No plagiarism, APA 7th edition style

 Post a comparison of at least two APRN board of nursing regulations in your state/region with those of at least one other state/region. Describe how they may differ. Be specific and provide examples. Then, explain how the regulations you selected may apply to Advanced Practice Registered Nurses (APRNs) who have legal authority to practice within the full scope of their education and experience. Provide at least one example of how APRNs may adhere to the two regulations you selected 

Respond to this Discussion.

 

Agonist-to-Antagonist Spectrum of Action

The agonist-to-antagonist spectrum refers to the  range of actions that psychopharmacologic agents can have when they  interact with receptors. Agonists activate receptors, while antagonists  block them. Partial agonists and inverse agonists provide intermediate  or opposite actions (Stahl, 2021).

Understanding the agonist-to-antagonist spectrum is  critical for achieving the desired therapeutic effect while minimizing  side effects. For instance, clozapine is an atypical antipsychotic that  acts as an antagonist at various neurotransmitter receptors, including  dopamine D2 and serotonin 5-HT2A receptors. Unlike typical  antipsychotics, which are primarily dopamine D2 antagonists, clozapine’s  broader receptor profile may explain its efficacy in  treatment-resistant schizophrenia as well as its different side-effect  profile (Stahl, 2021).

Partial Agonists: Buspirone is a  partial agonist at serotonin 5-HT1A receptors and is used to treat  generalized anxiety disorder (GAD). Its partial agonist activity allows  for anxiolytic effects without the sedation seen with benzodiazepines,  which are full agonists at GABA receptors (Stahl, 2021).

Inverse Agonists: The antihistamine  loratadine acts as an inverse agonist at the H1 histamine receptor, not  only blocking the action of histamine but reducing the baseline activity  of the receptor, which can be beneficial for controlling allergic  symptoms (Stahl, 2021).

Clozapine, an atypical antipsychotic, acts primarily  as an antagonist at various neurotransmitter receptors, demonstrating  how multi-receptor targeting can be beneficial for certain psychiatric  conditions. On the other hand, buspirone serves as a partial agonist at  5-HT1A receptors, providing anti-anxiety effects with less potential for  sedation. Loratadine, an antihistamine, acts as an inverse agonist,  reducing the baseline activity of H1 histamine receptors.

G-Protein-Coupled Receptors vs. Ion-Gated Channels

G-Protein-Coupled Receptors (GPCRs) and Ion-Gated  Channels are two different types of protein structures that drugs can  target to produce therapeutic effects. GPCRs are involved in slow,  modulatory signaling, while Ion-Gated Channels provide fast synaptic  transmission (Stahl, 2021).

Beta-blockers like propranolol interact with GPCRs,  specifically beta-adrenergic receptors, to modulate cardiac activity by  reducing heart rate and blood pressure. They do this by antagonizing the  beta-adrenergic receptors, thereby inhibiting the action of adrenaline  and noradrenaline (Stahl, 2021)

In contrast, via Ion-Gated Channels, drugs like  gabapentin act on voltage-gated calcium channels, not by blocking them  but by modulating their activity. This makes gabapentin useful for  conditions like neuropathic pain and epilepsy (Stahl, 2021).

Role of Epigenetics in Pharmacologic Action

Epigenetics in pharmacology refers to the  modification of gene expression rather than altering the genetic code  itself. These modifications can affect how an individual responds to  medications (Stahl, 2021).

Antidepressants like fluoxetine (Prozac) may not only  affect neurotransmitter levels but also induce epigenetic changes that  impact long-term mood regulation. They can modify DNA methylation  patterns related to the expression of neuroplasticity-related genes,  possibly contributing to their therapeutic effect (Castrén & Kojima,  2017).

Impact on Prescription Decisions

The impact on prescription decisions refers to how  the aforementioned factors might influence a healthcare provider’s  choice of medication, dosage, and treatment plan for individual  patients(Stahl, 2021).

Understanding the agonist-antagonist spectrum can be  vital in cases like dual diagnosis of opioid addiction and anxiety.  Here, a partial agonist like buspirone could be more appropriate than a  benzodiazepine due to its lower potential for abuse. Also, for patients  with treatment-resistant depression, considering a medication like  ketamine that works through different mechanisms and has potential  epigenetic impacts could offer another treatment avenue (Zanos et al.,  2016).

