Category: Nursing

Question 1: Describe the roles and responsibilities of the APRN when prescribing medication.

An Advanced Practice Registered Nurse (APRN) has an important role when prescribing medication. They must assess the patients condition by reviewing symptoms, medical history, and current medications before deciding on treatment. APRNs are responsible for choosing the correct medication, dose, and length of treatment based on evidence and guidelines. They must also follow state and federal laws when prescribing, especially for controlled substances. Another responsibility is to monitor how the patient responds to the medication and adjust it if needed. APRNs also need to prevent medication errors and check for possible drug interactions to keep patients safe (Bickley, 2021; Woo & Robinson, 2020).

Question 2: Describe the method used to determine what drug therapy to prescribe.
To decide what drug therapy to prescribe, APRNs follow a step-by-step process. First, they make a correct diagnosis based on patient assessment and test results. Then, they look at clinical guidelines and evidence-based practices to choose the best medication. They also consider the patients age, weight, allergies, other health problems, and current medications. Cost and access to medication may also be considered. APRNs weigh the benefits and risks of each drug before making a final decision. This process helps ensure the medication is safe and effective for the patient (Arcangelo et al., 2021).

Question 3: Discuss responsibilities for patient education and teaching based on the prescribed therapy.
Patient education is a major responsibility of the APRN. They must explain why the medication is being prescribed and how it will help the patient. APRNs should teach patients how to take the medication correctly, including the dose, timing, and route. They must also explain possible side effects and what to do if they occur. It is important to tell patients about drug interactions, such as avoiding certain foods or other medications. APRNs should encourage patients to ask questions and make sure they understand the instructions. Good education helps improve patient safety and medication adherence (Woo & Robinson, 2020).

Question 4: Discuss Schedule drugs and prescribing restrictions for each scheduled drug.
Controlled substances are divided into five schedules based on their risk for abuse and medical use.

• Schedule I drugs have no accepted medical use and a high risk of abuse. APRNs cannot prescribe these drugs.
• Schedule II drugs have a high risk of abuse but are accepted for medical use. Examples include opioids. These require strict prescribing rules, and refills are not allowed.
• Schedule III drugs have a moderate risk of abuse. APRNs can prescribe them, and limited refills are allowed.
• Schedule IV drugs have a lower risk of abuse. These can be prescribed with more flexibility and refills.
• Schedule V drugs have the lowest risk of abuse and may include some medications for cough or diarrhea. These have the least restrictions.
  APRNs must follow both federal laws and their states rules when prescribing controlled substances (DEA, 2022).

References:

Arcangelo, V. P., Peterson, A. M., Wilbur, V., & Reinhold, J. A. (2021). Pharmacotherapeutics for advanced practice: A practical approach (5th ed.). Wolters Kluwer.

Bickley, L. S. (2021). Bates guide to physical examination and history taking (13th ed.). Wolters Kluwer.

Drug Enforcement Administration (DEA). (2022). Controlled substance schedules.

Woo, T. M., & Robinson, M. V. (2020). Pharmacotherapeutics for advanced practice nurse prescribers (5th ed.). F.A. Davis.

i-Human Case Study: Evaluating and Managing Cardiovascular Conditions

Because cardiovascular conditions are preventable and manageable, it is important that the advanced practice nurse use both their understanding of the cardiovascular system and the impact of patient factors and behaviors that might increase patient risk of such conditions. This critical information can guide you in immediately identifying signs and symptoms that can inform differential diagnoses and lead to identification of appropriate treatment options and a treatment plan.

For this Case Study Assignment, you will analyze an i-Human simulation case study about an adult patient with a cardiovascular condition. Based on the patients information, you will formulate a differential diagnosis, evaluate treatment options, and create an appropriate treatment plan for the patient.

Resources

Be sure to review the Learning Resources before completing this activity.
Click the weekly resources link to access the resources.

To prepare:

• Review this weeks Learning Resources. Consider how to assess, diagnose, and treat patients with cardiovascular conditions.

