Category: Nursing
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Should Postpartum Depression Screening Be Mandatory at All P…
In last weeks discussion, we identified possible research paper topics and research questions. Now its time to make a definitive decision about your papers topic and get started on your research. Submit a Microsoft Word document (.doc or .docx) only. Submissions in any other format, such as PDF, will not be accepted. Please ensure you use the correct file type before submitting. Review these readings from last weeks discussion if necessary: Choosing a TopicLinks to an external site. What is a Research Question?Links to an external site. Now create a document that answers the following questions, devoting a 3-5 sentence paragraph to each: What topic have you decided to write your research paper on, and why have you chosen this topic? What is your research question, and what do you think your research will reveal as a possible answer to this question? Feel free to speculate here and touch on a few possibilities. What is one source (from the web or library databases) that provides useful background information on your topic or research questions, and how might you use it in your research paper? Provide a link. Some topics I was thinking about for my paper are Should Postpartum Depression Screening Be Mandatory at All Pediatric Visits During the First Year Postpartum?, Should Mental Health Services Be Fully Integrated into Primary Care, Settings?, Should Emergency Departments Be Required to Have Dedicated Psychiatric Crisis Nurses? or Should New Graduate Nurses Be Required to Complete a Nurse Residency Program?. -
The Connection Between Academic and Professional Integrity
Hi there, I have an assignment that is due next week Thurday. Can you please complete the template that is uploaded below. Also use the professor instructions to answer all the questions that is required for this template which is also uploaded. In addition, I have uploaded the previous week 1 turn-in assignment. I have also screenshot someone else example. Please use in text citation and references have to be within 5 years of occurence. Also I included the required chapters of the books which is needed to be incorporated into this assignement. Therefore the textbook is downloaded.
- American Nurses Association. (2015).
- . Retrieved from https://www.nursingworld.org/coe-view-only
- American Psychological Association. (2020). Publication manual of the American Psychological Association (7th ed.). https://doi.org/10.1037/0000165-000
- Chapter 1, Scholarly Writing and Publishing Principles
- Section 1.17, Implications of Plagiarism and Self-Plagiarism (p. 21)
- Chapter 4, Writing Style and Grammar
- Chapter 8, Works Credited in the Text
- Section 8.2, Plagiarism (p. 254)
- Section 8.3, Self-Plagiarism (p. 256)
- Chapter 10, Reference Examples
Attached Files (PDF/DOCX): Grad classacademic and integrity template.docx, Publication Manual of the American Psychological Association – 7th Edition by coll (z-liborg).pdf, MD1Assign_Lange_M.docx
Note: Content extraction from these files is restricted, please review them manually.
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3 paragraphs
1. What obligations do nurse leaders have to develop their own understanding of patient safety within their areas of responsibility? How could nurse leaders position themselves to demonstrate ongoing support for teamwork and patient safety?
2. Research materials on programs such as TeamSTEPPS. How could a teamwork intervention program make a difference within your (select one: acute care, maternity or long-term care) microsystem.
3. What evidence should nurse leaders look for that could indicate their teams and microsystems could benefit from improving their culture of safety? Consider reviewing the five Ps of the microsystem you have selected.
Use a minimum of 3 references that were written within the past 5 years
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Nursing question
For this course, the Individual Projects (IPs) will build from one week to the next. By the end of the course, you will have developed a proposal for a possible change to a practice or policy based on your evidence research. Note: You will not be collecting any data for this project. You will only be developing the idea and proposal.
The last assignment (due in the Unit 4 IP) will consist of a final paperthe culmination of work completed in the Unit 14 Discussion Boards and the Unit 3 IP. The paper will be graded by the Faculty.
Each week, you will complete parts of the final paper. It is outlined as follows:
- Unit 1: Use of the Hierarchy of Evidence Model in evidence-based practice
- Unit 2: Development of the PICOT question consider the following:
- Explanation of the selected population
- Discussion of selected theoretical framework
- What is the intervention, and why it is selected?
- How will you measure the outcomes? How will you evaluate effectiveness?
