Nursing

Assignment:General Knowledge In Healthcare
Assignment:General Knowledge In Healthcare
Module 7 discussion
Discussions A/B
Complete the discussion in Group A or B as assigned by the instructor and then respond to the alternate group. All students are required to review all posts for general knowledge. Keep in mind that you will earn points for your initial discussion posts, as well as your responses. If you do not posts responses, you cannot earn full credit. Refer to the Discussion Rubric on how points are earned.
Discussion A: Group A will complete initial post, Group B will respond to the post.
Bobby was hospitalized 6 days ago for appendicitis. After an appendectomy following a perforated appendix, he now has an open incision requiring BID dressing changes and contact isolation due to a hospital acquired MRSA infection. It is anticipated that he will be here for 5-10 more days for long term antibiotic therapy and wound care. He is 13 years old. He has been afebrile for 24 hours. The wound is open with minimal serous drainage.
He is withdrawn and relates “just tired” when you inquire about how he is this morning. Last week he shared his interest in school. Gets A’s in math, computer science and was supposed to be competing in the school science fair this week.
What do you know about the adolescent and the appropriate developmental level?
Keeping his diagnosis in mind, what about visitation?
Is socialization a need?
What other questions should you ask?
Group B Response
It is 10 pm and you make assessment rounds and find Bobby crying. You ask him what his pain level is. What pain scale are you using?
He says he misses his family and wonders when they are going to come to get him and take him home? He relates his dad told him to be brave but he couldn’t stay with him since
Bobby was going to be in the hospital for such a long time and his dad had to work. He has 2 other brothers older than him. You also notice that his tray is untouched.
In addition to Erikson’s theory of development, children have fear of loss. What is Bobby’s fear?
(do not forget the interdisciplinary team members)
Video: Pre-operative teaching
Discussion B: Group B will complete the initial post, Group A will respond to the post.
Tina is 5 years old, lives with her mother and grandmother. Mother works 2 jobs to help support her mother and her daughter. Tina is well cared for but is now admitted for a cardiac catheterization due to the Ventricular Septal Defect (VSD) that was noted at birth.
Tina has an extensive history of respiratory infections and a nursing diagnosis of ‘activity intolerance’. Her mother relates that she does not allow her to play organized or competitive games due to her health. Tina smiles broadly when you come in the room to begin the pre-operative checklist. She starts to ask you a question when her grandmother tells her she must stay in the bed. “The nurse knows what she is doing and you will just be in the way.” Tina continues to smile at you but moves back to the bed.
You have identified some unique family dynamics, please relate.
What is the Erikson developmental level that Tina should exhibit? And where do you think she is?
How can you assist in the developmental growth?
What education can you give to Tina and her grandmother pre operatively?
What will she expect post operatively?
Group A Response
You begin to explain that the first thing you will need to get done is an I.V. Tina’s grandmother doesn’t give you a chance to ask her to help. She excuses herself and says she can’t watch. She will go to the cafeteria and return later. Tina starts to cry and begins to suck her thumb.
What tools have you brought with you?
How can you comfort Tina?
What methods of communication might you use to help relieve anxiety?
Can you give Tina choices?
How can you successfully get the IV in?

Major Challenges in Developing a Plan
Major Challenges in Developing a Plan
Week 1 Project
Introduction
While treating the chronically ill, a major challenge is developing a plan of care that addresses the specific needs of a patient and a caregiver. You need to be in close touch with patients and their support group, family and peers, to come up with an ideal plan.
In this course project, you are going to develop a plan of care for a chronic illness group of your choice using the Healthy People 2020 Topics. While executing the tasks of this project, remember that while you need to give a general overview of the biomedical considerations of the case, the focus should always be on the psychosocial elements. Your perspective in this care plan should be the patient’s goals rather than those of the medical team.
Each week, you will complete a part of this project. You will submit a final completed project in Week 5. Be sure to take the time to carefully complete each of the weekly assignments and then put it all together in Week 5.
Ensure that you save a copy of this course project after you have submitted it at the end of this course. You are expected to resubmit this project along with the other course projects at the end of the Registered Nurse (RN) to Bachelor of Science in Nursing (BSN) program. File Transfer Protocol (FTP) details will be provided in the Capstone course.
Identifying a Group
Identify an area of chronic illness of specific interest to you and that is represented as a Healthy People 2020 topic (healthypeople.gov). Explain your choice and your interest in it. Prepare a questionnaire utilizing your knowledge of health and illness, with the aim of acquiring all information you need from patients to prepare a plan of care for the specific illness group. Submit your information in a 4- to 5-page Microsoft Word document. In addition to your questionnaire, be sure to include the following details in your paper.