Assignment Requirements:

• Access i-Human from this weeks Learning Resources and review the assigned case study.
• Please note: You will complete i-Human cases in case review mode. This may differ from your previous course experience.
• Analyze the provided patient history, physical exam findings, and diagnostic test results to support clinical decision-making.
• Complete the assigned case study. For guidance on using i-Human, refer to the i-Human Graduate Programs Help link within the i-Human platform.
• You must follow the Management Plan Template (located in this weeks Learning Resources) when writing your treatment plan. Be sure to follow all directions and include each required section.
• Carefully review the grading rubric to understand how your assignment will be evaluated.
• Please note: You will not receive a score within the i-Human platform. This is different from some previous courses. All grading will occur in the Canvas classroom based on your submitted work and the rubric.
• Ensure that all responses are clear, evidence-based, and align with the rubric expectations. Submit the completed assignment in the required format and refer to the Management Plan Template for structure and guidance.

By Day 7

• Submit the written case study assignment as a Word document

submission information

Before submitting your final assignment, you can check your draft for authenticity. To check your draft, access the Turnitin Drafts from the Start Here area.

1. To submit your completed assignment, save your Assignment as WK4Assgn+last name+first initial
2. Then, click on Start Assignment near the top of the page.
3. Next, click on Upload File and select Submit Assignment for review.

Library Assignment Instructions for Nursing Students

Purpose:

The purpose of this library assignment is to help nursing students to develop their research skills and to become familiar with different credible data sources available through the Library page at the FNU.edu website. In addition, this assignment will help students to apply the PICOT (Population, Intervention, Comparison, Outcome, and Time) question format to develop a research question and to locate and evaluate scholarly sources.

Instructions:

1. Topic Selection: Select a nursing theorist of choice and research him/her. Include a summary of your research and how it correlates to the subject you are studying. Identify their key contribution to nursing and explain its importance in healthcare. Your topic should be broad enough to allow for an in-depth exploration but narrow enough to be manageable within the scope of an 250-500-word (1 page) research paper.
2. Searching for Literature: Use the Library page at the FNU.edu website to search for scholarly sources related to your topic. You must utilize at least 3 scholarly sources that have been published within the last 5 years. You may use databases such as CINAHL, MEDLINE, Embase, Clinical Key, The Cochrane Library. Be sure to use appropriate keywords and to apply search filters to limit your search to scholarly, peer-reviewed articles.
3. Evaluating Sources: Once you have identified potential sources, use the CRAAP test (Currency, Relevance, Authority, Accuracy, and Purpose) to evaluate their credibility and relevance to your research question. Be sure to select sources that are relevant to your topic, written by credible authors, and based on rigorous research methods.
4. Writing the Paper: Your research paper should follow APA 7 guidelines and include the following sections: Introduction, Literature Review, Methodology, Results, Discussion, and Conclusion. Be sure to use in-text citations and to include a reference list at the end of your paper.
5. Please keep in mind that the paper will be checked for plagiarism, and similarity above 25% will not be accepted for submission.

Grading Criteria: DUE WEEK 6 (10/9)

Your research paper will be graded based on the following criteria:

• PICOT question format (10 points)
• Use of at least 3 scholarly sources published within the last 5 years (10 points)
• Credibility and relevance of sources (10 points)
• APA 7 formatting, including in-text citations and reference list (10 points)
• Introduction (10 points)
• Literature Review (20 points)
• Methodology (10 points)
• Results (10 points)
• Discussion (10 points)
• Conclusion (10 points)
• Plagiarism (10 points)

Total points: 100

Overview

This discussion integrates your experiences with client safety concerns during patient care.

Instructions

Based upon an experience in which you encountered a client safety issue in an acute care setting or outpatient setting, write 200250 words responding to the discussion prompts provided. This could be a situation in which you were the patient, a family member, or an employee. Then, respond to at least two of your peers posts substantively. Each response needs to have a minimum of 100 words.

Discussion Prompts

• Describe the problem (patient safety/quality issue) you have experienced in an acute care or outpatient setting.
• Identify at least three factors that contributed to the problem.
• Based on the concepts that youve learned related to improving patient safety and quality, what recommendations would you make to improve this issue? Provide at least two recommendations.