- Unit 3: Individual Project: Appraisal of the literature
- What is the best level of evidence to support the PICOT?
- What literature supports your PICOT?
- Unit 4: Individual Project: Finalizing and submitting the proposal (IP 4)
- The culmination of work completed in the Unit 14 DBs and Unit 3 IP
- Development of an evidence-based proposal for a change to a policy or practice
Unit 4 IP Assignment
Review and incorporate the feedback from your previous assignments.
Create a document of 8-12 pages, excluding the title and reference pages, following the APA Expectations document for the College of Nursing.
Develop a complete proposal that includes all of the content from the Unit 14 DBs and your Unit 3 IP. Please be sure to address the following points:
- Discuss the PICOT question in detail, and explain why this research is important to the nursing profession.
- Analyze the literature review, and determine how the current research supports the PICOT question, discussing all of the articles from the literature review.
- Analyze possible evaluation and measurement strategies and potential outcomes.
- Provide insight on how personal experience affects evidence-based practice.
- Discuss change strategies and how to implement them in the work environment to help promote change.
- Determine potential barriers in the workplace to consider when implementing change.
Please click the following link for help with APA formatting: .
Use the CTU Writing Style Guide (templates provided), not the Introductory Writing Style Guide.
Please submit your assignment.
For assistance with your assignment, please use your textbook, all course resources, and any external research and resources you have gathered.
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Nursing Question
ASSIGNMENT: CASE STUDIES
Case studies are a useful way for you to apply your knowledge of pharmacokinetics and pharmacodynamic aspects of pharmacology to specific patient cases and health histories.
For this Assignment, you evaluate drug treatment plans for patients with various disorders and justify drug therapy plans based on patient history and diagnosis.
RESOURCES
Be sure to review the Learning Resources before completing this activity.
Click the weekly resources link to access the resources.To Prepare:
- Review the case study posted in Announcements by your Instructor for this Assignment
- Review the information provided and answer questions posed in the case study
- When recommending a medication, write out a complete prescription for the medication
- Whenever possible, use clinical practice guidelines in developing your answers when possible
- Include at least three references to support your answer and cite them in APA format.
Note: If you do not purchase Lecturio, please consult these resources for this week.
- Rosenthal, L. D., & Burchum, J. R. (2025). Lehnes pharmacotherapeutics for advanced practice nurses and physician assistants (3rd ed.). Elsevier.
- Chapter 37, Diuretics (pp. 285292)
- Chapter 38, Drugs Acting on the Renin-Angiotensin-Aldosterone System (pp. 292303)
- Chapter 39, Calcium Channel Blockers (pp. 303308)
- Chapter 40, Vasodilators (pp. 308311)
- Chapter 41, Drugs for Hypertension (pp. 311320)
- Chapter 42, Drugs for Heart Failure (pp. 321332)
- Chapter 43, Antidysrhythmic Drugs (pp. 333344)
- Chapter 44, “Prophylaxis of Atherosclerotic Cardiovascular Disease: Drugs That Help Normalize Cholesterol and Triglyceride Levels” (pp. 345359)
- Chapter 45, Drugs for Angina Pectoris (pp. 360367)
- Chapter 46, Anticoagulant and Antiplatelet Drugs (pp. 368384)
Welcome to Week 2: Cardiovascular System
Happy Monday Morning Class and Welcome to Week 2.In Week 2, we will continue our pharmacology journey and apply the concepts to the cardiovascular system. Pharmacodynamics and pharmacokinetics are the two branches of pharmacology. Remember, pharmacokinetics describes what the body does to the drug through absorption, distribution, metabolism, and excretion (ADME), whereas pharmacodynamics describes what the drug does to the body.When selecting drugs and determining dosages for patients, it is essential to consider individual patient factors that might impact the patients pharmacokinetic and pharmacodynamic processes. These patient factors include genetics, gender, ethnicity, age, behavior (ie diet, nutrition, smoking, alcohol, illicit drug abuse), and/or pathophysiological changes due to disease.Learning Resources: Please plan accordingly throughout the week to review all learning resources that include but not limited to the