Category: Nursing

Assessment Descriiption
Answer all of the questions below using the “Discussion Forum Sample” for your discussion response.
Scenario
A.O. is a 28-year-old woman who presents to your clinic with complaints of rectal bleeding and weakness. Five days ago, she noticed bright red blood in her stools. Furthermore, she reports that her daily bowel movements have increased to five or six with significant diarrhea. She has been weak for approximately 3 days. She has not traveled outside of the city, been hospitalized, or received antibiotics recently.
A proctosigmoidoscopy was conducted 3 days after the patient’s discharge from the acute care clinic. A significant pseudopolyps formation could be seen. Biopsies of the colon revealed erosions of the mucosa and ulcerations into the submucosa with mixed acute (i.e., neutrophils) and chronic (lymphocytes and macrophages) inflammatory cells. No dysplastic cells suggesting the development of colon carcinoma were seen. No multinucleated giant cells suggesting Crohn’s disease were seen. Inflammation and ulceration were limited to the rectum and sigmoid colon only. Crypts of Lieberkühn were intensely inflamed. Marked hemorrhaging of capillaries in the mucosa was also observed.
Laboratory Blood Test Results
Na+ = 143 meq/L
BUN = 20 mg/dL
Plt = 315,000/mm3
AST = 33 IU/L
K+ = 3.2 meq/L
Cr = 1.1 mg/dL
PO4-3 = 4.0 mg/dL
ESR = 24 mm/hr
ALT = 41 IU/L
Cl- = 108 meq/L
Hb = 10.8 g/dL
CRP = 1.5 mg/dL
T bilirubin = 0.9 mg/dL
Alb = 3.1 g/dL
HCO+3 = 18 meq/L
Hct = 36%
Ca+2 = 8.9 mg/dL
PT = 11.3 sec
Glu, fasting = 132 mg/dL
WBC = 9,400/mm3
Questions
1.What is the relevance of the last sentence in the first paragraph of the scenario provided above: “She has not traveled outside of the city, been hospitalized, or received antibiotics recently”? Explain your answer in detail.
2.What is the diagnosis? Explain your answer. Why and how did you come up with this diagnosis?
3.Identify eight abnormal laboratory blood test values and provide a brief pathophysiological explanation for each of them.

For Assignment 1, you will conduct descriptive statistical analyses using quantitative data. For Assignment 2, you will conduct content coding to analyze qualitative data. Please review the Instructions: Quantitative Analysis Assignment and Instructions: Content Coding of Challenges of Staying in the Hospital in this week’s resources to review how to complete both parts of this Assignment. Note: Assignments 1 and 2 will not be accepted unless the required templates are used.
Completes accurate analysis of: mean age, percentage of patients fallen, percentage of patients reported catheter-associated urinary tract infections, percentage of patients reported medication errors, percentage of patients reported methicillin-resistant Staphylococcus aureus (MRSA) infections when first admitted. 5 points for each analysis.
Follow the step-by-step instructions provided in the Instructions: Quantitative Analysis Assignment document in this week’s resources on using the Excel program to conduct descriptive analyses of quantitative data.
The Quantitative Data Excel Assignment spreadsheet that you will need is in the resources for this week.
For this Assignment, you will need to describe the findings from your analyses and summarize what they tell you about these patients and the extent of the adverse events they experienced during their hospitalization. What additional information would you need to help develop a plan to decrease the occurrence of these events? Use the Summary Data Analysis Form in this week’s resources to complete your analysis.

