Nursing Pathophysiology Assignment Week 8

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Resources

  • 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 15: Structure and Function of the Neurologic System
    • Chapter 16: Pain, Temperature Regulation, Sleep, and Sensory Function (stop at Sleep); Summary Review
    • Chapter 17: Alterations in Cognitive Systems, Cerebral Hemodynamics, and Motor Function (start at Acute confusional states and delirium) (stop at Alterations in neuromotor functions); (Parkinson’s Disease); Summary Review
    • Chapter 18: Disorders of the Central and Peripheral Nervous Systems and the Neuromuscular Junction (stop at Degenerative disorders of the spine); (start at Cerebrovascular disorders) (stop at Tumors of the central nervous system); Summary Review
    • Chapter 44: Structure and Function of the Musculoskeletal System (stop at Components of muscle function); Summary Review
    • Chapter 45: Alterations of Musculoskeletal Function (stop at Bone tumors); (start at Disorders of joints); Summary Review
    • Chapter 47: Structure, Function, and Disorders of the Integument (section on Lyme Disease)
  • Chin, L. S. (2018). Spinal cord injuriesLinks to an external site.. Retrieved from https://emedicine.medscape.com/article/793582-overview#a4

 

In your Case Study Analysis related to the scenario provided, explain the following:

  • Both the neurological and musculoskeletal pathophysiologic processes that would account for the patient presenting these symptoms.
  • Any racial/ethnic variables that may impact physiological functioning.
  • How these processes interact to affect the patient.

nurse5400

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Nurses are well positioned for reforming health care in ways that promote a healthier public and reduce healthcare cost. Discuss the role nurse plays in COVID vaccination mandate, telemedicine, and prescription drug pricing as advocates in the healthcare system.

The discussion must address the topic.

Rationale must be provided

May use examples from your nursing practice

150 words minimum (excluding the reference)

Minimum of two references in APA format within the last five years published.

Attached you can find the rubric to follow up this work.

W8 M see attachment

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Chamberlain


NR599-11532

Week 8

Midweek Comprehension Questions

Discussion

Purpose

NI knowledge, skills, and competencies are so pervasive in the modern technology-rich healthcare environment it is difficult to imagine one without the other. This course provided foundational and introductory knowledge regarding informatics with an emphasis on developing an understanding of concepts of nursing informatics (NI) and becoming knowledgeable about the application of informatics in advanced practice. Reflect upon one NI competency relevant to APNs which you learned in this course. Provide a brief summary (100 words or less) 

Stakeholder Analysis

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Identify the stakeholder’s role/position in your organization.

pm2 m2 writeen

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summit the complete question

Unit 9 peer response. ADHD Medications. 800W. APA. 4 references due 10-30-23

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Advanced Psychopharmacology and Health Promotion

Unit 9 peer response. ADHD Medications. 800W. APA. 4 references due 10-30-23.

Instructions:

Please read and respond to at least two of your peers' initial postings. You may want to consider the following questions in your responses to your peers:

· Compare and contrast your initial posting with those of your peers.  

· How are they similar or how are they different?

· What information can you add that would help support the responses of your peers?

· Ask your peers a question for clarification about their post.

· What most interests you about their responses? 

Please be sure to validate your opinions and ideas with citations and references in APA format.


Mihaela

Unit 9 – ADHD Medications

1.
What screening tools can be used to affirm your initial diagnosis that Mr. Deliver meets the criteria for ADHD?

One commonly used screening tool is the Adult ADHD Self-Report Scale (ASRS). The ASRS consists of a series of questions that evaluate both inattentive and hyperactive-impulsive symptoms (Anbarasan et al., 2020). Another useful screening tool is the Conners' Adult ADHD Rating Scales (CAARS), which assesses various domains affected by ADHD, such as attention problems, hyperactivity/impulsivity, and executive functioning (Smyth et al., 2019).

2.
Further assessment determines that Mr. Deliver does meet the criteria for ADHD, inattentive type. What is the current recommendation for pharmacological treatment for Mr. Deliver?