Mypost:One of the patient safety concerns that I seen happened in acute care hospital when transferring a patient to a medical unit after the emergency department. The patient documented to be severely allergic to latex, which was not explicitly reported in the handoff report between nurses. As the patient came to the unit, latex-based equipment was initially utilized during care preparation. Luckily, the electronic health record later identified the allergy alert and the patient did not react. This scenario showed how failures in communication in care transitions can pose severe safety risks.

This was caused by a number of factors. One, there was a lack of time in handoff communication between departments where important information was missed. Second, employees were highly dependent on oral report rather than confirming patient alerts in the electronic health record. Third, the hectic clinical environment and large amount of patients augmented the risk of missed care. Communication issues at care transitions are generally considered an important factor in patient safety events.

Healthcare organizations are encouraged to standardize handoff communication with the application of structured tools to enhance patient safety, including SBAR (Situation, Background, Assessment, Recommendation). It is also demonstrated that structured communication tools can minimise errors and enhance information transfer among healthcare providers (Ghosh et al., 2021). Besides this, nurses should always check patient allergy alerts directly in the electronic health record before commencement of care. It is also demonstrated through research that the enhancement of communication systems and safety culture can greatly reduce the amount of harm that can be prevented and enhance the quality of care (Mistri et al., 2023).

References

Ghosh, S., Rananoorthy, L., & Pottakat, B. (2021). Impact of Structured Clinical Handover Protocol on Communication and Patient Satisfaction. Journal of Patient Experience, 8.

Mistri, I. U., Badge, A., & Shahu, S. (2023). Enhancing Patient Safety Culture in Hospitals. Cureus, 15(12).

Peer1:For this specific discussion, Ill be sharing about my late grandmothers experience. During her hospital stay for kidney failure, I noticed a safety concern which was related to fall prevention. My grandmother was considered a fall risk, yet there were no consistent or clearly implemented safety measures that were set in place that would prevent her from falling. Her bed alarm was not always activated, her personal items were out of reach, and the nursing staff, due to staff shortage, was not able to consistently go to her to assist her whenever she needed to get up. For me, as a family member, initially you could see that something was wrong, but as I gain more knowledge from this program, I can definitely see that something was wrong.

The three factors that contributed to this issue was first lack of communication when it came to her fall risk status. The second factor was that the unit was understaffed and that showed in the care that the patients received. And then lastly, lack of accountability when it came to consistently following fall prevention protocols.

Again, as my knowledge expands throughout this program, the two recommendations that I would suggest is reinforcing fall risk protocols by making sure that the bed alarms are activated and that the patients belongings are within reach. Lastly, making sure that communication is a priority and not an afterthought when it comes to report handoffs and encouraging the nurses to prioritize high risk patients such as my grandmother.

Peer2:Patient safety concern I encountered during acute care experience: failure to properly follow through with fall risk precautions with a patient.

Brief description: A patient had been placed on high fall risk, but their bed alarm was not engaged and they got out of bed on their own and fell towards the floor. Luckily, I was walking past the room and was able to catch them before they hit the ground, but they couldve been seriously injured.

Reasons for concern: Poor communication during change of shift about fall precautions that were needed. There was also high turnover and inadequate staffing that night which caused people to become overwhelmed with workload and miss certain safety precautions. Additionally, there was some disconnect with following policies.

Interventions to improve this safety issue: I would try to implement some sort of change based on patient safety/QI concepts learned to address this. Using SBAR during handoff would improve communication between nurses during change of shift to prevent missing important patient information like fall risk. I would also try to improve accountability with hourly rounding, so patients on fall precautions are safely monitored. I would also educate staff/peers on following fall precautions to try and prevent falls from happening. If implemented correctly, I believe these changes would improve patient safety by limiting patient harm as there are multiple opportunities for falls to occur that arent just based on one individuals performance.

References

CDC (2024), Older Adult Fall Prevention to an external site.

World Health Organization (2021), World Health Organization to an external site.

Overview

Responsibility refers to specific accountability or liability associated with the performance of duties. Nurses must not engage in practices prohibited by law or delegate activities to others that are prohibited by the practice acts of other health care providers.

Instructions

. Read the selected case study and answer the questions using a Microsoft Word document. Each response should be 24 sentences in length, clear and concise, and use correct grammar. You only need to complete one of the following case studies

Meet Bill.