For example, in a patient with a dual diagnosis of  opioid addiction and anxiety, a nurse practitioner might opt for a  partial agonist like buspirone for the treatment of anxiety instead of a  benzodiazepine, which has a higher abuse potential. Similarly, if a  patient has treatment-resistant depression and has not responded to  typical SSRIs, considering an agent like ketamine, which works through  NMDA receptor antagonism and also induces epigenetic changes, could be a  thoughtful next step (Zanos et al., 2016).

 

Response

   

       Makhanu 

  

       John Green’s case presents several socioeconomic, spiritual,  lifestyle, and cultural factors that should be considered when  interacting with him as a healthcare provider.

  1. Gender Identity and Transition: John identifies as a  male but was assigned female at birth. Understanding his gender  identity and history of transitioning is crucial for providing sensitive  and appropriate care (Coleman, 2019). Questions might include:
    • Could you please share more about your gender transition journey and any specific healthcare needs related to it?
    • Are there any gender-specific health concerns or challenges you’d like to discuss?
  2. Unemployment and Financial Situation: John is  currently unemployed and has concerns about being a burden on his  family. Exploring his financial situation, any potential stressors  related to unemployment, and his support system is important (Coleman,  2019). Questions could include:
    • Can you tell me more about your current employment situation and any financial stress you might be experiencing?
    • Do you have a support network that you can rely on during this period of unemployment?
  3. Substance Use: John’s smoking and marijuana use can  have a significant impact on his health. It’s important to assess the  frequency and quantity of use and discuss potential health risks  associated with these behaviors. Questions might include:
    • Can you share more about your smoking habits, including when you started and how many cigarettes you smoke daily?
    • Tell me about your marijuana use. How often do you use it, and in what quantities?
  4. Depression: John mentions experiencing episodes of  depression. Exploring the severity, triggers, and coping mechanisms  related to his depression is important for providing mental health  support. Questions could include:
    • Could you describe your experiences with depression, including when it started and how it affects your daily life?
    • Have you sought any mental health support or counseling for your depression?
  5. HIV Status and Medication: Understanding John’s HIV  status, treatment regimen, and adherence is critical for assessing his  overall health (CDC,2020). Questions might include:
    • Can you provide more information about your HIV diagnosis, including how you’re managing it?
    • How has your experience with HIV treatment been, and have you encountered any challenges or side effects?
  6. Social Support and Family Dynamics: John has moved  back home with his parents. Exploring his relationship with his family  and the impact of this living arrangement on his mental and emotional  well-being is essential. Questions could include:
    • How is your relationship with your family, especially since you moved back home?
    • Are there any specific challenges or stressors related to living with your parents that you’d like to discuss?
  7. Spiritual and Cultural Beliefs: Assessing John’s  spiritual and cultural beliefs can help tailor care to his preferences  (Young             et al.,2016). Questions might include:
    • Do you have any spiritual or cultural practices that are important  to you, and would you like them to be incorporated into your healthcare?
  8. Access to Healthcare: John mentions obtaining  testosterone online and receiving HIV medication by mail. Understanding  his access to healthcare and the reliability of these sources is crucial  (Ball et al., 2023). Questions could include:
    • How have you been obtaining your medications, and do you have concerns about their source or quality?
    • Have you faced any barriers to accessing healthcare, such as cost or transportation?

Sensitivity to John’s unique experiences and challenges related to  his gender identity, unemployment, substance use, mental health, and HIV  status is essential to providing patient-centered care. Building  rapport and trust through open and non-judgmental communication is key  to addressing his healthcare needs effectively.

Health Promotion: Prevention of Disease

 

Visit http://www.aha.org/advocacy-issues/communicatingpts/pt-care-partnership.shtml and review the American Hospital Association’s Patients’ Bill of Rights. Discuss how health care professionals can ensure that patients’ rights are upheld and protected.

Instructions: 

Post your discussion to the Moodle Discussion Forum.  Initial post must be made by Day #3.  Word limit 500 words.  Reply to at least two other student posts with a reflection of their response.  Please make sure to provide citations and references (in APA, 7th ed. format) for your work.  

emerging populations

Choose two emerging populations, such as Latino/Hispanic Americans, Asian Americans/Pacific Islanders, or Black/African Americans. How do health issues differ between the two populations?

week 8 sinformation

Reflection on AACN Essentials Informatics Self-Assessment

Discussion

Purpose

The purpose of this week’s reflection topic relates to the following Course Outcome (CO):

Preparing the Discussion

· Reflection is an activity that involves your deep thought into your own experiences related to the concepts of the week. Answers should be detailed. In reflections students:

· Demonstrate understanding of concepts for the week

· Engage in meaningful dialogue with classmates and/or instructor

· Express opinions clearly and logically, in a professional manner

· Use the rubric on this page as you compose your answers.

