Nursing

Discussion: PICOT STATEMENT
Discussion: PICOT STATEMENT
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The first step of the EBP process is to develop a question from the nursing practice problem of interest.
Select a practice problem of interest to use as the focus of your research.
Start with the patient and identify the clinical problems or issues that arise from clinical care.
Following the PICOT format, write a PICOT statement in your selected practice problem area of interest, which is applicable to your proposed capstone project.
The PICOT statement will provide a framework for your capstone project (the project students must complete during their final course in the RN-BSN program of study).
Conduct a literature search to locate research articles focused on your selected practice problem of interest. This literature search should include both quantitative and qualitative peer-reviewed research articles to support your practice problem.
Select six peer-reviewed research articles which will be utilized through the next 5 weeks as reference sources. Be sure that some of the articles use qualitative research and that some use quantitative research. Create a reference list in which the six articles are listed. Beneath each reference include the article’s abstract. The completed assignment should have a title page and a reference list with abstracts.
Suggestions for locating qualitative and quantitative research articles from credible sources:
Use a library database such as CINAHL Complete for your search.
Using the advanced search page check the box beside “Research Article” in the “Limit Your Results” section.
When setting up the search you can type your topic in the top box, then add quantitative or qualitative as a search term in one of the lower boxes. Research articles often are described as qualitative or quantitative.
To narrow/broaden your search, remove the words qualitative and quantitative and include words that narrow or broaden your main topic. For example: Diabetes and pediatric and dialysis. To determine what research design was used, review the abstract and the methods section of the article. The author will provide a description of data collection using qualitative or quantitative methods.
Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.
This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

Effective hearing conservation program
Effective hearing conservation program
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1.) You have been tasked with establishing and implementing an effective hearing conservation program for a metal stamping facility. Noise monitoring shows that employees working in the press areas of the facility are exposed to 8-hour TWA noise exposures between 85.0 dBA and 89.0 dBA. Based on the requirements of 29 CFR 1910.95, summarize the requirements for an effective hearing conservation program and discuss steps to make the program as effective as possible. Please refer to 29 CFR 1910.95(b)(2) for the formula.
2.) Three workers (8-hour work shift) were monitored for work in different areas of a facility using calibrated noise dosimeters. The results are summarized in the attached table labeled question 3 attachment.
a. Calculate the 8-hour time-weighted average (TWA) noise exposure for each of the three workers.
b. Summarize which (one) of the exposures exceeds OSHA’s permissible exposure limit (PEL) and/or action level for noise.
c. Discuss what factors about the noise monitoring may have affected the accuracy of the noise measurements.
Show your work for all mathematical calculations. Please refer to Appendix A to 29 CFR 1910.95 for assistance on how-to solve this problem.
3.) A plant that manufactures automobile chassis includes a production area containing 100 robotic welding stations. An adjacent area contains 10 welding booths where employees perform hand welding using MIG welders to rework welds that have been identified as unacceptable. Personal air sampling shows that personal exposures at 5 of the welding booths located in the middle of the rework exceed the OSHA PEL for lead, nickel, and iron oxide fumes. On average, the personal exposures exceed the applicable OSHA PEL by 2-3 times.
Using OSHA’s Hierarchy of Controls, write one paragraph for the hazard scenario above that summarizes your approach to reducing the risks associated with the hazard. Indicate which type of hazard control you will use, and describe exactly how it will be used to control the hazard.
4.) A plant has an operation that produces automotive headliners in a press. The process uses a compound that contains methylene bisphenyl isocyanate (MDI). The compound containing MDI must be used in the production process to meet the client’s specifications for the headliner. The OSHA PEL for MDI is 0.02 ppm as a ceiling concentration. Personal air samples collected for 15 minutes at the time when the press opens show that short-term exposures range from 0.02 ppm to 0.06 ppm.
Using OSHA’s Hierarchy of Controls, write one paragraph for the hazard scenario above that summarizes your approach to reducing the risks associated with the hazard. Indicate which type of hazard control you will use, and describe exactly how it will be used to control the hazard.
5.) A press area of a plant has six 400-ton presses in operation 24 hours a day, 7 days a week. Personal monitoring using noise dosimeters has shown that 8-hour time-weighted average (TWA) exposures range from 92.0 dBA to 94.5 dBA.
Using OSHA’s Hierarchy of Controls, write a hazard scenario using the information above that summarizes your approach to reducing the risks associated with the hazard. Indicate which type of hazard control you will use, and describe exactly how it will be used to control the hazard.
6.) Employees in the paint department of an automotive parts production facility use styrene to clean residue off the parts as they come off the paint line. The OSHA PEL for styrene is 100 ppm as an 8-hour TWA exposure. Personal air samples show that during peak production times, exposures range from 150 ppm to 200 ppm for an 8-hour shift. The parts cleaning is performed in a small room with one door.
Using OSHA’s Hierarchy of Controls, write one paragraph for the hazard scenario above that summarizes your approach to reducing the risks associated with the hazard. Indicate which type of hazard control you will use, and describe exactly how it will be used to control the hazard.

