pathophysiology
physiology
physiology
Assignment topic for Communication:
Under the communication topic is the idea of advanced directives. The advance directive idea has grown from basic forms that can be found in the state statutes to very refined documents such as Five Wishes or POLST or MOLST. But to start this topic we can access the Florida State statutes and see what the State of Florida has to offer as a advance directive. Here is the direct link to the Florida State Statute 765.101 https://www.caringinfo.org/planning/advance-directives/by-state/florida/
Scroll down to “Download Florida Advance Directive” This will give you an idea about the contents of the standard State form using the Florida one as an example. If you list the main parts it will give you an idea about the types of choices these forms allow for which are not exactly detailed or extensive in content. Now if you were to open a Five Wishes form: https://www.fivewishes.org/five-wishes-sample.pdf
Links to an external site. and compare to the earlier State form it becomes obvious the difference.
As a variation on the same theme there is also the POLST form which also gives several choices as a type of advance directive form. This will be our discussion for the communication module.
Assignment: Compare the two methods of Advanced Directives, that is the State of Florida form with either the Five Wishes or the POLST form and describe the following:
a) What are the differences between the forms?
b) Why do you think that there are differences between the forms?
c) What is accomplished by the newer generation of advanced directive (eg. Five Wishes or POLST)?
d) Which form would you rather have as a patient? and why?
Your answer should be at least 300 words and have a reference to it. You should comply with APA 7th ed guidelines and answer all of the questions clearly and completely.
I need a psychiatric progress note regarding a patient with PPH: of Depression, Anxiety and Insomnia . It cannot be similar, Thank you.
Here below I leave you a sample.
Patient is a XXXX y/o, female with Past Psychiatric History of Depression, Anxiety and Insomnia was seen today on telehealth platform for follow up and medication treatment who alleges getting better with the last treatment of trazodone 50mg at bedtime and mirtazapine 7.5mg at bedtime, she reports decrease symptoms of sadness ,loneliness, depression , hopelessness, as well as she expresses feeling motivated, optimistic and with more energy in the morning, improve mood, self-esteem and affect because she feels useful ,decreased anxiety and stressing over her personal problems, restlessness, nervousness, as result decreased difficulty falling asleep because sleeping better and more hours at night with her previous treatment the melatonin 5mg at bedtime, also in the morning she waking up rested after a night’s sleep. Patient denies side effects of the medications, suicidal and homicidal ideation, no visual or auditory hallucinations, agitation, psychotic symptoms or paranoia .Follow up in 4 weeks.
Please see the attachment for instructions
NR326 Mental Health Nursing
RUA: Scholarly Article Review Guidelines
The student will review, summarize, and critique a scholarly article related to a mental health topic.
Course outcomes: This assignment enables the student to meet the following course outcomes.
(CO 4) Utilize critical thinking skills in clinical decision-making and implementation of the nursing process for psychiatric/mental health clients. (PO 4)
(CO 5) Utilize available resources to meet self-identified goals for personal, professional, and educational development appropriate to the mental health setting. (PO 5)
(CO 7) Examine moral, ethical, legal, and professional standards and principles as a basis for clinical decision-making. (PO 6)
(CO 9) Utilize research findings as a basis for the development of a group leadership experience. (PO 8)
Due date: Your faculty member will inform you when this assignment is due. The Late Assignment Policy applies to this assignment.
Total points possible: 100 points
1) Follow these guidelines when completing this assignment. Speak with your faculty member if you have questions.
a. Select a scholarly nursing or research article, published within the last five years, related to mental health nursing. The content of the article must relate to evidence-based practice.
· You may need to evaluate several articles to find one that is appropriate.
b. Ensure that no other member of your clinical group chooses the same article, then submit your choice for faculty approval.
c. The submitted assignment should be 2-3 pages in length, excluding the title and reference pages.
2) Include the following sections (detailed criteria listed below and in the Grading Rubric must match exactly).
a. Introduction (10 points/10%)
· Establishes purpose of the paper
· Captures attention of the reader
b. Article Summary (30 points/30%)
· Statistics to support significance of the topic to mental health care
· Key points of the article
· Key evidence presented
· Examples of how the evidence can be incorporated into your nursing practice
c. Article Critique (30 points/30%)
· Present strengths of the article
· Present weaknesses of the article
· Discuss if you would/would not recommend this article to a colleague
d. Conclusion (15 points/15%)
· Provides analysis or synthesis of information within the body of the text
· Supported by ides presented in the body of the paper
· Is clearly written
e. Article Selection and Approval (5 points/5%)
· Current (published in last 5 years)
· Relevant to mental health care
· Not used by another student within the clinical group
· Submitted and approved as directed by instructor
f. APA format and Writing Mechanics (10 points/10%)
RUA: Scholarly Article Review Guidelines
RUA: Scholarly Article Review Guidelines
NR326_RUA_Scholarly_Article_Review_V4b_FINAL_MAY21 2
· Correct use of standard English grammar and sentence structure
· No spelling or typographical errors
· Document includes title and reference pages
· Citations in the text and reference page
For writing assistance (APA, formatting, or grammar) visit the
APA Citation and Writing page in the online library.
