Compare two leadership theories. Provide an overview of each and discuss the strengths and weakness in relation to nursing practice.

An applicant’s professional history and qualifications are outlined in a resume. A cover letter is a way for the applicant to make a professional introduction to the hiring manager and demonstrate an interest in the company.

Develop a current resume and create a formal cover letter for a position for which you would like to apply. Create both the cover letter and resume using a professionally accepted format.

Include the following:

1. Resume: Detail your overall education, credentials, and professional experience, such as licenses, earned degrees, certifications, professional experiences, previous positions held, membership in professional organizations, publications, and skills.
2. Write a one-page double spaced introductory cover letter in which you explain your professional objectives, professional interests, and strengths as an applicant.
3. Prior to submission, share your resume with a colleague and obtain feedback. Revise your resume as needed

While APA style format is not required for the body of this assignment, solid academic writing is expected, and in-text citations and references should be presented using APA documentation guidelines, which can be found in the APA Style Guide, located in the Student Success Center.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion. 

You are required to submit this assignment to LopesWrite. Refer to the LopesWrite Technical Support articles for assistance.

I want to apply for ICU Director, I work as an ICU nurse.

Address the following questions.  

a.      What are some of the causes of lack of attentiveness?

b.      Discuss the legal challenges and the recommendations to increase attentiveness/surveillance in nursing.

Must address topic: Answer questions with a minimum of 250 words. APA style

Respond to this discussion . Add some facts with at least 2 citations APA Format

Discussion: Community-Acquired Pneumonia

                                                                                                              Case  Study

HH is a 68-yr M who has been admitted to the medical ward with community-acquired pneumonia for the past three days. His PMH is

significant for COPD, HTN, hyperlipidemia, and diabetes. He remains on empiric antibiotics, including ceftriaxone 1 g IV q day (day 3) and

azithromycin 500 mg IV q day (day 3). Since admission, his clinical status has improved, with decreased oxygen requirements. He is not tolerating a

diet at this time, complaining of nausea and vomiting. Ht: 5’8″ Wt: 89 kg Allergies: Penicillin (rash).

Diagnosis: Community-Acquired Pneumonia (CAP)

CAP is the term used to describe an acute infection of the lungs that develops outside the hospital setting by an immune-competent

individual who has not been recently hospitalized (Shoar & Musher, 2020). Adults with CAP typically present with cough, fever, sputum production or

shortness of breath, oxygen desaturation, confusion, leukocytosis or leukopenia, and pleuritic chest pain, along with the presence of an acute

infiltrate on the chest radiograph (Shoar & Musher, 2020).

Antibiotic suggested for CAP’s empiric treatment is based on agents useful against CAP’s major treatable bacterial causes. The bacterial

pathogens responsible for CAP include Streptococcus pneumoniae, Mycoplasma pneumoniae, Chlamydia pneumoniae, Haemophilus

influenzae, Staphylococcus aureus, Legionella species, and Moraxella catarrhalis (Metlay et al., 2019).

The patient is on right treatment, his clinical status has improved, with decreased oxygen requirement. Recommended treatment plan for

patients with comorbidities such as alcoholism, COPD, post influenza, asplenia, diabetes mellitus, lung/liver/renal diseases include: Combination

of a beta-lactam (ceftriaxone 1 g IV q24h or cefotaxime 1 g IV q8h or ceftaroline 600 mg IV q12h) plus azithromycin 500 mg IV q24h (Donovan, 2019).

The therapy duration is a minimum of 5 days. The patient needs to be afebrile for 48-72 hours, controlled blood pressure, adequate oral intake, and

room air oxygen saturation of greater than 90% and treatment duration can be extended if symptoms are not recovered in some cases (Donovan,

2019).

             In this case, the patient symptoms are improving, his oxygen requirement is decreased, but he is not tolerating a diet at this time,

complaining of nausea and vomiting. The patient received antibiotics for three days, so antibiotics need to be continued. With appropriate antibiotic

therapy, some improvement in the patient’s clinical course is usually seen within 48 to 72 hours (File, 2020).

                                                                                     Health Needs and Treatment Regimen

The patient is not tolerating diet and complaining of nausea and vomiting. Gastrointestinal (GI) manifestations such as nausea, vomiting,

and diarrhea are considered possibly due to adverse drug (antibiotics) effects (Lin et al., 2009). Changing the antibiotic can help patients to avoid

these side effects. Levofloxacin 750 mg IV or PO q24h is a recommended dose to treat CAP patients (Donovan, 2019).

