1. Examine the advanced nursing practice role for which you are being prepared (Nurse Practitioner) and briefly describe the role including the history of the role, education and certification, and major functions of this role.
2. Create a marketing plan to support your value to the healthcare team. You will need to look at the literature beyond nursing. Address each of the 4Ps to market your advanced nursing practice role.
3. Investigate at least two of the Central and Core Competencies (i.e., Direct Clinical Practice, Guidance and Coaching, Consultation, Evidence-based Practice, Leadership, Collaboration, Ethical Decision Making) described in Hamrics Integrative Model of Advanced Practice Nursing and how these competencies can influence and advance healthcare.

Your presentation must be presented in a single PowerPoint presentation. The presentation must be between 7 and 10 slides in length, not including the title and reference list slides. The presentation must use proper APA formatting as directed in the APA Publication Manual, 6th edition formatting, including title slide and reference list with properly formatted citations in the body of the presentation. You will record this as a voice-over PowerPoint. This must be at least 10 minutes in length.

 

1) **********minimum 3 full pages ( not words)**************************** (cover or reference page not included) 

2)**********APA norms  ( All paragraphs need to be cited properly. All responses must be in a narrative format)

3)********** It will be verified by Turnitin and SafeAssign***************** 

4) **********References from the last 5 years  

5) The points don’t be must copied in the work. It must be identified by numbers.

This assignment has two parts.

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Part 1: Minimum 2 full pages.

 

Chronic Stable Angina

E.H. is a 45-year-old African American man who recently moved to the community from another state. He requests renewal of a prescription for a calcium channel blocker, prescribed by a physician in the former state. He is unemployed and lives with a woman, their son, and the womans 2 children. His past medical history is remarkable for asthma and six heart attacks that he claims occurred because of a 25-year history of drug use (primarily cocaine). He states that he used drugs as recently as 2 weeks ago. He does not have any prior medical records with him. He claims that he has been having occasional periods of chest pain. He is unable to report the duration or pattern of the pain. Before proceeding, explore the following questions: What further information would you need to diagnose angina (substantiate your answer)? What is the connection between cocaine use and angina? Identify at least three tests that you would order to diagnose angina.

Diagnosis: Angina

1. List specific goals of treatment for E.H.

2. What dietary and lifestyle changes should be recommended for this patient?

3. What drug therapy would you prescribe for E.H. and why?

4. How would you monitor for success in E.H.?

5. Describe one or two drugdrug or drugfood interactions for the selected agent.

6. List one or two adverse reactions for the selected agent that would cause you to change therapy.

7. What would be the choice for the second-line therapy?

8. Discuss specific patient education based on the prescribed first-line therapy.

9. What over-the-counter and/or alternative medications would be appropriate for E.H.?

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Part 2:  Minimum 1 page

 

Chief complaint: Im here for a medication refill because I ran out of my medicines.

HPI:  Mrs. Allen is a 68-year-old African American who presents to the clinic for prescription refills. The patient indicates that she has noticed shortness of breath which started about 3 months ago. The SOB gets worse with exertion, especially when she is walking fast, and it is resolved when she is resting. She reports that she is also bothered by shortness of breath that wakes her up intermittently during her sleep. Her symptoms of shortness of breath resolve after sitting upright on 3 pillows. She also has lower leg edema pitting 1+ which started 2 weeks ago. She indicates that she often feels light headed at times with intermittent syncope episodes while going up a flight of stairs, but it resolves after sitting down to rest. She has not tried any over the counter medications at home.

She started taking her medications, but failed to refill the prescriptions because she cannot afford the medications as she only works part-time and lives alone. In addition, she reports that she does not think taking all these medications would help her condition anyway.

PMH: Primary Hypertension, Previous history of MI 1 year ago

Surgeries:

1 year ago-Left Anterior Descending (LAD) cardiac stent placement

Allergies: Penicillin

Vaccination History:  Up-to-date

Social history:

High school graduate married and no children. Drinks one 4-ounce glass of red wine daily. She is a former smoker and stopped 5 years ago.

Family history:

Both parents are alive. Father has history of MI and valvular heart disease; mother alive and cardiac history is unknown. He has one brother who is alive and has history of MI 5 years ago at age 52.

ROS:

Constitutional: Lightheaded and faint with exertion. Respiratory: Shortness of breath with exertion. + Orthopnea. Cardiovascular: + 2 pitting leg edema for 3 weeks.

Psychiatric: Non-contributory.