Health Education and Health Promotion
Health Education and Health Promotion
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QUESTION 4:
Chapter 4, Health Education and Health Promotion
The community health nurse is planning a health promotion workshop for a high school PTSO (Parent-Teacher-Student Organization). The choice of topics was suggested by the high school’s registered nurse who has observed a gradual increase in student obesity. The two nurses have collaborated to develop this workshop to provide parents, students, and teachers with information about the importance of health promotion. (Learning Objectives 6, 8, and 9)
a. Describe the importance of a focus on health promotion.
b. According to the health promotion model developed by Becker (1993), what four variables influence the selection and use of health promotion behaviors?
c. Describe four components of health promotion.
QUESTION 5: Chapter 5, Adult Health and Nutritional Assessment
The registered nurse prepares to conduct a nutritional assessment on Mrs. Varner, a 52-year-old Caucasian female who describes herself as “overweight most of my adult life.” The client states that her health is good. She works part time as a receptionist and volunteers about 10 hours per week in her church. The nurse obtains Mrs. Varner’s height as 64 inches and her weight as 165 pounds. (Learning Objective 8)
a. What is the rationale for computing body mass index? What is Mrs. Varner’s BMI?
b. Calculate her ideal body weight. What is your assessment of her BMI and weight?
c. Based on Mrs. Varner’s BMI and weight, the nurse measures her waist circumference. Describe the proper procedure for this assessment.
d. Mrs. Varner’s waist circumference is 38 inches. What is your assessment?
e. What laboratory values would the nurse review to evaluate Mrs. Varner’s protein levels?

Assignment: benefit of targeted therapies
Assignment: benefit of targeted therapies
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Question 1 A nurse educator who coordinates the staff education on an oncology unit is conducting an inservice on targeted therapies. What potential benefit of targeted therapies should the nurse highlight in this education session?
A) Targeted therapies achieve the therapeutic benefits of traditional chemotherapy with no risk of adverse effects.
B) Targeted therapies have the potential to provide prophylactic protection against neoplasia in high-risk individuals.
C) Targeted therapies are significantly more cost-effective than traditional chemotherapeutic drugs.
D) Targeted therapies have the potential to damage cancerous cells while leaving normal body cells less affected.
Question 2 An oncology nurse is aware of the risks for injury that exist around the preparation, transportation, and administration of chemotherapeutic agents. In order to reduce these risks of injury, the nurse should take which of the following actions?
A) Dispose of intravenous lines used for chemotherapy administration in a covered trash can in the patient’s room.
B) Use an IV system for administration that includes needles to reduce the risk of accidental spills.
C) Prime the IV tubing with an approved IV solution rather than with the drug itself.
D) Encourage patients who have been receiving chemotherapy to use a bedside commode rather than a toilet.
Question 3 A patient has just received her first dose of imatinib and the nurse on the oncology unit is amending the patient’s care plan accordingly. What nursing diagnosis is most appropriate in light of this addition to the patient’s drug regimen?
A) Risk for Infection related to bone marrow suppression
B) Risk for Acute Confusion related to adverse neurological effects of imatinib
C) Risk for Impaired Skin Integrity related to exaggerated inflammatory response
D) Risk for Deficient Fluid Volume related to changes in osmotic pressure
Question 4 A nurse has administered filgrastim to a diverse group of patients in recent months. Which of the following patients should the nurse observe for extremely elevated white blood cell counts following administration of the drug?
A) A 19-year-old male receiving radiotherapy
B) A 25-year-old female with a diagnosis of congenital neutropenia
C) A 39-year-old female with a nonmyeloid malignancy
D) A 47-year-old male with aplastic anemia

