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1) Minimum 6 pages (No word count per page)- Follow the 3 x 3 rule: minimum of three paragraphs per page ( minimum 300 words per page)
You must strictly comply with the number of paragraphs requested per page.
The number of words in each paragraph should be similar
Part 1: minimum 3 pages
Part 2: minimum 3 pages
2)¨******APA norms
The number of words in each paragraph should be similar
Must be written in the third person
All paragraphs must be narrative and cited in the text- each paragraph
The writing must be coherent, using connectors or conjunctive to extend, add information, or contrast information.
Bulleted responses are not accepted
Don’t write in the first person
Do not use subtitles or titles
Don’t copy and paste the questions.
Answer the question objectively, do not make introductions to your answers, answer it when you start the paragraph
Submit 1 document per part
3)****************************** It will be verified by Turnitin (Identify the percentage of exact match of writing with any other resource on the internet and academic sources, including universities and data banks)
********************************It will be verified by SafeAssign (Identify the percentage of similarity of writing with any other resource on the internet and academic sources, including universities and data banks)
********************************It will be verified by the AI writing Detector (Identify the percentage of AI writing) *****Under no circumstances will AI writing be tolerated*****
4) Minimum 4 references (APA format) per part not older than 5 years (Journals, books) (No websites)
All references must be consistent with the topic-purpose-focus of the parts. Different references are not allowed
5) Identify your answer with the numbers, according to the question. Start your answer on the same line, not the next
Example:
Q 1. Nursing is XXXXX
Q 2. Health is XXXX
Q3. Research is…………………………………………………. (a) The relationship between……… (b) EBI has to
6) You must name the files according to the part you are answering:
Example:
Part 1.doc
Part 2.doc
_______________________________________________________________________________

Part 1: Evaluation and Evidence-Based Practice in Recreational Therapy
France is a 47-year-old woman who lives with her husband, three sons, and one daughter. Denise holds a bachelor’s degree and is a freelance writer. She first experienced some slurring and difficulty enunciating while reading to her children at bedtime. Symptoms progressed impacting her vocal chords and facial muscles. She was originally diagnosed with myasthenia gravis. Upon having increased difficulty in motor tasks was revaluated and diagnosed with Bulbar-onset Amyotrophic Lateral Sclerosis.She lives in a two-story home with her husband and children. She is alone for up to eight hours a day. Her family serves as primary care givers supporting her independence. She utilizes a walker in the home and a wheelchair when in the community. Prior to diagnosis, patient was physically active, enjoying running, swimming, biking, roller blading, playing volleyball, playing whiffle ball with her children, going to the park. Travel was a large part of the family’s leisure. Denise saw her doctor to discuss her medications and changing medical condition. The doctor has responded by increasing her antidepressant dosage and prescribing a consult with a recreation therapist and leisure education. He has referred Denise to you, a CTRS in the day program at the hospital where she was originally diagnosed, to help her in reaching her goals. Denise’s provider shares the following information from her most recent visit:
Significant past medical history: Three normal pregnancies and deliveries. Hospitalized (ICU) with H1N1. Family history of stroke and myasthenia gravis. Father had severe reaction to prednisone, resulting in death. Mother has dementia.
Medications: Gabapentin, Baclofen, Rilutek (riluzole), Sertraline (25mg) before bed. Baclofen PRN for muscle stiffness
Cognition/perception: Patient struggles with depression and accepting the diagnosis and limitations of her physical body have proven difficult. She enjoys being active and is adjusting to changes. Patient voices frustrations with inaccessible environments as they limit her ability to travel. She has adequate social supports and uses her writing to process as well as help others. She wants to remain connected to her close family through activities that don’t center around her medical condition.
Physical examination:
a.Sensation: Moderately impaired for light touch, pain, and temperature right and left distal LE (below the knee to the sole of the foot) with the ability to accurately identify five of 10 stimuli.
b.ROM: Limited both upper and lower extremities
c.Strength: Difficulty with gripping and fine motor tasks
d.Balance: WNL in sitting; however, patient requires a standard walker to maintain balance once independently attained from sitting. Patient uses wheelchair in community settings and is a fall risk.
e.Pain: Patient reports severe back pain at rest and after long periods of immobility such as sleeping. Muscles stiffen quickly.
Mobility:
a.Bed mobility: Needs assistance rising from bed in morning
b.Transfers: Transfers are independent with a walker for home-level function. Supervised transfers for car and uneven surfaces.
c.Gait: Patient is able to ambulate with a standard walker for short distances.”
Client Goals
1.Group activities to encourage family connectedness
2.Learn techniques to cope with evolving illness
3.Physical activity to assist with my muscle stiffness
1. Create a treatment plan for Denise France, using evidence-based practice to guide your decision on appropriate interventions following the DENT problem-solving method.