lecturio resources and all required reading. There is much information provided but all is relevant that you will need not only for the successful completion of this course but also as you begin your practice as a Nurse Practitioner. As well, there are many required media videos for you to view this week and they are very informative.Week 2 Assignment: Please use the following Case Studies to complete your Assignment for this week that is Due by Day 7. Case studies are a useful way for you to apply your knowledge of pharmacokinetics and pharmacodynamic aspects of pharmacology to specific patient cases and health histories.For your Week 2 assignment, evaluate drug treatment plans for patients with various disorders and justify drug therapy plans based on patient history and diagnosis.DIRECTIONS: For each of the scenarios below, answer the questions using your learning resources, Medscape, and clinical practice guidelines (ie JNC 8, AHA, ACC etc). Lecturio is an optional resource but highly recommended. Be sure to thoroughly answer ALL questions. When recommending medications, write out a complete medication order. What would you send to a pharmacy? Include drug, dose, route, frequency, special instructions, # dispensed (days supply) and refill information. Also state if you would continue, discontinue or taper the patients current medications.Review and discuss ALL labs and possible interactions. Use at least 3 sources for each scenario and cite sources using APA format; include in-text citations. You do not need an introduction or conclusion paragraph. Please also review assignment rubric. SCENARIO 1What are the errors in the following prescriptions (1 per prescription)? Rewrite each prescription correctly. What is each medications classification and mechanism of action (MOA)?
- Repatha 140 mg IV every 2 weeks #1 1 RF
- Hyzaar (losartan/hydrochlorothiazide) 50/25 mg PO daily #30 3 RF
- digoxin 1.25 mg PO daily #30 1 RF
- hydralazine/isosorbide mononitrate (BiDil) 37.5 mg/20 mg PO every 8 hours #90 1 RF
- clonidine 0.3 mg patch PO once weekly #4 1 RF
SCENARIO 2A patient with stable angina is prescribed nitroglycerin. The provider avoids oral tablets and instead chooses a sublingual or transdermal formulation. Why is oral nitroglycerin not clinically useful? Discuss how first-pass metabolism affects nitroglycerins bioavailability and define both terms. Identify the route of administration with 100% bioavailability and explain how alternative routes overcome the first pass effect. Include a sample prescription for nitroglycerin.SCENARIO 3Where are the majority of cytochrome P450 (CYP) enzymes located? Using the Drugs.com pill identifier, enter the following characteristics to identify the medication AND strength. What CYP enzyme metabolizes this medication? How can this information be applied to medication therapy management? Write a sample prescription for the identified medication and strength.Imprint (E 137) Shape (Round) Color (Pink) Form (Tablet) Scoring (None) SCENARIO 4KU is a 47-year-old male following up on his labs that were drawn last week. He smokes 1 pack per day. He is currently on lisinopril 40 mg po daily, liraglutide (Victoza) 0.6 mg subcutaneously once daily and St. Johns Wort. Fasting lipid profile shows total cholesterol 260 mg/dL, LDL 180 mg/dL, HDL 43 mg/dL, and TG 185 mg/dL. He is 59 and weighs 204 lbs. What treatment plan would you implement for KU? What are GOAL Total Cholesterol (TC), HDL, LDL, and Triglyceride levels for KU? What is his BMI per Medscape calculator? What patient monitoring and education would you provide? How many risk factors for coronary artery disease does this patient have? Identify them specifically.Also, it will be very helpful to view the rubric for each assignment to ensure you’ve included all requirements before submission.Please let me know if you have any questions by posting in the Class Cafe’, Inbox, or please feel free to email me.I look forward to and am excited about all that we will learn in Week 2!
- please also attach the turnitin score! thanks!
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Discussion post response
All students need to respond to at least two peers in your group with written clinical reflection. This is to help generate meaningful discussion about the case. Responses should be 5-6 sentences in length (equivalent to one paragraph). Below is my peers post that I need to reply to.
Attached Files (PDF/DOCX): Ethics Discussion Post.docx
Note: Content extraction from these files is restricted, please review them manually.