Mr. William Boggs (aka Bill) is a nurse manager for a busy ICU. He cannot cover all three shifts with the nurses he has available. He knows that if he does not have additional nurses, the RN working nights would not be able to leave the unit for breaks or any other reason. Bill has repeatedly voiced concerns to the Vice President of Nursing over the ongoing issue of short staffing but is simply told to deal with it. So, Bill institutes a change in the night shift patient to staff ratio. The RN on the unit will need to work without relief and have one CNA instead of another RN. Following a serious incident on the night shift, a disgruntled staff nurse anonymously reports Bills actions as unsafe to the State Board of Nursing. As a result of the investigation by the Board, Bill talks to the state hospital licensing agency and the local newspaper about the staffing patterns at the hospital. Consequently, the hospital receives bad press and is contacted by the hospital licensing agency. Bill is fired.

1. What values, virtues, or obligations are at stake in this case?
2. How would you assess this situation morally?
3. What are the clinical and medical dimensions of this situation?
4. What are the patients needs or desires?
5. What relationships are being affected?
6. What institutional factors are being affected?
7. What elements of the Code of Ethics for Nurses pertain?
8. If you were the nurse, how would you reason, ethically, about this?
9. What arguments would you make for this position (evidence-based, scholarly)?

Debriefing Questions

1. What insights did you gain about a nurses role?
2. How does a nurse deal with conflicting opinions about research treatment between patient and family or patient and provider?
3. To whom is the nurse most accountable, the patient, the family, or the physician?
4. How does a nurse balance these conflicting loyalties?
5. How does the Code of Ethics for Nurses guide you in spur-of-the-moment decisions when a response is expected momentarily?
6. What ideas did this learning exercise prompt in your thinking?NUR 213 – Learning Activity Rubric
   

   NUR 213 – Learning Activity Rubric

   Criteria	Ratings	Pts
   This criterion is linked to a Learning OutcomeConnections	56 ptsOutstandingEvidence of critical thinking and provides rationale as well as examples and specific details.42 ptsGoodEvidence of critical thinking and details are mostly specific.28 ptsProficientEvidence of critical thinking and details but usually of a generalized nature.14 ptsNeeds ImprovementIdea presence is limited or not supported.0 ptsUnacceptableIdea presence is limited and not supported.	56 pts
   This criterion is linked to a Learning OutcomeContent	24 ptsOutstandingExceptionally well-presented; ideas are detailed and well-developed.18 ptsGoodWell-presented; ideas are detailed and mostly well-developed.12 ptsProficientContent is sound and solid; ideas are present but not particularly developed or supported.6 ptsNeeds ImprovementContent is slightly reasonable.0 ptsUnacceptableContent is not sound.	24 pts

   80

Details

In this assignment, you will analyze a regulatory or scope-of-practice challenge in your state and consider its implications for patient care. Describe how your experience with this statute or regulation has affected your own professional practice, and identify a potential strategy to address the challenge.

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Writing Assignment (12 pages)

• Regulation or Limitation: Describe a specific scope-of-practice regulation in your state (e.g., prescriptive authority restrictions, physician oversight requirements, reimbursement policies).
• Affect on Practice: Analyze how this regulation affects an APRN’s professional autonomy, patient care delivery, or ability to serve specific populations. Discuss a time when this regulation or statute affected your professional autonomy, patient care delivery, or ability to serve specific populations.
• Strategy or Resource: Suggest one evidence-based strategy or resource (e.g., professional organization advocacy, legislative change, institutional policy, interprofessional collaboration) to help overcome or mitigate the challenge.

See the rubric for specific grading criteria.

