Category: Nursing

Less than 20% plaigarism and no AI or copy and pasting.
Writing assignment 
Instructions:
Review the Standards of Practice for Culturally Competent Nursing Care mentioned in the module. Choose four of them, describe them, and exemplify them with experiences in your clinical area.
Contribute a minimum of 2 pages. It should include at least 3 academic sources, formatted and cited in APA.
Submission Instructions:
Review the rubric to determine how your assignment will be graded.
Your assignment will be run through Turnitin to check for plagiarism.  If you are new to Turnitin, review the information in the Student Resource Center about it.
Rubric
2022 Essay Rubric
2022 Essay Rubric
Criteria Ratings Pts
This criterion is linked to a Learning OutcomeContent
Mastery of the information
30 pts
Excellent
The essay content aligns complies with the information requested and shows complete mastery of the content by showing complete information, details and examples.
25 pts
Good
The essay content aligns with the information requested and shows good mastery of the content. Provides sufficient information. But may have missed some details or examples.
20 pts
Acceptable
The essay content aligns with the information requested and shows partial mastery of the content. Provides sufficient information but lacks details and/or examples.
10 pts
Needs work
The essay content does not align with the information requested. Does not show mastery of the concepts and lacks information, details and/or examples.
0 pts
Not submitted
30 pts
This criterion is linked to a Learning OutcomeOrganization
Structure of the essay
20 pts
Excellent
The essay has a clear format with an introduction, body with clear transitions between evidence and supporting arguments and a conclusion. The information is presented in an orderly manner. All elements facilitate the flow of the information in the document.
15 pts
Good
The essay has a clear format with an introduction, body with evidence and supporting arguments and a conclusion. All elements facilitate the flow of the information in the document, but essay may missing transitions between sections, or has other small issues with organization.
10 pts
Needs work
Essay structure is problematic. Has one of these issues: The essay does not have a clear introduction or conclusion. OR The conclusion does not take into consideration the information presented. OR Evidence and supporting arguments are not aligned. OR The flow of the document is difficult to follow.
5 pts
Poor
Essay does not appear to have any structure. No introduction, progression of thought or defined conclusion.
0 pts
Not submitted
20 pts
This criterion is linked to a Learning OutcomeCritical Thinking
Development of Ideas
15 pts
Excellent
Details are considered and a point of view, thesis statement or main idea is clear. Presents excellent evidence, arguments or examples to support the point made. Draws insightful conclusions based on the information presented.
12 pts
Good
Details are considered and a point of view, thesis statement or main idea is clear. Presents sufficient evidence, arguments or examples to support the point made. Draws appropriate conclusions based on the information presented.
9 pts
Needs work
Details are considered and a point of view, thesis statement or main idea is identified. Presents some evidence, arguments or examples but some are not relevant to support the point made. Draws appropriate conclusions but not all are based on the information presented.
3 pts
Poor
Details are not considered and a point of view, thesis statement or main idea is vague. Evidence, arguments or examples are disconnected or not relevant. Lacks a conclusion or simply repeats previous statements made.
0 pts
Not submitted
15 pts
This criterion is linked to a Learning OutcomeInformation Literacy
Supporting Information
15 pts
Excellent
Supporting information is pertinent to the discussion, up to date (depending to what is acceptable in the field) and from academic and trusted sources.
12 pts
Good
Supporting information is pertinent to the discussion topic. Sources are not the most recent (depending to what is acceptable in the field) and from academic and trusted sources.
9 pts
Limited
Supporting information is pertinent to the discussion topic but not all sources are from academic and trusted sources; may or may not be the most recent (depending to what is acceptable in the field).
3 pts
Needs work
Supporting information is not pertinent to the discussion and/or none of the sources are from academic or trusted sources.
0 pts
Unacceptable
No supporting information
15 pts
This criterion is linked to a Learning OutcomeWriting
Mechanics
10 pts
Excellent
Writing is entirely free of typos, spelling, grammatical, punctuation, or translation errors.