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Analyze
Application of Technology and Professional Standards to Improve Emergency Department Intake Processes
Emergency Department Intake Processes
Emergency departments operate in fast-paced environments where delays in assessment and treatment can significantly affect patient outcomes. In the previous assessment, the primary process issue identified at the practicum site, AH Emergency Department, was inefficiencies within the intake process that create delays in patient assessment, monitoring, and treatment initiation. Patients often remain in intake areas without continuous monitoring or clearly assigned care ownership while nurses simultaneously manage roomed patients. These conditions increase the risk of delayed interventions for time-sensitive conditions such as sepsis, chest pain, and respiratory distress. Addressing this issue requires strong professional nursing leadership, adherence to regulatory standards, and effective use of healthcare technology to improve patient safety and operational efficiency.
Role in Process Change and Professional Standards
Registered nurses play a critical role in identifying workflow inefficiencies and advocating for improvements in patient safety. As a practicing emergency department nurse at the practicum site, my role in process change involves recognizing safety concerns, communicating workflow barriers to leadership, and participating in quality improvement initiatives. Nurses often provide valuable insight into operational issues because they directly observe patient flow challenges and patient deterioration risks in real time.
Although many operational decisions are determined by department leadership, bedside nurses contribute by documenting safety events, participating in quality committees, and providing feedback on process redesign. By advocating for improved intake workflows, nurses help ensure that patient assessment, monitoring, and treatment occur in a timely and safe manner.
Professional nursing standards emphasize accountability, patient advocacy, and quality improvement. The American Nurses Association (ANA) Code of Ethics highlights the responsibility of nurses to promote patient safety and participate in efforts to improve healthcare systems (American Nurses Association, 2021). Within the emergency department environment, this includes recognizing when workflow processes create unsafe patient care conditions and advocating for system changes that enhance patient outcomes.
Role of the BSN-Prepared Nurse in Process Change
The BSN-prepared registered nurse plays an expanded role in healthcare improvement through evidence-based practice, leadership, and systems thinking. BSN education emphasizes quality improvement, informatics, and interprofessional collaboration, which are essential competencies when addressing complex operational issues such as ED intake inefficiencies.
A BSN-prepared nurse is expected to evaluate clinical processes, analyze patient safety risks, and use evidence-based strategies to guide improvement initiatives. For example, BSN-prepared nurses may participate in workflow redesign initiatives, evaluate patient throughput metrics, and collaborate with leadership to develop standardized intake protocols. In addition, they are responsible for incorporating health information technology into patient care to enhance monitoring, documentation accuracy, and communication among healthcare teams.
Within the practicum setting, my role could include assisting with quality improvement projects focused on ED throughput, providing feedback regarding intake monitoring gaps, and participating in interdisciplinary discussions regarding patient flow strategies.
Nurse Practice Act and Nursing Responsibilities
The North Carolina Nurse Practice Act outlines the legal responsibilities and scope of practice for registered nurses within the state. According to the North Carolina Board of Nursing, registered nurses are responsible for assessment, planning, implementation, and evaluation of nursing care, as well as collaboration with other healthcare professionals to ensure patient safety (North Carolina Board of Nursing, 2024).
The Nurse Practice Act emphasizes that nurses must exercise professional judgment and advocate for safe patient care environments. When workflow processes create potential patient safety risks, such as delayed reassessments or a lack of monitoring, nurses have a professional obligation to communicate these concerns through appropriate channels. This legal framework reinforces the nurse’s responsibility to identify unsafe practices and support system improvements that enhance patient care delivery.
In the context of the ED intake process, the Nurse Practice Act supports nursing involvement in quality improvement initiatives aimed at improving patient assessment, monitoring, and timely intervention.
Interprofessional Collaboration
Improving emergency department intake processes requires strong collaboration among multiple healthcare professionals. The ED relies on coordinated communication among physicians, nurses, advanced practice providers, respiratory therapists, technicians, and administrative staff.
Currently, interprofessional collaboration occurs through team communication regarding patient acuity, physician triage assessments, and escalation of care when patient conditions worsen. However, opportunities exist to further strengthen collaboration to improve intake processes.
