Contraception

/in /by

Week 13 Discussion: Contraception

J.L., a 27-year-old account executive, presents to the family medicine office for her annual checkup with her primary care provider. She has no significant past medical history except heavy menses. Her medications include calcium carbonate 500 mg orally twice a day and a multivitamin daily. She exercises regularly. Her family history is significant for cardiovascular disease (her father had an MI at age 54 and died of a further MI at age 63). She notes that she has been dating her current partner for approximately 5 months. She is interested in a reliable form of contraception. After discussing the various contraceptive options, she is here for contraceptive counseling.

Questions:

1. Before prescribing an OCP regimen, what tests or examinations would you like to perform?

2. Identify three different contraceptive regimens that could be chosen for J.L. Note their differences and why you chose them.

3. Identify the potential side effects that need to be relayed to J.L. Note especially those side effects for which J.L. should seek immediate medical care.

Shortness of Breath case study

/in /by

Q-1

Complete the following discussion question using the DxR website:

1. Access the DxR Clinician website at  https://gcu.dxrclinician.com/ .

2. Select the folder labeled: gcu_npstudents_patients.

3. Select the Darrin Lancaster – Shortness of Breath case study.

4. Upon clicking on the case, you will see the “Enter Case” button at the top of the page. Select “Enter Page.” Under “Name,” enter First Initial, Last Name, all in lower case. Leave password blank. This will give you entry into the case study.

5. Complete the Darrin Lancaster – Shortness of Breath case study.

6. Discuss the diagnostic tool you selected and explain how it was helpful. Remember that pertinent negatives also guide your diagnoses. Describe how you prioritized the data.

Support your answer with two or three peer-reviewed resources.

 

drug toxicities and poison control

Q-2

A new patient has been brought to the intensive care from the C-section suite. The baby is healthy with normal APGAR scores. During closing, the surgeon noted a hemorrhage occurring in the abdomen. After the prolonged procedure to repair the artery was concluded, the patient had received 15 units of packed red blood cells. 10 units of fresh frozen plasma, and 5 units of platelets. The patient is in the ICU at risk for disseminated intravascular coagulopathy (DIC).

· What;

is the physiology behind DIC after an enormous amount of blood products?

specific assessment findings you are looking for and the diagnostic workup you need to monitor.

findings that will prompt you to begin treatment for DIC and outline appropriate treatment for DIC.

are the risk factors you need to take into consideration when developing a treatment plan for this patient?

Support your answer with two or three peer-reviewed resources.

overdose of the drug

Q-3

Choose a medication that could be prescribed or is available over the counter. Ideally, using a scenario from clinical practice, describe the presentation of a patient with an overdose of the drug. Explain the diagnostic workup. What are the differences in critical care and emergent situation conditions and disorders inclusive of drug toxicities and poison control? Provide differential diagnoses associated with the overdose and rationale for the treatment of the patient with the specific overdose. You may not select a medication that has already been profiled by another learner. Support your answer with two or three peer-reviewed resources.

 

Q-4

Poisonous agents that are harmful to the human body exist in one’s environment for the convenience of daily activities. Patients could intentionally ingest these agents or have an accidental ingestion. Choose an agent that is readily available. And discuss the physical and diagnostic findings associated with ingestion of the agent. Provide differential diagnoses and explain the treatment for stabilization. Support your answer with two or three peer-reviewed resources.

Multi-organ dysfunction syndrome

/in /by

Q-1

Multi-organ dysfunction syndrome (MODS) presents within patients that often have multiple comorbidities which when compounded become acute. Describe a MODS case and explain the differential diagnoses followed with treatment plans. Support your answer with two or three peer-reviewed resources.

Q-2

Adult respiratory distress syndrome (ARDS) is often induced based on treatment prescribed by the provider. Discuss types of treatment that can lead to ARDS. Explain the assessment and radiographic findings of ARDS in a patient. Describe concerns that exist when managing the patient via the ventilator. Use research to support your response. Support your answer with two or three peer-reviewed resources.

Q-3

What are some of the most significant or major risk factors for trauma in adult and adult-gerontological patients? How could these situations be prevented? Use evidence-based literature or clinical guidelines to support your statements. Support your answer with two or three peer-reviewed resources.

Q-4

Explain how to approach fluid resuscitation in the trauma patient. Discuss how and why your approach might differ if the patient is geriatric. Explain what comorbidities you must consider when resuscitating and why. Identify when you would choose normal saline vs. lactated Ringer’s solution vs. blood for fluid resuscitation. Provide a rationale for using each of these options. Support your answer with two or three peer-reviewed resources.

