Mrs. Elizabeth (Libby) Gardner is a 63-year-old African-American woman who is arriving at the outpatient heart clinic for her first visit. She is married, has two adult children, and four grandchildren. Libby and her husband Joe, live in a middle-class suburb, and her children live locally. Until this hospitalization, she worked as an administrative assistant for a law office. Her husband has recently retired and stays busy with community activities. She was discharged from the hospital one week ago after experiencing a large anterior wall myocardial infarction (MI) which resulted in left-sided heart failure. The discharge summary from the hospital includes the following data: Blood Pressure 136/88 Pulse 96 and regular Respirations 20 and clear Temperature 37.1 C temporal Weight of 156 pounds S3 heart sound audible in early diastole Bilateral non-pitting edema present in feet and ankles Libby states a past medical history of hypertension, elevated cholesterol, and type 2 diabetes mellitus; she states that all of these conditions run in [her] family. Her reported medication history includes an ACE inhibitor, Beta Blocker, diuretic, statin, and oral hypoglycemic agent. The patient states she is pretty good about taking her medications and following dietary recommendations. Intake assessment data at the heart clinic includes: Blood Pressure 162/96 Pulse 92 and regular Respirations 32 with crackles in the bases, bilaterally Temperature 37.1 C temporal The patient denies pain She is mildly anxious and complains of shortness of breath at night and with mild activity Bilateral 2+ pitting edema is present in ankles and feet Directions Answer each question below using an outline format: From the case study choose ONE aspect of patient education that you will provide for Mrs. Gardner. For example, you may want to discuss patient education related to: Dietary management Medication management Shortness of breath with activity and at night Or, another area you feel that is important Discuss briefly the Pathophysiology of congestive heart failure Include one reputable resource that you can direct her or her family for further support, maintenance, and/or reinforcement of the education you provided. Be creative, you may want to use a community resource, electronic resource, support group, technological tool, assistive device, etc. In addition to your course textbooks, provide one peer-reviewed nursing journal reference to support any recommendations. Please use APA format for your citation and reference page using APA style.

My professor has been taking points away stating prompts are not addressed completely.

For this discussion, you will be introduced to the PICO process. You will be exploring the evidence that informs you best about each criterion applied to the PICO process. Use the PICO format to present your clinical topic. You can discuss each P-I-C-O criterion in a paragraph format. First, the P in PICO directs you to recognize a problem and the population that you have witnessed, experienced, or just read about and it interests you. Include statistical data the proves this is a problem and in addition, reflect on your own opinion about the people and the problem. Next, identify one I in PICO which is an intervention. The intervention should improve the problem or reduce the risk of worsening symptoms or occurrences. Include the pathophysiology of the medication and this should show the reader why your intervention may work. Now, C in PICO which is compare what is presently being implemented to address the problem you have identified. Perhaps nothing is being done or maybe you are changing medications or adding additional medication to what is presently being done. Compare means that you identify what is being done now before you test your new intervention on the problem. See the examples below. Finally, write out the O in PICO, which is an outcome. An outcome statement is part of the nursing process and CJMM. It is specific to the subject (patient), the action under expected performance, and the time frame. An outcome is measurable. The criterion for this discussion is as follows: PICO Criteria PICO Criteria Topic Include the evidence in a paragraph format P – Population/Problem The population that experiences a problem such as MI, angina, a specific dysrhythmia, a coagulation problem or are at risk for a medication error. Define the populations and problem. Include evidence such as statistics as to incidence or occurrence. This proves it is a problem. Include what causes this problem such as the pathophysiology for a disease or disorder. If you choose medication errors, then you would explain the actions by the nurse that could result in a patient safety event. I – Intervention What may fix or reduce the problem. This needs to be a medication that may prevent or treat a cardiovascular problem or one strategy that could reduce the risk of a medication error depending on the problem you identify. Explain the intervention. If the intervention is medication, explain the pathophysiology of the medication so the reader knows why it may be effective. Include the therapeutic classification and pharmacologic class of the medication as well as actions and uses. If it is a strategy to reduce the risk of a medication error, explain what this one strategy is and how it may be effective. Please do not select a staffing change as an intervention as you are not in a role to implement this complicated change. C – Comparator/Compare What is being done now before you start your intervention. Write a statement of what is being done now. Perhaps the patient is managing a disorder by diet only so the addition of a medication would compare to diet only. Or Perhaps now one nurse is calculating incorrectly so a two nurse check may work best and reduce the risk of a medication error. O – Outcome What is the effect you want to occur? Remember, an outcome is specific to the subject (patient), the action, under expected performance and the time frame. This is measurable. Write an outcome statement for example: The patient will maintain a strong, regular radial pulse at a rate of 60-90/min in 24 hours. The patient’s episode of chest pain will be resolved in 5 min. The patient will experience a weight loss of 1 kg in a 24 hour period. Medication errors that reach the patient will be reduced in the specified environment over a one month period.

