Nursing

Analysis of Biostatistical Article
Identify a peer-reviewed article from Online Library that presents statistical analysis of a pertinent topic of public health interest or importance; CHILDHOOD OBESITY
1) Provide a link to this article and give a brief summary of the article
2) Include Hypotheses, Methods, and Findings.
3) Research the topic and available data sources.
4) On the basis of the biostatistical methods analyze the article and its findings.
Here are some points to consider in your analysis: You must use at least 10-13 headings
• What data are available on this topic?
• What data does the article use?
o Discuss the level of measurement, assumptions that can be made, statistics that can be calculated from these data, and the general quality of the data.
• What is the type of study or study design used?
o Explain the type of biostatistical study design that the author has used.
o Describe the hypothesis or hypotheses that the author intends to test.
o Explain the statistics that the author uses to test these hypotheses.
• What are the article’s statistical findings?
o Describe the statistical results of the author’s analysis.
o Provide a substantive interpretation of these findings (What do the results mean in relation to the hypotheses and the public health topic?).
o Describe the author’s recommendations about this topic based on his or her findings and hypotheses.
• If you had been the author, what changes, if any, would you have made in the study you analyzed?
o Discuss whether the author made any statistical errors.
• Were the correct data used for the questions asked?
• Were the correct data available?
• Were the correct statistics used for the data available?
• What other data might you want to collect and why?
• Do the statistical findings support the author’s conclusions?
Write a 7-page, double-spaced paper in Word format. Apply APA standards to citation of sources. Utilize at least 7–10 scholarly sources in your research and be sure to include a references page. Write in a clear, concise, and organized manner; demonstrate ethical scholarship in accurate representation and attribution of sources; and display accurate spelling, grammar, and punctuation.

NUR 533 Vulnerable Populations and Health Disparities
NUR 533 Vulnerable Populations and Health Disparities
Turnitin®
This course has Turnitin® fully integrated into the course dropbox. This
means that you should only submit your assignments to the dropbox below. Please
do not submit your assignment directly to Turnitin.com.
Once submitted, your assignment will be evaluated by Turnitin®
automatically. You will be able to view an Originality Report within minutes of
your first submission that will show how much of your work has been identified
as similar to other sources such as websites, textbooks, or other student
papers. Use your Originality Report as a learning tool to identify areas of
your assignment that you may not have cited appropriately. The overall match
can be no higher than 15%, with any one match no higher than 2%. You may
resubmit your assignment through this dropbox as many times as you need to
check to see if you have made improvements, until the due date of the
assignment. However, once you have made your first submission, you will need to
wait 24 hours after each subsequent submission to receive a new Originality
Report. Plan accordingly as you draft your assignment. Once the due date has
passed, your assignment submission will be considered final.
The culminating paper builds on the work you’ve done for the annotated
bibliography and will focus on vulnerable populations and health disparities.
Your resources for the paper are the peer reviewed literature included in the
bibliography, other articles that you may have identified but not included in
the bibliography.
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Evaluation
This assignment will be graded using the Culminating Paper: Health
Disparities and Vulnerable Populations Grading Rubric located on the Course
Rubrics page within the Start Here section of the course. Please review the
rubric prior to beginning your work so that you ensure your submission meets
the criteria in place for this assignment. This assignment is worth 20% of your
final course grade.
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NURS 6630: Psychopharmalogical Approaches to Treat Psychopathology
Dicussion: Treatment for a Patient With a Common Condition
Insomnia is one of the most common medical conditions you will encounter as a PNP. Insomnia is a common symptom of many mental illnesses, including anxiety, depression, schizophrenia, and ADHD (Abbott, 2016). Various studies have demonstrated the bidirectional relationship between insomnia and mental illness. In fact, about 50% of adults with insomnia have a mental health problem, while up to 90% of adults with depression experience sleep problems (Abbott, 2016). Due to the interconnected psychopathology, it is important that you, as the PNP, understand the importance of the effects some psychopharmacologic treatments may have on a patient’s mental health illness and their sleep patterns. Therefore, it is important that you understand and reflect on the evidence-based research in developing treatment plans to recommend proper sleep practices to your patients as well as recommend appropriate psychopharmacologic treatments for optimal health and well-being.
Reference: Abbott, J. (2016). What’s the link between insomnia and mental illness? Health. https://www.sciencealert.com/what-exactly-is-the-link-between-insomnia-and-mental-illness#:~:text=Sleep%20problems%20such%20as%20insomnia%20are%20a%20common,bipolar%20disorder%2C%20and%20attention%20deficit%20hyperactivity%20disorder%20%28ADHD%29
For this Discussion, review the case Learning Resources and the case study excerpt presented. Reflect on the case study excerpt and consider the therapy approaches you might take to assess, diagnose, and treat the patient’s health needs.
https://www.psychiatry.org/File%20Library/Psychiatrists/Practice/Clinical%20Practice%20Guidelines/APA-Draft-Schizophrenia-Treatment-Guideline.pdf
https://www.clozapinerems.com/CpmgClozapineUI/rems/pdf/resources/Clozapine_REMS_A_Guide_for_Healthcare_Providers.pdf
https://content.waldenu.edu/content/dam/laureate/laureate-academics/wal/ms-nurs/nurs-6630/week-07/Resource-Document-2018-QTc-Prolongation-and-Psychotropic-Med.pdf
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4388122/
https://search.proquest.com/docview/223229782/fulltextPDF/C1856C2BB38C4C71PQ/2?accountid=14872
https://www.accessdata.fda.gov/scripts/cder/daf/index.cfm
*Utilize at least 3 scholarly, peer reviewed resources.
