Powerpoint on a PICOT question|2025

/in /by

Assignment: Evidence-Based Project, Part 3: Advanced Levels of Clinical Inquiry and Systematic Reviews

Your quest to purchase a new car begins with an identification of the factors important to you. As you conduct a search of cars that rate high on those factors, you collect evidence and try to understand the extent of that evidence. A report that suggests a certain make and model of automobile has high mileage is encouraging. But who produced that report? How valid is it? How was the data collected, and what was the sample size?

In this Assignment, you will delve deeper into clinical inquiry by closely examining your PICO(T) question. You also begin to analyze the evidence you have collected.

To Prepare:

· Review the Resources and identify a clinical issue of interest that can form the basis of a clinical inquiry.

· Develop a PICO(T) question to address the clinical issue of interest for the Assignment.

· Use the key words from the PICO(T) question you developed and search at least four different databases in the Walden Library to identify at least four relevant peer-reviewed articles at the systematic-reviews level related to your research question.

· Reflect on the process of creating a PICO(T) question and searching for peer-reviewed research.

The Assignment (Evidence-Based Project)

Part 3: Advanced Levels of Clinical Inquiry and Systematic Reviews

Create a 6- to 7-slide PowerPoint presentation in which you do the following:

· Identify and briefly describe your chosen clinical issue of interest.

· Describe how you developed a PICO(T) question focused on your chosen clinical issue of interest.

· Identify the four research databases that you used to conduct your search for the peer-reviewed articles you selected.

· Provide APA citations of the four peer-reviewed articles you selected.

· Describe the levels of evidence in each of the four peer-reviewed articles you selected, including an explanation of the strengths of using systematic reviews for clinical research. Be specific and provide examples.

 

RESOURCES

https://catalog.loc.gov/vwebv/ui/en_US/htdocs/help/searchBoolean.html

Davies, K. S. (2011). Formulating the evidence based practice question: A review of the frameworks for LIS professionals. Evidence Based Library and Information Practice, 6(2), 75–80. https://doi.org/10.18438/B8WS5N.

 

Stillwell, S. B., Fineout-Overholt, E., Melnyk, B. M., & Williamson, K. M. (2010a). Evidence-based practice, step by step: Asking the clinical question: A key step in evidence-based practice. American Journal of Nursing, 110(3), 58–61. doi:10.1097/01.NAJ.0000368959.11129.79.

 

Melnyk, B. M., Fineout-Overholt, E., Stillwell, S. B., & Williamson, K. M. (2009). Evidence-based practice: Step by step: Igniting a spirit of inquiry. American Journal of Nursing, 109(11), 49–52. doi:10.1097/01.NAJ.0000363354.53883.58. Retrieved from https://journals.lww.com/ajnonline/fulltext/2009/11000/Evidence_Based_Practice__Step_by_Step__Igniting_a.28.aspx

 

Stillwell, S. B., Fineout-Overholt, E., Melnyk, B. M., & Williamson, K. M. (2010b). Evidence-based practice, step by step: Searching for the evidence. American Journal of Nursing, 110(5), 41–47. doi:10.1097/01.NAJ.0000372071.24134.7e. Retrieved from https://journals.lww.com/ajnonline/Fulltext/2010/05000/Evidence_Based_Practice,_Step_by_Step__Searching.24.aspx

 

 

DISCUSSION POST WITH MY ORIGINAL PICOT QUESTION .

A PICOt question will yield the most relevant and best evidence from a search of existing literature (Melnyk & Fineout-Overholt, 2019, p. 17). PICOt stand for the following;

P- Population, Problem, or patient

I- Intervention/Exposure

C- Comparative Intervention/Exposure

O- Outcome

t- Time

PICOt approach will provide an initial basis for mutual understanding, communication, and direction to help answer clinical study questions(Riva, Malik, Burnie, Endicott, & Busse, 2012).

When formulating my PICOt question, I first wrote down my general question Does music therapy help with outbursts on the Senior Behavioral Health Unit. Then by using the PICOt formula, I was able to rewrite my question to:

In Geriatric patients over 50 years old with Dementia and behavioral outbursts (P) does music therapy (I) reduce behavioral outbursts (O) compared to no music therapy (C) in two weeks (t)?