Assignment: Interpersonal Conflict in Television
Assignment: Interpersonal Conflict in Television
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Before you complete this paper, you must do the following:
Read this from a previous class.
Do the training.
Take the .
Choose one television show or film from the list provided below:
Black-ish
This television show can be found for no charge with closed captioning at .
Modern Family
This television show can be found for no charge with closed captioning at .
The Big Bang Theory
This television show can be found for no charge with closed captioning at .
Films – Can be found on streaming services such as YouTube or Netflix or rented:
Frozen
War of the Roses
Erin Brokovich
Watch one episode of one of the above television programs and identify and describe one interpersonal conflict that was not handled effectively. Remember, you should focus on one exchange, not the entire plot of the episode. Based on what you have learned in Chapters 8 and 9 of Bevan and Sole (2014), write a two-page paper explaining why the conflict was not handled effectively and describe the strategies that could have been used to resolve this conflict. Be sure to focus on one particular interpersonal conflict and not the television show as a whole. The television programs can be found in syndication, weekly on air, and through the links provided above.
Before you submit this paper, you must do the assignment training for this paper and take the quiz.
The Interpersonal Conflict in Television paper
Must be two double-spaced pages in length (not including title and references pages) and formatted according to APA style. For assistance, visit the Ashford Writing Center’s .
Must include a title page with the following (for further assistance with the formatting and the title page, please refer to Ashford Writing Center’s ):
Title of paper
Student’s name
Course name and number
Instructor’s name
Date submitted
Must include an introduction and conclusion paragraph. Your introduction paragraph needs to end with a clear thesis statement that indicates the purpose of your paper. For assistance writing introductions, conclusions, and thesis statements, please refer to the following web pages, housed within the Ashford Writing Center & Library resources tab:
Must use the textbook as a source. The tutorial will offer further assistance on including supporting information and reasoning.
Must document any information from a source in APA style, as outlined in the Ashford Writing Center’s .
Must include a separate APA References List that is formatted according to APA style. Given you will be citing a single episode, instead of the series, please review the Ashford Writing Center’s guidelines for . The following web page provides guidance for doing both: . Follow the instructions for referencing a single episode of a television series.
Before you submit your written assignment, you are encouraged to review tutorial, set up a Grammarly account (if you have not already done so), and use Grammarly to review a rough draft of your assignment. Then carefully review all issues identified by Grammarly and revise your work as needed.
Need more help?
In this class, you have three tutoring services available: Paper Review, Live Chat, and . Click on the Writing Center & Library tab in the left-navigation menu, in your online course, to learn more about these tutoring options and how to get help with your writing.
Late Policy: Written assignments (essays, journals, presentations) are due on the specified days in the course. Written assignments will be subject to a late penalty of up to 10% per day up to three days late. If written assignments are submitted after 72 hours past the due date, instructors can give a penalty up to and including a grade of zero for the assignment.
Carefully review the for the criteria that will be used to evaluate your assignment.