Changing story time up this time. I will provide the story and you will choose the words to fill in, using the words and word elements from chapter 9-12. Submit the completed story in the text box below. I will not open file attachments. Once posted you will be able to see others stories and will be able to read and comment/ like others if you choose.
Fill in the blanks with your choice of word to go along with the story.
The Story of Elmo Strange
Elmo Strange was a ________ little old man who owned a sock factory. He lived__________ the small town of Yorkshire. The only problem that Elmo had was that he had an__________ opinion of himself.
Elmo’s employees felt that he had a cold _______________ when it came to paying them or giving them raises. He expected his employees to keep an accurate _______________ of every sock made or discarded. Elmo refused to raise the salaries of his employees, which were already low. When he said “NO,” he expected not a_________________ to be uttered by anyone! It was enough to cause the employees to have spasms of the ______________. After all, it took a lot of________________ to run the machines that knitted the socks. The working hours were so long that the employees complained of _____________ and __________ of the feet from standing on the cement floor so long.
One day during an _________________ storm, Elmo’s sock factory caught on fire! Elmo experienced __________________ , ________________ , and ________________ when he thought he might lose everything! Thanks to the quick actions of his employees, the fire was quickly extinguished. They saved the sock factory!
Elmo’s ________________ disappeared. He was so happy to have his factory saved. He was so pleased with his employees that he gave everyone a very big raise! The employees were thrilled! They then realized that Elmo Strange had a warm ________________ after all!
Here is a list of words/ elements to choose from:
1. agglutin/o
1. angi/o
1. alveol/o
1. amyl/o
1. hepat/o
2. aniso-
2. aneurysm/o
2. bronch/o
2. appendic/o, append/o
2. ile/o
3. bas/o
3. arter/o
3. epiglott/o
3. bil/i
3. jejun/o
4. blast/o, -blast
4. arteri/o
4. laryng/o
4. bucc/o
4. lapar/o
5. chrom/o
5. arteriol/o
5. nas/o
5. cec/o
5. lingu/o
6. coagul/o
6. ather/o
6. orth/o
6. cheil/o
6. lip/o
7. cyt/o
7. cardi/o, card/o
7. pector/o
7. chol/e
7. lith/o
8. -emia
8. coron/o
8. pharyng/o
8. col/o
8. -lysis
9. eosin/o
9. ech/o
9. phren/o
9. colon/o
9. mandibul/o
10. erythr/o
10. electr/o
10. pleur/o
10. dent/o
10. odont/o, dent/o
11. -globin
11. megal/o
11. pne/o
11. cholecyst/o
11. or/o
12. hem/o
12. endo-
12. pneum/o
12. duoden/o
12. rect/o
13. hemat/o
13. ox/o
13. pneumon/o
13. -ectasia
13. peritone/o
14. kary/o
14. my/o
14. pulmon/o
14. -emesis
14. -pepsia
15. morph/o
15. ventricul/o
15. rhin/o
15. enter/o
15. sial/o
16. phag/o, -phage
16. -gram
16. sinus/o
16. esophag/o
16. sigmoid/o
17. poikil/o
17. -emia
17. thorac/o
17. gastr/o
17. steat/o
18. sider/o
18. -itis
18. trache/o
18. gingiv/o
18. stomat/o
19. spher/o
19. -osis
19. -scope
19. gloss/o
19. -tresia
20. thromb/o
20. bronchiol/o
20. gluc/o, glyc/o
20. -tripsy

APA citation and Referencing.
Plagiarism check.
Write out all the references on a separate page.
An older client was recently discharged from the hospital for evaluation of seizure activity. His history reveals that he has late-stage Alzheimer’s disease, Parkinson’s disease, hypertension, and type II diabetes mellitus, which is controlled by diet. He lives at home, where his wife and daughter take care of him. His discharge medications include phenytoin (Dilantin), 100 mg BID; hydrochlorothiazide (HydroDIURIL), 50 mg QD; levodopa (Sinemet), 25/100 TID; and haloperidol (Haldol), 1 mg before bed. The client has been referred for home care nursing follow-up.
Questions:
On the initial home visit by the nurse, what assessments should be made?
The wife and daughter need teaching about his antiepileptic medication. What teaching should be included?
During the initial home visit, the client experiences a generalized seizure. What action should the nurse take?