For my question, I decided to use PsycArticles and PsycINFO since my questions are psych related. My results were the following:

PsycINFO

Behavioral Outbursts & Music Therapy – 0 results

Dementia & Music Therapy- 281 results

Dementia & Music Therapy & 2 weeks- 9 results

Geriatric & Music Therapy- 153 results

Geriatric & Music Therapy & Behavioral outbursts- 0 results

Geriatric & Dementia & Music Therapy- 67 results

Geriatric & Dementia & Outbursts- 0 results

 

PsycARTICLES

Behavioral Outbursts & Music Therapy- 0 results

Dementia & Music Therapy- 4 results

Dementia & Music Therapy & 2 weeks- 0 results

Geriatric & Music Therapy- 3 results

Geriatric & Music Therapy & Behavioral outbursts- 0 results

Geriatric & Dementia & Music Therapy- 3 results

Geriatric & Dementia & Outbursts- 0 results

The number of results decreased after I added more words and interchanged words. I had better results with PsycINFO than I did with PsycARTICLES. To increase the rigor and effectiveness, one needs to consider all areas of the PICOt question. One can also relook at their PICOt question to make sure it is correctly worded, does it need to be reworded, and are you missing a part of the question. Once you relook at your question a new search can be completed. This is something I will be utilizing throughout my nursing career now.

 

Needs help with similar assignment?

We are available 24x7 to deliver the best services and assignment ready within 3-4 hours? Order a custom-written, plagiarism-free paper

Get Answer Over WhatsApp Order Paper Now

Middle Range or Interdisciplinary Theory Evaluation|2025

/in /by

Assignment 2: Middle Range or Interdisciplinary Theory Evaluation

 

As addressed this week, middle range theories are frequently used as a framework for exploring nursing practice problems. In addition, theories from other sciences, such as sociology and environmental science, have relevance for nursing practice. For the next few weeks you will explore the use of interdisciplinary theories in nursing.

This Assignment asks you to evaluate two middle range or interdisciplinary theories and apply those theories to a clinical practice problem. You will also create a hypothesis based upon each theory for an evidence-based practice project to resolve a clinical problem.

Note: This Assignment will serve as your Major Assessment for this course.

 

To prepare:

 

  • Review strategies for evaluating theory presented by Fawcett and Garity in this week’s Learning Resources (see under list of Required Readings and attached pdf file)
  • Select a clinical practice problem that can be addressed through an evidence-based practice project. Note: You may continue to use the same practice problem you have been addressing in earlier Discussions and in Week 7 Assignment 1.
  • Consider the middle range theories presented this week, and determine if one of those theories could provide a framework for exploring your clinical practice problem. If one or two middle range theories seem appropriate, begin evaluating the theory from the context of your practice problem.
  • Formulate a preliminary clinical/practice research question that addresses your practice problem. If appropriate, you may use the same research question you formulated for Assignment #4.

Write a 10- to 12-page paper (including references) in APA format and a minimum of 8 references or more, using material presented in the list of required readings to consider interdisciplinary theories that may be appropriate for exploring your practice problem and research question (refer to the sample paper attached as “Assignment example”). Include the level one headings as numbered below:

1)       Introduction with a purpose statement (e.g. The purpose of this paper is…)

2)       Briefly describe your selected clinical practice problem.

3)       Summarize the two selected theories. Both may be middle range theories or interdisciplinary theories, or you may select one from each category.

4)       Evaluate both theories using the evaluation criteria provided in the Learning Resources.

5)       Determine which theory is most appropriate for addressing your clinical practice problem. Summarize why you selected the theory. Using the propositions of that theory, refine your clinical / practice research question.