Rubric

Week 3: Regulatory Challenge Analysis Rubric

Week 3: Regulatory Challenge Analysis Rubric

Criteria	Ratings	Pts
This criterion is linked to a Learning OutcomeContent & Comprehensiveness	50 to >45.0 ptsExceeds ExpectationsThoroughly addresses all required elements with depth, accuracy, and clear alignment to objectives.45 to >40.0 ptsMeets ExpectationsAddresses most required elements with adequate accuracy and alignment to objectives. 40 to >25.0 ptsApproaches ExpectationsAddresses some required elements but lacks depth, detail, or clear alignment to objectives.25 to >0 ptsDoes Not Meet ExpectationsDoes not adequately address required elements; incomplete or inaccurate.	50 pts
This criterion is linked to a Learning OutcomeOrganization & Clarity	24 to >21.0 ptsExceeds ExpectationsThe paper is well-organized and flows logically. Writing is clear and concise; formatting enhances readability.21 to >19.0 ptsMeets ExpectationsThe paper is generally organized with some minor lapses in flow or clarity; formatting is acceptable. 19 to >12.0 ptsApproaches ExpectationsThe organization is inconsistent; writing lacks clarity; and formatting distracts from readability.12 to >0 ptsDoes Not Meet ExpectationsThe paper is disorganized; writing is unclear; and formatting is missing or incorrect.	24 pts
This criterion is linked to a Learning OutcomeEvidence & Support	8 to >7.0 ptsExceeds ExpectationsEffectively integrates peer-reviewed sources, guidelines, or standards to fully support analysis.7 to >6.0 ptsMeets ExpectationsUses some relevant sources with adequate integration into analysis. 6 to >4.0 ptsApproaches ExpectationsLimited sources are used; integration is weak or inconsistent.4 to >0 ptsDoes Not Meet ExpectationsNo evidence or inappropriate sources are used.	8 pts
This criterion is linked to a Learning OutcomeMechanics & APA	8 to >7.0 ptsExceeds ExpectationsThe assignment accurately and consistently follows APA Style. Meets length and formatting requirements of the assignment.7 to >6.0 ptsMeets ExpectationsThe assignment consistently follows current APA Style with only isolated and inconsistent mistakes. Mostly meets length and formatting requirements of the assignment. 6 to >4.0 ptsApproaches ExpectationsThe assignment has numerous errors in APA Style. Reflects incomplete knowledge of APA Style. May not meet length and formatting requirements of the assignment.4 to >0 ptsDoes Not Meet ExpectationsThe assignment has significant errors in APA Style. Does not meet length and formatting requirements of the assignment.	8 pts

• the purpose of this assignment is to provide students with an opportunity to develop critical thinking skills, clinical reasoning, and clinical judgment when providing an assessment with findings for adult and geriatric clients with Respiratory, Cardiovascular, Musculoskeletal, Abdomen, HEENTThis assignment will bei.PowerPoint presentationii.Each PowerPoint will include:a.Definitionb.Head to toe assessment by systemi.Review of systemii.And Head to Toe assessmentc.Signs and Symptomsd.Client EducationInstructions:1. Students will work individually.2. The assignment will be presented by:a)PowerPoint will be based on a case scenario.b)All topics need to be mastered to obtain a maximum grade.3. Identify the disorder for which a patient would seek care and work it out.4. Incorporate therapeutic communication techniques in the client-nurse relationship.5. Include key elements/symptoms and behaviors you identified to substantiate your diagnosis and provide appropriate assessment findings.6. A lottery will be done with the topics6. Present by creating a case scenario with one of the following themes:HEETAcromegalyCushing SyndromeCachecticHyperthyroidismHypothyroidismFetal Alcohol Spectrum DisordersDown SyndromeHydrocephalyEczemaCataractConjunctivitis: AllMenier DiseaseOtitis MediaPeripheral vascularPeripheral Venous DiseasePeripheral Arterial DiseaseHeartRight Side Congestive Heart FailureLeft Side Congestive Heart FailureAnginaMyocardial InfarctionHypertensionAbdomenCholecystitisHepatitis AHepatitis BGastritisPeptic UlcerCrohn DiseaseUlcerative ColitisAppendicitisPeritonitisIntestinal ObstructionColon CancerPyelonephritisCystitisEctopic PregnancyStomach CancerColon CancerPancreatitisUmbilical HerniaInguinal HerniaMusculoskeletalRheumatoid ArthritisOsteoarthritisOsteoporosisBursitisEpicondylitisScoliosisNeuroBell PalsyHemorrhagic StrokeIschemic StrokeParkinsonHeadache: All typesEpilepsyBrain CancerAlzheimersMaleBenign Prostatic HyperplasiaProstate CancerHemorrhoidsRectal CancerSexually Transmitted Disease FemaleBreast CancerLeiomyomaPolycystic Ovarian SyndromePelvic Inflammatory DiseaseEndometriosisSexually Transmitted DiseaseSkinPressure UlcersSystemic Erythematous LupusSkin Cancer RespiratoryAsthmaPneumoniaCOPDSinusitisCovid 19Upper Respiratory InfectionLung Cancer