Physical examination:

Vital Signs: Height: 5 feet 1 inches Weight: 175 pounds BMI: 32, Obese, BP 160/92, T 98.0, P 111,  R 22 and non-labored

HEENT: Normocephalic/Atraumatic, Bilateral cataracts; PERRLA, EOMI; Teeth intact. Negative for gum disease. NECK: Neck supple, no palpable masses, no lymphadenopathy, no thyroid enlargement. LUNGS: + Mild Crackles on inspiratory phase not clearing with cough. Equal breath sounds. Symmetrical respiration. No respiratory distress. HEART: Normal S1 with S2 during expiration. An S4 is noted at the apex; + systolic murmur noted at the right upper sternal border without radiation to the carotids. Pulses are 2+ in upper extremities and 2+ in pedal pulses bilaterally. 2+ pitting edema to her knees noted bilaterally. ABDOMEN: No abdominal distention. Nontender. Bowel sounds + x 4 quadrants. No organomegaly. Normal contour; No palpable masses. GENITOURINARY: No CVA tenderness bilaterally. GU exam deferred. MUSCULOSKELETAL: + Heberden’s nodes at the DIP joints, hands. + Crepitus, bilateral knees. Slow gait but steady. No Kyphosis. PSYCH: Normal affect. Cooperative. SKIN: No rashes. Positive for dry skin.

Labs: Hgb 13.2, Hct 38%, K+ 4.0, Na+137, Cholesterol 228, Triglycerides 187, HDL 37, LDL 190, TSH 3.7, glucose 98.

A:

Primary Diagnosis: Congestive Heart Failure (CHF)

Secondary Diagnoses: Primary Hypertension, Obesity, Osteoarthritis (OA)

Differential Diagnosis: Peripheral Vascular Disease (PVD)

Plan:

Medications: Tylenol 650 mg PO Q4 hours as needed for arthritis pain

Labs: UA; Brain natriuretic peptide (BNP); LFTs and TSH; 12-lead EKG, Chest X-ray; Initial 2D echo with Doppler; Ankle-brachial index.

Additional lab results: Echo results 1 week ago: Left ventricular EJ Fraction decreased to 35 %

BNP not available.

As a future FNP, you need to determine the medications for CHF/ASCVD. (Arteriosclerotic Cardiovascular Disease).

Questions:

1.     According to the ACC/AHA guidelines, what medications should this patient be prescribed?

2.     Does he need medication(s) given his history of MI?

Please use the patient information provided below for this paper.

This assignment assesses intended course outcome(s)

#4 Use information found in patients health histories, genograms, and assessments to formulate an individualized plan of nursing care that focuses on the patients individual health promotion and disease prevention needs 

Students will use the information found in Tina’s history, physical exam, and problem list to formulate an individualized health promotion and disease prevention plan of care. Recommendations should be evidence-based and from credible sources. The readings in module eight contains some suggested sources for obtaining health and screening recommendations for your patient. 

The plan for addressing the health promotion and disease prevention needs for your patient should include:

Demographics:

–          Age, gender and race of patient

–          Education level (health literacy)

–           Access to health care

Insurance/Financial status

–          Is the patient able to afford medications and health diet, and other out-of-pocket expenses?

Screening/Risk Assessment

–          Identified health concerns based on screening assessments and demographic information

Nutrition/Activity

–          What is the patients activity level, is the environment where the patient lives safe for activity

–          Nutrition recommendations based on age, race gender and pre-existing medical conditions

–          Activity recommendations

Social Support

–          Support systems, family members, community resources

Health Maintenance

–          Recommended health screening based on age, race, gender and pre-existing medical conditions

Patient Education:

–          Identified knowledge deficit areas/patient education needs (medication teaching etc).

–          Self-care needs/ Activities of daily living

* The paper should be written and referenced in APA format and be no longer than 4 pages (excluding cover page and references).

Your paper will be evaluated based on the following criteria:

Criteria

Level 3

Level 2

Level 1

Demographics

(5%)

Includes age, race and gender of patient

Missing one data item

Missing 2 or more data items

Insurance/Financial status

(10%)

Includes information regarding patients insurance status and ability to afford medications and other  out-of-pocket expenses

Missing some information regarding insurance status and ability to pay for medications and other out-of-pocket expenses.

Missing information regarding the patients insurance status, ability to pay of medications and other out-of-pocket expenses

Screening /risk assessment

(10%)

Identifies health concerns based on screening assessments and demographic information.