· Scholarly sources are
NOT required for this reflection

· Best Practices include:

· Participation early in the week is encouraged to stimulate meaningful discussion among classmates and instructor.

· Enter the reflection often during the week to read and learn from posts.

· Select different classmates for your reply each week.

 Reflection Question

Prior to posting your answer, complete the 

Week 8 AACN Essentials Self-Assessment

linked here. Compare your scores from Week 1 to Week 8. Reflect on the following: 

· How far have you come?

· How will you apply this information to continue to improve your informatics knowledge in nursing practice?

· EBOOK to use for one citation:

· https://bookshelf.vitalsource.com/reader/books/9781323903148/epubcfi/6/492%5B%3Bvnd.vst.idref%3DP7001015544000000000000000002CB2%5D!/4/2%5BP7001015544000000000000000002CB2%5D/2/2%5BP7001015544000000000000000002CB3%5D/7:6%5B%20In%2Cter%5D

· email:
[email protected]

· Pwd: Leroyismyhero1#

·

let me know if you cannot have access to the ebook

Response to discussion 8

PLEASE READ THE FOLLOWING BELOW IN RESPOND IN 50 WORDS OR MORE:

 In my Week 1 discussion post, I talked about my concerns with nursing wages and burnout becoming more prominent. Throughout the semester, I have been able to deepen my understanding of these topics. I completed my article review on nursing burnout and through my research, I found that burnout has been gradually getting worse throughout the years. The number seems to be rising more than before and the lack of bedside nurses is climbing as well. This also causes a high nurse turnover and more dissatisfaction over time. Many hospitals are now turning to residency programs to have less nurse turnover as new graduates are required to sign a residency contract if they would like to work in that setting. This allows for less turnover and longer training times at the cost of flexibility and appropriate wages. At least in my case, I was getting paid more at my previous job (SNF) than I was starting at the hospital through the residency even though my previous job offered me less than the median salary for SNF nurses. I also believe that the cost of living in South Florida has gone up exponentially over the past few years and regardless of what “middle-class” job you have, money will be very tight for young adults trying to start to live independently without government support. Overall, I hope to see a change over the next few years for those who love the nursing practice as we are responsible for a significant amount of care provided in the healthcare setting and should be respected as so. 

Assigment .Apa seven . All instructions attached.


Week 3: Paper #1 Due

Complementary and alternative medicine (CAM) is becoming increasingly common in the United States and the rest of the western world. Most of nursing education in the United States, Canada, the United Kingdom, Europe, and Australia—often referred to as Western countries—has been under the umbrella of biomedicine, and thus Western nurses are familiar and comfortable with its beliefs, theories, practices, strengths, and limitations. Fewer nurses have studied alternative medical theories and practices and as a result may lack information or even harbor misinformation about these healing practices. Unlike the profession of medicine in general, however, the profession of nursing has traditionally embraced two basic concepts embodied by alternative therapies—holism and humanism—in its approach with clients.
Your assignment is to write a 2-3 page paper discussing how nurses can incorporate alternative medicine into a holistic approach to patient care. Please use references within the last 5 years and submit the work in APA format.

Holistic Approach and Caring Science

Please see the 2 attachments for the instructions 

Health Assessment

 Arrange an appropriate time and setting with your volunteer “patient” to perform a skin, hair, and nails examination. 

Download and review the Skin, Hair, and Nails Student Checklist and Key Points, provided in this week’s Learning Resources, and review the Seidel’s Guide to Physical Examination online media.

 Perform the skin, hair, and nails examination, covering all of the areas listed in the checklist.

 

  • Skin: Start by observing the color, texture, moisture, temperature, and any lesions. Use a good light source. Ask the patient about any changes, itching, or pain.
  • Hair: Look at the color, distribution, and texture. Ask about any changes, loss, or scalp problems.
  • Nails: Observe the color, shape, and condition of the nails. Look for any abnormalities like ridges, spots, or discoloration. Ask about any changes or problems.

Remember to always explain what you’re doing to the patient and ensure they’re comfortable throughout the examination.