
%Thesis Development and Purpose Paper lacks any discernible overall
purpose or organizing claim. Thesis is insufficiently developed or
vague. Purpose is not clear. Thesis is apparent and appropriate to
purpose. Thesis is clear and forecasts the development of the paper.
Thesis is descriptive and reflective of the arguments and appropriate to
the purpose. Thesis is comprehensive and contains the essence of the
paper. Thesis statement makes the purpose of the paper clear.
5.0
%Argument Logic and Construction Statement of purpose is not justified
by the conclusion. The conclusion does not support the claim made.
Argument is incoherent and uses noncredible sources. Sufficient
justification of claims is lacking. Argument lacks consistent unity.
There are obvious flaws in the logic. Some sources have questionable
credibility. Argument is orderly, but may have a few inconsistencies.
The argument presents minimal justification of claims. Argument
logically, but not thoroughly, supports the purpose. Sources used are
credible. Introduction and conclusion bracket the thesis. Argument shows
logical progressions. Techniques of argumentation are evident. There is
a smooth progression of claims from introduction to conclusion. Most
sources are authoritative. Clear and convincing argument that presents a
persuasive claim in a distinctive and compelling manner. All sources
are authoritative.
5.0
%Mechanics of Writing (includes spelling, punctuation, grammar,
language use) Surface errors are pervasive enough that they impede
communication of meaning. Inappropriate word choice or sentence
construction is used. Frequent and repetitive mechanical errors distract
the reader. Inconsistencies in language choice (register), sentence
structure, or word choice are present. Some mechanical errors or typos
are present, but they are not overly distracting to the reader. Correct
sentence structure and audience-appropriate language are used. Prose is
largely free of mechanical errors, although a few may be present. A
variety of sentence structures and effective figures of speech are used.
Writer is clearly in command of standard, written, academic English.
5.0 %Format
2.0
%Paper Format (use of appropriate style for the major and assignment)
Template is not used appropriately or documentation format is rarely
followed correctly. Template is used, but some elements are missing or
mistaken; lack of control with formatting is apparent. Template is used,
and formatting is correct, although some minor errors may be present.
Template is fully used; There are virtually no errors in formatting
style. All format elements are correct.
3.0
%Documentation of Sources (citations, footnotes, references,
bibliography, etc., as appropriate to assignment and style) Sources are
not documented. Documentation of sources is inconsistent or incorrect,
as appropriate to assignment and style, with numerous formatting errors.
Sources are documented, as appropriate to assignment and style,
although some formatting errors may be present. Sources are documented,
as appropriate to assignment and style, and format is mostly correct.
Sources are completely and correctly documented, as appropriate to
assignment and style, and format is free of error.
100 %Total Weightage