6)       conclusion

MY PRACTICE PROBLEM IS AS FOLLOWED:

 

P: Patients suffering from Type 2 Diabetes Mellitus

 

I:  Who are involved in diabetic self-care programs

 

C: Compared to those who do not participate in self-care programs

 

O: Are more likely to achieve improved glycemic control

 

THE THEORIES USED FOR THIS MODEL ARE:

Dorothea Orem Self-Care Theory and The Self-Efficacity in nursing Theory by Lenz & Shortridge-Baggett, or the Health Promotion Model by Pender, Murdaugh & Parson (Pick 2)

 

Required Readings

 

McEwin, M., & Wills, E.M. (2014). Theoretical basis for nursing. (4th ed.). Philadelphia, PA: Wolters Kluwer Health.

  • Chapter 10, “Introduction to Middle Range Nursing Theories”

Chapter 10 begins the exploration of middle range theories and discusses their development, refinement, and use in research.

  • Chapter 11, “Overview of Selected Middle Range Nursing Theories”

Chapter 11 continues the examination of middle range theories and provides an in-depth examination of a select set of theories

·         Chapter 15, “Theories from the Biomedical Sciences”

Chapter 15 highlights some of the most commonly used theories and principles from the biomedical sciences and illustrates how they are applied to studies conducted by nurses and in nursing practice.

·         Chapter 16, “Theories, Models, and Frameworks from Administration and Management”

Chapter 16 presents leadership and management theories utilized in advanced nursing practice.

·         Chapter 18, “Application of Theory in Nursing Practice”

Chapter 18 examines the relationship between theory and nursing practice. It discusses how evidence-based practice provides an opportunity to utilize research and theory to improve patient outcomes, health care, and nursing practice.

 

 

 

 

Gray, J.R., Grove, S.K., & Sutherland, S. (2017). Burns and Grove’s the practice of nursing research: Appraisal, synthesis, and generation of evidence (8th ed.). St. Louis, MO: Saunders Elsevier.

  • Chapter 6, “Objectives, Questions, Variables, and Hypotheses”

Chapter 6 guides nurses through the process of identifying research objectives, developing research questions, and creating research hypotheses.

·         Review Chapter 2, “Evolution of Research in Building Evidence-Based Nursing Practice”

·         Chapter 19, “Evidence Synthesis and Strategies for Evidence-Based Practice”

This section of Chapter 19 examines the implementation of the best research evidence to practice.

 

 

 

Fawcett, J., & Garity, J. (2009). Chapter 6: Evaluation of middle-range theories. Evaluating Research for Evidence-Based Nursing. Philadelphia, Pennsylvania: F. A. Davis.

Note: You will access this article from the Walden Library databases.

This book chapter evaluates the use and significance of middle-range theories in nursing research and clinical practice.

 

DeSanto-Madeya, S., & Fawcett, J. (2009). Toward Understanding and Measuring Adaptation Level in the Context of the Roy Adaptation Model. Nursing Science Quarterly, 22(4), 355–359.

Note: You will access this article from the Walden Library databases.

This article describes how the Roy Adaptation Model (RAM) is used to guide nursing practice, research, and education in many different countries.

Jacelon, C., Furman, E., Rea, A., Macdonald, B., & Donoghue, L. (2011). Creating a professional practice model for postacute care: Adapting the Chronic Care Model for long-term care. Journal of Gerontological Nursing, 37(3), 53–60.

Note: You will access this article from the Walden Library databases.

This article addresses the need to redesign health care delivery to better meet the needs of individuals with chronic illness and health problems.

 

Murrock, C. J., & Higgins, P. A. (2009). The theory of music, mood and movement to improve health outcomes. Journal of Advanced Nursing, 65 (10), 2249–2257. doi:10.1111/j.1365-2648.2009.05108.x

Note: You will access this article from the Walden Library databases.

This article discusses the development of a middle-range nursing theory on the effects of music on physical activity and improved health outcomes.

 

 

Amella, E. J., & Aselage, M. B. (2010). An evolutionary analysis of mealtime difficulties in older adults with dementia. Journal of Clinical Nursing, 19(1/2), 33–41. doi:10.1111/j.1365-2702.2009.02969.x

Note: You will access this article from the Walden Library databases.