Assignment: Create and interpret histograms
Assignment: Create and interpret histograms
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For this three-part assessment, you will create and interpret histograms and compute descriptive statistics for given variables; analyze the goals of data screening; and generate z scores for variables, analyze types of error, and analyze cases to either reject or not reject a null hypothesis. You will use SPSS software and several Capella course files to complete this assessment.
A solid understanding of descriptive statistics is foundational to grasping the concepts presented in inferential statistics. This assessment measures your understanding of key elements of descriptive statistics.
By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and assessment criteria:
Competency 1: Analyze the computation, application, strengths, and limitations of various statistical tests.
Analyze the strengths and limitations of examining a distribution of scores with a histogram.
Analyze the relevant data from the computation, interpretation, and application of z-scores.
Analyze real-world application of Type I and Type II errors and the research decisions that influence the relative risk of each.
Competency 2: Analyze the decision-making process of data analysis.
Analyze meaningful versus meaningless variables reported in descriptive statistics.
Apply the logic of null hypothesis testing to cases.
Competency 4: Interpret the results of statistical analyses.
Interpret histogram results, including concepts of skew, kurtosis, outliers, symmetry, and modality.
Interpret descriptive statistics for meaningful variables.
Competency 5: Apply a statistical program’s procedure to data.
Apply the appropriate SPSS procedures for creating histograms to generate relevant output.
Apply the appropriate SPSS procedure for generating descriptive statistics to generate relevant output.
Apply the appropriate SPSS procedures for creating z-scores and descriptive statistics to generate relevant output.
Competency 7: Communicate in a manner that is scholarly, professional, and consistent with expectations for members of the identified field of study.
Communicate in a manner that is scholarly, professional, and consistent with expectations for members of the identified field of study.
Read for important information on the following topics:
The standard normal distribution and z scores.
Hypothesis testing.
Null and alternative hypotheses.
Type I and Type II errors.
Probability values and the null hypothesis.

Assignment: ibuprofen therapy for osteoarthritis
Assignment: ibuprofen therapy for osteoarthritis
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Question 23 A 43-year-old woman was diagnosed with multiple sclerosis 2 years ago and has experienced a recent exacerbation of her symptoms, including muscle spasticity. Consequently, she has been prescribed Dantrolene (Dantrium). In light of this new addition to her drug regimen, what teaching point should the woman’s nurse provide?
A) “This will likely relieve your muscle spasms but you’ll probably develop a certain amount of dependence on the drug over time.”
B) “We’ll need to closely monitor your blood sugar levels for the next week.”
C) “There’s a small risk that you might experience some hallucinations in the first few days that you begin taking this drug.”
D) “You might find that this drug exacerbates some of your muscle weakness while it relieves your spasticity.”
Question 24 A nurse is instructing a patient who was recently diagnosed with multiple sclerosis about dantrolene (Dantrium). The patient is a 38-year-old-male and the foreman for a construction company. In order to minimize one important adverse effect of the drug, the nurse will give the patient which of the following instructions?
A) Eat a high-protein diet
B) Decrease the dosage if any adverse effect is experienced
C) Wear appropriate clothing and sunscreen whenever he is in direct sunlight
D) Have a complete blood cell count done weekly
Question 25 A 40-year-old woman with a diagnosis of fibromyalgia has been prescribed cyclobenzaprine (Flexeril) as an adjunct to her existing drug regimen. What nursing diagnosis should the nurse prioritize when updating the nursing care plan for this patient?
A) Risk for Injury related to CNS depressant effects
B) Diarrhea related to anticholinergic effects
C) Altered Nutrition, Less than Body Requirements, related to appetite suppression
D) Impaired Swallowing related to increased muscle tone
Question 26 A 70-year-old woman who is on long-term ibuprofen therapy for osteoarthritis has returned to the clinic for her regular 6-month visit. In the last couple of months, she has been having increasing periods of abdominal pain. The nurse suspects that this pain may be related to
A) anemia
B) peptic ulcer disease or gastritis
C) interstitial nephritis
D) constipation