Chronic Illness of interest
Morbidity and comorbidity of the disease
Impact of the chronic illness and patient morbidity and the affect to overall health of nation
Healthy People 2020 goals and objectives for specific illness group
Support your responses with examples.
On a separate references page, cite all sources using APA format.
Use this APA Citation Helper as a convenient reference for properly citing resources.
This handout will provide you the details of formatting your essay using APA style.
You may create your essay in this APA-formatted template.
Week 2 Project
The Impact of Chronic Illness
Identify one person from the illness group you chose in Week 1. The person should not be a patient at the facility in which you work. You can use friends, family members, or coworkers. Do not use the person’s name in the paper but only initials. Administer the questionnaire you created in Week 1 to that person. Compile the data and analyze the responses to better illustrate where this person, his or her family, and friends are in relation to accepting the diagnosis in relation to the standard health or illness definitions. The analysis should also include coping skills, treatment, and support aspects of the illness. Identify how this will direct care plan development for the chosen illness group.
Compile a report of your interview with the questions you created, the responses you received, your analysis, and your interpretation of how it will affect planning care for the group in a 4- to 5-page Microsoft Word document.
Support your responses with examples.
On a separate references page, cite all sources using APA format.
Use this APA Citation Helper as a convenient reference for properly citing resources.
This handout will provide you the details of formatting your essay using APA style.
You may create your essay in this APA-formatted template.
Week 3 Project
Instructions
Using the information from the interview you conducted in Week 2, list in descending order the support needs of your participant. Also discuss how to implement objectives of Healthy People 2020 to increase wellness. Give examples of appropriate interventions of the professional caregiver, for example, the nurse.
Submit your findings in a 4- to 5-page Microsoft Word document.
Support your responses with examples.
On a separate references page, cite all sources using APA format.
Use this APA Citation Helper as a convenient reference for properly citing resources.
This handout will provide you the details of formatting your essay using APA style.
You may create your essay in this APA-formatted template.
Week 4 Project
Locating Resources
Locate a minimum of three community or national resources for your illness group chosen in Week 1, preferably in your community. Study these resources and write a report about them in a 4- to 5-page Microsoft Word document. Include in your response all the information the patient should know about them (the specific services they offer, fee schedules, if and when appropriate, criteria for eligibility, and any other important information). Discuss potential advantages and disadvantages for vulnerable populations in seeking these resources.
Support your responses with examples.
On a separate references page, cite all sources using APA format.
Use this APA Citation Helper as a convenient reference for properly citing resources.
This handout will provide you the details of formatting your essay using APA style.
You may create your essay in this APA-formatted template.
Week 5 Project
Creating a Plan of Care
Utilizing the information you have gathered over the weeks regarding the specific illness group you identified, this week, you will create a plan of care for your chronic illness group.
Create the plan in a 4- to 6-page Microsoft Word document (the 4–6 pages include the holistic care plan). Include the following in your plan:
Start the paper with a brief introduction describing the chronically ill group you selected and provide rationale for selecting this illness and the participants. Clearly identify the Healthy People 2020 topic chosen and why this topic was chosen.
You will want to compile the information gathered from Weeks 1–4 over 2 to 3 pages. This should be in APA format and paragraph form. This is not to be copied and pasted from previous assignments. It is to be a summary of each week.
The paper should include the care plan for your chronic illness group organized under the following headings:
Nursing Diagnoses
Assessment Data (objective and subjective)
Interview Results
Desired Outcomes
Evaluation Criteria
Actions and Interventions
Evaluation of Patient Outcomes
You will need to ensure that the care plan is holistic and includes at least 3 nursing diagnoses related to the topic and interview results from the previous weeks.
Include strategies for the family or caregiver in the care plan and provide your rationale on how they will work.
Include a reference page to provide reference for all citations for the paper as well as the care plan.
On a separate references page, cite all sources using APA format.
Use this APA Citation Helper as a convenient reference for properly citing resources.
This handout will provide you the details of formatting your essay using APA style.
You may create your essay in this APA-formatted template.