Please note that your instructor may provide you with additional assessments in any form to determine that you fully understand the concepts learned in the review module.
Grading Rubric Criteria are met when the student’s application of knowledge demonstrates achievement of the outcomes for this assignment.
Assignment Section and Required Criteria (Points possible/% of total points available) |
Highest Level of Performance |
High Level of Performance |
Satisfactory Level of Performance |
Unsatisfactory Level of Performance |
Section not present in paper |
Introduction (10 points/10%) |
10 points |
8 points |
0 points |
||
Required criteria 1. Establishes purpose of the paper 2. Captures attention of the reader |
Includes 2 requirements for section. |
Includes 1 requirement for section. |
No requirements for this section presented. |
||
Article Summary (30 points/30%) |
30 points |
25 points |
24 points |
11 points |
0 points |
Required criteria 1. Statistics to support significance of the topic to mental health care 2. Key points of the article 3. Key evidence presented 4. Examples of how the evidence can be incorporated into your nursing practice |
Includes 4 requirements for section. |
Includes 3 requirements for section. |
Includes 2 requirements for section. |
Includes 1 requirement for section. |
No requirements for this section presented. |
Article Critique (30 points/30%) |
30 points |
25 points |
11 points |
0 points |
|
Required criteria 1. Present strengths of the article 2. Present weaknesses of the article 3. Discuss if you would/would not recommend this article to a colleague |
Includes 3 requirements for section. |
Includes 2 requirements for section. |
Includes 1 requirement for section. |
No requirements for this section presented. |
|
Conclusion (15 points/15%) |
15 points |
11 points |
6 points |
0 points |
|
1. Provides analysis or synthesis of information within the body of the text 2. Supported by ides presented in the body of the paper 3. Is clearly written |
Includes 3 requirements for section. |
Includes 2 requirements for section. |
Includes 1 requirement for section. |
No requirements for this section presented. |
|
Article Selection and Approval (5 points/5%) |
5 points |
4 points |
3 points |
2 points |
0 points |
1. Current (published in last 5 years) 2. Relevant to mental health care |
Includes 4 |
Includes 3 |
Includes 2 |
Includes 1 |
No requirements for |
NR326 Mental Health Nursing
RUA: Scholarly Article Review Guidelines
NR326_RUA_Scholarly_Article_Review_V4b_FINAL_MAY21 4
3. Not used by another student within the clinical group 4. Submitted and approved as directed by instructor |
requirements for section. |
requirements for section. |
requirements for section. |
requirement for section. |
this section presented. |
APA Format and Writing Mechanics (10 points/10%) |
10 points |
8 points |
7 points |
4 points |
0 points |
1. Correct use of standard English grammar and sentence structure 2. No spelling or typographical errors 3. Document includes title and reference pages 4. Citations in the text and reference page |
Includes 4 requirements for section. |
Includes 3 requirements for section. |
Includes 2 requirements for section. |
Includes 1 requirement for section. |
No requirements for this section presented. |
Total Points Possible = 100 points |
Watch the videos listed below and answer the questions that follow:
Adolescents & Addiction:
Adolescent Drug Addiction
The Science of Relapse
Brain imaging on drugs
Please answer the following questions and indicate what videos helped you answer the question.
Please see the attachment for instructions
NR341 Max Cook Student Instructions
© 2021 Chamberlain University. All Rights Reserved.
Revised 4.1.2021 1
Student Instructions for i-Human Virtual Simulation
NR341 Max Cook
PURPOSE:
The following information is to be used in guiding your preparation and participation in the virtual simulation
scenario for this course. This document will provide applicable course outcomes in preparation for your
simulation.
SCENARIO OVERVIEW:
Max Cook is a 74-year-old male who presented to the emergency department (ED) 24 hours ago with
complaints of shortness of breath, decreased energy level, and fever. He had not been feeling well for several
days when he went to primary care provider who began treatment for pneumonia. Patient reported that he
did not feel that antibiotic was helping him, so he stopped taking his med 2 days ago. His overall health
declined rapidly over past 48 hours. Mr. Cook’s wife called the ambulance for transport to ED at Chamberlain
Hospital. He was admitted to the Medical Intensive Care Unit (ICU).