*Utilize SafeAssgn Drafts to obtain originality report before final submission
NURS 6630: Psychopharmalogical Approaches to Treat Psychopathology
Case: An elderly widow who just lost her spouse.
Subjective: A patient presents to your primary care office today with chief complaint of insomnia. Patient is 75 YO with PMH of DM, HTN, and MDD. Her husband of 41 years passed away 10 months ago. Since then, she states her depression has gotten worse as well as her sleep habits. The patient has no previous history of depression prior to her husband’s death. She is awake, alert, and oriented x3. Patient normally sees PCP once or twice a year. Patient denies any suicidal ideations. Patient arrived at the office today by private vehicle. Patient currently takes the following medications:
Metformin 500mg BID
Januvia 100mg daily
Losartan 100mg daily
HCTZ 25mg daily
Sertraline 100mg daily
Current weight: 88 kg
Current height: 64 inches
Temp: 98.6 degrees F
BP: 132/86
By Day 3 of Week 7
Post a response to each of the following:
List three questions you might ask the patient if she were in your office. Provide a rationale for why you might ask these questions.
Identify people in the patient’s life you would need to speak to or get feedback from to further assess the patient’s situation. Include specific questions you might ask these people and why.
Explain what, if any, physical exams, and diagnostic tests would be appropriate for the patient and how the results would be used.
List a differential diagnosis for the patient. Identify the one that you think is most likely and explain why.
List two pharmacologic agents and their dosing that would be appropriate for the patient’s antidepressant therapy based on pharmacokinetics and pharmacodynamics. From a mechanism of action perspective, provide a rationale for why you might choose one agent over the other.
For the drug therapy you select, identify any contraindications to use or alterations in dosing that may need to be considered based on ethical prescribing or decision-making. Discuss why the contraindication/alteration you identify exists. That is, what would be problematic with the use of this drug in individuals based on ethical prescribing guidelines or decision-making?
Indicate any therapeutic changes that you might make based on possible outcomes that may happen given your treatment options chosen.
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NURS 6630 Week7 Discussion Rubric
Main Posting:
Response to the Discussion question is reflective with critical analysis and synthesis representative of knowledge gained from the course readings for the module and current credible sources.–
Levels of Achievement:
Excellent
Point range: 90–100 40 (40%) – 44 (44%)
Good
Point range: 80–89 35 (35%) – 39 (39%)
Fair
Point range: 70–79 31 (31%) – 34 (34%)
Poor
Point range: 0–69 0 (0%) – 30 (30%)
Main Posting:
Writing–
Levels of Achievement:
Excellent
Point range: 90–100 6 (6%) – 6 (6%)
Good
Point range: 80–89 5 (5%) – 5 (5%)
Fair
Point range: 70–79 4 (4%) – 4 (4%)
Poor
Point range: 0–69 0 (0%) – 3 (3%)
Main Posting:
Timely and full participation–
Levels of Achievement:
Excellent
Point range: 90–100 9 (9%) – 10 (10%)
Good
Point range: 80–89 8 (8%) – 8 (8%)
Fair
Point range: 70–79 7 (7%) – 7 (7%)
Poor
Point range: 0–69 0 (0%) – 6 (6%)
First Response:
Post to colleague’s main post that is reflective and justified with credible sources.–
Levels of Achievement:
Excellent
Point range: 90–100 9 (9%) – 9 (9%)
Good
Point range: 80–89 8 (8%) – 8 (8%)
Fair
Point range: 70–79 7 (7%) – 7 (7%)
Poor
Point range: 0–69 0 (0%) – 6 (6%)
First Response:
Writing–
Levels of Achievement:
Excellent
Point range: 90–100 6 (6%) – 6 (6%)
Good
Point range: 80–89 5 (5%) – 5 (5%)
Fair
Point range: 70–79 4 (4%) – 4 (4%)
Poor
Point range: 0–69 0 (0%) – 3 (3%)
First Response:
Timely and full participation–
Levels of Achievement:
Excellent
Point range: 90–100 5 (5%) – 5 (5%)
Good
Point range: 80–89 4 (4%) – 4 (4%)
Fair
Point range: 70–79 3 (3%) – 3 (3%)
Poor
Point range: 0–69 0 (0%) – 2 (2%)
Second Response:
Post to colleague’s main post that is reflective and justified with credible sources.–
Levels of Achievement:
Excellent
Point range: 90–100 9 (9%) – 9 (9%)
Good
Point range: 80–89 8 (8%) – 8 (8%)
Fair
Point range: 70–79 7 (7%) – 7 (7%)
Poor
Point range: 0–69 0 (0%) – 6 (6%)
Second Response:
Writing–
Levels of Achievement:
Excellent
Point range: 90–100 6 (6%) – 6 (6%)
Good
Point range: 80–89 5 (5%) – 5 (5%)
Fair
Point range: 70–79 4 (4%) – 4 (4%)
Poor
Point range: 0–69 0 (0%) – 3 (3%)
Second Response:
Timely and full participation–
Levels of Achievement:
Excellent
Point range: 90–100 5 (5%) – 5 (5%)
Good
Point range: 80–89 4 (4%) – 4 (4%)
Fair
Point range: 70–79 3 (3%) – 3 (3%)
Poor
Point range: 0–69 0 (0%) – 2 (2%)
Total Points: 100
NURS 6630 Discussion: Treatment for a Patient with a Common Condition
The case study is about a 75-year-old female with insomnia. She has a history of diabetes, hypertension, and depression. Her depression and insomnia have worsened since her husband passed away 10 months ago. The purpose of this discussion is to discuss appropriate additional questions to ask, physical exams and tests, differential diagnosis, and pharmacologic therapy.