Place your notes from the reading, including words (and their definitions) you had to look up because you didn’t know them (e.g. dystopian, hubris, despots) in the forum. Also, respond to the following: After reading the review, what is the book about (summarize)? Do you believe some people are “wired” to be influenced more by social media? Share your thoughts.

Review of The Chaos Machine

THE CHAOS MACHINE: The Inside Story of How Social Media Rewired Our Minds and Our World,by Max Fisher

In Max Fishers authoritative and devastating account of the impacts of social media, The Chaos Machine, he repeatedly invokes Stanley Kubricks masterpiece 2001: A Space Odyssey. The 1968 movie, in which a supercomputer coldly kills astronauts on a ship bound for Jupiter, was in Fishers thoughts as he researched the book. Its stark, ambiguous aesthetic is perfectly poised between the utopian and the dystopian. And as a story about trying to fix a wayward technology as it hurtles out of control, it is beautifully apt.

The cinematic opening to Fishers book cuts from the shining halls of Facebooks headquarters to a view of Earth from contemplative heights. We see far-off despots, wars and upheavals. … A sudden riot, a radical new group, widespread belief in some oddball conspiracy. The way the book connects these dots is utterly convincing and should obliterate any doubts about the significance of algorithmic intervention in human affairs.

Fisher, a New York Times journalist who has reported on horrific violence in Myanmar and Sri Lanka, offers firsthand accounts from each side of a global conflict, focusing on the role Facebook, WhatsApp and YouTube play in fomenting genocidal hate. Alongside descriptions of stomach-churning brutality, he details the viral disinformation that feeds it, the invented accusations, often against minorities, of espionage, murder, rape and pedophilia. But hes careful not to assume causality where there may be mere correlation. The book explores deeply the question of whether specific features of social media are truly responsible for conjuring mass fear and anger.

The enjoyment of moral outrage is one of the key sentiments Fisher sees being exploited by algorithms devised by Google (for YouTube) and Meta (for Facebook, Instagram and WhatsApp), which discovered they could monetize this impulse by having their algorithms promote hyperpartisanship. Divisiveness drives engagement, which in turn drives advertising revenues. Fisher details the evolution of behavioral technologies that belie the many denials by company representatives that their platforms are inherently or intentionally manipulative.

These denials also dont stand up against the stated intentions of company founders. In 2017, Mark Zuckerberg wrote an essay claiming that the tech industry would be responsible for humanitys next step. Facebook, he said, would provide the social infrastructure of a new stage in human relations. Peter Thiel, a founder of the companies PayPal and Palantir, expressed unambiguously antidemocratic leanings as early as 2009, saying that society couldnt be entrusted to the unthinking demos. He and his Silicon Valley peers, Fisher writes, saw society as a set of engineering problems waiting to be solved.

The story of these outsize protagonists is one of hubris and ignorance. Fisher traces the tech culture from which they emerged to the

and to some of the more toxic forums on 4chan and Reddit, where extremist incels and neo-Nazis, among others, got their first inklings of power and forged the alt-right movement. In a culture with a high tolerance for crude simplification, the tech billionaires are cloaked in the most clichd myths of genius: the white male nerd displaying, to use Thiels phrase, an Aspergers-like social ineptitude that is so often associated in popular culture (at the expense of any real understanding of the autism spectrum) with savantlike gifts.

But the mythologies mask deep failings. In the opening scene of the book, when Fisher is ushered through Facebooks steel and glass playground, he is

that outline the platforms policies on speech. Theres no orderly or comprehensive list, only disconnected PowerPoint presentations and Excel spreadsheets, scattered responses to complex geopolitical matters, outsourced guidebooks with contradictory rules. This is what Facebooks moderators are equipped with. One of the tech industrys biggest open secrets, Fisher writes, is that no one quite knows how the algorithms that govern social media actually work.

Fisher doesnt dwell on the fact that this combination of hubris and ignorance already existed in the behavioral sciences the platforms have recklessly employed. He mentions Zuckerbergs astoundingly nave view that there is a fundamental mathematical law underlying human social relationships that governs the balance of who and what we all care about. In Fishers rigorous quest to understand how social media might have rewired our minds, he interviews many psychologists about their academic studies, and discovers insights that will fascinate readers. But he doesnt treat with skepticism the ultimate premises of a science that both created the malign effects of social media and presents itself as their potential solution.

For as long as psychology has existed as an applied science it has served two purposes: medical applications, for psychological ills; and military applications, in the field of psychological operations. But psychologists have increasingly embraced the role of social engineers. Social psychology exploits predictable forms of irrationality to nudge subjects in particular directions, whether online, at work or in public policy. Positive psychology focuses on well-being and resilience, with the aim of remedying perceived social ills by promoting strengths and virtues. Both branches of psychology have treated humans as manipulable components of societies. And the most important studies of social medias effects have taken place within these fields.

But basic causal mechanisms still remain opaque. The laws of human behavior are often speculative, derived from unprovable hypotheses. Fishers exposition reflects this. Stories meant to show that morality is an instinctual drive that evolved in primitive human societies, one that correlated with known neural pathways, can sometimes seem as awkwardly unrealistic as the

sequence in 2001. They also leave many important causal questions unresolved.