8 pts
Good
Minimal (1-3) typos, spelling, grammatical, punctuation, or translation errors.
5 pts
Needs work
Multiple (4-9) typos, spelling, grammatical, punctuation, or translation errors.
0 pts
Not submitted
0 pts
Problematic
10 or more typos, spelling, grammatical, punctuation, or translation errors.
10 pts
This criterion is linked to a Learning OutcomeInformation Literacy
Correct application of APA
10 pts
Excellent
Flawless execution of APA. Correct formatting, setup, title page, and perfect citations and references.
8 pts
Good
Correct formatting, setup, title page, with minimal formatting or punctuation errors in the citations or references.
6 pts
Needs work
Correct formatting, setup, title page, but significant errors with citations and references.
2 pts
Problematic
Incorrect formatting, setup or missing title page, and/or problematic citations and references.
0 pts
Not used
APA style not used
10 pts
Total Points: 100
PreviousNext

Classmate 1 Based upon what you have learned in this module choose a complication from the following list:
Prolapse Cord – when the umbilical cord is displaced, protruding through the cervix and can comprise fetal circulation (Althoff et al., 2023). 1. Identify a potential cause of the complication?
This can present due to rupture of amniotic membranes, long umbilical cord, and/or position other than vertex of the fetus (Althoff et al., 2023).
2. What are the physiologic changes the RN would notice when assessing a patient with this complication?
The RN will be able to palpitate and/or see the cord and the client will feel something abnormal coming out the vagina. The fetus can be hyperactive then decreased movement, FHR monitoring will show prolonged deceleration – this can be signs of hypoxia of the fetus (Althoff et al., 2023).
3. Identify two priority management interventions the RN would expect the physician to order for a patient with this complication supported by evidence. Nursing Intervention 1: Call for help immediately and insert two sterile glove fingers into the vagina, apply pressure to the either side of the cord to the fetal presenting to elevate off the cord- the nurse needs to ensure to stay like this until delivery (Althoff et al., 2023). Nursing Intervention 2: The nurse needs to position patient in knee to chest, Trendelenburg, or lateral semi prone position and put a rolled towel under hip to help release pressure off of cord (Althoff et al., 2023). 10 L/min needs to be administered via facemask for fetal oxygen. Reference
Althoff, A., Cawley, M. E., Henry, N. J., Gearhart, M., Johnson, J., Roland, P., Wheless, L., & Holman, H. C. (2023). RN Maternal newborn nursing: Review module (12.0). ATI Nursing, Assessment Technologies Institute.
Classmate 2
Based upon what you have learned in this module choose a complication from the following list:
· Uterine rupture
Now respond to these prompts using the chosen complication:
1. Identify a potential cause of the complication? A potential cause for a uterine rupture to occur could be from uterine trauma that occurred from either accidents or surgery such a c-sections (Althoff et al., 2023).
2. What are the physiologic changes the RN would notice when assessing a patient with this complication? Physiological findings that an RN would notice upon assessment of a patient experiencing uterine rupture would be a change in the shape of the uterus along with being able to palpate the fetus, a change in fetal heart rate that presents with bradycardia, decelerations and variability, a halt in contractions, and signs and symptoms related to hypovolemic shock such as low blood pressure, rapid heart rate, and pale cool skin that is clammy (Althoff et al., 2023).
3. Identify two priority management interventions the RN would expect the physician to order for a patient with this complication supported by evidence. Two priority nursing interventions for uterine rupture are preparing the client for an immediate c-section, and administering IV fluids (Althoff et al., 2023).
IV fluids should be administered because when uterine rupture occurs, the patient is at risk for going into shock. It has been shown that hypovolemic shock has been the main cause of death in those with uterine rupture. The reason to prepare for am emergency c-section is due to the fact that uterine rupture is rare and it can be fatal and cause life-threatening complications (2022). References
Althoff, A., Cawley, M. E., Gearhart, M., Henry, N. J., Holman, H. C., Phillips, B. C., Roland, P., & Wheless, L. (2023). RN Maternal Newborn Nursing (12th ed.). Assessment Technologies Institute.