You should respond to at least two of your peers by extending, refuting/correcting, or adding additional nuance to their posts. each answer at least 150 words with intext citation from 1 academic source for each question.
uestion 1:
ANPs were granted authority to prescribe medications in the United States in the 1960’s. By 2005, 13 states and the District of Columbia authorized ANPs to independently prescribe, including controlled drugs. There are now 21 states in America deemed to have full practice authority. This authority includes prescriptive authority without mandated collaborative arrangements (Fong et al., 2015). In the United States the roles and responsibilities of the advanced nurse practitioners in prescribing vary. Advanced nurse practitioners (ANPs) are more commonly seen because of a decline in physicians and medical providers due to the aging population. There has been a demand in health care services in under privileged communities therefore making ANPs a growing specialization.
The implementation of ANPS serves to improve access to treatment; provide cost-effective care; target at-risk populations; provide outreach services in all settings but in particular outer metropolitan, rural, and remote communities; and provide mentorship and clinical expertise to other health professionals (Fong, Buckley, & Cashin, 2015). Although ANPs are granted authority to prescribe medications, each state has prescriptive authority which is regulated by the State Board of Nursing, Board of Pharmacy or Board of Physicians. Some states allow collaborative practice which is an agreement with a collaborating physician. Other states allow supervised practice which is practice under direct supervision by a physician. States that allow independent practice allow the ANPs to practice to their full scope including prescribing.
It is critical for the ANP to follow up with the patient after prescribing to reassess for any drug interactions, side effects or efficacy of the treatment. If the current prescribed medication is not successful, the ANP should then move to the second-line therapy and re-evaluate whether that medication was successful or not. Communication is extremely important between the ANP and the patient. This can help the ANP make a change in the current regimen or not. It is also important to factor patients’ socioeconomic status, living environment, or support systems when prescribing medications. If a medication is too expensive for a patient, they may not be able to purchase it therefore foregoing the regimen the ANP prescribed. The ANPs role and responsibility when it comes to prescribing medications begins by conducting a thorough clinical history and physical exam on a patient. After conducting this exam, the ANP can assess and diagnose in order to create a treatment plan for the patient. If the treatment plan calls for a prescription, the ANP will choose from a list of medications in a specific drug class which suits the patient based on the collected data such as allergies, side effects, medical history and current drug regimens. An integral part of the practitioner’s role and responsibility is educating the patient about drug therapy and its intended therapeutic effect, potential side effects, and strategies for dealing with possible adverse drug reactions (Poole Arcangelo & Peterson, 2013).
References
Fong, J., Buckley, T., & Cashin, A. (2015). Nursing: Research and Reviews. Nurse Practitioner Prescribing: an international perspective. Retrieved from https://www.researchgate.net/profile/Jacqueline_Fo…
Virginia, Poole Arcangelo and Andrew M. Peterson. Pharmacotherapeutics for Advanced Practice: A Practical Approach. Third. Ambler: Wolters Kluwer: Lippincott Williams & Wilkins, 2013.Ebook..
Question 2:
Advanced nurse practitioners play a crucial role in healthcare. Given the growing shortage of GPs in primary care, it gives patients a chance to receive timely care and avoid needless delays in receiving treatment. ANPs in community and primary care settings can forge enduring bonds with their patients and collaborate with them to promote maximum health. Advanced Nurse Practitioners are independent decision-makers who base their choices on evaluating, diagnosing, and interpreting test results (Maier, 2019). ANPs can independently recommend essential treatment, assess patients, or contact other specialists. This essay will focus on the roles and responsibilities of Advanced Nurse Practitioners in prescribing.
Nurses’ most crucial and exciting role is patient assessment and treatment of various illnesses. This entails history taking, physical examination, and conducting laboratory or imaging studies to develop a treatment. Advanced Nurse Practitioners can make conclusions based on their observations, analyses, and understanding of test outcomes (VandeWaa et al., 2020). They recommend both supportive and definitive drugs. Supportive medication includes analgesics for pain, antipyretics for fever, and intravenous fluids in case of burns or dehydration. The definitive management depends on the nursing diagnosis and can involve antibiotics, anticoagulants, chemotherapy, or radiotherapy in cancer patients. When selecting which medication to provide to a patient, the advanced nurse practitioner must consider several factors to avoid harming the patient and ensure the best possible outcome. These factors include the patient’s history of known food and drug allergies, the cost of the drug, side effects, and the patient’s ability to adhere and comply with the medication.
On the other hand, ANPs offer patients medication information such as the purpose of the drug, effects, side effects, name and qualities of the drug, how to respond to side effects, warnings, and instructions for administration. Patient education is a crucial part of the path of treatment. Patients risk under or overdosing when they do not carefully adhere to a prescription’s directions (VandeWaa et al., 2020). Before patients leave the office, ANPs should review any new prescription instructions and encourage them to always read the directions before taking their drugs. Also, nurses should remind patients that it is crucial to take their prescriptions exactly and to use any measuring tools that come with liquid drugs.
Additionally, ANPs should conduct risk–benefit analysis of the drug therapy chosen. Advanced nurse practitioners have been shown to give antibiotics more frequently than doctors. In order to minimize antibiotic resistance, the advanced nurse practitioner should exercise caution while deciding whether to give an antibiotic. Also, the nurses are required to evaluate whether the drug administered corresponds to the patient’s diagnosis (Maier, 2019). This should be coupled with patient education to advise them to avoid other medications during treatment. Proper analysis helps reduce the time needed to regain health and allows for efficient patient follow-up. Lastly, ANPs have a role in considering ethical and practical issues while prescribing medications. If the advanced nurse practitioner has obtained their Drug Addiction Treatment Act (DATA) 2000 waiver and is authorized to administer this drug by their state’s regulatory authority, they may do so legally.
In conclusion, the World Health Organization recommends a multi-step strategy for the prescription that can aid healthcare professionals in sharpening their treatment goals. The rules are still valid today despite being set in 2007. It shows that ANPS should analyze and specify the patient’s issue, identify the pharmacological therapy’s therapeutic goal, choose the proper medication, give patients information, cautions, and directions should be given to patients, maintain regular patient observation, keep drug prices in mind, and use the right tools, such as prescribing software and electronic drug references to prevent prescription errors.
References
Maier, C. B. (2019). Nurse prescribing of medicines in 13 European countries. Human Resources for Health, 17(1). https://doi.org/10.1186/s12960-019-0429-6Links to an external site.
VandeWaa, E. A., & Dolan, C. (2020). Undefined. The Journal for Nurse Practitioners, 16(3), 186-190. https://doi.org/10.1016/j.nurpra.2019.12.014Links to an external site.