Potential collaborative strategies include
Development of standardized intake protocols with physician and nursing leadership.
Collaboration with respiratory therapists for the rapid assessment of respiratory distress patients.
Coordination with patient transport teams to improve room placement efficiency.
Engagement with hospital informatics teams to improve monitoring technology and electronic documentation workflows.
Although bedside nurses may have limited authority to independently implement system changes, they can contribute by participating in workflow discussions, providing feedback during staff meetings, and collaborating with leadership on quality improvement initiatives. As a nurse within the organization, I would advocate for multidisciplinary meetings focused on improving ED throughput and patient monitoring during intake periods.
Government Agencies and Recommendations
Several national healthcare organizations provide guidance related to emergency department safety, patient flow, and quality monitoring.
The Centers for Medicare & Medicaid Services (CMS) monitors emergency department throughput measures, including patient wait times, length of stay, and the number of patients who leave without being seen (CMS, 2023). CMS emphasizes the importance of efficient triage processes and timely patient evaluation to prevent deterioration and improve overall quality of care.
The Joint Commission also emphasizes the importance of patient safety and clinical monitoring in emergency care environments. Their safety goals highlight the need for effective communication, patient monitoring, and rapid response to clinical deterioration (The Joint Commission, 2024).
Additionally, the National Database of Nursing Quality Indicators (NDNQI) tracks nursing-sensitive quality measures such as patient safety events, staffing levels, and patient outcomes. Data from NDNQI demonstrate that adequate staffing and effective workflow processes contribute to improved patient safety and reduced adverse events (Press Ganey, 2023).
These regulatory organizations collectively emphasize that safe patient care requires adequate staffing, effective communication, and systems that allow for timely patient assessment and monitoring.
Current Technology Used at the Practicum Site
The practicum site currently utilizes electronic medical record (EMR) systems and electronic triage documentation tools to support patient intake processes. These systems allow nurses to document triage assessments, vital signs, and initial clinical findings. Electronic tracking boards are also used to monitor patient location and status within the emergency department.
Despite the presence of these technologies, limitations remain within the intake process. Patients waiting in intake areas often lack continuous monitoring capabilities, which can delay detection of clinical deterioration. In addition, nurses responsible for intake patients may simultaneously care for multiple roomed patients, making it difficult to consistently reassess waiting patients.
Another challenge involves workflow inefficiencies within electronic documentation systems, which can increase cognitive workload for nurses managing multiple tasks simultaneously. When nurses must rapidly alternate between documentation, patient assessment, and communication with providers, the risk of missed reassessments or delayed interventions increases.
Recommended Technology from the Literature
Research suggests that technology-supported intake models can improve emergency department patient flow and safety. One recommended approach is the use of rapid medical evaluation (RME) systems, which incorporate physician or advanced practice provider assessment during the intake phase to accelerate diagnostic testing and treatment initiation.
Another promising technology includes wireless patient monitoring systems for patients waiting in intake areas. Portable monitoring devices can continuously track vital signs such as heart rate, oxygen saturation, and blood pressure, allowing staff to identify clinical deterioration earlier.
Telehealth-supported triage systems are also increasingly used in emergency departments to assist with patient assessment and triage decision-making. Virtual providers can help initiate orders, prioritize high-acuity patients, and reduce delays in care.
Evidence indicates that integrating monitoring technology and provider-assisted intake models can reduce patient wait times, improve patient safety, and decrease the number of patients who leave without being seen (AHRQ, 2022).
Potential Implementation Challenges
While new technologies offer potential improvements, several barriers may affect implementation. Financial costs represent a significant challenge, as monitoring equipment and system upgrades require institutional investment.
Staff training is another consideration. Nurses and providers must receive adequate education on new monitoring systems and workflow changes to ensure successful implementation. Without proper training, new technology may increase confusion and workflow inefficiencies.
Resistance to change can also affect adoption. Healthcare professionals working in high-stress environments may initially resist workflow modifications, particularly if they believe new processes will increase workload or disrupt established routines
Finally, infrastructure limitations within the physical emergency department environment may affect the ability to deploy new monitoring equipment or redesign intake spaces.