Major Challenges in Developing a Plan

Case: Clients With Bipolar Disorder
Case: Clients With Bipolar Disorder
Week 4 assignment
Assignment: Assessing and Treating Clients with With Bipolar Disorder
Bipolar disorder is a unique disorder that causes shifts in mood and energy, which results in depression and mania for clients. Proper diagnosis of this disorder is often a challenge for two reasons: 1) clients often present as depressive or manic, but may have both; and 2) many symptoms of bipolar disorder are similar to other disorders. Misdiagnosis is common, making it essential for you to have a deep understanding of the disorder’s pathophysiology. For this Assignment, as you examine the client case study in this week’s Learning Resources, consider how you might assess and treat clients presenting with bipolar disorder.
Learning Objectives
Students will:
Assess client factors and history to develop personalized plans of bipolar therapy for clients
Analyze factors that influence pharmacokinetic and pharmacodynamic processes in clients requiring bipolar therapy
Evaluate efficacy of treatment plans
Analyze ethical and legal implications related to prescribing bipolar therapy to clients across the lifespan
Learning Resources
Note: To access this week’s required library resources, please click on the link to the Course Readings List, found in the Course Materials section of your Syllabus.
Required Readings
Note: All Stahl resources can be accessed through the Walden Library using this link. This link will take you to a log-in page for the Walden Library. Once you log into the library, the Stahl website will appear.
Stahl, S. M. (2013). Stahl’s essential psychopharmacology: Neuroscientific basis and practical applications (4th ed.). New York, NY: Cambridge University Press.
To access the following chapters, click on the Essential Psychopharmacology, 4th ed tab on the Stahl Online website and select the appropriate chapter. Be sure to read all sections on the left navigation bar for each chapter.
Chapter 6, “Mood Disorders”
Chapter 8, “Mood Stabilizers”
Stahl, S. M., & Ball, S. (2009b). Stahl’s illustrated mood stabilizers. New York, NY: Cambridge University Press.
To access the following chapters, click on the Illustrated Guides tab and then the Mood Stabilizers tab.
Chapter 4, “Lithium and Various Anticonvulsants as Mood Stabilizers for Bipolar Disorder”
Chapter 5, “Atypical Antipsychotics as Mood Stabilizers for Bipolar Disorder”
Vitiello, B. (2013). How effective are the current treatments for children diagnosed with manic/mixed bipolar disorder? CNS Drugs, 27(5), 331-333. doi:10.1007/s40263-013-0060-3
Note: Retrieved from Walden Library databases.
Chen, R., Wang, H., Shi, J., Shen, K., & Hu, P. (2015). Cytochrome P450 2D6 genotype affects the pharmacokinetics of controlled-release paroxetine in healthy Chinese subjects: comparison of traditional phenotype and activity score systems. European Journal of Clinical Pharmacology, 71(7), 835-841. doi:10.1007/s00228-015-1855-6
Note: Retrieved from Walden Library databases.
Required Media
Laureate Education. (2016f). Case study: An Asian American woman with bipolar disorder [Interactive media file]. Baltimore, MD: Author
Note: This case study will serve as the foundation for this week’s Assignment.
Optional Resources
Mostafavi, A., Solhi, M., Mohammadi, M., Hamedi, M., Keshavarzi, M., & Akhondzadeh, S. (2014). Melatonin decreases olanzapine induced metabolic side-effects in adolescents with bipolar disorder: a randomized double-blind placebo-controlled trial. Acta Medica Iranica, 52(10), 734-739.
Retrieved from http://acta.tums.ac.ir/index.php/acta
To prepare for this Assignment:
Review this week’s Learning Resources. Consider how to assess and treat clients requiring bipolar therapy.
The Assignment
Examine Case Study: An Asian American Woman With Bipolar Disorder. You will be asked to make three decisions concerning the medication to prescribe to this client. Be sure to consider factors that might impact the client’s pharmacokinetic and pharmacodynamic processes.
At each decision point stop to complete the following:
Decision #1
Which decision did you select?
Why did you select this decision? Support your response with evidence and references to the Learning Resources.
What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.
Explain any difference between what you expected to achieve with Decision #1 and the results of the decision. Why were they different?
Decision #2
Why did you select this decision? Support your response with evidence and references to the Learning Resources.
What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.
Explain any difference between what you expected to achieve with Decision #2 and the results of the decision. Why were they different?
Decision #3
Why did you select this decision? Support your response with evidence and references to the Learning Resources.
What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.
Explain any difference between what you expected to achieve with Decision #3 and the results of the decision. Why were they different?
Also include how ethical considerations might impact your treatment plan and communication with clients.

Case: EBP in nursing Assignment
Case: EBP in nursing Assignment
Week 4 discussion
DQ1 What are some of the obstacles or barriers to implementing EBP in nursing? Provide a rationale for your answer. Since there are numerous topics on the issue, it is not appropriate to repeat one that has already been mentioned unless providing new information.
