Category: Nursing

Choose ONE of the following prompts and then reply to one of your classmates:

1. Select at least two theories from this module (other than the caring theories) and describe how they related/could have related to incidents in your clinical practice

or

2. Find a current article (within the past 5 years) that discusses caring as a science. Summarize the article and describe how this could influence your clinical practice.

I would like for you to do question #1 with these chosen theories: Ch 10 (self efficacy) and Ch 7 (self-transcendence)

1. Application of Course Knowledge: Answer all questions/criteria with explanations and detail.

• Do you recommend criminalizing healthcare errors as an effective approach to holding healthcare providers accountable for their mistakes? Why or why not?
• How can healthcare providers balance the goal of high-quality care with the potential risks and consequences of errors?
• Are current legal and regulatory frameworks adequate to address healthcare errors? If so, why? If not, what changes are necessary to ensure the regulations best serve clients and providers?

When using sources, ensure it’s a scholarly source dated no later than 5 years ago.

MY SELECTED TOPIC – SCHIZOPHRENIA Introduction

For this assignment, you will examine the role of the nurse in caring for clients with cognitive and/or mental health issues. You will identify your target audience (such as staff nurses, pre-licensure nursing students, etc.) and create an educational PowerPoint presentation (instructions below). This final assignment will reflect ability and achievement in the following areas:

• Intentional Learning, Reflection, and Clinical Judgment
• Decision Making and Evidence Based Practice
• Organization and Presentation
• Writing and APA Formatting

Objectives

• Demonstrate collaborative standardization of safe practices through health promotion.
• Integrate course concepts within management of a cognitive alteration.

Instructions

You are the nurse educator preparing an orientation on cognitive or mental health illness. There is a need to address the many clients with cognitive issues that seek healthcare services and how to better understand their needs. Choose a cognitive/mental health illness that you feel less knowledgeable about and address the following prompts by including two to three examples of each bullet point:

• Choose a cognitive or mental health illness.
• What is it? How is it diagnosed? How is it treated?
• How does it differ from a physical or “visible” illness?
• Address the following for your chosen diagnosis.
• Historical
• Socioeconomic impact
• Political issues or impact
• Educational needs
• Topographical findings
• Geographical impact
• Cultural impact
• Include interdisciplinary interventions for this disease.
• Discuss the impact of a patient’s value systems on management of this disease.
• Address the following health-care practices:
• Acute versus preventive care
• Barriers to health care
• Impact of pain and the sick role
• Cultural practices
• Identify challenges related to:
• Learning styles
• Autonomy
• Educational preparation
• Disease management

Your presentation should be 15-20 slides (not including title, objectives, and references slides) with detailed presenter notes with in-text citations for each slide. Include at least four (4) scholarly sources. Follow best practices for PowerPoint presentations related to text size, color, images, effects, wordiness, and multimedia enhancements. Review the rubric criteria for this assignment. Audio recording is required. Be sure to completely answer all the prompts/questions. Use clear headings that allow your professor to know which bullet you are addressing on the slides in your presentation. Support your content with in-text citations throughout your presentation. Make sure to reference the citations using the APA 7th Edition writing style for the presentation. Include at least one slide for your references at the end.

Assignment Expectations

• Length: 15-20 slides; answers must thoroughly address the questions in a clear, concise manner. Include at least four (4) scholarly sources. Below is a recommended breakdown for the assignment.
• Title: 1 slide
• Objectives/Introduction: 1 slide
• What is the cognitive/mental health disease?: at least 2 slides
• Address historical, socioeconomic, political issues, educational needs, topographical findings, geographical impact, and cultural impact: at least 4 slides
• Interdisciplinary interventions: at least 3 slides
• Address health care practices: at least 4 slides
• Identify any challenges such as learning styles, autonomy, educational preparation, or disease management: at least 3 slides
• Conclusion: 1 slide
• References: 1 slide (PLEASE BE SURE ITS WITHIN 5 YEARS FROM 2021 TO CURRENT 2026).
• Audio recording narration

How to create an APA 7th edition formatted PowerPoint presentation:

• In-text citations are required just as with any professional writing.
• Utilize detailed presenters notes.
• To open presenters notes, click on ‘notes’ in the bottom right-hand corner of PowerPoint.
• Detailed presenters notes should be a minimum of 75 words per body slide.
• These notes will help guide you during the audio recording.