Course Objective for Assignment #4:
Explain ambulatory care and contrast the types and ranges of ambulatory care settings, differentiate among hospital versus non-hospital settings, and categorize the benefits of ambulatory care to patients, providers, and third-party payers.
Assignment Requirements:
In 3–4 pages address the following aspects:
List five different types of ambulatory care settings, describe the services they provide, the populations they serve, their importance within the U.S. healthcare system, and discuss why ambulatory care makes sense in the current healthcare environment.
Compare and contrast free-standing settings versus hospital-based settings.
Include an APA Title Page, APA Reference Page, and provide at least two APA references with correlating in-text citations.
https://leocontent.umgc.edu/content/dam/course-con…
https://leocontent.umgc.edu/content/dam/course-con…
PDF – The Joint Commission National Patient Safety Goals 2022 for Ambulatory Health Care Program
PDF – Understanding the Unique Demands of Ambulatory Care Settings Article
CDC Website: Outpatient and Ambulatory Care Settings Landing Page
PDF – Management of a Heart Failure Patient in an Ambulatory Care Setting Article
PDF – Ambulatory Care Nursing and Health Equity Publication
APA 7th Edition Formatting for eBook: Reiter, K.L. & Paula H. Song, P.H. (2021). Gapenski’s healthcare finance: An introduction to accounting and financial management. (7th ed.). Health Administration Press
Read PDF – McKinsey & Company 2020 Publication: Ambulatory Care
Read PDF – AHRQ: Ambulatory Care Information
Read PDF – MedPac Ambulatory Care Publication 2022
Read PDF – Trends in Hospitalization vs Observation in Ambulatory Care Article
AHRQ Website: Ambulatory Care Landing Page
Accreditation Association for Ambulatory Health Care (AAAHC) Website: Main Page
PDF – JAMA Article: Trends in Hospitalization for Ambulatory Care Sensitive Conditions During COVID-19
PDF – HHS and AHRQ Patient Safety in Ambulatory Settings

The presentation must provide information:Introduce a fictitious patient with a disease or disorder based on your assigned group topic. ( ADJUSTMENT DISORDER) Must specifically address the disease as it relates to one of the following populations: infants, toddlers, school-aged children, adolescents, adults, or the elderly.
Definition of the disease or disorder
Epidemiology of the disease or disorderIncidence
Prevalence
PathogenesisPathophysiology of the disease/disorder to the cellular level.
Including genetics/genomics, neurotransmitters, and neurobiology of this specific disorder.
Clinical features of the disease or disorderHistory of the patient’s problems
Physical findings
Psychiatric findings
RecommendationsTreatment recommendations according to the US clinical guidelines. Patient education for management and anticipatory guidance.
Non-pharmaceutical, cultural, and spiritual considerations must be addressed
Format Requirements: Followed 7th Edition APA formatting including citation of references.
Powerpoint presentations with 10-15 slides were clear and easy to read with no less than 16-point font. Speaker notes expanded upon and clarified content on the slides.
Incorporate a minimum of 4 current (published within last five years) scholarly journal articles or primary legal sources (statutes, court opinions) within your work. Journal articles and books should be referenced according to APA style (the library has a copy of the APA Manual).

Nursing writer preferred. References within 5 years.
APA 7th edition.
Article: Emotionally Focused Therapy
Find evidence-based article related to the therapy selected. Write a summary describing the therapy, what it is used for, what to expect from the therapy, and other information you may find pertinent. Provide an APA citation for your work.

In this assignment, you will be writing a 1,000-1,250 word paper describing the differing approaches of nursing leaders and managers to issues in practice. To complete this assignment, do the following:
1) Select an issue from the following list: bullying, unit closures and restructuring, floating, nurse turnover, nurse staffing ratios, use of contract employees (i.e., registry and travel nurses), or magnet designation.
2) Describe the selected issue. Discuss how it impacts quality of care and patient safety in the setting in which it occurs.
3) Discuss how professional standards of practice should be demonstrated in this situation to help rectify the issue or maintain professional conduct.
4) Explain the differing roles of nursing leaders and nursing managers in this instance and discuss the different approaches they take to address the selected issue and promote patient safety and quality care. Support your rationale by using the theories, principles, skills, and roles of the leader versus manager described in your readings.
5) Discuss what additional aspects managers and leaders would need to initiate in order to ensure professionalism throughout diverse health care settings while addressing the selected issue.
6) Describe a leadership style that would best address the chosen issue. Explain why this style could be successful in this setting.
Use at least three peer-reviewed journal articles other than those presented in your text or provided in the course.
Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required

3 page lesson plan discussing CAUTI and plan to improve incidents.
Cause related to lack of staff education and training.