DQ2 Conducting research projects while ensuring the protection of human subjects is necessary. What are some methods to protect personal rights of someone in one of the groups that is labeled as vulnerable? Justify your rationale.
Week 2 discussion
DQ1 Visit the website: http://www.hl7.org/newsroom/inthenews.cfm
Select the Newsroom Link at the top of the page. Review the issues and policies, press releases, in the news, and industry news links. Discuss one of the topics and how it relates to the content in the course.
DQ2 Select one of the standards discussed in this week’s assigned reading. Discuss the standard and how it helps achieve interoperability.
Week 3 discussion
DQ1 Explain how the Continuity of Care Document (CCD) can help meet meaningful use criteria.
DQ2 Discuss the purpose of HL7, CDA, and CCD, and how they have influenced current health care. In your responses, discuss how you see these affecting future informatics practices or changing over time.
Week 4 discussion
DQ1 Discuss the need for imaging standards in healthcare informatics. Utilize assigned reading and resources from this week to support your post.
DQ2 COLLAPSE
Visit the following website and review the PowerPoint presentation. Then, discuss one of the sections of the CCR presented. Incorporate course resources to enhance your discussion on the topic.
https://www.hl7.org/documentcenter/public_temp_DC462D64-1C23-BA17-0C80B6292410A5DF/calendarofevents/himss/2004/presentations/ContinuityofCareRecord.pdf
Week 5 discussion
DQ1 Visit the following website http://www.nuemd.com/icd-10/codes and search for “diseases” (for example, infection). Discuss what word you searched for and what was returned. Were there challenges you noticed with the specificity of your search keyword? What did you learn and how would you approach a different search or guide a colleague in future searches?
DQ2 Examine the need to switch to ICD-10; explore challenges that healthcare organizations are facing in doing so. What have they done to overcome those challenges? Provide suggestions for future institutions that desire to switch to ICD-10.
Week 6 discussion
DQ1 Discuss how using a standard terminology like SNOMED CT helps achieve meaningful use. Use 2–3 specific examples.
DQ2 Review the ISMP List of High-Alert Medications in Acute Care Settings document at this link: https://www.ismp.org/tools/highalertmedications.pdf
Complete a search for one of the medications from the ISMP lList. Discuss your findings (e.g., a search for “digoxin” returns one element in “ingredient,” three elements in Brand Name, four elements in dose form group, and 10 elements of “Clinical Drug or Pack”). Share your findings.
You can use https://www.nlm.nih.gov/research/umls/rxnorm/overview.html as an additional reference.
Week 7 discussion
DQ1 Discuss an advantage and a disadvantage of using XML in health information systems. Explain the alternative file formats to XML and how they differ.
DQ2 Explain the purpose and use of the Unified Medical Language System (UMLS) and discuss how it influences interoperability.
Week 8 discussion
DQ1 Discuss the advantages of standardizing nursing languages, and describe how standardized nursing languages are applied in the clinical setting.
DQ2 Discuss the application of a national EHR. Discuss whether you support or oppose the concept of national EHRs. Support with references.
Week 1 Achieving Interoperability in Times of Change Paper
A hospital system has acquired a cancer treatment center that does not currently have an electronic health record system.
Complete the two-system merger interactive scenario to get started.
Then briefly research the functions, significance, and factors that affect implementation of EHR technology discussed in the textbook.
Compose your paper discussing each listed component in APA format, citing a minimum of two scholarly resources in addition to the assigned reading. Examples of scholarly sources include professional journal articles and books obtained from library databases, national guidelines, and informatics organizations, published within the last five years. A title page is not necessary, but you do need to include a reference page.
Your paper should be 2 to 3 pages in length.
Week 2 HL7 Messaging Structure Paper
Discuss in a one-page paper what HL7 messaging structure is and why it is used. Provide an example of a real-world event that you have had occur and how that would translate into an HL7 message.
Utilize the assigned reading and a minimum of one outside scholarly resource.
Examples of scholarly sources include professional journal articles and books obtained from library databases, national guidelines, and informatics organizations, published within the last five years. Compose your paper in APA format. A title page is not necessary, but you do need to include a reference page.
Week 3 HL7, Interoperability, and Transitions of Care Paper
Write a two- to three-page paper discussing how the Health Level Seven (HL7) Clinical Document Architecture (CDA) and Continuity of Care Document (CCD) promote interoperability and transitions of care. In your paper, discuss the ways this affects technical, semantic, and process interoperability using examples from your own practice.