This article presents findings from a meta-analysis of 48 research studies that examined mealtime difficulties in older adults with dementia.

 

Frazier, L., Wung, S., Sparks, E., & Eastwood, C. (2009). Cardiovascular nursing on human genomics: What do cardiovascular nurses need to know about congestive heart failure? Progress in Cardiovascular Nursing, 24(3), 80–85.

Note: You will access this article from the Walden Library databases.

This article discusses current genetics research on the main causes of heart failure.

 

Mahon, S. M. (2009). Cancer Genomics: Cancer genomics: Advocating for competent care for families. Clinical Journal of Oncology Nursing, 13(4), 373–3 76.

Note: You will access this article from the Walden Library databases.

This article advocates for nurses to stay abreast of the rapid changes in cancer prevention research and its application to clinical practice.

 

Mayer, K. H., Venkatesh, K. K. (2010). Antiretroviral therapy as HIV prevention: Status and prospects. American Journal of Public Health, 100(10), 1867–1 876. doi: 10.2105/AJPH.2009.184796

Note: You will access this article from the Walden Library databases.

This article provides an in-depth examination of potential HIV transmission prevention.

 

Pestka, E. L., Burbank, K. F., & Junglen, L. M. (2010). Improving nursing practice with genomics. Nursing Management, 41(3), 40–44. doi: 10.1097/01.NUMA.0000369499.99852.c3

Note: You will access this article from the Walden Library databases.

This article provides an overview of genomics and how nurses can apply it in practice.

 

Yao, L., & Algase, D. (2008). Emotional intervention strategies for dementia-related behavior: A theory synthesis. The Journal of Neuroscience Nursing, 40(2), 106–115.

Note: You will access this article from the Walden Library databases.

This article discusses a new model that was developed from empirical and theoretical evidence to examine intervention strategies for patients with dementia.

 

Fineout-Overholt, E., Williamson, K., Gallagher-Ford, L., Melnyk, B., & Stillwell, S. (2011). Following the evidence: Planning for sustainable change. The American Journal Of Nursing, 111(1), 54–60.

This article outlines the efforts made as a result of evidence-based practice to develop rapid response teams and reduce unplanned ICU admissions.

 

Kleinpell, R. (2010). Evidence-based review and discussion points. American Journal of Critical Care, 19(6), 530–531.

This report provides a review of an evidence-based study conducted on patients with aneurismal subarachnoid hemorrhage and analyzes the validity and quality of the research.

 

Koh, H. (2010). A 2020 vision for healthy people. The New England Journal Of Medicine, 362(18), 1653–1656.

This article identifies emerging public health priorities and helps to align health-promotion resources, strategies, and research.

 

Moore, Z. (2010). Bridging the theory-practice gap in pressure ulcer prevention. British Journal of Nursing, 19(15), S15–S18.

This article discusses the largely preventable problem of pressure ulcers and the importance of nurses being well-informed of current prevention strategies.

 

Musker, K. (2011). Nursing theory-based independent nursing practice: A personal experience of closing the theory-practice gap. Advances In Nursing Science, 34(1), 67–77.

This article discusses how personal and professional knowledge can be used in concert with health theories to positively influence nursing practice.

 

Roby, D., Kominski, G., & Pourat, N. (2008). Assessing the barriers to engaging challenging populations in disease management programs: The Medicaid experience. Disease Management & Health Outcomes, 16(6), 421–428.

This article explores the barriers associated with chronic illness care and other factors faced by disease management programs for Medicaid populations.

 

Sobczak, J. (2009). Managing high-acuity-depressed adults in primary care. Journal of the American Academy of Nurse Practitioners, 21(7), 362–370. doi: 10.1111/j.1745-7599.2009.00422.x

This article discusses a method found which positively impacts patient outcomes used with highly-acuity-depressed patients.

 

Thorne, S. (2009). The role of qualitative research within an evidence-based context: Can metasynthesis be the answer? International Journal of Nursing Studies, 46(4), 569–575. doi: 10.1016/j.ijnurstu.2008.05.001

The article explores the use of qualitative research methodology with the current evidence-based practice movement.