In your submission, make sure you address the following:

• Review the PICO(T) process.( P Patient/population/problem.
• I Intervention.
• C Comparison (of potential interventions, typically).
• O Outcomes.
• T Time frame (if time frame is relevant).

• Explain your diagnosis from Assessment 1 in terms of outcomes, risks, and complications. In your explanation, be sure to include the risks and complications for vulnerable populations or those affected by healthcare disparities andthe impact of those disparities.
• Consider your diagnosis from Assessment 1. Develop a research question using the PICO(T) process to address an issue of your choosing related to your diagnosis.
• Properly format your PICO(T) question to guide your search of the literature.
• Describe your search of the literature, noting search engines, key words, and credibility factors.
• Locate evidence that explores your intervention and comparison of your PICO(T) question with an emphasis on your specific outcome (at least three diagnosis-issue-specific sources of evidence (scholarly articles)).
• Explain the content of each of your scholarly articles.
• Explain the credibility and relevance of each of the articles you chose to your diagnosis issue.
• Analyze the evidence. Determine the answer to your PICO(T) question based on your analysis of the evidence.

Scoring Guide

1. Explain a diagnosis in terms of outcomes, risks, and complications, including the risks and complications for vulnerable populations or those affected by healthcare disparities, and the impact of those disparities.
2. Describe a research question developed using the PICO(T) process to address a chosen issue related to a diagnosis
3. Describe a search of the literature noting search engines, key words, and credibility factors.
4. Explain the content of at least three sources of evidence, including the credibility and relevance of the articles to a specific diagnosis issue.
5. Analyze evidence to explain the answer to a PICO(T) question
6. Organize content so ideas flow logically with smooth transitions; contains few errors in grammar/punctuation, word choice, and spelling.
7. Apply APA formatting to in-text citations and references, exhibiting adherence to most aspects of APA format.

This final assignment of your Research Proposal Project will be submitted in a Poster Format. This poster will provide you the opportunity to justify the need for research on the problem you identified, outline the way in which the proposed study can be undertaken, and explain this potential study’s significance in advancing nursing practice

Review the following resources video and written Resources to assist with Research Project:

Written Resource

Berg, J., & Hicks, R. (2017). . Journal of the American Academy of Nurse Practitioners, 29(8), 461469.

Video Resource

(Video, 3 minutes 53 seconds, captioned)

You can use one of the poster templates from Microsoft PowerPoint for your poster. You can also search for and download an academic poster template from the internet.

Your Poster should include the following sections:

• Title:
  • Title of your Research Proposal Project, your name, and credentials.

• Background:
  • Introduce the research topic
• Research Question and Hypotheses:
  • One to two research questions.
    • hypotheses (developed from research statements, if applicable).

• Method:
  • Design:
    • Overall design and specific type of research being used in your study.
  • Sample and Setting:
    • Sample:
      • Target population identified for your study including:
        • Eligibility criteria
        • Size of sample.
    • Setting:
      • Where you plan to recruit participants
• Procedure
  • How data will be collected.
  • Tools/instruments you will use to collect data
• Results
  • How data will be analyzed (i.e., type of statistical tests, type of software)
  • Limitations of your proposed study.

• Ethical Considerations:
  • Will Institutional Review Board (IRB) approval be needed and if it is needed where will it be obtained from?
• Conclusion:
  • two to four bullet points summarizing the important components of the research proposal
  • Consider including how this proposed research study can:
  • • • • address inequities and disparities
        • advance healthcare education, practice, and/or policy
        • promote nurses’ engagement as leaders and innovators in healthcare practice, education, and/or policy

• References
  • • In APA format
    • You may place references on the Poster (if there is room) or on a separate document (if there is not room)