(2022, December 3). VBAC: Know the pros and cons. Mayoclinic. Retrieved May 13, 2024, from https://www.mayoclinic.org/healthy-lifestyle/labor-and-delivery/in-depth/vbac/art-20044869#:~:text=Uterine%20rupture%20is%20rare%2C%20happening,to%20prevent%20life%2Dthreatening%20complications.

Respond to at least one other student’s initial case presentation and include the following:
Generalized Anxiety Disorder
Panic Disorder
Post-Traumatic Stress Disorder
Based on the initial case presentation, list your top three differential diagnoses (
Generalized Anxiety Disorder
Panic Disorder
Post-Traumatic Stress Disorder 
Choose the most likely diagnosis. Generalized Anxiety Disorder
Support your decision with scholarly sources that represent a logical link between the case study and article information. Integrate relevant scholarly sources as defined by program expectationsLinks to an external site..
Respond to a peer who does not already have a peer response in the discussion.

Psychotherapy is often misunderstood or devalued.
Discuss your views of the PMHNP as a psychotherapist
Discuss whether it is feasible to provide psychotherapy at each patient encounter
Submission Instructions:
Your initial post should be at least 500 words, formatted, and cited in current APA style with support from at least 2 academic sources.  Your initial post is worth 8 points.

Discussion Board 3: COPD
The patient is a 60-year-old white female presenting to the emergency department with acute onset shortness of breath. Symptoms began approximately 2 days before and had progressively worsened with no associated, aggravating, or relieving factors noted. She had similar symptoms approximately 1 year ago with an acute, chronic obstructive pulmonary disease (COPD) exacerbation requiring hospitalization. She uses BiPAP ventilatory support at night when sleeping and has requested to use this in the emergency department due to shortness of breath and wanting to sleep.
She denies fever, chills, cough, wheezing, sputum production, chest pain, palpitations, pressure, abdominal pain, abdominal distension, nausea, vomiting, and diarrhea.
She reports difficulty breathing at rest, forgetfulness, mild fatigue, feeling chilled, requiring blankets, increased urinary frequency, incontinence, and swelling in her bilateral lower extremities that are new-onset and worsening. Subsequently, she has not ambulated from bed for several days except to use the restroom due to feeling weak, fatigued, and short of breath.
There are no known ill contacts at home. Her family history includes significant heart disease and prostate malignancy in her father. Social history is positive for smoking tobacco use at 30 pack years. She quit smoking 2 years ago due to increasing shortness of breath. She denies all alcohol and illegal drug use. There are no known foods, drugs, or environmental allergies.
Past medical history is significant for coronary artery disease, myocardial infarction, COPD, hypertension, hyperlipidemia, hypothyroidism, diabetes mellitus, peripheral vascular disease, tobacco usage, and obesity. Past surgical history is significant for an appendectomy, cardiac catheterization with stent placement, hysterectomy, and nephrectomy.
Her current medications include fluticasone-vilanterol 100-25 mcg inhaled daily, hydralazine 50 mg by mouth, 3 times per day, hydrochlorothiazide 25 mg by mouth daily, albuterol-ipratropium inhaled every 4 hours PRN, levothyroxine 175 mcg by mouth daily, metformin 500 mg by mouth twice per day, nebivolol 5 mg by mouth daily, aspirin 81 mg by mouth daily, vitamin D3 1000 units by mouth daily, clopidogrel 75 mg by mouth daily, isosorbide mononitrate 60 mg by mouth daily, and rosuvastatin 40 mg by mouth daily.
Physical Exam
Initial physical exam reveals temperature 97.3 F, heart rate 74 bpm, respiratory rate 24, BP 104/54, HT 160 cm, WT 100 kg, BMI 39.1, and O2 saturation 90% on room air.
Constitutional: Extremely obese, acutely ill-appearing female. Well-developed and well-nourished with BiPAP in place. Lying on a hospital stretcher under 3 blankets.