 

methodology for personal evaluation

/in /by

Q-1

As a busy AGACNP, finding sufficient time to stay current with and apply best practices can be a challenge. Share your methodology for personal evaluation. Including the positives and negatives of the approach you are currently taking. Propose ways in which you could enhance your current efforts incorporating evidence-based inquiry. And evaluation without adversely affecting a healthy work-life balance. What are the benefits of using current research or experiential learning to improve your practice? Support your answer with two or three peer-reviewed resources.

Q-2

Describe a clinical situation in which you have directly applied evidence-based data to produce a successful patient outcome. If you have not yet done so in practice, describe a clinical situation in which you envision this as a possibility. Explain your process. What steps in the process would you either add or eliminate if you were to encounter this particular set of circumstances again? How could your actions lead to better patient advocacy or a community action? Support your answer with two or three peer-reviewed resources.

medical surgical unit supervisor

Q-3

As the most senior staffer and only AGACNP on your team, you are tasked by a medical surgical unit supervisor with developing a 1-hour teaching module based on a disease process from one of the following: Neurology, Cardiovascular, Pulmonary, Gastroenterology, Urology, Endocrinology, Orthopedics, Dermatology, Renal, Hematology. This is intended for a small group of new-hire, newly licensed RNs on your medical surgical unit.

You have been asked to introduce them to the key principles of noninvasive hemodynamic monitoring and other concepts they will need to firmly understand to perform their jobs. In the lesson, be sure to analyze theories regarding implementation of change in clinical practice. Also include the importance of implementing the best standard of care in the acute care setting. Using the course text and a minimum of three evidence-based, peer-reviewed resources, create and post an outline with a brief rationale of the proposed educational lesson you will deliver.

disease process

You may not repeat a disease process that one of your colleagues has already completed. In your forum responses to your colleagues, select one area of focus of their proposed lesson plans and offer additional suggestions to improve or expand that area to provide a richer, more in-depth learning experience for the learners. Support your answer with two or three peer-reviewed resources. Cite your lesson and feedback sources in APA format.

Q-4

Discuss the role of an AGACP as an educational change agent in health care. Then select one colleague’s proposed educational lesson from the first DQ in this topic. Do not select a lesson for which you have provided feedback. Analyze their method on disseminating evidence to other health care professionals. Provide constructive feedback to your colleague regarding the following.

1. Additional information that should be included in the lesson plan.

2. Structure and flow of the lesson.

3. Other supportive ideas to assist your colleague in developing a comprehensive, effective, and relevant lesson on the chosen educational topic.

Use the course text and a minimum of three evidence-based, peer reviewed resources in your response.

the maturation of pain systems

/in /by

Despite increased abilities across developmental realms, including the maturation of pain systems involving self-regulation and the coordination of affect and cognition, the transition to young adulthood is accompanied by higher rates of mortality, greater engagement in health-damaging behaviors, and an increase in chronic conditions.  Rates of motor vehicle fatality and homicide peak during young adulthood, as do mental health problems, substance abuse, unintentional pregnancies, and sexually transmitted infections.

Describe how the advanced practice nurse can play a role in improving the health of young adults through preventive screening and intervention.

 

Word limit 500 words.  Support your answers with the literature and provide citations and references in APA format.  Reply to at least two other student posts with a reflection of their response.

Caregiver Role Strain: Ms. Sandra A.

/in /by

Caregiver Role Strain: Ms. Sandra A.

Sandra, a 47-year-old divorced woman, received a diagnosis of stage 3 ovarian cancer 4 years ago, for which she had a total hysterectomy, bilateral salpingo- oophorectomy, omentectomy, lymphadenectomy, and tumor debulking followed by chemotherapy, consisting of cisplatin (Platinol), paclitaxel (Taxol), and doxorubicin (Adriamycin). She did well for 2 years and then moved back to her hometown near her family and underwent three more rounds of second-line chemotherapy. She accepted a less stressful job, bought a house, renewed old friendships, and became more involved with her two sisters and their families.

Sandra developed several complications, including metastasis to the lungs. Then she could no longer work, drive, or care for herself. She had been told by her oncologist that there was nothing else that could be done and that she should consider entering a hospice. She met her attorney and prepared an advance directive and completed her will. She decided to have hospice care at home and, with the help of her family, set up her first floor as a living and sleeping area. She was cared for by family members around the clock for approximately 3 days.

Sandra observed that she was tiring everyone out so much that they could not really enjoy each other’s company. At this time, she contacted the Visiting Nurse Association (VNA) to seek assistance. Her plan was to try to enjoy her family and friend’s visits. After assessment, the VNA nurse prioritized her problems to include fatigue and caregiver role strain. Other potential problem areas that may need to be incorporated into the care plan include anticipatory grieving and impaired comfort.