LEARNER OBJECTIVES:
1. Utilize clinical reasoning skills to perform a health history and physical assessment on an adult patient.
(CO 1, 3, 4, 6)
2. Construct a plan of care based by prioritizing assessment findings and nursing diagnoses (CO 1, 3, 4, 6, 7)
3. Evaluate patient outcomes to determine the effectiveness of nursing interventions and need for ongoing
care (CO 1, 4, 6)
4. Communicate and collaborate with the patient, family and interdisciplinary healthcare team members
(CO 1, 3, 6, 7)
STUDENT ROLES DURING SIMULATION:
You are the staff nurse at the hospital who will be conducting a comprehensive assessment. After completing
your assessment, you are expected to document your findings as a nurses note in SBAR format.
KEY FEATURES OF i-HUMAN:
• As the nurse, you are expected to complete the case scenario using the following tabs: EHR,
History, Physical, Nursing Notes, Summary
• Gear Heads: These are icons that open required questions and/or additional information
related to the case. The questions, information, and videos must be reviewed prior to
progressing to the next tab.
• Nursing Notes: At the end of the simulation, you will document your assessment findings using ISBAR.
NR341 Max Cook Student Instructions
© 2021 Chamberlain University. All Rights Reserved.
Revised 4.1.2021 2
Confidentiality:
To preserve the educational value, integrity and safety of the learning environment, you agree to maintain strict
confidentiality about the proceedings of the simulation session, details of the training scenarios and the
performance of all participants. You acknowledge that this expectation aligns with the guidelines related to the
Health Insurance Portability and Accountability Act (HIPAA) as well as laws governing Protected Health
Information (PHI) in client care environments.
You will not view, discuss, share, record or disclose any confidential information pertaining to the
session. You understand that lapses in confidentiality are considered academic misconduct and could result in
dismissal from the academic program.
Fiction Agreement:
You will suspend judgment of realism for any given simulation in exchange for the promise of learning new
knowledge and skills, treating the simulated patients with the same care due an actual patient, act with a
genuine desire to learn even when it may be difficult to do so.
DUE DATE:
The virtual simulation is assigned to be completed during Week 4 prior to your scheduled debriefing with
faculty/peers.
SIMULATION TIMING:
• Pre-simulation preparation: 30-60 minutes
• Pre-brief: 30 minutes
• Run Time: 2-2.5 hours
• Debriefing: 60 minutes
NR341 Max Cook Student Instructions
© 2021 Chamberlain University. All Rights Reserved.
Revised 4.1.2021 3
ASSESSMENT & EVALUATION
Faculty will utilize your participation measurements in the i-Human case, and debriefing discussions to identify
areas of opportunity for enhancement of your clinical growth. Your experiences in i-Human will contribute to
your overall completion of clinical requirements for the course as documented on the Clinical Learning Evaluation
tool.
i-Human Evaluation – What does my total score mean?
NR341 Max Cook Student Instructions
© 2021 Chamberlain University. All Rights Reserved.
Revised 4.1.2021 4
REVIEW AND COMPLETE PRIOR TO THE START OF THE VIRTUAL SIMULATION:
In order to prepare for the simulation, you are required to complete the pre-simulation questions below and
submit this prework to the faculty via uploading your responses in Canvas prior to the start of the virtual
simulation. If you do not complete the pre-simulation questions and upload them, you will not be able to
access or participate in the simulation.
1. Compare/contrast systemic inflammatory response syndrome (SIRS) and sepsis.
2. What are key nursing interventions when caring for patient on a ventilator?
3. Describe the purpose for the following types of vascular access devices: central venous catheter &
arterial line.
4. A patient is experiencing worsening hypotension and is prescribed norepinephrine continuous
infusion.
a. Prescription: Start Norepinephrine (levophed) 0.5 mcg/min and titrate to maximum of 12
mcg/min to maintain mean arterial pressure great than 65.
b. Pharmacy has mixed the drip as Norepinephrine 4mg in 250mL of D5W.
c. How many mL/hr should the nurse program the pump to deliver 0.5mcg/min?
**Immediately following the completion of the virtual simulation, you will complete the evaluation of the
simulation using the link provided.
EVIDENCE BASE IN DESIGN
When politics and medical science intersect, there can be much debate. Sometimes anecdotes or hearsay are misused as evidence to support a particular point. Despite these and other challenges, however, evidence-based approaches are increasingly used to inform health policy decision-making regarding causes of disease, intervention strategies, and issues impacting society. One example is the introduction of childhood vaccinations and the use of evidence-based arguments surrounding their safety.
In this Discussion, you will identify a recently proposed health policy and share your analysis of the evidence in support of this policy.
RESOURCES
Be sure to review the Learning Resources before completing this activity.
Click the weekly resources link to access the resources.