a. Define the problem: Clearly identify and articulate the specific problem or challenge that needs to be addressed. This involves understanding the current situation, desired outcomes, and any constraints or limitations (1 paragraph)
b.Explore possible solutions: Generate a range of potential solutions or approaches to solving the problem. Encourage creative thinking and consider different perspectives or alternative options.(1 paragraph)
c. Narrow down options: Evaluate the potential solutions and select the most feasible and effective ones. Consider the advantages, disadvantages, and potential risks associated with each option.(1 paragraph)
d. Take action: Implement the chosen solution or solutions. Develop a plan, allocate resources, and set specific goals and timelines for execution. (1 paragraph)
2. What assessment would be most appropriate for you to give to Denise? (1 paragraph: Question 2 and Question 3)
3.What factors must be considered when planning Denise’s intervention?
4.What is your PICO question? (1 paragraph: Question 4 and Question 5)
5.What outcomes do you anticipate from your treatment plan?
6.How will you evaluate the outcomes of your treatment plan? (1 paragraph: Question 6 and Question 7)
7.What contraindications should you consider in Denise’s treatment?
8.What recreational activities would be appropriate considering Denise’s interests, goals, and current functioning level? (1 paragraph)
9.How would you communicate your recommendations to Denise?” (1 paragraph)
Part 2: Evaluation and Evidence-Based Practice in Recreational Therapy
“Adam Smith is an 8-year-old boy in the second grade with ADHD. He recently moved to New Hampshire, and this is the fourth move he has experienced in four years and the fourth school he has attended in the same amount of time. Because of this, his peers in class are slow to accept the newcomer. Making friends is nearly impossible for him, so he has relied on his mother for companionship. Adam’s parents divorced due to domestic violence when he was three years old. Although his father now lives in Idaho, Adam maintains a reasonably good relationship with his father and sees him during the summer and during breaks in the school year. Adam’s mother, who also has ADHD, works full time in management for a national corporation. Her job requires that Adam attend before- and after-school care at the school. After work, his mother is often too tired to enforce the rules she has established for homework and behavior, so Adam experiences inconsistent expectations.Adam’s mother is receiving notes from his teacher about his disruptive behavior in the classroom and lack of attention to instruction. This is not unusual; she received similar information from Adam’s teachers in the schools he previously attended. This time, however, she reaches out to the school psychologist, who suggests professional counseling for both of them.One of the suggestions made by the mother’s psychologist is that she look into requesting therapeutic recreation services through the school district for Adam. You are the CTRS for the school district. In addition to working with teachers to promote inclusive practices, you often meet with students and their families to create treatment plans to address their concerns in and out of the classroom. In your meeting with Adam and his mother, you note the following information.
Significant past medical history: Adam witnessed an incident of domestic violence between his mother and father
Medications: Recent medication change to Strattera; used to take Adderall XR but was losing too much weight”
Behavioral complaint (Per mother): inconsistent in follow-through with chores
Behavioral complaint (Per teacher): difficulty sitting still; impulsive; highly distractible, inattentive, disorganized, unpredictably irritable
Client Goals
1.Make friends
2.Deal with ADHD symptoms
1. Using the DENT problem-solving model and evidence-based practice, create a treatment plan for Adam based on his interests, goals, and current diagnosis.
a. Define the problem: Clearly identify and articulate the specific problem or challenge that needs to be addressed. This involves understanding the current situation, desired outcomes, and any constraints or limitations (1 paragraph)
b.Explore possible solutions: Generate a range of potential solutions or approaches to solving the problem. Encourage creative thinking and consider different perspectives or alternative options.(1 paragraph)
c. Narrow down options: Evaluate the potential solutions and select the most feasible and effective ones. Consider the advantages, disadvantages, and potential risks associated with each option.(1 paragraph)
d. Take action: Implement the chosen solution or solutions. Develop a plan, allocate resources, and set specific goals and timelines for execution. (1 paragraph)
2. What assessment would be most appropriate for you to give to Adam? (1 paragraph: Question 2 and Question 3)
3.What factors must be considered when planning Adam’s treatment plan?
4.What is your PICO question?(1 paragraph: Question 4 and Question 5)
5.What outcomes do you anticipate from your treatment plan?
6.How will you evaluate the outcomes of your treatment plan? (1 paragraph: Question 6 and Question 7)
7.What contraindications should you consider in Adam’s treatment plan?
8.What recreational activities would be appropriate considering Adam’s interests, goals, and current level of functioning? (1 paragraph)
9.How can this treatment plan be communicated to his teacher at school?” (1 paragraph)

Discuss how nurse leaders serve as advocates for their employees. Describe how advocacy for employees affects patient care and outcomes.

at least 500 words, formatted and cited in proper current APA style with support from at least 2 academic sources.

Part 1: Skin
KM is a 38-year-old white woman with a 6-year history of psoriasis. Her family history includes allergies and asthma and her mother with psoriasis. KM returns today for an increase in symptoms, and she wants to improve the appearance of her skin. Please discuss the following:
What is the underlying cause of psoriasis?
What are the common signs and symptoms of this disease?

Part 2: Breasts
Define, Compare and Contrast the following conditions:
Fibrocystic breast disease
Fibroadenoma
Malignant breast tumor

Instructions
As a new nurse, you have had clients with Myasthenia Gravis (MG) and are concerned about their level of understanding of the disease process. You have taken on the task of developing a teaching pamphlet to provide clear discharge instructions including information on the disease, support resources, medication teaching, and signs and symptoms of Myasthenic Crisis. You will include the following information in the pamphlet.
Describe the disease process for MG.
List (2) local community resources available that can provide support such as:
Nutrition.
Transportation.
Psychosocial needs such as support groups.
Include medication administration instructions and the importance of timing of medication delivery.
Include signs of symptoms of Myasthenic Crisis and when to notify health care provider.
Write at least one paragraph to address each criteria.