Addressing these barriers requires leadership support, staff engagement, and structured implementation planning.
Conclusion
Emergency department intake inefficiencies present significant risks to patient safety, quality of care, and operational performance. Nurses play a vital role in identifying workflow challenges and advocating for improvements in healthcare systems. Professional standards, regulatory guidelines, and the North Carolina Nurse Practice Act all support nursing involvement in quality improvement initiatives aimed at enhancing patient safety.
Improving the intake process requires interprofessional collaboration, effective use of health information technology, and evidence-based workflow redesign. Technologies such as wireless monitoring systems and rapid medical evaluation models offer promising strategies for improving patient monitoring and reducing delays in care.
By integrating technology, strengthening collaborative practices, and supporting nurse involvement in process improvement initiatives, healthcare organizations can enhance emergency department patient flow while protecting patient safety and improving outcomes.
References
Agency for Healthcare Research and Quality. (2022). Emergency department crowding and patient safety.
American Nurses Association. (2021). Code of ethics for nurses with interpretive statements.
Centers for Medicare & Medicaid Services. (2023). Emergency department throughput measures.
North Carolina Board of Nursing. (2024). North Carolina Nurse Practice Act.
Press Ganey. (2023). National database of nursing quality indicators (NDNQI) overview.
The Joint Commission. (2024). National patient safety goals.
********Analyze the application of technology and professional standards related to your health process issue at your practicum site in a 46 page scholarly paper.
- Explain aspects of your role in process change and professional standards.
- Explain the aspects of the role of the BSN-prepared RN in process change and professional standards.
- Identify your potential role in process change at your existing practicum site. If applicable, describe that role.
- If your role is limited, explain how you would envision your role in process change if you were a nurse at this site.
- Summarize what your state’s nurse practice act says related to the nurse’s role and process change. (The Find Your Nurse Practice Act website in your Assessment 3 resources provides a search function to assist you in finding individual state nurse practice acts.)
- Explain what interprofessional collaboration you have and will implement.
- What opportunities for collaboration do you see?
- Are you able to implement some of them in your current role at your practicum site? If not, how would you implement interprofessional collaboration as a nurse at this site?
- Review government agencies associated with your process of concern. Explain the recommendations.
- Examples of agencies include:
- The Joint Commission.
- National Database of Nursing Quality Indicators (NDNQI).
- Centers for Medicare & Medicaid Services (CMS).
- Describe current technology used in your practicum site to address your practice issue.
- What are they currently using? Did you notice any problems or issues with the use of this technology?
- Review the literature to determine technology available and recommended for your practice issue. Summarize the recommendations.
- Do you see new technology that isn’t being used?
- Describe any potential implementation issues you see for using the new technology?
- Format: Format your paper using APA style.
Be sure to include the following:
- A title page and reference page. An abstract is not required.
- Appropriate section headings.
- Length: Your paper should be approximately 46 pages in length, not including the reference page.
- Supporting evidence: Cite at least five sources of scholarly or professional evidence that support your central ideas. Resources should be no more than five years old and be relevant to your topic. Provide in-text citations and references in APA format.
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case study 2
M8 Case Study
Module 8 Case Study
Overview
Case studies are designed to increase your knowledge and analysis of weekly topics and also to expand your knowledge on the content presented as you apply it to a real life patient scenario. Utilize this case study as an entry into applying pathophysiology content to the clinical setting. After completing this assignment you will have a thorough understanding of the topic and the application of material you are learning this semester.
Learning Objective(s)
- 8-1 Explain how alterations of normal cardiovascular function causes disease or illness (CLO 1)
- 8-2 Identify the structure of normal cardiovascular and lymphatic function (CLO 1)
- 8-3 Explain how management of obesity and nutrition disorders positively impact health (CLO 3)
- 8-4 Distinguish the impact of obesity on adverse health conditions (CLO 4)
- 8-5 Recommend appropriate solution, adverse effects, and/or treatment for abnormal alterations (CLO 5)
Case Study:
You will submit your case study completed in the sections identified below:
1. Definition of diagnosis you suspect in this patient
2. Epidemiology
3. Etiology/Classification
4. Risk Factors
5. Pathophysiology
6. Clinical Presentation (including History and Physical Exam pertinent findings)
7. Diagnosis (including criteria, laboratory findings, imaging) *What diagnosis does this patient have? Diagnosis is established here.