Questions You Might Ask the Patient If She Were In the Office
Which other symptoms have you been experiencing? To establish other symptoms common in depression.
How often have you been feeling fatigued in the last two weeks? Patients with depression often have diminished energy levels (Giannelli, 2020).
How have the current symptoms negatively impacted your daily life activities? To identify impairments in the patient’s life.
People in the Patient’s Life I Would Need to Speak to or Get Feedback From
I would need to speak with the patient’s caregiver to obtain more information on the patient’s symptoms that the patient may have omitted. I would ask the caregiver about any odd behaviors and changes in mood in the patient (Giannelli, 2020). In addition, I would inquire from the caregiver if the client experiences any challenges in carrying out activities of daily living. Besides, I would ask if the patient expresses inappropriate guilt or death wishes at home to identify the presence of suicidal thoughts.
Appropriate Physical Exams and Diagnostic Tests
A complete head-to-toe exam would be appropriate for this patient due to her medical history of hypertension and diabetes. It would help identify any underlying abnormalities or disease comorbidities. Appropriate diagnostic tests include a Hemoglobin A1c test to assess the patient’s average glycemic level in the past three months. In addition, a Thyroid-stimulating Hormone (TSH) test would be appropriate to assess for Hypothyroidism, which has similar features to MDD (Giannelli, 2020).
Differential Diagnosis
The differential diagnosis is Major depressive disorder (MDD), which manifests with two primary features a depressed mood or a diminished interest in pleasurable activities. MDD is the differential owing to the patient’s history of MDD and report of worsening depression and insomnia (Giannelli, 2020). Insomnia is a common symptom of MDD. The patient has been on an antidepressant (Sertraline), which means that she could be having treatment-resistant depression.
Pharmacologic Agents
Duloxetine 30 mg PO once daily. This agent was chosen because it is an SNRI, the recommended second-line agents when SSRIs such as Sertraline are ineffective (Ruberto et al., 2020).
Wellbutrin SR 150 mg orally once daily. Wellbutrin was selected because it is an antidepressant used in treatment-resistant depression (Ruberto et al., 2020).
Selected Drug Therapy
Duloxetine would be chosen over Wellbutrin because the former has a stronger safety profile and thus will have fewer side effects. Besides, Duloxetine has better tolerance and a higher compliance rate than Buproprion, making it a better agent for this patient. However, Duloxetine is contraindicated in patients on Monoamine oxidase inhibitors due to psychotic disorders (Avasthi & Grover, 2018). In addition, the patient should be monitored for Serotonin syndrome, and the drug discontinued if the syndrome’s symptoms occur. Supportive therapy would be provided if the patient developed Serotonin syndrome from the Duloxetine.
Conclusion
It is important to obtain additional information about the patient’s mood and behavioral symptoms from the caregiver. Appropriate tests include a head-to-toe exam, HbA1c, and a TSH test. The differential diagnosis is MDD and the most appropriate drug therapy is Duloxetine, due to its safety profile.
References
Avasthi, A., & Grover, S. (2018). Clinical Practice Guidelines for Management of Depression in Elderly. Indian journal of psychiatry, 60(Suppl 3), S341–S362. https://doi.org/10.4103/0019-5545.224474
Giannelli, F. R. (2020). Major depressive disorder. Journal of the American Academy of PAs, 33(4), 19-20. https://doi.org/10.1097/01.JAA.0000657208.70820.ab
Ruberto, V. L., Jha, M. K., & Murrough, J. W. (2020). Pharmacological treatments for patients with treatment-resistant depression. Pharmaceuticals, 13(6), 116. https://doi.org/10.3390/ph13060116

Improvement Plan-In-service presentation
For this assessment, you will develop a 5 slide PowerPoint presentation with thorough speaker’s notes designed for a hypothetical in-service session related to the safe medication administration improvement plan you developed in Assessment 2.
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Solution

Discution
Read the following articles. Provide three important points you took from each article:
Individualized Family-Centered Developmental Care: An Essential Model to Address the Unique Needs of Infants with Congenital Heart Disease (2018)
Asthma 101: Teaching children to use metered dose inhalers (2019)
Asthma self-management in children: a best practice implementation project (2019)
Kawasaki Disease in Infancy (2019)
You must provide a complete APA reference for one of the articles and reply to one peer. Initial posts must be no less than 250 word.