Utilize your course readings and a minimum of three outside scholarly resources in your paper.
Examples of scholarly sources include professional journal articles and books obtained from library databases, national guidelines, and informatics organizations, published within the last five years. Compose your paper in APA format. A title page is not necessary, but you do need to include a reference page.
Week 4 The Influence of DICOM Paper
In a two-page paper, describe the implementation, use, and necessity of DICOM in a new organization. Discuss the advantages of having DICOM and its effects on meaningful use and interoperability.
In addition to course resources, use a minimum of two additional scholarly resources.
Examples of scholarly sources include professional journal articles and books obtained from library databases, national guidelines, and informatics organizations, published within the last five years. Compose your paper in APA format. A title page is not necessary, but you do need to include a reference page.
Week 5 LOINC and Interoperability Paper
In a one-page paper, discuss the background, functions, and format of LOINC. Include the fields included in the database, and the ways LOINC affects interoperability.
Include a minimum of two scholarly sources in addition to the course resources.
Examples of scholarly sources include professional journal articles and books obtained from library databases, national guidelines, and informatics organizations, published within the last five years. Compose your paper in APA format. A title page is not necessary, but you do need to include a reference page.
Week 6 Utilizing SNOWMED CT Website Activity and Reflection
Visit the website: http://browser.ihtsdotools.org/ Click for more options
Click on Local Extensions/United States.
In the database browser, search for a disorder, organism, procedure, or substance (e.g., naegleria > (disorder) > infection caused by naegleria).
Discuss the following:
What was your search item? (1–2 sentences)
How many search results did you get?
What is the purpose of SNOMED CT?
Write all the structures of your search item (e.g., “infection caused by naegleria”). It may be easier to use Microsoft Word or PowerPoint to draw this structure.
Compose a one-page paper in APA format, citing a minimum of one scholarly resource.
Examples of scholarly sources include professional journal articles and books obtained from library databases, national guidelines, and informatics organizations, published within the last five years. A title page is not necessary, but you do need to include a reference page.
Week 7 XML Document
Create an XML document that contains a patient’s name, date of birth, address, phone number, name of contact person, one allergy, an adverse reaction, the severity, and the onset date (assume any calendar date).
Utilize the course and a minimum of two outside scholarly resources.
Examples of scholarly sources include professional journal articles and books obtained from library databases, national guidelines, and informatics organizations, published within the last five years.
Week 8 Signature Assignment: The Complexities of Interoperability Paper and Presentation
Since the start of the Affordable Care Act, many hospital systems have chosen to merge and form strategic partnerships to help reduce cost and expand resources. You will be examining the effect of mergers on informatics, EHR’s, and interoperability.
Complete the three-system merger interactive scenario to get started.
Remember this important background information from the scenario: Three healthcare systems have decided to merge.
System A consists of one large acute care hospital with 450 beds. Services range from outpatient surgery to inpatient services for cardiology, obstetrics, pediatrics, and chemical dependency. They have medical surgical floors, an extensive ER, and several intensive care units. They have a range of radiology and laboratory services.
Case: EBP in nursing Assignment
Case: EBP in nursing
Case: EBP in nursing
Case: EBP in nursing Assignment

Case Study: Labor Management
Case Study: Labor Management
Module 3 discussion
Labor Management
Complete the discussion in Group A or B as assigned by the instructor and then respond to the alternate group. All students are required to review all posts for general knowledge. Keep in mind that you will earn points for your initial discussion posts, as well as your responses. If you do not posts responses, you cannot earn full credit. Refer to the Discussion Rubric on how points are earned.
Part 1: An 18 year old Primigravida presents to Labor And Delivery with what appears to be active labor. Upon questioning, you discover she has received no prenatal care. In obtaining some history while placing her on the fetal monitor you learn she is a smoker, approximately 1 pack per day, occasional marijuana for stress, and denies any support system. The Father of the Baby (FOB) has no knowledge of the pregnancy. No prenatal vitamins – they were too hard to swallow. She has no idea when her LMP was and she relates always being very irregular. * remember LMP is to ask the first day of the Last Menstrual cycle, not when the bleeding stopped*
What other questions are essential for her safe care?
What lab values do you need to obtain?
What exam findings should you obtain at this time?
What education will you provide for her?
She asks you how long this will take to have the baby – what is your best response?
Group B
Part 2: Objective information:
Fetal heart tones are 130, with minimal variability
Vaginal exam is 4 cm/90%effaced/ -1 station
She is complaining of pain – 8/10 on a numerical scale.
