Nutritional Principles in Nursing

Module 02 Content

To prepare for the live classroom session and your written submission, use your chapter readings and course materials.

The focus for this live classroom is on Dietary Reference Intakes (DRI). You can review information about DRI at

https://www.nal.usda.gov/fnic/dietary-reference-intakes

Complete the Interactive DRI on yourself. Go to https://www.nal.usda.gov/fnic/dri-calculator/

Be prepared to answer the following questions:

What are the three components of the DRI?

Describe how RDA, AI, and UL influence health?

After reviewing your results on the Interactive DRI, how well are you meeting the RDAs suggested?

What two changes can you make to improve?

After the live classroom discussion, submit written answers to the above questions.

Assessment 3 Project Implementation Plan and Logic Model

ORAL HEALTH SERVICE EXPANSION (OHSE)
SAMPLE IMPLEMENTATION PLAN

Outline the activities required to provide new and/or expanded oral health services, including hiring/contracting at least 1.0 FTE new, onsite
licensed dental provider within 120 days of the Notice of Award. The Implementation Plan WILL count against the page limit. Applicants may
choose the focus areas and goals stated below or provide different focus areas and goals based on actions steps necessary for implementation of
the proposed OH project.

Goal
On separate rows, identify the goals for
each focus area. Goals should describe

measureable results.

Key Action Steps
Identify the action steps that

must occur to accomplish each
goal.

Person/Area Responsible
Identify who will be

responsible and
accountable for carrying

out each action step.

Time Frame
Identify the expected

time frames for carrying
out each action step.

Comments
As desired, provide

supplementary
information.

Focus Area: Create Operational Oral Health Site within 120 Days

Goal A1: Convert unutilized storage
space into two dental operatories. 1. Gut storage space 1. Contractor (TBD) 1. 30 days of award

2. Install plumbing and
electrical outlets 2. Contractor (TBD) 2. 60 days of award

3. Finish room (drywall,
cabinets) 3. Contractor (TBD) 3. 90 days of award

Goal A2: Order dental equipment. 1. Action Step 1. Person Responsible 1. Time Frame

2. Action Step 2. Person Responsible 2. Time Frame

Focus Area: Onboard Dental Providers within 120 Days
Goal B1: Create dental provider
recruitment plan. 1. Action Step 1. Person Responsible 1. Time Frame

2. Action Step 2. Person Responsible 2. Time Frame

Goal B2: 1. Action Step 1. Person Responsible 1. Time Frame

2. Action Step 2. Person Responsible 2. Time Frame

  • ORAL HEALTH SERVICE EXPANSION (OHSE)
  • SAMPLE IMPLEMENTATION PLAN

2nd Discussion post

 

All students are expected to contribute meaningful discussion related to the discussion topic of cultural diversity.  The term “cultural diversity” can also refer to having different cultures respect each other’s differences. Please answer and discuss the following questions.

  • What is culturally sensitive nursing care?
  • How do you assess culture in nursing?
  • How can nurses improve/nurture diversity?

On-line etiquette and respect is expected! Plagiarism will not be tolerated. The student must document the use of sources per APA 7th edition guidelines. See Discussion Rubric under DQ content tab for grading requirements. I have also attached a link with the Rubric directly in the discussion question. 

1 Initial post due: 11/3/23 9:00pm 

  • Initial post 300 word minimum; 2 scholarly reference minimum within 5 yrs

2 Peer responses due: 11/17/23 9:00pm

  • 2 Peer responses 100 word minimum; 1 scholarly reference minimum within 5 years

RESPONSE TO DISCUSSION BOARD 4

Use the attached document to provide responses to the discussion board. please provide 2 scientific references in APA format.

Health Assessment

Module 01 Written Assignment – Assessment and Health and Illness Beliefs

Module 01 Content

In a 2-3 page paper discuss how health and illness beliefs can influence the assessment process. You can use your textbook or any other evidence-based sources. Include how belief structure might impact how a client responds to an assessment interview and how culture might influence physical findings. Your assignment must have accurate spelling and grammar and use APA Format.

Scoring Rubric: Assessment and Health and Illness Beliefs

  
Criteria

 
Points

  Belief structure influences client response

 10

  Culture impact findings

 5

  2-3 page paper with accurate spelling and grammar & 
in APA format

 5

   

  

  
Total

 20


Respiratory

Discuss what is happening on a cellular level with the disease process. Be careful to realize that patients have co-morbidities, and you may need to discuss the other diseases impact on the pathophysiology and care of the patient.  Three (3) resources after 2008 are required along with APA format. Add questions to paper

CASE STUDY: 
Asthma

 

Patient Profile:

    Miss Winters, age 25, comes to the emergency department with severe wheezing, dyspnea, and anxiety. She was in the ED only 6 hours ago with an acute asthma attack, which resolved with nebulized albuteral treatments.