USE THIS AS A SAMPLE DO NOT COPY PAST
Individualized Family-Centered Developmental Care: An Essential Model to Address the Unique Needs of Infants with Congenital Heart Disease (2018)
1. Infants with critical congenital heart disease have 3-4x the risk of developing developmental learning disabilities, behavioral problems, mental health problems, and other developmental delays or deficits. The environment that infant is in does not help support the infant’s development of trust during this stage of their life, so it makes sense why these infants might have developmental delays.
2. Sleep is required for the formation of synapses and facilitation of memory. Infants who are in the CICU do not get an adequate amount of sleep as they are often disrupted by routine medical work, excessive noise, or bright lights.
3. The developing infant brain needs the voice and closeness of their mother and family in order to support the development of trust and security. While staying in the CICU, the infant is exposed to painful procedures and invasive lines and tubes. Rather than being close with their family members during this time developing trust, they are in unknown loud places experiencing painful stimuli. This has a huge impact on the baby’s ability to develop trust.
Asthma 101: Teaching children to use metered dose inhalers (2019)
1. Research has demonstrated that one barrier to asthma management is the incorrect use of inhalers and simple spacers. There are many different devices out there to manage asthma, each with different techniques for use. The vast amount of devices requiring different techniques causes confusion in both the patient and provider which decreases both efficacy and adherence to medication administration and thus asthma management.
2. The incorrect use of pMDI is found to deliver 50-80% of medication to the oropharynx rather than the lungs. This incorrect medication administration results in incorrect dosages and might explain why 54% of pediatric patients with asthma reported at least one asthma attack in 2016.
3. 75% of patients who were confident in their ability to use an inhaler with or without a VHC missed more than one of the eight steps required for proper usage. With the amount of devices available and different techniques for each, I can understand how confusion may occur. 15-69% of providers cannot demonstrate proper use of inhaler or VHC. If the provider cannot demonstrate proper use, then the patients won’t get the education on self administration necessary to manage their asthma.
Asthma self-management in children: a best practice implementation project (2019)
1. There is an estimated 250,000 deaths each year due to asthma. Many asthma fatalities are preventable but are still prevalent worldwide due to suboptimal long term management and delays in obtaining help help for asthma attacks.
2. Some patients and caregivers believe that steroids are toxic, hinder the growth of children, cause weight gain and lead to addiction. Patient teaching from medical professionals is essential in the prevention of beliefs like these that cause harm to those with asthma.
3. Education includes asthma triggers, warning signs, and treatment options. Due to the lack of time of Doctors, nurses provide patient teaching on medication administration for patients with asthma. An educational pamphlet, along with leaflet covering warning signs, treatment options, AAPs and four vidoes for different inhaler devices are provided to patients to help educate how to manage their asthma. Between 2009-2010 66% of children experienced an asthma attack which is why providing this education to patients with asthma and caregivers of patients with asthma is vital.
Kawasaki Disease in Infancy (2019)
1. If kawasaki disease is left untreated, 25% of children affected will develop coronary artery aneurysms. This is a difficult disease to treat as the main symptoms are fever and rash, which can be attributed to many other reasons. Symptoms may also be transient, making it that much harder to diagnose.
2. Even if the disease is treated within 10 days of infection, infants have much higher rate of developing coronary artery abnormalities. This is disheartening as it is a difficult disease to diagnose and the likelihood of coronary artery aneurysm is higher if it is not diagnosed, but even if treated within 10 days the infant still isn’t safe from negative impact on their heart.
3. Children who are over the age of 5 are more likely to not meet full diagnosis criteria, even if they have KD. Infants are also more likely to not meet full diagnostic criteria despite having KD. 10% of those who develop coronary aneurysms do not have all criteria for diagnosis. This disease is the leading cause of childhood acquired heart disease and yet seems impossible to catch in time. I can see why the emphasis is on prevention.
Thank you for your help.
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Solution
Individualized Family-Centered Developmental Care: An Essential Model to Address the Unique Needs of Infants with Congenital Heart Disease (2018)
Infants with Congenital Heart Disease might develop slow growth compared to the infant born on normal conditions. The disease tends to accumulate more lipids in developing the child’s brain and leave out the body’s growth process. As a result, the child might look thin and younger than their age.
During prenatal stages, Congenital Heart Disease in infants can be detected by the four-chamber screening, whereas the issue on the infant’s heart can be seen. Through this screening, effective diagnosis planning can be successful in that the parent and the doctors can be prepared effectively.
The parents of the infant and the infant can experience PTSD due to the conditions of the infant. It is because the diagnosis can either heal or become worse in the infant’s growth.
Asthma 101: Teaching children to use metered-dose inhalers (2019)
The inhaler has a mouthpiece that helps to effectively inject the medicine to the child into their mouths without exposing it to their eyes. The inhaler medicine has a great effect when exposed to eyes, whereas many children, according to research, have developed cataracts. This helps to reduce these risks by using a metered-dose.