An IV has been started with an 18 gauge catheter with 1 liter of Lactated Ringers at 150 ml per hr in left forearm.
How can you provide non pharmacological comfort to this patient?
What are the pharmacological methods to use?
Without prenatal records or history GBS is unknown. What must you provide?
Contractions are 5 minutes apart and you receive an order to augment labor – what non pharmacological methods can you employ (or ask the MD to provide?)
Pitocin is ordered, please include at what rate you will start Pitocin, and how often you titrate. What equipment is needed to hang and run Pitocin IV?
Preterm Labor Management
Preterm labor
Group B: complete Part 1
Part 1: 25 y/o presents to Labor and Delivery with complaints of uterine cramping and lower back pain. Denies any vaginal bleeding at this time. Has related history of a preterm birth at 32 weeks gestation with her last pregnancy. The baby is 3 years old now and has no developmental issues.
Her current gestational age is 30 weeks.
She is O+ and all other lab values are normal. No noted STI’s.
1. Group Beta Strep is missing from the labs – most often is obtained at 35 – 37 weeks gestation.
2. Without this information it is often determined to treat the patient anyway – presumptively to protect a premature baby from the risk.
3. What other information would you like to ask her?
4. What nursing intervention will you provide?
5. What screening tests are often obtained to help determine her risk for preterm labor.
6. And if it is determined she is in preterm labor what medications may you want to use with a doctors order?
7. Please also give dose, side effects and possible result of the medication.
Group A to complete Part 2 after Part 1 is completed.
Part 2: The patient is now 3cm/100% effaced /-2 station. What is the plan of care for the safety of this patient and her baby? Fetal heart rate is 160 with moderate variability. Contractions are now mild and 15 minutes in frequency.
1. Magnesium Sulfate is used to stop the contractions, and this has been successful.
2. What is the dose you will start with, what is the maintenance dose>
3. Please indicate what nursing interventions are necessary for use with Magnesium Sulfate?

Assignment: Valuation of Cough
Assignment: Valuation of Cough
Tammy is a 33-year-old who presents for evaluation of a cough. She reports that about 3 weeks ago she developed a “really bad cold” with rhinorrhea. The cold seemed to go away but then she developed a profound, deep, mucus-producing cough. Now, there is no rhinorrhea or rhinitis—the primary problem is the cough. She develops these coughing fits that are prolonged, very deep, and productive of a lot of green sputum. She hasn’t had any fever but does have a scratchy throat. Tammy has tried over-the-counter cough medicines but has not had much relief. The cough keeps her awake at night and sometimes gets so bad that she gags and dry heaves. Through and extensive work-up, she is diagnosed with bronchitis.
What is the etiology of bronchitis?
Describe in detail the pathophysiological process of bronchitis.
Identify hallmark signs identified from the physical exam and symptoms.
Describe the pathophysiology of complications of bronchitis.
What teaching related to her diagnosis would you provide?
Question 2
Module 09 Written Assignment – Seizures
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?
Submit your completed assignment by following the directions linked below. Please check the Course Calendar for specific due dates.

Case: General Appraisal Overview
Case: General Appraisal Overview
Week 2 discussion
DQ1 Review the “General Appraisal Overview for All Studies,” available in Appendix B in the textbook You should save this tool and use it throughout the development of the PICOT question, problem description, and literature review
Begin the development of your PICOT question, using the following resources:
“Appendix A: Template for Asking Clinical Questions,” available in the textbook appendix
Text readings
Formulate your PICOT question and post it to the main forum Respond to at least four other statements, providing feedback Review the statements to see if the clinical issue is clearly defined and that all aspects are identified Also refer to the “PICOT: Components of an Answerable, Searchable Question” table, located in chapter 2 of the text If one PICOT statement has at least three feedback posts, move to another statement
You will be using the feedback to make revisions to your PICOT question before using it in your “Section B: Problem Description” assignment
DQ2 What strategies will you use in your new practice as an advance practice nurse to review and critique literature pertinent to your practice?
Week 4 discussion
DQ1 Discuss the need for imaging standards in healthcare informatics. Utilize assigned reading and resources from this week to support your post.
DQ2 COLLAPSE
Visit the following website and review the PowerPoint presentation. Then, discuss one of the sections of the CCR presented. Incorporate course resources to enhance your discussion on the topic.
https://www.hl7.org/documentcenter/public_temp_DC462D64-1C23-BA17-0C80B6292410A5DF/calendarofevents/himss/2004/presentations/ContinuityofCareRecord.pdf
Week 5 discussion
DQ1 Visit the following website http://www.nuemd.com/icd-10/codes and search for “diseases” (for example, infection). Discuss what word you searched for and what was returned. Were there challenges you noticed with the specificity of your search keyword? What did you learn and how would you approach a different search or guide a colleague in future searches?