 

Subjective Data:

-Admits to use of albuterol inhaler several times weekly for the last few months 

-Asthma symptoms occasionally awaken her at night (about 3 times a week), and she has cancelled several outings with her family due to her symptoms

          -Can now only speak in one to three word sentences

          -Is allergic to cigarette smoke

-Began to experience increased shortness of breath and chest tightness when she returned home

-Used albuterol inhaler repeatedly at home without relief

-History of pruritic skin lesions that have come and gone since childhood.

 

Objective Data:

            Physical Examination:

                -Using accessory muscles to breath

             -Audible inspiratory and expiratory wheezing to auscultation with no air movement in lower lobes of l

                     lungs

             -HR = 126/min; Resp = 40/min

             -Areas of dry, scaling skin in antecubital areas bilaterally with evidence of scratching

            
Diagnostic Studies:

                        ABGs: PO2  = 80 mm Hg

                                    PCO2  = 35mm Hg

                                    HCO3  = 24 mEq/L

                                    pH = 7.48

                        PEFR: 150 L/min (Personal best: 400 L/min)

                        Continuous pulse oximetry: 82-85

 

CRITICAL THINKING QUESTIONS:

 

1. Why did Ms. W. return to the ED? Explain the pathophysiology of this second exacerbation of asthma.

 

2. Describe the progression of breath sounds auscultated from early in an asthma attack through very severe respiratory impairment. How do the sounds change as the patient improves?

 

3. What is the significance of her dry, scaling, pruritic skin lesions? What is your diagnosis (no nursing dx please)? How do these types of lesions relate to asthma? What is their physiologic cause ?

 

4. Analyze the ABG. What type of acid-base disorder is present? Why? Is there any compensation?

 

5. Discuss the four categories of asthma diagnosis advocated in the 
Guidelines for the Diagnosis and Management of Asthma from the National Heart, Lung, and Blood Institute of the National Institutes of Health. Which classification best describes Ms. W.'s asthma?

 

6. According to the asthma treatment guidelines from #5: the “Step up-Step down” approach, what is the recommended treatment strategy for a patient currently at Ms. W.’s classification level once this current exacerbation is controlled? When would it be appropriate to reevaluate the interventions and possibly adjust the medications?

 

7. She lost her Peak Flow meter during a recent house move. Why would you want to order a new one for her? How is it used and how can it help increase her ability to control her asthma? Explain the red, yellow, and green zones. What is the significance of her PEFR level on her return to the Emergency Room?

 

Nursing M1 assignment 1 response

What matters at the end of life and Palliative care, a  different voice in healthcare. There are two Utube videos above and you  need to pick only one and tell about it. Here is what you can report on:

a) What is the subject that the speaker is covering?

b) Does it effect the ideas that you have already about palliative care?

c) It is very important for someone to think about and be able to  converse about the subject of death and dying if they are considering  working as a nurse in this area. Why would that be?

Critical reflection

I attached assignment task description 

And module 1 
Rest module 2-8 I will combine and send you 1 file. 
As there is 4 part of assignment to reflect which student have to pick from module. It will be good if you pick Mildred video to reflect on it in module 6 I have put link in document. 
For the 1 st critical reflection is from module 1 personal leadership philosophy. 
For the 2nd it is related to standard 
For the 3 reflection it is good to pick Mildred video module 6
For the 4th, you can pick any reading in the modules which you feel good to do critical reflection as a nurse leader not as organisation leader. 

Week 5 Unit 5 Discussion Medications for Depression and Anxiety Related Disorders2 Peer Response 800w. due10-4-23

Week 5 Unit 5 Discussion Medications for Depression and Anxiety Related Disorders2 Peer Response 800w. due10-4-23

Instructions:

Please read and respond to the two peers' initial postings for week 2 below. Consider the following questions in your responses.

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

1. How are they similar or how are they different?

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

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

4. What most interests you about their responses? 

5. Summaries at least 1 evidence based article that supports there point.

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

·
Response 1 400 words IA

·

This case scenario is quite interesting since this is about a young female patient who reports multiple symptoms starting three weeks ago. This is where one researches and I believe this patient may be having an episode of major depressive disorder. I dare to come to come up with this diagnosis since she presents multiple symptoms starting about three weeks ago. Going over the multiple sections to cover this week in the “Diagnostic and Statistical Manual of Mental Disorders” I found that she presents with subjective information such as having insomnia, diminished ability to concentrate, lack of interest, weight loss due to loss of appetite, crying spells with no apparent reason. This young lady also reports feeling “tired & fatigued” and has lost interest in activities she usually enjoys. The key for me here was finding all these symptoms under the diagnostic criteria for major depressive disorder box (Diagnostic and Statistical Manual of Mental Disorders: DSM-5-TR 2022). Although she does not meet all the criteria, she presents more than five symptoms with onset about three weeks ago and according to our manual symptoms must be present at least two weeks (Diagnostic and Statistical Manual of Mental Disorders: DSM-5-TR 2022).