Please follow the rubric and instructions. Please use the link at the bottom of the page.

Good afternoon,

How are you? Attached is the information regarding this paper. I already used bullet with chat to make you understand each question since I had this patient. All the information will help writing the paper. Please no plagiarism because my school is very strict, 3 pages and 2 3 Scholarly sources within 5 years just like mentioned in the instruction ( please read the attached file). Please let me know if you have a question. If Im satisfied I will tip with well.

Thank you,

Submission Instructions:

• Your initial post should be at least 500 words, formatted and cited in current APA style with support from at least 2 academic sources.
• You should respond to at least two of your peers by extending, refuting/correcting, or adding additional nuance to their posts.
• All replies must be constructive and use literature where possible.

Discussion

Nursing theory provides the foundation for understanding patient phenomena, research validates or refines these theoretical concepts, and EBP applies both to real-world clinical decision-making.

In your initial post:

1. Select one nursing theory (grand, middle-range, or practice-level) that has influenced nursing practice in your area of interest.
2. Analyze how this theory has guided researchinclude at least one example of a research study (within the last five years) that supports, tests, or challenges the theory.
3. Discuss how EBP operationalizes this theory in the clinical setting. Provide a specific example of how theoretical principles are applied through evidence-based interventions or guidelines.
4. Critically reflect on how understanding the dynamic interplay among theory, research, and EBP enhances your role as an advanced nurse (e.g., clinician, leader, educator, or researcher).

Post your major takeaway from this week’s content (3-4 sentences) by the due date. Include your text as a reference.

Classification of Antibiotics

Drugs work on:

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• Cell wall synthesis
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• Cell membrane permeability
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• Protein synthesis (lethal)
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• Nonlethal inhibitors of protein synthesis
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• Synthesis of nucleic acids
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• Antimetabolites
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• Viral enzyme inhibitors

Acquired Resistance

The mechanisms for acquired resistance are:

• Spontaneous mutation
• Conjugation

The emergence of drug-resistant Microbe

Factors to the emergence of drug-resistant Microbe

• Antibiotic use promotes resistance
• Antibiotics that promote resistance
• The extent of antibiotic use affects resistance
• Nosocomial infections
• Superinfection
• Active against a variety of bacteria
• Direct toxicity: Low
• Principal adverse effect: Allergic reaction
• Structure includes a beta-lactam ring
• Beta-lactam family includes:
• Cephalosporins
• Aztreonam
• Imipenem
• Meropenem
• Ertapenem

Mechanism of action

• Weaken the cell wall, causing bacteria to take up excessive water and rupture.
• Active only against bacteria undergoing growth and division.
• Bactericidal

Bacterial resistance

• Inability of penicillins to reach their target
• Inactivation of penicillins by bacterial enzymes

Staphylococcus aureus & Penicillin

When penicillin was introduced in 1940, all strains of Staphylococcus aureus were sensitive to it. However by 1960, 80% of the Staphylococcus aureus found in hospital settings displayed resistance to penicillin.

As a result, a penicillin derivative, methicillin was developed, which is resistant to actions of beta-lactamases.

Today, a methicillin-resistant Staphylococcus aureus (MSRA) strain exists that have a unique mechanism of resistance. It produces penicillin-binding proteins (PBPs) with a low affinity for penicillins and all other beta-lactam antibiotics.

MRSA developed this ability by acquiring genes that code for low-affinity PBPs from other bacteria.