HEENT: Head: Normocephalic and atraumatic
Mouth: Moist mucous membranes Macroglossia
Eyes: Conjunctiva and EOM are normal. Pupils are equal, round, and reactive to light. No scleral icterus. Bilateral periorbital edema present.
Neck: Neck supple. No JVD present. No masses or surgical scarring. Throat: Patent and moist
Cardiovascular: Normal rate, regular rhythm, and normal heart sound with no murmur. 2+ pitting edema bilateral lower extremities and strong pulses in all four extremities.
Pulmonary/Chest: No respiratory status distress at this time, tachypnea present, (+) wheezing noted, bilateral rhonchi, decreased air movement bilaterally. The patient was barely able to finish a full sentence due to shortness of breath.
Abdominal: Soft. Obese. Bowel sounds are normal. No distension and no tenderness
Skin: Skin is very dry
Neurologic: Alert, awake, able to protect her airway. Moving all extremities. No sensation losses
Questions
What pertinent labs and diagnostics are ordered for this patient?
What are your differential diagnosis?
What is your treatment plan?
Use APA 7th Edition , references within 5 years of publication for each post. All paragraphs need to be cited properly. All responses must be in a narrative format and each paragraph must have at least 4 sentences. Please post your initial post by Wednesday

Select a community organization or group that you feel would be interested in learning about ethical and policy issues that affect the coordination of care. Then, develop and record a 10-12-slide, 20-minute presentation, with audio, intended for that audience. CREATE A DETAILED NARRATIVE SCRIPT OR SPEAKER NOTES FOR YOUR PRESENTATION 4-5 PAGES IN LENGTH. 
USE THIS COMMUNITY RESOURCE
American Heart Association: This organization focuses on cardiovascular health and
provides education, support, and advocacy for individuals with heart disease and stroke.
PowerPoint has a feature to type the speaker notes directly into the presentation. You are encouraged to use that feature or you may choose to submit a separate document. See Microsoft Office Software for technical support about the use of PowerPoint, including voice recording and speaker notes.
For this assessment, develop your presentation slides and speaker notes
Your slide deck should consist of 10–12 slides, not including a title and references slide with typed speaker notes
Create a detailed narrative script for your presentation, approximately 4–5 pages in length.
Cite 3–5 credible sources from peer-reviewed journals or professional industry publications to support your presentation. Include your source citations on a references page appended to your narrative script.
Explain how governmental policies related to the health and/or safety of the community affect the coordination of care.
Provide examples of a specific policy affecting the organization or group.
Refer to the assessment resources for help in locating relevant policies.
Be sure influential policies include the Health Insurance Portability and Accountability Act (HIPPA).
Identify national, state, and local policy provisions that raise ethical questions or dilemmas for care coordination.
What are the implications and consequences of specific policy provisions?
What evidence do you have to support your conclusions?
Assess the impact of the code of ethics for nurses on the coordination and continuum of care.
Consider the factors that contribute to health, health disparities, and access to services.
Consider the social determinants of health identified in Healthy People 2020 as a framework for your assessment.
Provide evidence to support your conclusions.
Communicate key ethical and policy issues in a presentation affecting the coordination and continuum of care for a selected community organization or support group. Either speaker notes or audio voice-over are included for a proficient score; both speaker notes and the audio voice over are included for a distinguished score.
PLEASE FOCUS CLOSELY ON THE REQUIRED INFORMATION NEEDED FOR THIS PPT PRESENTATION.

Need to make poster. Please see attached word file to get detailed information about the poster and the topics to choose from 

In your professional life, you will need to find credible evidence to support your decisions and your plans of action. You will want to keep abreast of best practices to help your organization adapt to the ever-changing health care environment. Being adept at research will help you find the information you need. For this assessment, you will research a health care problem or issue faced by current health care organizations. Please see the assessment example on proper formatting and content. You will need four (4) articles in total. If you have any questions, please reach out via text messaging.