 

 

 

Optional Resources

 

McCurry, M., Revell, S., & Roy, S. (2010). Knowledge for the good of the individual and society: Linking philosophy, disciplinary goals, theory, and practice. Nursing Philosophy, 11(1), 42–52.

 

Calzone, K. A., Cashion, A., Feetham, S., Jenkins, J., Prows, C. A., Williams, J. K., & Wung, S. (2010). Nurses transforming health care using genetics and genomics. Nursing Outlook, 58(1), 26–35. doi: 10.1016/j.outlook.2009.05.001

 

McCurry, M., Revell, S., & Roy, S. (2010). Knowledge for the good of the individual and society: Linking philosophy, disciplinary goals, theory, and practice. Nursing Philosophy, 11(1), 42–52.

Needs help with similar assignment?

We are available 24x7 to deliver the best services and assignment ready within 3-4 hours? Order a custom-written, plagiarism-free paper

Get Answer Over WhatsApp Order Paper Now

the public perception of nursing|2025

/in /by

Discuss factors that influence the public’s perception of nursing? Describe ways to educate the general public on the professional nurse’s role and scope of nursing within a changing health care

The general public has different perceptions and opinions about nursing as a profession. Some of these views are stereotypical and are tainted with misinformation. However, many people perceive nursing as a noble profession that involves a high level of selflessness. They believe that a nurse’s primary role is to provide care to persons who need it without discrimination. On the other hand, people assume that nursing is a field specifically designed for women, not knowing that male nurses contribute significantly to medical practice (Dickerson, 2015).

Several factors influence how the public views nursing. Firstly, the media portrays nurses’ image and their line of work that is far from reality. Nurses are usually depicted in a flirtatious manner with pictures showing slim figures and flashy dressing. This creates a flawed expectation of how a typical nurse should appear and behave. Past experiences with nursing also inform public perception. Experience is the best teacher, and it is only through this that people can form accurate opinions. The public can be educated about a nurse’s role and the scope of nursing in numerous ways. The media can be an instrumental tool to conduct mass education about who a nurse is, the educational credentials and level of training required to qualify an individual as a nurse, and the extent of practice (Yvonne ten Hoeve, 2014).

References

Dickerson, P. (2015). Changing Views: Influencing How the Public Sees Nursing. ALD Publishing, From https://www.nursingald.com/articles/13112-changing-views-influencing-how-the-public-sees-nursing.

Yvonne ten Hoeve, G. J. (2014). The nursing profession: public image, self‐concept, and professional identity. A discussion paper. Journal of Advanced Nursing, https://doi.org/10.1111/jan.12177.

system.

Needs help with similar assignment?

We are available 24x7 to deliver the best services and assignment ready within 3-4 hours? Order a custom-written, plagiarism-free paper

Get Answer Over WhatsApp Order Paper Now

Clinical Worksheet Plan of Care Concept Map|2025

/in /by

1) Patient Introduction

Olivia Jones is a 23-year-old African-American female, G1P0 at 36 weeks of gestation. She has been diagnosed with severe preeclampsia and is admitted to the labor and delivery unit for assessment and surveillance.

Pregnancy has been unremarkable until routine prenatal visit at 30 weeks with elevated blood pressure at 146/92 mm Hg, proteinuria, and developing mild preeclampsia. She has been on bed rest at home until prenatal visit today with increasing symptoms, resulting in admission.

She has gained 3 pounds since prenatal visit 1 week ago. Protein dipstick is +4, negative ketones, negative glucose, +2 dependent edema, and facial puffiness.

Ms. Jones is complaining of a headache that is not resolved with acetaminophen. She presents with nausea and fatigue and complaining of epigastric pain, visual changes, and chest tightness. The fetus is active; however, patient states that it is a bit quieter than normal. There is a possibility of premature rupture of membranes. An IV with lactated Ringer’s is running at 125 mL/hr. Labs were obtained.