· Milstead, J. A., & Short, N. M. (2019). Health policy and politics: A nurse’s guide (6th ed.). Jones & Bartlett Learning.
o Chapter 5, “Public Policy Design” (pp. 87–95 only)
o Chapter 8, “The Impact of EHRs, Big Data, and Evidence-Informed Practice” (pp. 137–146)
o Chapter 9, “Interprofessional Practice” (pp. 152–160 only)
o Chapter 10, “Overview: The Economics and Finance of Health Care” (pp. 183–191 only)
· American Nurses Association (ANA). (n.d.). AdvocacyLinks to an external site.. Retrieved September 20, 2018, from https://www.nursingworld.org/practice-policy/advocacy/
· Centers for Disease Control and Prevention (CDC). (n.d.). Step by step: Evaluating violence and injury prevention policies: Brief 4: Evaluating policy implementationLinks to an external site.. Retrieved from https://www.cdc.gov/injury/pdfs/policy/Brief%204-a.pdf
· Congress.govLinks to an external site.. (n.d.). Retrieved September 20, 2018, from https://www.congress.gov/
· Klein, K. J., & Sorra, J. S. (1996). The challenge of innovation implementationLinks to an external site.. Academy of Management Review, 21(4), 1055–1080.
· Sacristán, J., & Dilla, T. D. (2015). No big data without small data: Learning health care systems begin and end with the individual patientLinks to an external site.. Journal of Evaluation in Clinical Practice, 21(6), 1014–1017.
· Tummers, L., & Bekkers, V. (2014). Policy implementation, street level bureaucracy, and the importance of discretionLinks to an external site.. Public Management Review, 16(4), 527–547.
To Prepare:
· Review the Congress website provided in the Resources and identify one recent (within the past 5 years) proposed health policy.
· Review the health policy you identified and reflect on the background and development of this health policy.
· Post a description of the health policy you selected and a brief background for the problem or issue being addressed. Which social determinant most affects this policy? Explain whether you believe there is an evidence base to support the proposed policy and explain why. Be specific and provide examples.
Original Work, No Plagiarism, Cite and Reference
Hugo is a graduate student working on a research study that is seeking to explore the efficacy of a new medicine for the prevention of chemotherapy-induced peripheral neuropathy. As part of his duties, he is asked to make himself available during participant recruitment to clarify any questions that the recruitment personnel or the participants may have. On one of these occasions, a research nurse named Phoebe is obtaining informed consent from a young adult named Simon.
The informed consent form includes information on the purpose of the study, a double-blinded, randomized intervention trial to test the efficacy of a medicine for the prevention of chemotherapy-induced peripheral neuropathy. The form explains the risks and benefits of participation at length, including the anticipated side effects of the new medicine.
The benefits are thought to outweigh the risks. The participants in the treatment arm of the study may benefit from the medicine's hypothesized prevention of chemotherapy-induced peripheral neuropathy. Participants in both groups will receive close monitoring of neuropathy symptoms and evidence-based care while being in the study. Finally, the form explains that the information collected may help to lead to the discovery of an agent that may reduce chemotherapy-induced peripheral neuropathy, of which there are currently no none effective preventative treatments.
As Phoebe is reviewing the informed consent form, Simon appears somewhat uncomfortable and apprehensive. Hugo thinks that his response may be related to the surroundings and/or situation. They are sitting in the exam room shortly after Simon learned of the treatment options for advanced stage colorectal cancer and the doctor left without answering all of his questions. Simon also has additional oncology appointments shortly after the consent discussion.
Hugo is also struck by Simon's interaction with Phoebe. He nods and his occasional brief responses sound more like someone receiving a set of instructions than an indication of understanding.
During the time it takes to complete the informed consent form, which is quite lengthy, Hugo begins to wonder whether Simon truly understands the research study and his part in it. Hugo also questions whether Simon understands what randomization is and how this technique will affect him as a research participant. Hugo is distracted from his thoughts by movement from across the room. Simon is ready to place his signature on the informed consent form. He seems to be eager to do so. The form states that study subjects have the right to refuse to participate and that they may withdraw at any time, but Hugo begins to question whether Simon truly has a choice in giving his consent. Do the benefits from this study, overwhelm any concerns he may feel regarding being in the study?
Hugo is unsure how to address his discomfort with the informed consent process that he has just witnessed and he begins to deliberate about what course of action he should take to address his concerns.
Discussion Questions:
1. How could the informed consent form or the process of obtaining informed consent be modified to address Hugo's concerns?
2. What types of questions or techniques could have Phoebe provided to assess Simon's understanding of the study?
3. How would you describe “randomization” to a prospective study participant?
4. How would you respond to a participant who says “can we skip the rest of this and sign the form” during the informed consent discussion?
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