Once it is confirmed through further assessment that Mr. Deliver meets the criteria for ADHD, inattentive type, the current recommendation for pharmacological treatment would typically involve stimulant medications such as methylphenidate or amphetamine derivatives. These medications have consistently shown efficacy in improving attention, reducing impulsivity, and enhancing executive functions in adults with ADHD (Farhat et al., 2022). Non-stimulant options like atomoxetine or viloxazine (norepinephrine modulator) may also be considered if there are contraindications or intolerance to stimulants (Mechler et al., 2022). However, considering Mr. Deliver's concerns about stigma and psychotropic medications' risks, it may be worth discussing non-pharmacological interventions as well. Cognitive-behavioral therapy (CBT) has demonstrated efficacy in managing symptoms of adult ADHD. CBT can help Mr. Deliver develop strategies to improve organization skills, time management, and enhance his ability to focus on tasks (Young et al., 2020).

3.
Assume that instead of Mr. Deliver being 36 years old, Thomas is a 13-year-old male that also meets the diagnostic criteria for ADHD, hyperactive type (Thomas is not on any medications at this age). How will your pharmacological treatment change?

In the case of Thomas, a 13-year-old boy diagnosed with ADHD hyperactive type who is not currently taking any medications, the most probable treatment approach would involve the use of stimulant medications. According to the American Academy of Pediatrics (AAP), stimulant medications like methylphenidate are recommended as first-line treatment options for children and adolescents with ADHD, as they have been shown effective in reducing symptoms and improving functioning (Shrestha et al., 2020). However it is important to monitor growth and potential side effects in pediatric patients (Vertessen et al., 2023).

References

Anbarasan, D., Kitchin, M., & Adler, L. A. (2020). Screening for adult adhd. 
Current Psychiatry Reports, 
22(12). 

https://doi.org/10.1007/s11920-020-01194-9Links to an external site.

Farhat, L. C., Flores, J. M., Behling, E., Avila-Quintero, V. J., Lombroso, A., Cortese, S., Polanczyk, G. V., & Bloch, M. H. (2022). The effects of stimulant dose and dosing strategy on treatment outcomes in attention-deficit/hyperactivity disorder in children and adolescents: A meta-analysis. 
Molecular Psychiatry, 
27(3), 1562–1572. 

https://doi.org/10.1038/s41380-021-01391-9Links to an external site.

Mechler, K., Banaschewski, T., Hohmann, S., & Häge, A. (2022). Evidence-based pharmacological treatment options for adhd in children and adolescents. 
Pharmacology & Therapeutics, 
230, 107940. 

https://doi.org/10.1016/j.pharmthera.2021.107940Links to an external site.

Shrestha, M., Lautenschleger, J., & Soares, N. (2020). Non-pharmacologic management of attention-deficit/hyperactivity disorder in children and adolescents: A review. 
Translational Pediatrics, 
9(S1), S114–S124. 

https://doi.org/10.21037/tp.2019.10.01Links to an external site.

Smyth, A. C., & Meier, S. T. (2016). Evaluating the psychometric properties of the conners adult adhd rating scales. 
Journal of Attention Disorders, 
23(10), 1111–1118. 

https://doi.org/10.1177/1087054715624230Links to an external site.

Vertessen, K., Luman, M., Swanson, J. M., Bottelier, M., Stoffelsen, R., Bet, P., Wisse, A., Twisk, J. R., & Oosterlaan, J. (2023). Methylphenidate dose–response in children with adhd: Evidence from a double-blind, randomized placebo-controlled titration trial. 
European Child & Adolescent Psychiatry. 

https://doi.org/10.1007/s00787-023-02176-xLinks to an external site.

Young, Z., Moghaddam, N., & Tickle, A. (2016). The efficacy of cognitive behavioral therapy for adults with adhd: A systematic review and meta-analysis of randomized controlled trials. 
Journal of Attention Disorders, 
24(6), 875–888. 

https://doi.org/10.1177/1087054716664413Links to an external site.


Ruth

Unit 9: Initial Discussion ADHD Medications

What screening tools can be used to affirm your initial diagnosis that Mr. Deliver meets the criteria for ADHD?