The inhaler should be well shaken because the medicine in the inhaler might have relaxed, creating layers. When the medication is taken without shaking, the inappropriate composition of the dose might be taken, weakening the strength of the medicine. The inhaler should be shaken well to create the perfect medicine mixture to be effective.
If the child is using corticosteroids, they should rinse their mouths or even brush their teeth to prevent swallowing the medicine. It is because the corticosteroids might enter the bloodstream and generate many side effects and swollen legs.
Asthma self-management in children: a best practice implementation project (2019)
Through data and choice help, the utilization of intuitive well-being specialized gadgets can change practices and, along these lines, work on tolerant personal satisfaction and decrease the weight of ailment. These gadgets work because the ideal way to impact practices is to learn explicit practices in a protected and animating climate before giving them a shot in a genuine climate.
Asthma education creates awareness and enables parents to foresee the triggers and symptoms of asthma in the early stages. It helps in managing the disease before it gets critical.
Approximately many people die out of asthma due to failing to notice the triggers of asthma. Managing asthma is to learn which environment is best for the child to avoid certain circumstances that can lead to fatality.
Kawasaki Disease in Infancy (2019)
Kawasaki disease is linked to the gene mutation in infants or the virus that causes the disease. It is a critical issue in that it can develop into pediatric acquired heart disease.
Kawasaki disease symptoms are not easy to understand in that it develops as a normal condition in infants. For instance, the infant’s fever might arise, and they can also develop skin rash in their bodies, especially the areas where the diaper is placed, which most infants suffer from.
Kawasaki disease can make veins all around the body become aroused or enlarged. On the off chance that left untreated, the expanding can harm the vein dividers, especially those prompting the heart.

Alterations in Cellular Processes
Photo Credit: Getty Images
At its core, pathology is the study of disease. Diseases occur for many reasons. But some, such as cystic fibrosis and Parkinson’s Disease, occur because of alterations that prevent cells from functioning normally.
Understanding of signals and symptoms of alterations in cellular processes is a critical step in diagnosis and treatment of many diseases. For the Advanced Practice Registered Nurse (APRN), this understanding can also help educate patients and guide them through their treatment plans.
For this Discussion, you examine a case study and explain the disease that is suggested. You examine the symptoms reported and explain the cells that are involved and potential alterations and impacts.
To prepare:
• By Day 1 of this week, you will be assigned to a specific scenario for this Discussion. Please see the “Course Announcements” section of the classroom for your assignment from your Instructor.
By Day 3 of Week 1
Post an explanation of the disease highlighted in the scenario you were provided. Include the following in your explanation:
• The role genetics plays in the disease.
• Why the patient is presenting with the specific symptoms described.
• The physiologic response to the stimulus presented in the scenario and why you think this response occurred.
• The cells that are involved in this process.
• How another characteristic (e.g., gender, genetics) would change your response.
McCance, K. L. & Huether, S. E. (2019). Pathophysiology: The biologic basis for disease in adults and children (8th ed.). St. Louis, MO: Mosby/Elsevier.
• Chapter 1: Cellular Biology; Summary Review
• Chapter 2: Altered Cellular and Tissue Biology: Environmental Agents (pp. 46-61; begin again with Manifestations of Cellular Injury pp. 83-97); Summary Review
• Chapter 3: The Cellular Environment: Fluids and Electrolytes, Acids, and Bases
• Chapter 4: Genes and Genetic Diseases (stop at Elements of formal genetics); Summary Review
• Chapter 5: Genes, Environment-Lifestyle, and Common Diseases (stop at Genetics of common diseases); Summary Review
• Chapter 7: Innate Immunity: Inflammation and Wound Healing
• Chapter 8: Adaptive Immunity (stop at Generation of clonal diversity); Summary Review
• Chapter 9: Alterations in Immunity and Inflammation (stop at Deficiencies in immunity); Summary Review
• Chapter 10: Infection (pp. 289–303; stop at Infectious parasites and protozoans); (start at HIV); Summary Review
• Chapter 11: Stress and Disease (stop at Stress, illness & coping); Summary Review
• Chapter 12: Cancer Biology (stop at Resistance to destruction); Summary Review
• Chapter 13: Cancer Epidemiology (stop at Environmental-Lifestyle factors); Summary Review
Justiz-Vaillant, A. A., & Zito, P. M. (2019). Immediate hypersensitivity reactions. In StatPearls. Treasure Island, FL: StatPearls Publishing. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK513315/
Credit Line: Immediate Hypersensitivity Reactions – StatPearls – NCBI Bookshelf. (2019, June 18). Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK513315/. Used with permission of Stat Pearls
Module 1 Overview with Dr. Tara Harris
Dr. Tara Harris reviews the structure of Module 1 as well as the expectations for the module. Consider how you will manage your time as you review your media and Learning Resources throughout the module to prepare for your Discussion and Assignment. (4m)
Accessible player
Foundational Concepts of Cellular Pathophysiology – Week 1 (14m)
Accessible player
Immunity and Inflammation
Khan Academy (2010, February 24). Inflammatory response | Human anatomy and physiology | Health & medicine [Video file]. Retrieved from https://www.youtube.com/watch?v=FXSuEIMrPQk
Note: The approximate length of the media program is 14 minutes.