The Health Care Problem Question is: When repositioning a person who is at reisk of developing a pressure ulcer what is the most effective  position. 
Instructions 
B.  Discuss the impact of a clinical practice problem on the patient or patients and the organization it affects.
1.  Identify each of the following PICO components of the clinical practice problem:
•   P: patient, population, or problem
•   I: intervention
•   C: comparison
•   O: outcome
2.  Develop an evidence-based practice (EBP) question based on the clinical practice problem discussed in part B and the PICO components identified in part B1.
Note: Refer to the “Appendix B: Question Development Tool” web link for information on the creation of an EBP question.
C.  Select a research-based article that answers your EBP question from part B2 to conduct an evidence appraisal.
Note: The article you select should not be more than five years old.
1.  Discuss the background or introduction (i.e., the purpose) of the research-based article.
2.  Describe the research methodology used in the research-based article.
3.  Identify the level of evidence for the research-based article using the Johns Hopkins Nursing Evidence-Based Practice (JHNEBP) model.
Note: Refer to the “Appendix E: Research Evidence Appraisal Tool” web link for information on how to level a research-based article.
4.  Summarize how the researcher analyzed the data in the research-based article.
5.  Summarize the ethical considerations of the research-based article. If none are present, explain why.
6.  Identify the quality rating of the research-based article according to the JHNEBP model.
Note: Refer to the “Appendix E: Research Evidence Appraisal Tool” web link for information on how to establish the quality rating.
7.  Analyze the results or conclusions of the research-based article.
a.  Explain how the article helps answer your EBP question.
D.  Select a non-research-based article from a peer-reviewed journal that helps to answer your EBP question from part B2 to conduct an evidence appraisal.
Note: The article you select should not be more than five years old.
1.  Discuss the background or introduction (i.e., the purpose) of the non-research-based article.
2.  Describe the type of evidence (e.g., case study, quality improvement project, clinical practice guideline) used in the non-research-based article.
3.  Identify the level of evidence in the non-research-based article using the JHNEBP model.
Note: Refer to the “Appendix F: Non-Research Evidence Appraisal Tool” web link for information on how to level the non-research-based article.
4.  Identify the quality rating of the non-research-based article according to the JHNEBP model.
5.  Discuss how the author’s recommendations in the non-research-based article help answer your EBP question.
E.  Recommend a practice change that addresses your EBP question using both the research-based and non-research-based articles you selected for part C and part D.
1.  Explain how you would involve three key stakeholders in supporting the practice change recommendation.
2.  Discuss one specific barrier you may encounter when implementing the practice change recommendation. 
3.  Identify one strategy that could be used to overcome the barrier discussed in part E2.
4.  Identify one outcome (the O component in PICO) from your EBP question that can be used to measure the recommended practice change.
F.   Acknowledge sources, using in-text citations and references, for content that is quoted, paraphrased, or summarized.
G.  Demonstrate professional communication in the content and presentation of your submission.

Preparing the Assignment
Requirements
Content Criteria:
Read the case study listed below.
Refer to the rubric for grading requirements.
Utilizing the Week 3 Case Study TemplateLinks to an external site., provide your responses to the case study questions listed below.
You must use at least one scholarly reference to provide pathophysiology statements. For this class, use of the textbook for pathophysiology statements is acceptable. You may also use an appropriate evidence-based journal.
You must use the current Clinical Practice Guideline (CPG) for the management and prevention of COPD (GOLD Criteria) to answer the classification of severity and treatment recommendation questions. The most current guideline may be found at the following web address: https://goldcopd.org/Links to an external site.. At the website, locate the current year’s CPG and download a personal copy for use. You may also use a medication administration reference such as Epocrates to provide medication names.
Proper APA format (in-text citations, reference page, spelling, English language, and grammar) must be used.
Case Study Scenario
Chief Complaint
A.C., is a 61-year old male with complaints of shortness of breath.