Attention-Deficit/Hyperactivity Disorder (ADHD) is the most common neuropsychiatric disorder of childhood, with impairing symptoms persisting into adulthood in approximately 70% of cases. Several screening tools are available to help providers identify and diagnose ADHD. The World Health Organization (WHO) Adult ADHD Self-Report Scale Part A is the most commonly used screening tool for ADHD cases in adults. The tool is available in national and international ADHD guidelines.  The screening tool contains six questions that cover inattentive and hyperactive-impulsive symptoms. It also includes a threshold of four or more, which is used for probable ADHD.  The score is calculated according to the number of questions that meet the criteria: sometimes endorsing/often/very often for questions 1–3 and endorsing usually/very often for questions 4–6. However, this screening, even if the patient is positive, may not have an active diagnosis of ADHD; further evaluation is required to ensure symptoms are related to ADHD diagnosis (Chamberlain et al., 2021). 

Further assessment determines that Mr. Deliver does meet the criteria for ADHD, inattentive type. What is the current recommendation for pharmacological treatment for Mr. Deliver?

According to his age and diagnosis, the current recommendation for this patient will be amphetamine 12.5 mg daily. Recommend that the patient start CBT and encourage exercise. A study showed that ADHD drugs are more effective and tolerated by children and adolescents than adults; the reason for this discrepancy is unknown. Amphetamines, methylphenidate, atomoxetine, and modafinil cause weight loss in children, adolescents, and adults. Amphetamines and atomoxetine increased blood pressure in children and adolescents, and methylphenidate increased blood pressure in adults. Methylphenidate showed better symptom control with the most minor side effects for children and adolescents, and amphetamines produced the best results for adults (Gupta, 2018). 

Reference:

Chamberlain, S. R., Cortese, S., & Grant, J. E. (2021). Screening for adult ADHD using brief rating tools: What can we conclude from a positive screen? Some caveats. 
Comprehensive Psychiatry, 
106, 152224. https://doi.org/10.1016/j.comppsych.2021.152224

Gupta, S. (2018). Best First-Line ADHD Medications for Children, Adults: Study Results. 
Attitude. https://www.additudemag.com/adhd-drugs-methylphenidate-vs-amphetamine-treatment/

Mayo Clinic. (2023). Amphetamine (Oral Route). 

https://www.mayoclinic.org/drugs-supplements/amphetamine-oral-route/proper-use/drg-20150941Links to an external site.

EVIDENCE-BASED PROJECT, PART 3: CRITICAL APPRAISAL OF RESEARCH

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EVIDENCE-BASED PROJECT, PART 3: CRITICAL APPRAISAL OF RESEARCH

Realtors rely on detailed property appraisals—conducted using appraisal tools—to assign market values to houses and other properties. These values are then presented to buyers and sellers to set prices and initiate offers.

Research appraisal is not that different. The critical appraisal process utilizes formal appraisal tools to assess the results of research to determine value to the context at hand. Evidence-based practitioners often present these findings to make the case for specific courses of action.

In this Assignment, you will use an appraisal tool to conduct a critical appraisal of published research. You will then present the results of your efforts.

To Prepare:

· Reflect on the four peer-reviewed articles you selected in Module 2 and the four systematic reviews (or other filtered high- level evidence) you selected in Module 3.

· Reflect on the four peer-reviewed articles you selected in Module 2 and analyzed in Module 3.

· Review and download the Critical Appraisal Tool Worksheet Template provided in the Resources.

The Assignment (Evidence-Based Project)

Part 3A: Critical Appraisal of Research

Conduct a critical appraisal of the four peer-reviewed articles you selected by completing the Evaluation Table within the Critical Appraisal Tool Worksheet Template. Choose a total of four peer- reviewed articles that you selected related to your clinical topic of interest in Module 2 and Module 3.

Note: You can choose any combination of articles from Modules 2 and 3 for your Critical Appraisal. For example, you may choose two unfiltered research articles from Module 2 and two filtered research articles (systematic reviews) from Module 3 or one article from Module 2 and three articles from Module 3. You can choose any combination of articles from the prior Module Assignments as long as both modules and types of studies are represented.