Missing some information regarding health concerns, by excluding information from screening assessments and demographics

Health concerns are not identified due to information missing from screening assessments and demographics

Nutrition/activity

(20%)

Completely asses patients nutrition and activity levels and makes recommendations based on age, race, gender and pre-existing medical conditions

Missing some information regarding the patients nutrition and activity levels, make recommendations based on age, race, gender and pre-existing medical conditions

Most of the information regarding the patients nutrition and activity levels are missing, recommendations are missing or not based on the patients age, race, gender and pre-existing medical conditions

Social support

(10%)

Identifies support systems such as family members and community resources

Missing some information regarding support systems such as family members and/or community resources

Little to no information regarding social support

Health Maintenance

(20%)

Overall health maintenance recommendations made based on age, race, gender and pre-existing medical conditions

Missing some recommendations, mostly based on age, race, gender and pre-existing medical conditions

Missing many recommendations, loosely related to age, race, gender and pre-existing medical conditions

Patient Education

(20%)

Identified knowledge deficit areas/patient education needs including self-care needs and activities of daily living

Missing one or more areas of knowledge deficit/patient education needs including self-care and activities of daily living

Lacks identification of knowledge deficit areas/patient education needs. Does not consider self-care needs or activities of daily living.

Organization, spelling and grammar, APA

(5%)

Organized, easy to read, no spelling or grammar mistakes, appropriate use of APA

Organized and easy to read, few spelling or grammar mistakes, few errors in APA

Disorganized, difficult to read, many spelling and grammar errors mistakes. Does not use APA

Overall score

Points

(60-100)

Points

(24-59)

Points

( 0-23)

 

You must answer the 3 questions 2 times. You must submit 2 documents (each one 1 page), in each one you must answer the 3 questions. Copy and paste will not be admitted. You should address the questions with different wording, different references, but always, objectively answering the questions.

_____________________________________________________________

1) **********minimum 1 full pages per document= total 2 pages ( not words)**************************** (cover or reference page not included) 

2)**********APA norms  ( All paragraphs need to be cited properly. All responses must be in a narrative format)

3)********** It will be verified by Turnitin and SafeAssign***************** 

 

4) **********References from the last 5 years  

5) The points don’t be must copied in the work. It must be identified by numbers. 

______________________________________________________________-

Question(s): Technological advances hold promises for improving quality of life, decreasing need for personal care assistance, and enhancing independence and ability to live safely.

1) Choose one of the technologies mentioned in your textbook and discuss / explain it:

Choose one for each answer

Telehealth

Smart Homes

Robots

2) Please, support your answer with a research study

3) Is there any research study of technological innovation related with your topic that promises advantages in the future of healthcare? 

 

1. In the last century, what historical, social, political, and economic trends and issues have influenced todays health-care system?

2. What is the purpose and process of evaluating the three aspects of health care: structure, process, and outcome?

3. How does technology improve patient outcomes and the health-care system?

4. How can you intervene to improve quality of care and safety within the health-care system and at the bedside?

2. Select one nonprofit organization or one government agencies that influences and advocates for quality improvement in the health-care system. Explore the Web site for your selected organization/agency and answer the following questions:

What does the organization/agency do that supports the hallmarks of quality?

What have been the results of their efforts for patients, facilities, the health-care delivery system, or the nursing profession?

How has the organization/agency affected facilities where you are practicing and your own professional practice?

A nurse manager is reviewing occurrence reports of medical errors over the last six months. The nurse manager knows that medical errors are not the only indicator of quality of care. They are, however, a pervasive problem in the current health care system and one of the greatest threats to quality health care. The nurse manager is putting together a list of possible solutions to decrease the number of occurrences of medication errors.

1. Recognizing that health care errors affect at least one in every 10 patients around the world, the World Health Organizations World Alliance for Patient Safety and the Collaborating Centre identified priority program areas related to patient safety. What are the patient safety program areas the nurse manager should consider for implementation?

2. Describe the Joint Commission 2017 National Patient Safety Goals for Hospitals.

3. Discuss the Institute of Medicines four-pronged approach to reducing medical mistakes? 

 

You must answer the 4 questions 2 times. You must submit 2 documents (each one 1 page), in each one you must answer the 4 questions. Copy and paste will not be admitted. You should address the questions with different wording, different references, but always, objectively answering the questions.

_____________________________________________________________

1) **********minimum 1 full pages per document= total 2 pages ( not words)**************************** (cover or reference page not included) 

2)**********APA norms  ( All paragraphs need to be cited properly. All responses must be in a narrative format)

3)********** It will be verified by Turnitin and SafeAssign***************** 

___________________________________________________________

1) What is meditation?

2) Discuss the benefits of meditation? (mention at least 3). 

3 ) Is there any research study that support the benefits discussed in question 2? 

4) Have you ever practiced meditation? Discuss your experience?

____________________________________________________________

You must answer the 4 questions 2 times. You must submit 2 documents (each one 1 page), in each one you must answer the 4 questions. Copy and paste will not be admitted. You should address the questions with different wording, different references, but always, objectively answering the questions.

 

You must answer the 4 questions twice. You must submit two documents, in each one you must answer the 4 questions. Copy and paste will not be admitted. You should address the questions with different wording, different references, but always, objectively answering the questions.