Regarding her headache, and according to our book this patient can be reporting somatic complaints such as pain and aches instead of reporting an actual feeling of sadness (Diagnostic and Statistical Manual of Mental Disorders: DSM-5-TR 2022).

The classification of medication that I would recommend for this patient would be antidepressants. Our prescriber's book has a long list such as sertraline, paroxetine, trazodone, and escitalopram among many (Stahl, 2021). I would focus on a common drug that I see very often, and that is sertraline. Sertraline would be a good option for her since is an SSRI (selective serotonin reuptake inhibitor) (Stahl, 2021)

and I remember Dr. Kubiak mentioning that serotonin can be the usual one to blame for depression along with norepinephrine. This drug can boost the neurotransmitter serotonin and can also block the serotonin reuptake pump (Stahl, 2021)

References:

Diagnostic and statistical manual of mental disorders: DSM-5-TR (5th ed.). (2022). . American Psychiatric Association Publishing.

Stahl, S. M. (2021). Stahl’s essential psychopharmacology: The Prescriber’s Guide (7th ed.). Cambridge University Press.

Response 2. 400 words sy

What diagnosis do you believe may apply to this individual?

This patient presented with symptoms of headache, fatigue, sleep disturbance, weight loss, loss of interest in activities, and frequent crying spells, all of which are indicative of major depressive disorder (MDD). Signs that a patient might be suffering from MDD include avoiding certain situations that they enjoy, inability to concentrate, and being unable to go to work due to fatigue. MDD can disrupt the patient's daily life by affecting their home, work, and social life (Salvo et al., 2022). According to the DSM-5, to be diagnosed with MDD, patients must experience 5 or more symptoms in the last week.

What classifications of medications can be used to treat this disorder? Which medication do you recommend and why?

Treatment for this patient will include antidepressants. Antidepressants are classified into different types based on their work and chemical structures. There are four main groups: monoamine oxidase inhibitors (MAOIs), tricyclic antidepressants (TCAs), selective serotonin reuptake inhibitors (SSRIs), and serotonin-norepinephrine reuptake inhibitors (SNRIs).

SSRIs are a broad category of antidepressant medications. Since this patient has no significant past medical or psychiatric history and takes no regular medications, my recommendation would be fluoxetine 10 mg for 4 weeks, then increasing the dose to 20 mg daily if the drug is well tolerated by the patient (Arcangelo et al., 2021). SSRIs tend to be well-tolerated and are relatively cost-effective. Patients who take SSRIs exhibit fewer side effects in comparison to those who take Tricyclic Antidepressants (TCAs) and Monoamine Oxidase Inhibitors (MAOIs). Therefore, SSRIs are often considered the first line and primary choice for the treatment of mood and anxiety disorders. The class of SSRIs includes Fluoxetine (Prozac), Fluvoxamine (Luvox), Paroxetine (Paxil), Sertraline (Zoloft), Citalopram (Celexa), and Escitalopram (Lexapro). Side effects include weight gain, insomnia, sexual dysfunction, gastrointestinal issues, and agitation (Arcangelo & Peterson, 2021).

References

Arcangelo, V. & Peterson, A. (2021). Pharmacotherapeutics for advanced practice: A practical approach. (5th ed.). Wolters Kluwer

Imiuwa, M. E., Baynes, A., & Routledge, E. J. (2023). Understanding target-specific effects of antidepressant drug pollution on molluscs: A systematic review protocol. PLoS One, 18(6) https://doi.org/10.1371/journal.pone.0287582Links to an external site.

Salvo, G. D., Bianco, M., Teobaldi, E., Maina, G., & Rosso, G. (2022). A Psychoanalytic-Derived Brief Psychotherapeutic Approach in the Treatment of Major Depression: Monotherapy Studies. Medicina, 58(10), 1335. https://doi.org/10.3390/medicina58101335

informatics

identify at least 3 key concepts from the selected part of the textbook and provide clear and correct explanations. Writing shows a clear logical link between those concepts. Synthesize information from multiple sources (lectures, readings, activities) and derive a conclusion in your own words. The terminology used is clearly defined.