Part 3B: Critical Appraisal of Research

Based on your appraisal, in a 1-2-page critical appraisal, suggest a best practice that emerges from the research you reviewed. Briefly explain the best practice, justifying your proposal with APA citations of the research.

LEARNING RESOURCES


Required Readings

· Melnyk, B. M., & Fineout-Overholt, E. (2023). 
Evidence-based practice in nursing & healthcare: A guide to best practice (5th ed.). Wolters Kluwer.

· Chapter 6, “Critically Appraising Quantitative Evidence for Clinical Decision Making” (pp. 189–228)

· Fineout-Overholt, E., Melnyk, B. M., Stillwell, S. B., & Williamson, K. M. (2010). Evidence-based practice step by step: Critical appraisal of the evidence: Part I. 


American Journal of Nursing

Links to an external site.
, 110(7), 47–52. doi:10.1097/01.NAJ.0000383935.22721.9c

· Fineout-Overhold, E., Melnyk, B.M., Stillwell, S.B., & Williamson, K.M. (2010). Evidence-based practice step-by-step: Critical appraisal of the evidence: Part II. 


American Journal of Nursing

Links to an external site.
, 110(7), 47-52

· Fineout-Overholt, E., Melnyk, B., Stillwell, S., & Williamson, K. (2010). Critical appraisal of the evidence: Part III the process of synthesis: Seeing similarities and differences across the body of evidence.

American Journal of NursingLinks to an external site.
, 110(11), 43-51. doi:10.1097/01.NAJ.0000390523.99066.b5

· Williamson, K. M. (2009). Evidence-based practice: Critical appraisal of qualitative evidence. 

Journal of the American Psychiatric Nurses AssociationLinks to an external site.
, 15(3), 202–207. doi:10.1177/1078390309338733

·

Document: Critical Appraisal Tool Worksheet Template (Word document)

NUR 435 – Week 5 Discussion: Financial Considerations in Nursing No unread replies.No replies.

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Step 1 Post your response to the discussion board.

Currently, nursing services are considered an expense for which healthcare organizations cannot bill separately. Respond to the following questions and, if appropriate, include personal experience as part of your answers:

  • Why are healthcare organizations unable to bill separately for nursing services, and what is the impact on nurse leaders?
  • What can the nursing profession, and specifically nursing leaders, do to change this issue?
  • Why are nursing services considered an expense and not an income generator?

Step 2 Read other students’ posts and respond to at least two of them by Friday at 11:59pm Mountain Time.

Ask questions of the other students that promote further thinking and discussion on the topic. Consider the changes to billing identified by the other students. Do you agree or disagree that these changes can make an impact on nursing services? Why or why not?

Use your personal experience, if it’s relevant, to support or debate other students’ posts. If differences of opinion occur, debate the issues professionally and provide examples to support opinions.

SOAP NOTE WEEK 9

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Soap Note 1 “ADULT”(patient over 50 years old)  Wellness check up 

Follow the MRU Soap Note Rubric as a guide:

Use APA format and must include mia minimum of 2 Scholarly Citations.

Turn it in’ s Score must be less than 25% or will not be accepted for credit; it must be your own work and in your own words. Copy-paste from websites or textbooks will not be accepted or tolerated and will receive a grade of 0 (zero) with no resubmissions allowed.

Must use the sample templates for your soap note.
Attached you can find the rubric , template  and an example to following in this assigment. 

Health promotion w1 peer resp

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Health promotion week1 peers response 

respond to peers thoughtfully, add value to the discussion, and apply ideas, insights, or concepts from scholarly sources, such as: journal articles, assigned readings, textbook material, lectures, course materials, or authoritative websites. For specific details and criteria, refer to the discussion rubric in the Menu (⋮) or in the Course Overview Weekly Discussion Guidelines

1st peers post

Emilee Harper

WEEK 1 DISCUSSION 2

· Define health promotion in your own words.

 Health promotion, in my own words, is the process of empowering individuals, communities, and societies to enhance their overall well-being and achieve their highest level of physical, mental, and social health. It involves dedicated efforts to prevent illness, promote healthy behaviors, and address the encouragement of health to achieve optimal quality of life. 