Assignment: desmopressin therapy
Assignment: desmopressin therapy
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Question 17 During long-term desmopressin therapy in a 48-year-old woman, it will be most important for the nurse to assess which of the following?
A) The patient’s environment
B) The patient’s diet
C) The condition of the patient’s skin
D) The condition of the patient’s nasal passages
Question 18 A patient is taking gabapentin (Neurontin) for spasticity associated with multiple sclerosis. Which of the following should be the priority for monitoring?
A) Hepatic function
B) Cardiac function
C) Respiratory function
D) Renal function
Question 19 Following an assessment by her primary care provider, a 70-year-old resident of an assisted living facility has begun taking daily oral doses of levothyroxine. Which of the following assessment findings should prompt the nurse to withhold a scheduled dose of levothyroxine?
A) The resident has not eaten breakfast because of a recent loss of appetite
B) The resident’s apical heart rate is 112 beats/minute with a regular rhythm
C) The resident had a fall during the night while transferring from her bed to her bathroom
D) The resident received her annual influenza vaccination the previous day
Question 20 To minimize the risk of adverse effects of glucagon when given to an unconscious diabetic patient, as the patient regains consciousness, the nurse should
A) administer calcium supplements
B) position the patient in the side-lying position
C) administer carbohydrates
D) monitor for nausea and vomiting
Question 21 A 34-year-old male patient is prescribed methimazole (MMI). The nurse will advise him to report which of the following immediately?
A) Vertigo
B) Intolerance to cold
C) Loss of appetite
D) Epigastric distress
Question 22 A male patient is to begin glyburide (Diabeta) for type 2 diabetes. Before the drug therapy begins, a priority action by the nurse will be to assess the patient’s
A) blood pressure
B) potassium level
C) use of alcohol
D) use of salt in his diet

Assignment: Eating Disorders
Assignment: Eating Disorders
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Cultures idealizing thinness, pressure from peers to fit in, and constant images of bodily perfection shown by mass media, along with additional physiological and psychological factors, can combine to create the perfect storm for adolescents struggling with eating disorders. For this Assignment, choose one peer-reviewed research study about eating disorders that focuses on a minority group of adolescents. Consider connections between physiological development, adolescence, and eating disorders.
· Submit a 2-page paper for which you articulate a position on eating disorders in adolescent girls from diverse racial and cultural experiences.

· Explain how the position is related to the biological and/or physiological development as well as psychological development of adolescent girls.

· Further, explain how such findings can inform evidence-based social work practice.
· Please use the Learning Resources and the research study you identified to support your answer.
References (use at least 2)
AbigailNatenshon.com. (2011). Abigail H. Natenshon: Empowered parents. Retrieved from
Cheney, A. M. (2011). Most girls want to be skinny: Body (dis)satisfaction among ethnically diverse women. Qualitative Health Research, 21(10), 1347–1359.
Zastrow, C. H., & Kirst-Ashman, K. K. (2016). Understanding human behavior and the social environment (10th ed.). Boston, MA: Cengage Learning.
Chapter 6 (pp. 295-332).
Assignment 2: Multiracial Discrimination
Dalmage (2013) writes, “Parents and teachers should be aware of the unique forms of discrimination faced by multiracial children and the White supremacist system in which discrimination flourishes” (p. 101). As social workers, we should be aware of our own understanding of what it means to be multiracial in society. This awareness includes a review of our own potential biases that might exist. We need to challenge our own personal ideas about how we categorize individuals and those assumptions that follow along with those categories. Rather, we must respect our client’s experience as a multiracial person in the world, beginning with asking him or her how they would define themselves when completing an intake or assessment form. Further, a social worker must be aware of the many forms of racism and prejudice a person with a multiracial background might experience. As Dalmage discusses, judgment comes from many sides with different intentions and expectations. Being aware of the particular forms of racism that a person who is multiracial will experience will give you the ability to do your best to understand their experience and empathize.
· Submit a 2-page paper. Describe the impact of discrimination on individuals of multiracial backgrounds.
· Describe the impact of biracial/multiracial or multiethnic distinction on our society.