Medications

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• Penicillin G
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• PenicillinV
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• Antistaphylococcal penicillins
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• Broad spectrum penicillins
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• Extended spectrum penicillins

Drugs That Weaken the Bacterial Cell Wall II: Other Drugs

Cephalosporins

• Most widely used group of antibiotics

1. First generation: Cephalexin
2. Second generation: Cefoxitin
3. Third generation: Cefotaxime
4. Fourth generation: Cefepime
5. Fifth generation: Ceftaroline

Carbapenems

• Beta-lactam antibiotics have an extremely broad antimicrobial spectrum with low toxicity
• Not active against MRSA
• Imipenem
• Meropenem
• Ertapenem
• Doripenem

Others

• Vancomycin
• Telavancin
• Aztreonam
• Fosfomycin

Bacteriostatic Inhibitors of Protein Synthesis

Tetracyclines

Four (4) members of the tetracycline family are available for systemic therapy:

• Tetracycline
• Demeclocycline
• Doxycycline
• Minocycline

Uses:

• Mycoplasma pneumoniae
• Lyme disease
• Anthrax
• Helicobacter pylori

Macrolides

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Others

Aminoglycosides: Bactericidal Inhibitors of Protein Synthesis

Aminoglycosides Use:

Aerobic gram-negative bacilli

Most commonly used agents are: Gentamicin, tobramycin, amikacin.

Aminoglycosides are:

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• Narrow-spectrum antibiotics
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• Bactericidal
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• Not absorbed from GI tract
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• Microbial resistance

Adverse effects of Aminoglycosides are:

• Nephrotoxicity
• Ototoxicity (total cumulative and trough levels)
• Hypersensitivity reactions
• Neuromuscular blockade: Concurrent use with neuromuscular blocking agents, general anesthetics, and in myasthenia gravis
• Treatment of choice: Reversal with IV infusion of a calcium salt (e.g., calcium gluconate)

Other adverse effects include: Hypersensitivity reactions and Blood dyscrasias.

Serum Levels

• Dosing
• Single large dose every day or 2 or 3 smaller doses
• Monitoring of serum levels is common; the same aminoglycoside dose can produce very different plasma levels in different patients
• Peak levels must be high enough to kill bacteria; trough levels must be low enough to minimize toxicity

Peak and Trough Levels

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• 1
• Samples for peak levels should be taken 30 minutes after giving an IM injection or after completing a 30-minute IV infusion
• 2
• 2
• Sampling for trough levels depends on the dosing schedule
• 3
• 3
• Divided doses: Take sample just before the next dose
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• 4
• Once-daily doses: Draw a single sample 1 hour before the next dose; value should be very lowpreferably close to zero

Available Aminoglycosides:

Gentamicin [Garamycin]- Used to treat serious infections caused by aerobic gram-negative bacilli:

• Pseudomonas aeruginosa
• Escherichia coli
• Klebsiella
• Serratia
• Proteus mirabilis

Adverse effects:

• Nephrotoxicity
• Ototoxicity

Others:

• Tobramycin
• Amikacin
• Neomycin
• Kanamycin
• Streptomycin
• Paromomycin

First drugs available for systemic treatment of bacterial infection.

Sulfonamides inhibits the synthesis of folic acid (folate). Mammalian cells do not manufacture their own folate, therefore not affected only the bacteria are affected.

Primary use now: Urinary tract infection (UTI)

Other uses: Nocardiosis, Chlamydia trachomatis, conjugation therapy for toxoplasmosis/malaria, ulcerative colitis

Adverse effects:

• Hypersensitivity reactions: Stevens-Johnson syndrome
• Hematologic effects
• Kernicterus
• Renal damage from crystalluria

Drug interactions:

• Metabolism-related interactions
• Cross-hypersensitivity

Microbial resistance:

• Many bacterial species have developed resistance to sulfonamides.
• Especially high among gonococci, meningococci, streptococci, and shigellae .
• Resistance may be acquired by spontaneous mutation or by transfer of plasmids that code for antibiotic resistance (R factors).