· Discuss the differences in primary, secondary, and tertiary prevention.

1. Primary Prevention: This focuses on preventing the onset of health issues. It aims to reduce the risk of disease or injury before they occur. Examples include vaccinations, health education, and lifestyle interventions to promote healthy habits.

2. Secondary Prevention: Secondary prevention is about early detection and intervention to prevent the progression of a health issue. It includes activities like regular screenings, diagnostic tests, and prompt treatment to control a disease or injury in its early stages.

3. Tertiary Prevention: Tertiary prevention is geared towards minimizing the impact of established diseases or injuries and preventing their complications. It involves rehabilitation, disease management, and strategies to improve the patient's quality of life.

 

· Identify two patient-focused topics of interest from the Healthy People 2030 website that interest you. For each topic, identify an objective from the Healthy People 2030 website on which you would like to focus. Why are these topics of interest to you? Provide a rationale for your selections.

1. Topic 1: Mental Health and Mental Disorders

· Objective: “Increase the proportion of children, adolescents, and adults who receive treatment for a major depressive episode.”

· Rationale: Mental health is a critical but often stigmatized aspect of overall well-being. Focusing on increasing access to treatment for depression aligns with the goal of promoting mental health and reducing the burden of mental disorders.

2. Topic 2: Substance Abuse (Drug and Alcohol Use)

3.  

· Objective: “Reduce the proportion of people who misuse prescription drugs in the past year.”

· Rationale: The misuse of prescription drugs is a growing public health concern. Reducing this misuse can reduce the associated health risks, addiction, and adverse consequences on individuals and communities.

 

Increase the proportion of children and adolescents who get appropriate treatment for anxiety or depression – EMCD04. Increase the proportion of children and adolescents who get appropriate treatment for anxiety or depression – EMCD04 – Healthy People 2030. (n.d.).
https://health.gov/healthypeople/objectives-and-data/browse-objectives/children/increase-proportion-children-and-adolescents-who-get-appropriate-treatment-anxiety-or-depression-emc-d04

Prevention strategies – STATPEARLS – NCBI bookshelf. (n.d.).
https://www.ncbi.nlm.nih.gov/books/NBK537222/ Kisling LA, M Das J. Prevention Strategies. [Updated 2023 Aug 1]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-.

Reduce the proportion of people who misused prescription drugs in the past year – su12. Reduce the proportion of people who misused prescription drugs in the past year – SU12 – Healthy People 2030. (n.d.).
https://health.gov/healthypeople/objectives-and-data/browse-objectives/drug-and-alcohol-use/reduce-proportion-people-who-misused-prescription-drugs-past-year-su-12

 

2nd peer post

Melinda Goebel

Health Promotion is a huge factor in health care. It is about taking care of your health and preventing or treating disease and illness. Primary prevention is mostly about preventing damage to your health before it can occur. Secondary prevention is about preventing the illness from progressing and further damaging health. Tertiary prevention helps manage long term, complex health problems to improve life with the disease as much as a possible.

 

I chose to focus on Heart Disease and Stoke from the Health People 2030 website. I chose this because it relates so closely to my practice at work on a Heart and Vascular Unit. Another reasoning I had behind researching this topic is because it is so relevant in health promotion and heart disease effects so many Americans, when it could be prevented.

 

Part of the Heart Disease and Stroke topic included screening for atrial fibrillation. This objective caught my interest because it is so much more common than people realize and often people live with atrial fibrillation without knowing until a larger event, such as heart attack or stroke occur. It could do so much for Secondary Prevention if the general population had more of an understanding of atrial fibrillation and a way to screen.

 

Diabetes is a huge problem in the population of the United States and effects so many of all ages. As a nurse I about half of my patient will come in with type 2 diabetes. This is another disease that has so many other effects on the body and health that could be prevented or controlled.

 

Type 2 diabetes is occurring in children and young adults more often. This could be prevented with education on a balanced diet and the risk of being diabetic. There is also ways to control blood sugars and lower A1C in these younger generations that are being diagnosed with type 2 diabetes.

 

U.S. Department of Health and Human Services. (2021). Healthy People 2030. Health.gov. https://health.gov/healthypeople