In Myanmar, where social media conspiracies drummed up support for the militarys ruthless campaign against the Rohingya, Fisher acknowledges that no algorithm could generate hatred this severe out of nothing. There are of course facts on the ground that determine the algorithms effects, the local susceptibility to disinformation, the explosiveness of the divisions. And this highlights an important point: Millions of people use social media without succumbing to conspiracy theories or allowing moral outrage to escalate into violence.

Human judgment and morality, in other words, arent reducible to instinctual drives that can be manipulated. So we need to ask not just what makes some people susceptible to manipulation, but also what in the minds wiring protects others, even in lives saturated with social media. The answer will presumably include education, and will span the range from individual critical thinking skills to the overall quality of the information environment.

But this kind of understanding wont be satisfying to those who want to single-handedly transform humankind. At the end of 2001, Kubrick leaves us with the strange, ambiguous image of a glowing fetuslike creature floating over Earth. Martin Seligman, the founder of positive psychology, said in a 1999 speech that this image had always haunted him and had led him to believe he had a mission: That mission was, and is, to build with you a science of positive psychology.

The lesson of Fishers book is surely that we dont need more celestial inspirations for ambitious projects of human transformation. Rather, we need to make individual members of societies resistant to such efforts. We have the means to do so if the political will is strong enough, and if our political system hasnt yet been wrecked by the chaos machine.

The activities conducted at my practicum site to create change: during a meeting, an active-learning session based on six case studies to help nurses measure basic mobility, daily activities, and cognitive function. AMPAC ( to assess fall risk and plan care). A tool used in the post-acute care setting.

Write your personal philosophy of nursing:

Things to consider when writing your philosophy:

• Begin by remembering why you chose to become a nurse. What does owning the title of nurse mean to you personally? How does being a nurse help to define who you are?
• You may want to include a personal memory that inspired you to become a nurse, or a moment in your career that solidified your calling as a nursing professional.
• What do you hope or plan to achieve in your nursing career? What does it mean to you and/or your family?
• What does the profession of nursing contribute to the world? How can you impact your city, state, and/or country by your activities in nursing? (patient care, advocacy, the political arena, education, leadership, etc.)
• How do your personal strengths impact your role as a nurse leader? How do your strengths align with the characteristics that good nurses should possess? How can you help to shape the next generation of nursing professionals?

Your philosophy of nursing should be at least two substantial paragraphs. Since these are your personal ideas, you do not have to include references. However, you may include references if you so desire. Make sure to use proper grammar, spelling, and APA formatting (including margins, title, page number, etc.).

Write your personal philosophy of nursing:

Things to consider when writing your philosophy:

• Begin by remembering why you chose to become a nurse. What does owning the title of nurse mean to you personally? How does being a nurse help to define who you are?
• You may want to include a personal memory that inspired you to become a nurse, or a moment in your career that solidified your calling as a nursing professional.
• What do you hope or plan to achieve in your nursing career? What does it mean to you and/or your family?
• What does the profession of nursing contribute to the world? How can you impact your city, state, and/or country by your activities in nursing? (patient care, advocacy, the political arena, education, leadership, etc.)
• How do your personal strengths impact your role as a nurse leader? How do your strengths align with the characteristics that good nurses should possess? How can you help to shape the next generation of nursing professionals?

Your philosophy of nursing should be at least two substantial paragraphs. Since these are your personal ideas, you do not have to include references. However, you may include references if you so desire. Make sure to use proper grammar, spelling, and APA formatting (including margins, title, page number, etc.).

Briefly discuss the things you learned, validated or found enlightening after participating or watching the case study.

Based on what you have learned so far in this course, create a PowerPoint presentation that addresses each of the following points/questions. Be sure to answer all the questions for each bullet point completely. Use clear headings that allow your professor to know which bullet you are addressing on the slides in your presentation.

Part 1: Address an educational need among nursing staff at a health care agency. In the first part of this assignment, you will identify the educational need, assess internal and external frame factors, select a learning theory, develop a budget and an evaluation tool.

• Include an analysis of the evaluation plan in place for individual sessions and the program as a whole.
• Is there any evidence that the data collected for evaluation are used to revise the program and improve quality?

Part 2: For the second part of this assignment, develop and submit a PowerPoint with an audio presentation that would meet the nursing staff’s educational needs. Provide speaker notes to enhance content.

The following specifications are required for this assignment:

• Length: 14-17 slides; answers must thoroughly address the questions clearly and concisely.
• Structure:
• Title (1 slide)
• Objectives and detail (2 slides)
• Educational Activity Content (7 slides)
• Participant Evaluation details needed (3 slides)
• Reference(s) (minimum 1 slide)
• Additionally, a good presentation with few words on the slides includes a script with the verbiage you would say when presenting; the script should be a minimum of 50 words per slide. Provide speaker notes to enhance content.
• References: Use the appropriate APA style in-text citations and references for all resources utilized to answer the questions. Include at least three (3) scholarly sources to support your claims.