8. Management of the disease
9. Prevention of recurrence
10. Complications and Prognosis
Bonus- Differential Diagnoses. If you accurately list the pertinent differential diagnoses for this patient, you will be awarded bonus points per the rubric.
Note: Use 3 or more references. List your content in sections denoting the headings 1-10 and in the order listed above. Bonus differential diagnoses can be included at the end of your submitted case study.
CHIEF COMPLAINT: Increasing shortness of breath.
HISTORY OF PRESENT ILLNESS
67-year-old White male who presented to the ED with the chief complaint of increasing shortness of breath. He is only able to walk 5 to 10 feet before becoming short of breath. He has been sleeping in a recliner for the past 3 weeks and has been waking up 5 to 6 times every night with shortness of breath. He denied chest pain and dyspnea at rest but had a cough at night when lying on his back. The patient also gives history of consuming an increased amount of high-sodium processed meats similar to the Atkins diet in the previous several weeks.
PAST MEDICAL HISTORY: Coronary artery disease (CAD), hypertension (HTN), hyperlipidemia, peripheral vascular disease (PVD), morbid obesity, and diabetes mellitus (DM).
PAST SURGICAL HISTORY: Coronary artery bypass graft (CABG), iliac stenting, and transurethral resection of prostate.
CURRENT HOSPITAL MEDICATIONS
Aspirin 81 mg PO daily
Atorvastatin 80 mg PO daily.
Norvasc 5mg PO daily.
Glipizide 10mg PO daily.
ALLERGIES: No known medication or food allergies.
SOCIAL HISTORY: Married. The patient’s wife continues to work part time. His two sons and one daughter live nearby.
BEHAVIORAL: Current 70 pack/years tobacco use. “Occasional” alcohol intake.
REVIEW OF SYSTEMS
Head: Denies any trauma, headache, or history of seizures.
Eyes: No visual field changes or blurred vision.
Chest: Positive for dyspnea on exertion (DOE), orthopnea, paroxysmal nocturnal dyspnea (PND).
Heart: Denies any chest pain or chest pressure. Denies dyspnea at rest.
Circulation: Denies numbness to upper and lower extremities.
Abdomen: Denies abdominal pain, nausea, and vomiting.
Neurological: Denies weakness, numbness, slurred speech.
General/Constitutional: In usual state of health prior to a few weeks ago when he noticed increasing shortness of breath and inability to sleep flat.
PHYSICAL EXAMINATION
Vital signs: Temperature 97.1 F oral (36.2 C), pulse 54/minute, respiration 24/minute, BP 154/70, weight 331.4 lb (150.3 kg), height 72 inches (182.9 cm), and body mass index (BMI) of 44.
General: Overweight and in no mild distress.
Skin: Warm, dry, and both lower extremities cool.
Head, eyes, ears, nose, throat: Pupils 2 mm and equal.
Chest: Bilateral breath sounds were noted on auscultation of the lungs with crackles in the right lower lobe.
Heart: Regular, S1S2, no murmurs, clicks, or rubs. Jugular venous pressure (JVP) was elevated at the middle of the ear at 45 degrees
Abdomen: Large, soft, bowel sounds active all 4 quadrants.
Extremities: Upper extremities warm with 2+ bilateral radial pulses, 1+ pitting edema up to mid-shin bilaterally, 2+ distal pulses, and erythema secondary to venous stasis
Musculoskeletal strength: bilateral upper extremities 5/5, bilateral lower extremities 5/5.
Musculoskeletal tone: Normal in bilateral upper and lower extremities.
Neurological: Alert, oriented 3, follows command to bilaterally, visual fields intact, extraocular movements intact.