Silver sulfadiazine and mafenide

Used to suppress bacterial colonization in patients with second- and third-degree burns. Local application of mafenide frequently is painful. Application of silver sulfadiazine is usually pain free. Systemic absorption.

Trimethoprim

• Inhibits dihydrofolate reductase, the enzyme that converts dihydrofolic acid to its active form, tetrahydrofolic acid, thus suppressing bacterial synthesis of deoxyribonucleic acid (DNA), ribonucleic acid (RNA), and proteins.
• Uses:
• Acute and uncomplicated UTIs
• Escherichia coli, Proteus mirabilis, Klebsiella pneumoniae, Enterobacter, coagulase-negative Staphylococcus
• Adverse effects:
• Hematologic effects
• Hyperkalemia
• Use in pregnancy and lactation

Trimethoprim/Sulfamethoxazole (TMP/SMZ)

• Trimethoprim/sulfamethoxazole (TMP/SMZ) combination: Inhibits sequential steps in bacterial folic acid synthesis, making it much more powerful than TMP or SMZ alone. Plasma drug levels.
• Therapeutic uses:
• UTI, otitis media, bronchitis, shigellosis, pneumonia caused by Pneumocystis jiroveci, Pneumocystis pneumonia, and GI infection
• Adverse effects:
• Gastrointestinal
• Nausea and vomiting
• Rash
• Hyperkalemia
• Hypersensitivity reactions (Stevens-Johnson syndrome)
• Blood dyscrasias
• Kernicterus
• Renal damage: Crystalluria

Urinary Tract Infections (UTIs)

• Second most common infection
• Sexually active young women
• Older adult women in nursing homes
• Less frequent in males
• Occurrence likely associated with complications (e.g., septicemia, pyelonephritis)

Organisms That Cause UTIs and Treatment

• Escherichia coli, Klebsiella, Proteus, Enterobacter, Pseudomonas, staphylococci, enterococci, and E. coli
• Trimethoprim/sulfamethoxazole (TMP/SMZ) and nitrofurantoin:
• Frequently the treatment of choice for oral therapy of UTIs
• First-line and second-line treatments

Urinary Tract Antiseptics

• Nitrofurantoin
• Low concentrations: Bacteriostatic
• High concentrations: Bactericidal
• Uses: Lower UTIs, prophylaxis, recurrent lower UTIs
• Methenamine
• Decomposes into ammonia and formaldehyde, which denature bacterial proteins
• Therapeutic uses: Chronic lower UTIs (TMP/SMZ is the preferred drug)
• Drug interactions:
• Urinary alkalinizers
• Sulfonamides
• Adverse effects:
• Relatively safe and generally well tolerated
• Contraindicated in renal and liver failure

Miscellaneous Antibacterial Drug

Fluoroquinolones

• Broad-spectrum agents with multiple applications
• Disrupt DNA replication and cell division
• All can be administered orally or IV
• Side effects generally mild but can cause tendon rupture (low risk)
• Usually affects Achilles tendon
• Avoid in patients younger than 18 years
• Risk to all patients, especially those older than 60 years, those taking glucocorticoids, and those who have undergone kidney, heart, or lung transplantation

Ciprofloxacin [Cipro]

• Broad-spectrum antibiotic (gram-negative and some gram-positive organisms)
• Inhibits bacterial DNA gyrase and topoisomerase II

Others

• Levofloxacin
• Ofloxacin
• Moxifloxacin
• Gemifloxacin
• Metronidazole
• Daptomycin

In the next lesson, you’ll learn about Drug Therapy of Sexually Transmitted Diseases.

Sexually Transmitted Diseases: Infections or parasitic diseases transmitted primarily through sexual contact.

Types of STDs

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• Gonococcal infections
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• Nongonococcal urethritis
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• Pelvic inflammatory disease (PID)
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• Acute epididymitis
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• Syphilis
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• Trichomoniasis
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• Chancroid
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• Herpes simplex
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• Proctitis
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• Anogenital warts

Please follow the rubric and use the link at the bottom of the page. No cover page needed.