· Justify your response. How do these distinctions relate to social work practice with individuals, families, groups, and communities?

· Be sure to use APA formatting and references from the Learning Resources and two additional peer-reviewed resources from the Walden library about the discrimination against biracial and multiracial individuals.
References (use at least 3-4)
Adams, M., Blumenfeld, W. J., Castaneda, C., Hackman, H. W., Peters, M. L., & Zuniga, X. (Eds.). (2013). Readings for diversity and social justice. (3rd ed.). New York, NY: Routledge Press.
Chapter 11, (pp. 77–86)
Chapter 12, (pp. 86–92)
Chapter 14, (pp. 96–101)
Chapter 15, (pp. 102–109)
Bracey, J. R., Bamaca, M. Y., & Umana-Taylor, A. (2004). Examining ethnic identity and self-esteem among biracial and monoracial adolescents. Journal of Youth and Adolescence, 33(2), 123-123+. Retrieved from http://ezp.waldenulibrary.org/login?url=http://search.proquest.com/docview/204652736?accountid=14872
Johnson, N. L. (2009). Counselors’ measures of attitudes and knowledge of working with biracial and multiracial youth (Order No. 3400147). Available from ProQuest Central. (304927059). Retrieved from
National Association of Social Workers. (2007). Institutional racism & the social work profession: A call to action. Retrieved from
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Williams, R. F. (2009). Black-white biracial students in american schools: A review of the literature. Review of Educational Research, 79(2), 776-804. Retrieved from http://ezp.waldenulibrary.org/login?url=http://search.proquest.com/docview/214135707?accountid=14872

Assignment: Intermediate Medical Coding
Assignment: Intermediate Medical Coding
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1.Dr. Hansen, an orthopedist, is seeing Andrew, a 72 year old established male patient today who has complaints of severe knee pain in both knees and repeated falls over the past 2 months. Dr. Hansen completes a detailed history and exam with medical decision making of moderate complexity, including X-rays of each knee which show worsening osteoarthritis. Because the patient has been experiencing repeated falls, Dr. Hansen provides the patient with an adjustable tripod cane with instructions for safe use. Dr. Hansen recommends the patient begin taking OTC glucosamine chondroitin sulfate, anti-inflammatories for pain as needed, and schedules the patient for a follow up appointment in one month. E&M code:______________________________
ICD-10-CM code: ________________________
ICD-10-CM code: ________________________
CPT code: ______________________________
HCPCS code: ___________________________
2. Andrew returned for his follow up visit last week with increased pain and edema in his right knee and was scheduled for an arthroscopy. He presents to the surgical center today for a right knee diagnostic arthroscopy with synovial biopsy. Anesthesia is being performed on this 72-year-old male patient by a CRNA with medical supervision by a physician. Other than osteoarthritis, Andrew has essential hypertension, which is well-controlled. Postoperatively the patient was placed in a prefabricated canvas longitudinal knee immobilizer. CPT:___________________________________
Anesthesia: _____________________________
Concurrent Care Modifier: __________________
Physical Status Modifier: ___________________ HCPCS:_____________________________
1.Dr. Hansen, an orthopedist, is seeing Andrew, a 72 year old established male patient today who has complaints of severe knee pain in both knees and repeated falls over the past 2 months. Dr. Hansen completes a detailed history and exam with medical decision making of moderate complexity, including X-rays of each knee which show worsening osteoarthritis. Because the patient has been experiencing repeated falls, Dr. Hansen provides the patient with an adjustable tripod cane with instructions for safe use. Dr. Hansen recommends the patient begin taking OTC glucosamine chondroitin sulfate, anti-inflammatories for pain as needed, and schedules the patient for a follow up appointment in one month. E&M code:______________________________
ICD-10-CM code: ________________________
ICD-10-CM code: ________________________
CPT code: ______________________________
HCPCS code: ___________________________