Soo, P. (2018, July 28). Pathophysiology Ch 10 alterations in immune function [Video file]. Retrieved from https://www.youtube.com/watch?v=Jz0wx1-jTds
Note: The approximate length of the media program is 37 minutes.
Acid-Base Balance #1
MedCram. (2012, April 28). Medical acid base balance, disorders & ABGs explained clearly [Video file]. Retrieved from https://www.youtube.com/watch?v=4wMEMhvrQxE
Note: The approximate length of the media program is 13 minutes.
Acid-Base Balance #2
MedCram. (2012, April 29). Medical acid base balance, disorders & ABGs explained clearly | 2 of 8 [Video file]. Retrieved from https://www.youtube.com/watch?v=GmEeKVTpOKI
Note: The approximate length of the media program is 15 minutes.
Hyponatremia
MedCram. (2017, December 23). Hyponatremia explained clearly (remastered) – Electrolyte imbalances [Video file]. Retrieved from https://www.youtube.com/watch?v=bLajK5Vy55M
Note: The approximate length of the media program is 15 minutes.
Online Media from?Pathophysiology: The Biologic Basis for Disease in Adults and Children
In addition to this week’s media, it is highly recommended that you access and view the resources included with the course text, Pathophysiology: The Biologic Basis for Disease in Adults and Children. Focus on the videos and animations in Chapters 3, 7, and 8 that relate to alterations in immunity, hyponatremia, and acid/base balance.
Note: To access the online resources included with the text, you need to complete the FREE online registration that is located at https://evolve.elsevier.com/cs/store?role=student
To Register to View the Content
1. Go to https://evolve.elsevier.com/cs/store?role=student
2. Enter the name of the textbook, Pathophysiology: The Biologic Basis for Disease in Adults and Children, or ISBN 9780323654395 (name of text without the edition number) in the Search textbox.
3. Complete the registration process.
To View the Content for This Text
1. Go to https://evolve.elsevier.com/
2. Click on Student Site.
3. Type in your username and password.
4. Click on the Login button.
5. Click on the plus sign icon for Resources on the left side of the screen.
6. Click on the name of the textbook for this course.
7. Expand the menu on the left to locate all the chapters.
8. Navigate to the desired content (checklists, videos, animations, etc.).
Note: Clicking on the URLs in the APA citations for the Resources from the textbook will not link directly to the desired online content. Use the online menu to navigate to the desired content.
Excellent Good Fair Poor
Main Posting 45 (45%) – 50 (50%)
Answers all parts of the Discussion question(s) with reflective critical analysis and synthesis of knowledge gained from the course readings for the module and current credible sources.
Supported by at least three current, credible sources.
Written clearly and concisely with no grammatical or spelling errors and fully adheres to current APA manual writing rules and style. 40 (40%) – 44 (44%)
Responds to the Discussion question(s) and is reflective with critical analysis and synthesis of knowledge gained from the course readings for the module.
At least 75% of post has exceptional depth and breadth.
Supported by at least three credible sources.
Written clearly and concisely with one or no grammatical or spelling errors and fully adheres to current APA manual writing rules and style. 35 (35%) – 39 (39%)
Responds to some of the Discussion question(s).
One or two criteria are not addressed or are superficially addressed.
Is somewhat lacking reflection and critical analysis and synthesis.
Somewhat represents knowledge gained from the course readings for the module.
Post is cited with two credible sources.
Written somewhat concisely; may contain more than two spelling or grammatical errors.
Contains some APA formatting errors. 0 (0%) – 34 (34%)
Does not respond to the Discussion question(s) adequately.
Lacks depth or superficially addresses criteria.
Lacks reflection and critical analysis and synthesis.
Does not represent knowledge gained from the course readings for the module.
Contains only one or no credible sources.
Not written clearly or concisely.
Contains more than two spelling or grammatical errors.
Does not adhere to current APA manual writing rules and style.
Main Post: Timeliness 10 (10%) – 10 (10%)
Posts main post by Day 3. 0 (0%) – 0 (0%)
N/A 0 (0%) – 0 (0%)
N/A 0 (0%) – 0 (0%)
Does not post main post by Day 3.
First Response 17 (17%) – 18 (18%)
Response exhibits synthesis, critical thinking, and application to practice settings.
Provides clear, concise opinions and ideas that are supported by at least two scholarly sources.
Demonstrates synthesis and understanding of Learning Objectives.
Communication is professional and respectful to colleagues.
Responses to faculty questions are fully answered, if posed.
Response is effectively written in standard, edited English. 15 (15%) – 16 (16%)
Response exhibits critical thinking and application to practice settings.
Communication is professional and respectful to colleagues.
Responses to faculty questions are answered, if posed.
Provides clear, concise opinions and ideas that are supported by two or more credible sources.
Response is effectively written in standard, edited English. 13 (13%) – 14 (14%)
Response is on topic and may have some depth.
Responses posted in the Discussion may lack effective professional communication.
Responses to faculty questions are somewhat answered, if posed.
Response may lack clear, concise opinions and ideas, and a few or no credible sources are cited. 0 (0%) – 12 (12%)
Response may not be on topic and lacks depth.