History of Present Illness
A.C. was seen in the emergency room 1 week ago for an acute onset of mid-sternal chest pain. The event was preceded with complaints of fatigue and increasing dyspnea for 3 months, for which he did not seek care. He was evaluated by cardiology and underwent a successful and uneventful angioplasty prior to discharge. Despite the intervention, the shortness of breath has not improved. Since starting cardiac rehabilitation, he feels that his breathlessness is worse. The cardiologist has requested that you, his primary care provider, evaluate him for further work-up. Prior to today, his last visit with your practice was 3 years ago when he was seen for acute bronchitis and smoking cessation counseling.
Past Medical History 
Hypertension 
Hyperlipidemia 
Atherosclerotic coronary artery disease
Smoker
Family History
Father deceased of acute coronary syndrome at age 65
Mother deceased of breast cancer at age 58. 
One sister, alive, who is a 5 year breast cancer survivor.
One son and one daughter with no significant medical history. 
Social History
35 pack-year smoking history; he has cut down to one cigarette at bedtime following his cardiac intervention. 
Denies alcohol or recreational drug use 
Real estate agent  
Allergies
No Known Drug Allergies 
Medications
Rosuvastatin 20 mg once daily by mouth 
Carvedilol 25 mg twice daily by mouth
Hydrochlorothiazide 12.5 mg once daily by mouth
Aspirin 81mg daily by mouth
Review of Systems
Constitutional: Denies fever, chills or weight loss. + Fatigue.
HEENT: Denies nasal congestion, rhinorrhea or sore throat.  
Chest: + dyspnea with exertion. Denies productive cough or wheezing. + Dry, nonproductive cough in the AM.
Heart: Denies chest pain, chest pressure or palpitations.
Lymph: Denies lymph node swelling.
General Physical Exam  
Constitutional: Alert and oriented male in no apparent distress.  
Vital Signs: BP-120/84, T-97.9 F, P-62, RR-22, SaO2: 93% 
Wt. 180 lbs., Ht. 5’9″
HEENT 
Eyes: Pupils equal, round and reactive to light and accommodation, normal conjunctiva. 
Ears: Tympanic membranes intact. 
Nose: Bilateral nasal turbinates without redness or swelling. Nares patent. 
Mouth: Oropharynx clear. No mouth lesions. Dentures well-fitting. Oral mucous membranes dry. 
Neck/Lymph Nodes 
Neck supple without JVD. 
No lymphadenopathy, masses or carotid bruits. 
Lungs 
Bilateral breath sounds clear throughout lung fields. + Bilaterally wheezes noted with forced exhalation along with a prolonged expiratory phase. No intercostal retractions.
Heart 
S1 and S2 regular rate and rhythm, no rubs or murmurs. 
Integumentary System 
Skin cool, pale and dry. Nail beds pink without clubbing.  
Chest X-Ray 
Lungs are hyper-inflated bilaterally with a flattened diaphragm. No effusions or infiltrates.
Spirometry
Title Predicted Pre-bronchodilator % Predicted Post-bronchodilator % Predicted Change
FVC (L)
5.64
5.23
93
5.77
102
9%
FEV1 (L)
4.57
2.92
64
3.01
66
2%
FEV1/FVC (%)
81
56
69
52
64
-5%
TLC
5.5
6.9
125
6.9
125
0%
Case Study Questions
Pathophysiology & Clinical Findings of the Disease
Are the spirometry results consistent with obstructive or restrictive pulmonary disease? What is the most likely pulmonary diagnosis for this patient?
Explain the pathophysiology associated with the chosen pulmonary disease.
Identify at least three subjective findings from the case which support the chosen diagnosis.
Identify at least three objective findings from the case which support the chosen diagnosis.
Management of the Disease
*Utilize the required Clinical Practice Guideline (CPG) to support your treatment recommendations.
Classify the patient’s disease severity. Is this considered stable or unstable?
Identify two (2) “Evidence A” recommended medication classes for the treatment of this condition and provide an example (drug name) for each.
Describe the mechanism of action for each of the medication classes identified above.
Identify two (2) “Evidence A” recommended non-pharmacological treatment options for this patient.