Reflective Questions

1. What are some of the stresses on Sandra’s middle-aged sisters and their families?

2. What resources are available to manage these stresses and support the sisters while caring for their dying sister Sandra?

3. Describe Sandra’s feelings about dependency and loss of autonomy because she is unable to do her own activities of daily living any longer

Palliative Care

/in /by

Palliative Care

 Place in appropriate folder the day before class by 1159 pm.  No single word responses (at least 100+ words for each response)  Give at least 1 example  Cite resources, APA formatting (7th ed)  Give the questions some thought and answer honestly  Number your answers to correspond with the question  Worth 12 points / 5%

Questions:

1. Describe a time spirituality was important in your life or that of someone you love or cared for (e.g., family member, friend, patient). Why was it meaningful in that situation?

2. What would you do if a patient asked you to pray with them or read the Bible or another holy book he/she might have at the bedside? How would this request make you feel? Would you experience any conflict if you were a different faith than the patient? Explain your answer.

3. There is something called scripting which is having something written and memorized for difficult situations. Write a prayer or spiritual message you could use in the above situation. Explain why you chose those words.

Nursing Specialty: Psychiatric Mental Health Nurse Practitioner (PMHNP)

/in /by

NOTE: 300 Words with 4 resources.

Nursing Specialty: Psychiatric Mental Health Nurse Practitioner (PMHNP)

You have probably seen one or more of the many inspirational posters about decisions. A visual such as a forked road or a street sign is typically pictured, along with a quote designed to inspire.

Decisions are often not so easily inspired. Perhaps you discovered this when choosing a specialty within the MSN program. This decision is a critical part of your plan for success, and you no doubt want to get it right. This is yet another area where your network can help, as well as other sources of information that can help you make an informed choice.

To Prepare:

· Reflect on your decision to pursue a specialty within the MSN program, including your professional and academic goals as they relate to your program/specialization.

Assignment

Post an explanation of your choice of a nursing specialty within the program. Describe any difficulties you had (or are having) in making your choice, and the factors that drove/are driving your decision. Identify at least one professional organization affiliated with your chosen specialty and provide details on becoming a member.

Nursing Specialty: Psychiatric Mental Health Nurse Practitioner (PMHNP)

Health Promotion: Prevention Of Disease

/in /by

Despite increased abilities across developmental realms, including the maturation of pain systems involving self-regulation and the coordination of affect and cognition, the transition to young adulthood is accompanied by higher rates of mortality, greater engagement in health-damaging behaviors, and an increase in chronic conditions.  Rates of motor vehicle fatality and homicide peak during young adulthood, as do mental health problems, substance abuse, unintentional pregnancies, and sexually transmitted infections.

Describe how the advanced practice nurse can play a role in improving the health of young adults through preventive screening and intervention.

Instructions: 

Post your discussion to the Moodle Discussion Forum.  Word limit 500 words.  Support your answers with the literature and provide citations and references in APA format.  Reply to at least two other student posts with a reflection of their response.

Assessing And Treating Patients With ADHD

/in /by

Not only do children and adults have different presentations for ADHD, but males and females may also have vastly different clinical presentations. Different people may also respond to medication therapies differently. For example, some ADHD medications may cause children to experience stomach pain, while others can be highly addictive for adults. In your role, as a psychiatric nurse practitioner, you must perform careful assessments and weigh the risks and benefits of medication therapies for patients across the life span. For this Assignment, you consider how you might assess and treat patients presenting with ADHD.

To prepare for this Assignment:

The Assignment: 5 pages

Examine Case Study: A Young Caucasian Girl with ADHD. You will be asked to make three decisions concerning the medication to prescribe to this patient. Be sure to consider factors that might impact the patient’s pharmacokinetic and pharmacodynamic processes.

At each decision point, you should evaluate all options before selecting your decision and moving throughout the exercise. Before you make your decision, make sure that you have researched each option and that you evaluate the decision that you will select. Be sure to research each option using the primary literature.

Introduction to the case (1 page)

  • Briefly explain and summarize the case for this Assignment. Be sure to include the specific patient factors that may impact your decision-making when prescribing medication for this patient.

Decision #1 (1 page)

  • Which decision did you select?
  • Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
  • Why did you not select the other two options provided in the exercise? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
  • What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources (including the primary literature).
  • Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples.

Decision #2 (1 page)

  • Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
  • Why did you not select the other two options provided in the exercise? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
  • What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources (including the primary literature).
  • Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples.

Decision #3 (1 page)

  • Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
  • Why did you not select the other two options provided in the exercise? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
  • What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources (including the primary literature).
  • Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples.

Conclusion (1 page)

  • Summarize your recommendations on the treatment options you selected for this patient. Be sure to justify your recommendations and support your response with clinically relevant and patient-specific resources, including the primary literature.