Responses posted in the Discussion lack effective professional communication.
Responses to faculty questions are missing.
No credible sources are cited.
Second Response 16 (16%) – 17 (17%)
Response exhibits synthesis, critical thinking, and application to practice settings.
Provides clear, concise opinions and ideas that are supported by at least two scholarly sources.
Demonstrates synthesis and understanding of Learning Objectives.
Communication is professional and respectful to colleagues.
Responses to faculty questions are fully answered, if posed.
Response is effectively written in standard, edited English. 14 (14%) – 15 (15%)
Response exhibits critical thinking and application to practice settings.
Communication is professional and respectful to colleagues.
Responses to faculty questions are answered, if posed.
Provides clear, concise opinions and ideas that are supported by two or more credible sources.
Response is effectively written in standard, edited English. 12 (12%) – 13 (13%)
Response is on topic and may have some depth.
Responses posted in the Discussion may lack effective professional communication.
Responses to faculty questions are somewhat answered, if posed.
Response may lack clear, concise opinions and ideas, and a few or no credible sources are cited. 0 (0%) – 11 (11%)
Response may not be on topic and lacks depth.
Responses posted in the Discussion lack effective professional communication.
Responses to faculty questions are missing.
No credible sources are cited.
Participation 5 (5%) – 5 (5%)
Meets requirements for participation by posting on 3 different days. 0 (0%) – 0 (0%)
N/A 0 (0%) – 0 (0%)
N/A 0 (0%) – 0 (0%)
Does not meet requirements for participation by posting on 3 different days.
Group B
Scenario 4: A 27-year-old patient with a history of substance abuse is found unresponsive by emergency medical services (EMS) after being called by the patient’s roommate. The roommate states that he does not know how long the patient had been lying there. Patient received naloxone in the field and has become responsive. He complains of burning pain over his left hip and forearm. Evaluation in the ED revealed a large amount of necrotic tissue over the greater trochanter as well as the forearm. EKG demonstrated prolonged PR interval and peaked T waves. Serum potassium level 6.9 mEq/L.
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Solution
Alterations in Cellular Processes
Genetics’ Role in the Disease
Genetics play a role in substance abuse disorders. Alongside environmental factors, they are attributed to dependence behavior in substance abuse and relapse. Wang et al. (2019) explain that family members of persons with a history of an opioid use disorder are 10-fold times more likely to have opioid-related substance use disorders. The risk is higher if the person has a history of cannabis or cocaine abuse (Wang et al., 2019). Therefore, the patient’s substance abuse disorder can be associated with genetics if he had a first-degree relative with a substance use disorder.
Causes of the Patient’s Symptoms
The patient’s unresponsive state can be attributed to opiate overdose, which causes respiratory depression, depression of the central nervous system, and miosis (Wang et al., 2019). Necrotizing fasciitis is a complication of opioid overdose, which can cause burning pain over the left hip and forearm. Rhabdomyolysis is also an opiate overdose complication and can be attributed to the necrotic tissue on the greater trochanter.
The Physiologic Response to the Stimulus
The patient was administered naloxone, an opioid antagonist that reverses the effects of an opioid overdose. The patient became responsive since naloxone rapidly restores the normal breathing from an opioid overdose (Rzasa Lynn & Galinkin, 2018). Naloxone prolongs the Q-T interval due to a delay in repolarization, which causes the prolonged PR interval and peaked T waves.
Cells That Are Involved In This Process
Cells that mediate opioid effects include mu, kappa, and delta. Opioids are potent agonists to mu receptors that cause a complex gush of intracellular signals that trigger dopamine release, block pain signals, and cause euphoria (Rzasa Lynn & Galinkin, 2018).
How another Characteristic Would Change My Response
Gender would change my response since males are at a high risk of opioid overdose. Males are more to abuse drug substances than females (McHugh et al., 2020). The patient’s male gender may have contributed to the history of substance abuse.
References
McHugh, R. K. (2020). The Importance of Studying Sex and Gender Differences in Opioid Misuse. JAMA Network Open, 3(12), e2030676-e2030676. https://doi.org/10.1001/jamanetworkopen.2020.30676
Rzasa Lynn, R., & Galinkin, J. L. (2018). Naloxone dosage for opioid reversal: current evidence and clinical implications. Therapeutic advances in drug safety, 9(1), 63–88. https://doi.org/10.1177/2042098617744161
Wang, S. C., Chen, Y. C., Lee, C. H., & Cheng, C. M. (2019). Opioid Addiction, Genetic Susceptibility, and Medical Treatments: A Review. International journal of molecular sciences, 20(17), 4294. https://doi.org/10.3390/ijms20174294

Assignment 1: Group Processes and Stages of Formation
In a 2- to 3-page paper, address the following:
Explain the group’s processes and stage of formation.
Explain curative factors that occurred in the group. Include how these factors might impact client progress.
Explain intragroup conflict that occurred and recommend strategies for managing the conflict. Support your recommendations with evidence-based literature.

Identify two strategies you can implement to provide comfort to maintain function with an ethnically diverse older adult with a chronic disease? This can be nutrition, ADLs, exercise, etc.