              Levofloxacin possesses greater bioavailability and a longer serum half-life that allows for rapid step-down from intravenous administration

to oral therapy, minimizing unnecessary hospitalization, which may decrease costs and improve patient quality of life (Lynch III et al., 2006). Several

randomized clinical trials to evaluate levofloxacin to treat CAP demonstrate that levofloxacin is effective and safe for CAP treatment, displaying

relatively mild adverse effects. Levofloxacin has much to offer in terms of bacterial eradication (Lynch III et al., 2006). The other studies also

concluded that monotherapy with oral levofloxacin is as effective as treatment with Ceftriaxone plus, Azithromycin combination in patients with CAP

who required hospitalization (Izadi et al., 2019).

             Probiotics can be added to the treatment plan. Probiotics replenish the natural GI flora with nonpathogenic organisms. Few studies found

probiotics to be useful for preventing and treating antibiotic-associated diarrhea related to antibiotic treatment (Rodgers et al., 2013).

An antiemetic medication such as ondansetron can be added. It is a selective 5-HT3 serotonin-receptor antagonist and acts on central and

peripheral areas to prevent and treat nausea and vomiting (Griddine & Bush, 2020).

As the patient is diabetic, his blood sugar needs to monitor carefully because of sickness, nausea, and vomiting. Sliding scale insulin (SSI) is

recommended. Both hyperglycemia and hypoglycemia in hospitalized patients result in adverse outcomes, including increased infection rates,

longer hospital length of stay, and even death. The use of oral antidiabetic treatments during hospitalization is generally not recommended because

of their safety and efficacy and their significant risk of hypoglycemia and contraindications (Marín-Peñalver et al., 2016).

                                                             Patient Education for the management of Their Health Needs

The patient needs to be educated and encouraged to use an incentive spirometer (IS). Incentive spirometry is commonly used to break up

fluid that builds up in the lungs in people with pneumonia. IS helps to open the airways and help manage COPD symptoms (Yetman, 2020).

The patient needs to be educated about importance of the pneumococcal conjugate vaccine (PCV) and influenza vaccines.

As per International Journal of Chronic Obstructive Pulmonary Disease study, these vaccines decrease the risk of exacerbations in patients with

chronic obstructive pulmonary disease (COPD) (Ely, 2018). Patients over 65 years of age are more susceptible to community-acquired pneumonia

(CAP), and COPD patients are 20 times more prone to develop CAP (Ely, 2018). The Community-Acquired Pneumonia Immunization Trial in Adults

(CAPITA) provided evidence of the benefits of vaccinating with PCV13, which protects against 13 pneumococcal bacteria types (Ely, 2018).

              At the time of discharge, the patient needs to be educated to continue his home medications and finish the prescription of antibiotics if

prescribed, even if he starts to feel better. Taking the entire course of antibiotics is one way to prevent recurring and more severe infections and

combat antibiotic resistance (Rosenthal & Burchum, 2020).

                                                                                                                Conclusion

              Community-acquired pneumonia (CAP) is one of the most common acute infections requiring hospital admission. Age is a dominant risk

factor, with CAP’s incidence increasing markedly in patients who are over 65 years of age. Aging increases the mucosal cell surface protein

expression that bacteria can adhere to, enabling potential pathogens to avoid normal clearance mechanisms better. There is evidence that age

directly affects innate and adaptive immunity, a process called immunosenescence, which weakens lung immunity to invading microbes (Brown,

2012). Few behavior changes like quitting smoking and alcohol abuse and administering the vaccine can prevent or decrease CAP’s severity.