DQ2 Examine the need to switch to ICD-10; explore challenges that healthcare organizations are facing in doing so. What have they done to overcome those challenges? Provide suggestions for future institutions that desire to switch to ICD-10.

Case Study: Ecological theory
Case Study: Ecological theory
Week 4 Assignment 3 Quiz
1. Question :
Which theory focuses on the relationships among individuals as they develop and change in the environment?
Ecological theory
Cognitive theory
Humanistic theory
Sociocultural theory
Question 2. Question :
The Board of Nursing in each state is responsible for _____________.
certified medical assistants
pharmacy technicians
anesthesiologists
advanced practice nurses
Question 3. Question :
Stool of a breastfed infant is:
hard and dark brown
soft, yellow, and seedy
florescent green
white in color
Question 4. Question :
An essential tool in the evaluation of precocious puberty in girls is:
Menarche
Growth spurt
Thelarche
Pubarche
Question 5. Question :
The incidence of epiglottis has decreased because of which vaccine?
Hib
Prevnar
Varicella
Meningococcal
Question 6. Question :
What factors contribute to the inability among children to access health-care services?
Inability to obtain health insurance
Language and cultural barriers
Lack of financial resources
All of the above
Question 7. Question :
An eight-year-old has chronic intermittent nasal congestion. All but which one of the following would support allergic rhinitis?
Red swollen turbinates
Darkened areas below eyes
Increased basophils on complete blood count (CBC)
Itchy, watery eyes
Question 8. Question :
Parents or guardians of adolescents should ___________________.
not be included in the adolescent’s health care
receive health guidance information at least twice during adolescence
encourage reasonable use of alcohol and tobacco by the adolescent
encourage early sexual activity by providing condoms to the adolescent
Question 9. Question :
A five-year-old female presents for a follow-up emergency room visit with a diagnosis of bronchitis. Which treatment you would expect to have been prescribed?
Oral steroids
Azithromycin
Increase rest and fluid intake
Albuterol
Question 10. Question :
How does cultural sensitivity impact the care of infants in the primary care setting?
Health-care providers may possess cultural biases that can impact care.
Cultural sensitivities do not exist in health care.
Cultural sensitivity only impacts the parents of infants.
Cultural sensitivity increases access to timely health-care services for infants.
Question 11. Question :
The most typical chest radiographic finding consistent with the diagnosis of asthma is ______________.
normal chest film
diffuse airway edema
right upper-lobe infiltrate
hyperinflation
Question 12. :
A four-year-old male patient presents with his mother with a school referral regarding red eyes. Which questions would not assist in establishing a list of differential diagnoses?
Unilateral vs. bilateral presentation
Type of drainage
Vision status
History of a bacterial infection one month ago

Discussion: Sleep/Wake Disorders
Discussion: Sleep/Wake Disorders
Week 7 discussion
Di
It is not uncommon to experience a night or two of disrupted sleep when there is something major going on in your life. However, sleep/wake disorders are much more than an occasional night of disrupted sleep. A recent report from the Centers for Disease Control and Prevention estimated that between 50 and 70 million American have problems with sleep/wake disorders (CDC, 2015). Although the vast majority of Americans will visit their primary care provider for treatment of these disorders, many providers will refer patients for further evaluation. For this Discussion, you consider how you might assess and treat the individuals based on the provided client factors.
Learning Objectives
Students will:
Assess client factors and history to develop personalized therapy plans for clients with sleep/wake disorders
Analyze factors that influence pharmacokinetic and pharmacodynamic processes in clients requiring therapy for sleep/wake disorders
Evaluate efficacy of treatment plans for clients presenting for sleep/wake therapy
Apply knowledge of providing care to adult and geriatric clients presenting for sleep/wake disorders
Learning Resources
Note: To access this week’s required library resources, please click on the link to the Course Readings List, found in the Course Materials section of your Syllabus.
Required Readings
Note: All Stahl resources can be accessed through the Walden Library using this link. This link will take you to a log-in page for the Walden Library. Once you log into the library, the Stahl website will appear.
Stahl, S. M. (2013). Stahl’s essential psychopharmacology: Neuroscientific basis and practical applications (4th ed.). New York, NY: Cambridge University Press.