Citations should conform to APA guidelines.

NURS 6521
Assignment: Ethical and Legal Implications of Prescribing Drugs
What type of drug should you prescribe based on your patient’s diagnosis? How much of the drug should the patient receive? How often should the drug be administered? When should the drug not be prescribed? Are there individual patient factors that could create complications when taking the drug? Should you be prescribing drugs to this patient? How might different state regulations affect the prescribing of this drug to this patient?
These are some of the questions you might consider when selecting a treatment plan for a patient.
As an advanced practice nurse prescribing drugs, you are held accountable for people’s lives every day. Patients and their families will often place trust in you because of your position. With this trust comes power and responsibility, as well as an ethical and legal obligation to “do no harm.” It is important that you are aware of current professional, legal, and ethical standards for advanced practice nurses with prescriptive authority. Additionally, it is important to ensure that the treatment plans and administration/prescribing of drugs is in accordance with the regulations of the state in which you practice. Understanding how these regulations may affect the prescribing of certain drugs in different states may have a significant impact on your patient’s treatment plan. In this Assignment, you explore ethical and legal implications of scenarios and consider how to appropriately respond.
To Prepare
Review the Resources for this module and consider the legal and ethical implications of prescribing prescription drugs, disclosure, and nondisclosure.
Review the scenario assigned by your Instructor for this Assignment.
Search specific laws and standards for prescribing prescription drugs and for addressing medication errors for your state or region, and reflect on these as you review the scenario assigned by your Instructor.
Consider the ethical and legal implications of the scenario for all stakeholders involved, such as the prescriber, pharmacist, patient, and patient’s family.
Think about two strategies that you, as an advanced practice nurse, would use to guide your ethically and legally responsible decision-making in this scenario, including whether you would disclose any medication errors.
As a nurse practitioner, you prescribe medications for your patients. You make an error when prescribing medication to a 5-year-old patient. Rather than dosing him appropriately, you prescribe a dose suitable for an adult
Write 3-page paper that addresses the following:
Explain the ethical and legal implications of the scenario you selected on all stakeholders involved, such as the prescriber, pharmacist, patient, and patient’s family.
Describe strategies to address disclosure and nondisclosure as identified in the scenario you selected. Be sure to reference laws specific to your state.
Explain two strategies that you, as an advanced practice nurse, would use to guide your decision making in this scenario, including whether you would disclose your error. Be sure to justify your explanation.
Explain the process of writing prescriptions, including strategies to minimize medication errors.
Please Use APA format and follow intext citations and references rules. Do not use books as a reference. Only use peer-reviewed articles or journals no older than 5 years and to include doi. No running head needed. Thank you.
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Solution

Nursing Research
Please write 5-6 sentence response to each topic question. Please provide one reference per topic. Department is Emergency Room.
Topic 1:
How does the focus of research and evidence-based practice (EBP) differ? Discuss the application of research findings into evidence-based nursing practice.
Topic 2:
Provide a specific example of evidence-based practice used in your work facility or within the nursing profession. Were there any challenges or barriers to implementing the evidence-based practice? If so, how were they overcome?
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Solution
Topic 1: Research and Evidence-based Practice Differences and Application
The research uses qualitative and quantitative methodologies to investigate and identify new knowledge to add to existing knowledge. Evidence-based practice(EBP) is the process of making practice decisions that incorporate the best research evidence available with their practice expertise and with client attributes, values, preferences, and circumstances (Grove & Gray, 2018). Research findings are used as a scientific basis for the justification of a given medical practice. They act as a point of reference for nurses to determine whether a particular medical decision has been proven successful through scientific research. For instance, research findings have been used to develop evidence-based practices in the emergency room, such as infection control policies, standard operating procedures, and improvement of the standard of care given to patients.
Topic 2: Evidence-based Practice used in Nursing Profession
Infection Control
Hospital-Acquired infections (HAI) are diseases contracted by patients while they are in the hospital environment. A report by the Center for Disease Control on HAI indicated that one in 31 patients contract an infection during their hospital visit (Cdc.gov. 2021).In our organization, evidence-based infection control policies are vital in preventing HAIs, especially in the emergency room. These policies integrate medical research findings with our nursing expertise and patient records and contribute to developing processes and activities that aid in preventing and treating HAIs. One of the policies implemented in our emergency room by nurses includes restricting movement in and out of the emergency room through barriers. These barriers ensure un-sanitized people and unsterile equipment do not enter the emergency room. Our other policies include practicing proper hand sanitization, wearing personal protective clothing like gloves and protective wear, and maintaining a high standard of hygiene and cleanliness in the emergency room. The main challenges facing EBP in nursing in our organization is the shortage of nursing staff and lack of access to a large library containing nursing research articles. We addressed these challenges through recruitment of more nurses and using online libraries which have much more research articles than the physical library at the hospital.
References
Cdc.gov. 2021. Current HAI Progress Report | HAI | CDC. [online] Available at: [Accessed 3 November 2021].
Grove, S. K., & Gray, J. R. (2018). Understanding Nursing Research E-Book: Building an Evidence-Based Practice. Elsevier Health Sciences.