DIAGNOSTICS
Laboratory Findings:
CBC: WBC 10K, Hgb 12, HCT 35, PLT 231
BMP: Sodium 135, K 4, BUN 32 mg/dL, creatinine of 1.2 mg/dL
B-natriuretic peptide (BNP-469 pg/mL), A1C of 7.3, and negative troponins.
Chest X-ray: pulmonary congestion
ECG: showed sinus bradycardia with a heart rate of 54.
Echocardiogram: mild bi-atrial enlargement, left ventricular ejection fraction (LVEF) of 59%, grade II diastolic dysfunction, and mild pulmonary HTN.
Based on the main diagnosis of this patient you, the nurse practitioner identify, you will submit your case study completed in the sections identified below:
1. Definition of diagnosis you suspect in this patient
2. Epidemiology
3. Etiology/Classification
4. Risk Factors of the diagnosis – emphasize with an asterisk (*) the risk factors this patient exhibits
5. Pathophysiology
6. Clinical Presentation (including History and Physical Exam pertinent findings of the typical presentation of this diagnosis)
7. Diagnosis (including criteria, laboratory findings, imaging)
8. Management of the disease
9. Prevention of recurrence
10. Complications and Prognosis
Bonus- Differential Diagnoses. If you accurately list the pertinent differential diagnoses for this patient, you will be awarded bonus points per the rubric.
Note: Use 3 or more references. List your content in sections denoting the headings 1-10 and in the order listed above. Bonus differential diagnoses can be included at the end of your submitted case study.
Rubric
Case Study Rubric Week 8
Case Study Rubric Week 8
Criteria Ratings Pts This criterion is linked to a Learning OutcomeEpidemiology, Etiology/Classification & Risk Factors
16 pts
This criterion is linked to a Learning OutcomePathophysiolgy
21 pts
This criterion is linked to a Learning OutcomeClinical Presentation & DiagnosisClinical Presentation (including History and Physical Exam pertinent findings), Diagnosis (including criteria, laboratory findings, imaging)
19 pts
This criterion is linked to a Learning OutcomeManagement of the Disease, Prevention of Recurrence & Complications and Prognosis
16 pts
This criterion is linked to a Learning OutcomeBonus: Differential Diagnosis
0 pts
This criterion is linked to a Learning OutcomeReferences3 or more references listed in APA format.
4 pts
Total Points: 76
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no title
- Prepare Your Written Reflection
- After completing your PLP, write a brief (12 page) reflection addressing the following:
- Remediation Strategies Used: Describe what you did to review or improve your understanding (examples: textbook review, Sherpath lessons, tutoring, study groups, faculty office hours, etc.).
- Learning Insights: Identify key takeaways from the PLP. Which topics challenged you most? What new understanding did you gain?
- Application to Practice: Explain how this remediation will help you perform better in future simulations, clinical settings, or exams.
- Plan for Continued Improvement: Outline what you will do to maintain or strengthen these skills as you progress in the program.
- Submit the Following by the Due Date
- Proof of PLP completion: Screenshot or report from MyEvolve showing your completed activities.
- Written reflection: Uploaded as a Word or PDF document.
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Action Plan
The purpose of this assignment is for you to create an action plan to increase the power of the nursing profession within your community and to devise strategies for building a personal power base. Your paper should address the following:
- Discuss how Hustons six driving forces affect nursings power base.
- Create an action plan for increasing the power of the nursing profession in your community. Explain how you have decided to define your community for the purposes of the action plan. Address each of the seven criteria in Display 13.3, Action Plan for Increasing the Power of the Nursing Profession.
- Devise at least two specific strategies that you can use for building a personal power base. Your strategies should be geared toward your individual goals and situation.
- If you are in a leadership role, provide two examples of how you leverage your power and authority within the organization using the list from Display 13.1 in the textbook. If youre not in a leadership role, provide two examples of how you might leverage that power and authority if you were in a leadership role.
Your paper should be 1250 to 1750 words (5 to 7 pages, double-spaced), excluding the references. Use a minimum of five sources and cite them using APA format.