David Rosser
TuesdayJun 6 at 10:32pm
Week 2 discussion main post
Explain the agonist-to-antagonist spectrum of action of psychopharmacologic agents, including how partial and inverse agonist functionality may impact the efficacy of psychopharmacologic treatments.
In today’s world drugs are made up to be either agonists, antagonists, or partial agonists. An agonist refers to a chemical that binds to a receptor, the receptor activates, and a biological response is produced. In contrast, an antagonist blocks the action of an agonist, as an antagonist it will cause the opposite effect on the body (Stahl, 2013). Agonists can have different intrinsic efficacies and could be classified as full or partial agonists. A full agonist typically produces the maximal response possible, whereas a partial agonist produces a lesser agonist effect on a receptor (Berg & Clarke, 2018). For example, aripiprazole is a partial agonist Lowering dopaminergic neurotransmission in the mesolimbic pathway and enhancing dopaminergic activity in the mesocortical pathway (Berg & Clarke, 2018). So, when Aripiprazole is administered, the drug will occupy brain receptors where dopamine is elevated and will partially block the effects of dopamine, decreasing psychosis. However, if dopamine levels are low then aripiprazole will act as an agonist to increase dopamine transmission in these regions. These dual effects of partial agonists mean that they are sometimes called agonist–antagonists. This drug produces less extrapyramidal effects because it is a weak agonist. Therefore, never blocks dopamine function as much as an antagonist (Ghaemi. 2019). An inverse agonist binds to the same receptor binding sites as an agonist and not only antagonizes the effects of an agonist but exerts the opposite by suppressing spontaneous receptor signaling (Ghaemi. 2019).
Compare and contrast the actions of g-couple proteins and ion-gated channels.
Two receptor proteins perform their functioning in the opening and closing of postsynaptic ion channels. The ionotropic receptor is linked directly to ion channels. These receptors have two functions, the first one is an extracellular site binding neurotransmitters, and the second one is a membrane-spanning domain to form an ion channel (Jiangi et al., 2023) Therefore, inotropic receptors combine transmitter-binding and channel functions into one single molecular entity and are called ligand-gated ion channels. Such receptors are multimers and are comprised of four or five individual proteins subunit. Each of the monomeric subunits forms a functionally independent pore channel (Jiangi et al., 2023). The second neurotransmitter is the metabotropic receptor. This neurotransmitter’s movement of ions depends upon one or more metabolic steps. There are no ion channels in these receptors, but the channels are affected by the activation of intermediate molecules called G-proteins. For this same reason, metabotropic receptors are also referred to as G-protein-coupled receptors (Jiangi et al., 2023) ). Metabotropic receptors are monomeric proteins having an extracellular domain for neurotransmitter binding and an intracellular domain for binding to G-proteins. Neurotransmitter binding to metabotropic receptors activates G-proteins, after which it dissociates from the receptor and interact directly with ion channels or bind to other effector proteins, like enzymes to make intracellular messengers to open or close ion channels. Therefore, G-proteins work as transducers that couple neurotransmitter binding to the regulation of postsynaptic ion channels (Jiangi et al., 2023).
Explain how the role of epigenetics may contribute to pharmacologic action.
Epigenetics is a term that describes how genetic information is coded because of changes in your behavior or environment. Scientists are starting to learn and understand the actual function of the entire genome. According to Stefanska and MacEwan, (2015), drugs may have to be able to be more broad-acting over a range of epigenetic large-scale events instead of being designed to a particular ligand or specific to a particular gene or protein subtype. Thinking of epigenetics on a larger scale, epigenetic regulatory mechanisms may be involved with more than one gene or family of proteins that could regulate large groups of genes. Thinking in this manner we may find epigenetic variations could be responsible cause for any particular disease. Believing this way just targeting one protein of the multiple pathways involved in a disease could prove futile. For example, diseases such as cancer can mutate into different variations which are difficult to detect, predict, and effectively treat, leading too often to relapse. According to Stefanska and MacEwan, (2015), Epigenetics of cancers may be the key to more effective treatments.
Explain how this information may impact the way you prescribe medications to patients.
Include a specific example of a situation or case with a patient in which the psychiatric mental health nurse practitioner must be aware of the medication’s action.
When a nurse practitioner prescribes a medication, the prescriber needs to take a thorough health history and individualize the medication based on the person not just what illness they could have and what genetic implications and treatment options. According to McClarty et al. (2018), Antipsychotics are commonly prescribed for the treatment of psychosis along with behavioral and psychological symptoms of dementia in the elderly. This treatment can be ineffective and causes side effects in these patients. The provider should remember that advanced age affects drug metabolism and clearance, additional pharmacokinetic and pharmacodynamic changes due to aging-induced epigenetic alterations also impact processes important for antipsychotic function. Epigenetic mechanisms account for some of the altered efficacy and increased side effects seen in elderly patients involving histone modifications that can adversely affect the efficacy of antipsychotics and increase their side effects in elderly patients (McClarty et al., (2018). We need further investigation of this mechanism will benefit elderly patients who need treatment for psychosis.
References
Berg, K. A., & Clarke, W. P. (2018). Making sense of pharmacology: inverse agonism and functional selectivity. International Journal of Neuropsychopharmacology, 21(10), 962-977.
Ghaemi, N. (2019). Clinical psychopharmacology: Principles and practice. Oxford University Press, USA. Kew, J. N., & Davies, C. H. (Eds.). (2010). Ion channels: from structure to function. Oxford University Press, USA.
Jiang, C., He, X., Wang, Y., Chen, C. J., Othman, Y., Hao, Y., Yuan, J., Xie, X. Q., & Feng, Z. (2023). Molecular Modeling Study of a Receptor-Orthosteric Ligand-Allosteric Modulator Signaling Complex. ACS chemical neuroscience, 14(3), 418–434. https://doi.org/10.1021/acschemneuro.2c00554Links to an external site.
McClarty, B. M., Fisher, D. W., & Dong, H. (2018). Epigenetic alterations impact on antipsychotic treatment in elderly patients. Current treatment options in psychiatry, 5(1), 17- 29.
Stahl, S. M. (2013). Ion Channels as Targets of Psychopharmacologic Drug Action. In Stahl’s essential psychopharmacology: Neuroscientific basis and practical applications (3rd ed.). New York, NY: Cambridge University Press.
Stefanska, B., & MacEwan, D. J. (2015). Epigenetics and pharmacology.
Reply

Write a small reflection paragraph and post an objective reflection answering what knowledge was gained
from this class, how the objectives that you had for the class were met, and how do you anticipate the use of research 350 words 2 apa citations

Carefully read these directions and the grading rubric below.
Download the required template below under Template.
Rename that template as Your Last Name Professional Paper Worksheet.docx. This must be saved as a Microsoft Word document (.docx). Save it to your own computer or flash drive in a location where you will be able to retrieve it later. Type your assignment directly on the saved document. Save your work often
In the NR351 Announcements, locate the announcement entitled IMPORTANT: Assigned Article for Weeks 4 & 6 Assignments. In this announcement you will find:The link to the assigned article (you must be logged into the Chamberlain Library before clicking the link). Download this article in PDF format to your own computer for use in this assignment. Read the entire article once downloaded and saved.
The location of the required sentence for the quotation and citation.
The location of the required sentence for paraphrasing and citation.
This assignment must use the required article and sentences stated in the announcement described above to complete the following items:Reference for the assigned journal article,
Quotation with citation,
Paraphrased area with citation, and
Assigned article summary.
Each of required items above is clearly described on the Professional Paper Worksheet Template. Page numbers for resources in the current APA Manual are provided on the template for your use.
The Assigned Article Summary that you write must be 175-200 words. The Summary must contain the assigned sentence for quotation and citation as noted in the announcement, the assigned sentence for the paraphrased area with citation as noted in the announcement, several additional paraphrased areas, and appropriately formatted citations. You may also include one more short quotation if you wish.
When your Professional Paper Worksheet Assignment is completed, save and close the completed template. Click the Submit button at the top of this page to upload your completed assignment.
The required sentence for direct quotation and citation is located on page 43 in the middle of the middle column. The sentence begins with the words: Asking the patient about their ability to afford
The required sentence for paraphrasing and citation is located on page 40 near the bottom of the left-hand column. The sentence begins with the words: Nurses need to understand why patients may not
Follow the directions on the Graded Assignment pages to complete each assignment. Contact your instructor with any questions. PLEASE FOLLOW THE ATTACHED RUBRIC.