To access the following chapters, click on the Essential Psychopharmacology, 4th ed tab on the Stahl Online website and select the appropriate chapter. Be sure to read all sections on the left navigation bar for each chapter.
Chapter 11, “Disorders of Sleep and Wakefulness and Their Treatment”
Stahl, S. M. (2014b). The prescriber’s guide (5th ed.). New York, NY: Cambridge University Press.
To access information on the following medications, click on The Prescriber’s Guide, 5th ed tab on the Stahl Online website and select the appropriate medication.
Review the following medications:
For insomnia
alprazolam
amitriptyline
amoxapine
clomipramine
clonazepam
desipramine
diazepam
doxepin
flunitrazepam
flurazepam
hydroxyzine
imipramine
lorazepam
nortriptyline
ramelteon
temazepam
trazodone
triazolam
trimipramine
zaleplon
zolpidem
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.
Note: Retrieved from Walden Library databases.
Davidson, J. (2016). Pharmacotherapy of post-traumatic stress disorder: Going beyond the guidelines. British Journal of Psychiatry, 2(6), e16-e18. doi:10.1192/bjpo.bp.116.003707. Retrieved from http://bjpo.rcpsych.org/content/2/6/e16
To prepare for this Discussion:
Note: By Day 1 of this week, your Instructor will have assigned you to one of the following case studies to review for this Discussion. To access the following case studies, click on the Case Studies tab on the Stahl Online website and select the appropriate volume and case number.
Case 1: Volume 2, Case #16: The woman who liked late-night TV
Case 2: Volume 2, Case #11: The figment of a man who looked upon the lady
Case 3: Volume 1, Case #5: The sleepy woman with anxiety
Review this week’s Learning Resources and reflect on the insights they provide.
Go to the Stahl Online website and examine the case study you were assigned.
Take the pretest for the case study.
Review the patient intake documentation, psychiatric history, patient file, medication history, etc. As you progress through each section, formulate a list of questions that you might ask the patient if he or she were in your office.
Based on the patient’s case history, consider other people in his or her life that you would need to speak to or get feedback from (i.e., family members, teachers, nursing home aides, etc.).
Consider whether any additional physical exams or diagnostic testing may be necessary for the patient.
Develop a differential diagnoses for the patient. Refer to the DSM-5 in this week’s Learning Resources for guidance.
Review the patient’s past and current medications. Refer to Stahl’s Prescriber’s Guide and consider medications you might select for this patient.
Review the posttest for the case study.

Case: Transcultural Nursing Skills
Case: Transcultural Nursing Skills
Week 2 discussion
Transcultural Nursing Skills Self-Assessment
The Course Outcomes covered this week are CO2 and CO4.
CO2: Describe cultural differences related to drugs.
CO4: Perform a culturally competent nursing assessment. (PO7)
Nurses complete assessments on individuals on a daily basis. Self-assessments are in order before considering our abilities to provide culturally competent nursing care.
Complete Transcultural Nursing Skills Self-Assessment Form (Links to an external site.)Links to an external site.
Note the number of No answers in your self-assessment. Share one or two of your No answers with your classmates, and describe how you will convert the No to a Yes over the next few weeks.
What interventions are needed to turn each No into a Yes response?
Question 2
Week 1 discussion
Models of Transcultural Nursing
The Course Outcome covered this week is CO1.
CO1: Identify theories, concepts, and beliefs related to transcultural nursing. (PO1)
Chapter 1 of Andrews and Boyle (2016) discusses Leininger’s Sunrise Model of transcultural nursing. However, other models are described and are important to acknowledge, as well. An outstanding resource may be found at the Transcultural Nursing Society’s (TCNS) website.
Locate the website for TCNS (http://www.tcns.org (Links to an external site.)Links to an external site.). Click on the Theories tab.
Besides the Leininger and Purnell models, describe one model.
Explain how you may use the model in your practice setting.
Week 1 discussion
Models of Transcultural Nursing
The Course Outcome covered this week is CO1.
CO1: Identify theories, concepts, and beliefs related to transcultural nursing. (PO1)
Chapter 1 of Andrews and Boyle (2016) discusses Leininger’s Sunrise Model of transcultural nursing. However, other models are described and are important to acknowledge, as well. An outstanding resource may be found at the Transcultural Nursing Society’s (TCNS) website.
Locate the website for TCNS (http://www.tcns.org (Links to an external site.)Links to an external site.). Click on the Theories tab.
Besides the Leininger and Purnell models, describe one model.
Explain how you may use the model in your practice setting.