1) **********minimum 3 full pages per each document = Total 6 pages ( not words)**************************** (cover or reference page not included) 

2)**********APA norms  ( All paragraphs need to be cited properly. All responses must be in a narrative format and each paragraph must have at least 4 sentences)

3)********** It will be verified by Turnitin and SafeAssign 

4) **********References from the last 5 years  

5) The points don’t be must copied in the work. It must be identified by numbers. 

For example

1) the differentiations are ……………………… the definitions …… …….

2) Health care and social issues are ………………..

3) The characteristicsh are

4) ………………………………..

__________________________________________________________

Read well:

You must answer the 4 questions twice. You must submit two documents, in each one you must answer the 4 questions. Copy and paste will not be admitted. You should address the questions with different wording, different references, but always, objectively answering the questions.

______________________________________________________________

 

1. Mention and discuss the differentiation between the medical model and social construct definitions of disability.
2. Identify and discuss selected health care and social issues that influence the ability of people with disabilities to live and thrive in the community.
3. Mention and discuss the characteristics of rural community health nursing practice.
4. Mention and describe the features of the health care system and population characteristics common to rural aggregates.

Minimum of 250 words with at least 2 peer review reference in 6th edition apa style.

 

Create a list of three differential diagnoses and explain why you would include them on your list, based on the following information:

Sheila Jones, a 28-year-old female, has been diagnosed with new onset diabetes. She is severely hyperglycemic requiring intubation and aggressive intensive care management. In conjunction with being severely hyperglycemic, she is profoundly dehydrated, hypernatremic, and tachycardic.

 You must answer the 4 questions twice. You must submit two documents, in each one you must answer the 4 questions. Copy and paste will not be admitted. You should address the questions with different wording, different references, but always, objectively answering the questions.

1) **********minimum 3 full pages per each document = Total 6 pages ( not words)**************************** (cover or reference page not included) 

2)**********APA norms  ( All paragraphs need to be cited properly. All responses must be in a narrative format and each paragraph must have at least 4 sentences)

3)********** It will be verified by Turnitin and SafeAssign 

4) **********References from the last 5 years  

5) The points don’t be must copied in the work. It must be identified by numbers. 

For example

1) It is important that nurses learn about this culture …….

2) It is important to focus the diabetic patient on ………………..

3) It is important to assess the feeding habits of the patient with

4) ………………………………..

__________________________________________________________

 

Read well:

You must answer the 4 questions twice. You must submit two documents, in each one you must answer the 4 questions. Copy and paste will not be admitted. You should address the questions with different wording, different references, but always, objectively answering the questions.

_______________________________________________________________

Question:

 

Diabetes has been emerging as a major public health concern among Native American communities in the United States for the past 40 years. The Pima Indians in Arizona currently have the highest recorded prevalence of diabetes in the world. On average, American Indian and Alaska Native adults are 2.6 times more likely to have diabetes than non-Hispanic Whites of similar age. Diet is a key factor in controlling blood glucose levels and preventing serious cardiac, renal, peripheral vascular, and retinal complications such as heart attacks, renal failure, limb amputations, and blindness.

An Indian Health Service (IHS) nurse visits a patient in her mobile home, located on an Arizona Indian reservation. The patient is a 72-year-old, obese, female Pima Indian with a blood glucose level of 280. She is at risk for serious complications of type 2, or noninsulin-dependent, diabetes mellitus. With type 2 diabetes, the body either resists the effects of insulin or doesnt produce enough insulin to maintain a normal blood glucose level. The patient lives with her adult daughter, two grandchildren, and five great-grandchildren. The nurses goals are to use culturally appropriate diet education to repattern the patients eating habits for the purpose of reducing the blood glucose level to normal (between 70 and 110 mg/dL); promoting steady sustained weight loss (5 pounds per week); encouraging increased exercise and activity. The nurse also asks the patient to participate in group sessions at the Pima Community Center focused on healthy food preparation and eating a balanced meal.

1. If you were a nurse who just began doing home health care on the Pima Reservation, how would you learn about the specific cultural beliefs and practices related to nutrition and diet for this patient as a member of the Pima Indian Nation, versus stereotypes about the diet of Native Americans in general?
2. Given that the patients family doesnt own a vehicle, how will you encourage her to shop for healthy foods, prepare them, and actively participate in weight loss and exercise programs held free of charge at the Pima Community Center?
3. How would you assess the patients eating habits, for example, type of food, method of preparation, amount eaten, etc.?
4. Each of the patients children, grandchildren, and great-grandchildren is obese. How would you involve the patients family in the plan of care and motive them to lose weight as well?