References

Brown, J. S. (2012). Community-acquired pneumonia. Clinical Medicine, 12(6), 538–543. https://doi.org/10.7861/clinmedicine.12-6-538

Donovan, F. M. (2019). Community-acquired pneumonia empiric therapy: Empiric therapy regimens. https://emedicine.medscape.com/article/2011819-

overview

Ely, K. (2018). Study Shows the Efficacy of Vaccination in Patients With COPD. https://www.ajmc.com/view/study-shows-the-efficacy-of-vaccination-in-

patients-with-copd

File, T. M. (2020). Treatment of community-acquired pneumonia in adults who require hospitalization. UpToDate.

https://www.uptodate.com/contents/treatment-of-community-acquired-pneumonia-in-adults-who-require-hospitalization

Griddine, A., & Bush, J. S. (2020). Ondansetron – statpearls – ncbi bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK499839/

Izadi, M., Dadsetan, B., Najafi, Z., Jafari, S., Mazaheri, E., Dadras, O., Heidari, H., SeyedAlinaghi, S., & Voltarelli, F. (2019). Levofloxacin versus

            ceftriaxone and azithromycin combination in the treatment of community acquired pneumonia in hospitalized patients. Recent Patents on

            Anti-Infective Drug Discovery, 13(3), 228–239. https://doi.org/10.2174/1574891×13666181024154526

Lin, R. Y., Nuruzzaman, F., & Shah, S. N. (2009). Incidence and impact of adverse effects to antibiotics in hospitalized adults with pneumonia. Journal

             of Hospital Medicine, 4(2), E7–E15. https://doi.org/10.1002/jhm.414

Lynch III, J. P., File Jr, T. M., & Zhanel, G. G. (2006). Levofloxacin for the treatment of community-acquired pneumonia. Expert Review of Anti-infective

            Therapy, 4(5), 725–742. https://doi.org/10.1586/14787210.4.5.725

Marín-Peñalver, J., Martín-Timón, I., & del Cañizo-Gómez, F. (2016). Management of hospitalized type 2 diabetes mellitus patients. Journal of

           Translational Internal Medicine, 4(4), 155–161. https://doi.org/10.1515/jtim-2016-0027

Metlay, J. P., Waterer, G. W., Long, A. C., Anzueto, A., Brozek, J., Crothers, K., Cooley, L. A., Dean, N. C., Fine, M. J., Flanders, S. A., Griffin, M. R.,

           Metersky, M. L., Musher, D. M., Restrepo, M. I., & Whitney, C. G. (2019). Diagnosis and treatment of adults with community-acquired

           pneumonia. an official clinical practice guideline of the american thoracic society and infectious diseases society of america. American Journal

           of Respiratory and Critical Care Medicine, 200(7), e45–e67. https://doi.org/10.1164/rccm.201908-1581st

Rodgers, B., Kirley, K., & Mounsey, A. (2013). Prescribing an antibiotic? pair it with probiotics. PubMed Central (PMC).

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3601687

Rosenthal, L. D., & Burchum, J. R. (2020). Lehne’s pharmacotherapeutics for advanced practice nurses and physician assistants (2nd ed.). Saunders.

Shoar, S., & Musher, D. M. (2020). Etiology of community-acquired pneumonia in adults: A systematic review. Pneumonia, 12(1).

https://doi.org/10.1186/s41479-020-00074-3

Yetman, D. (2020). Incentive spirometer: What it’s for and how to use it. Healthline. https://www.healthline.com/health/incentive-spirometer

Module 3 – Case

GLOBAL, ENVIRONMENTAL, AND CULTURAL ASPECTS OF HEALTH

Assignment Overview

Global health is about worldwide improvement of health, reduction of disparities, and protection against global threats that disregard national borders. Regardless of where people live, their cultures and environments influence their health behaviors. In this assignment, you will explore concepts of Global, Environmental, and Cultural Aspects of Health as they relate to an outbreak among your specific target immigrant population.

Case Assignment

• Construct a table in which you use the PEN-3 Model as your framework to identify cultural influences on health that you must consider in addressing prevention and management of the outbreak among your chosen population. 
• Remember to include cultural factors that increase the occurrences of vaccine-preventable disease outbreaks among your population as well as cultural factors that influence vaccination adherence.
• See the table example provided.
• Note that in the column on the left you must add what the P, E, and N represent within each domain and clearly address each one. 

PEN-3 Domains

PEN-3 Domains

Positive

Negative 

Existential

Cultural Identity
P
E
N

Relationships
P
E
N

Cultural Empowerment
P
E
N

 Assignment Expectations

Length: 3 pages, excluding title page and references. You can single-space the table.

Assessment and Grading: Your paper will be assessed based on the performance assessment rubric. You can view it under Assessments at the top of the page. Review it before you begin working on the assignment. Your work should also follow these Assignment Expectations.