Medication: Magnesium sulfate (injection)

 

2 Patient Introduction

Brenda Patton is an 18-year-old Caucasian female, G1P0 at 38 2/7 weeks of gestation admitted to the labor and birthing unit for labor assessment.

The patient states that her water may have broken earlier this morning and she thinks she is in labor. AmniSure was positive. Vaginal exam reveals 50% effacement of cervix, cervical dilation 4 cm, and fetus at -2 station.

The patient’s boyfriend is present, and she has phoned her mother to inform her of her admission. The provider has been notified, and prenatal records have been pulled.

The lab report indicates that the patient’s group B strep vaginorectal culture taken at 36 weeks was positive. The patient wishes to have a natural birth without medication. Admission intrapartum orders have been initiated, initial labs have been drawn, and a saline lock has been placed in her forearm.

Medication: Promethazine hydrochloride

 

3 Patient Introduction

Amelia Sung is a 36-year-old Filipino female, G2P1 (L1) at 39 weeks of gestation, who was admitted 24 hours ago for induction of labor.

First-born male delivered vaginally 3 years and 3 months ago. Weight: 3,345 g (7 lb 6 oz). Length 55 cm (22 in).

She was started on oxytocin at 1 mL/1 mU, and the infusion was increased throughout the day per protocol. A mainline IV of lactated Ringer’s is running at 125 mL/hr, and oxytocin (30 units in 500 mL normal saline) is running at 20 mU/min (20 mL/hr).

Her cervical exam at admission was 2 cm dilation, 80% effaced, at -1 station, with fetus in vertex position. At 0100 hours, dilation was 4 cm, 100% effaced, still at -1 station and fetus in vertex position. She received an epidural shortly after that, and 1 hour later, her membranes ruptured; the fluid was clear.

Three hours ago, she was fully dilated and started pushing. The fetal heart rate has been stable with a baseline of 120/min, moderate variability, and early decelerations since she started pushing. She is getting tired from pushing, and the descent of the fetal head has been slow.

During the past few contractions, the baby has started to crown. The provider has been called and has arrived, so Amelia may continue pushing.

Medication: Oxytocin

 

4 Patient Introduction

Carla Hernandez is a 32-year-old Hispanic female, G2P1 (L1), at 39 5/7 weeks of gestation. She was admitted to labor and delivery in active labor at 0600 hours today, accompanied by her husband Earl.

To progress the delivery, artificial rupture of membranes was performed by the provider a few minutes ago. The provider has just left the room to make rounds.

Suddenly, the fetal heart rate drops dramatically, and you discover that the umbilical cord is prolapsed. You are ready to handle this situation with another nurse who is also present in the room.

Medication: Terbutaline sulfate

 

 

5 Patient Introduction

Fatime Sanogo is a 23-year-old primiparous female from Mali in her first hour after vaginal delivery. The patient was admitted yesterday at 0600 hours for oxytocin induction of labor secondary to postdates (41 4/7 weeks). She declined all pain medication during labor.

Following a prolonged second stage, she delivered a vigorous female infant at 0605 hours with Apgar scores of 9 and 9 and weight of 4,082 g (9 lb 0 oz). The patient contracted a second-degree perineal laceration during delivery; this has been repaired.

Placenta was delivered manually at 0635 hours via Dr. Schultz. Bleeding was controlled by fundal massage and infusion of remaining oxytocin induction bag, which is still running at 20 mL/hr (20 mU/min); approximately 100 mL left in the bag.

The patient was just up to the bathroom and couldn’t void. She is now dozing, and the father of the baby is at the bedside, holding the baby and sending text messages from the phone. Fatime does not speak English fluently, as she has only been in the country for 7 months. You enter the room to assume care of the patient and to perform the second of four assessments every 15 minutes.

Medication: Misoprostol

 

 

Needs help with similar assignment?

We are available 24x7 to deliver the best services and assignment ready within 3-4 hours? Order a custom-written, plagiarism-free paper

Get Answer Over WhatsApp Order Paper Now

Soap Note 2 topic|2025

/in /by

Soap notes will be uploaded to Moodle and put through TURN-It-In (anti-Plagiarism program)
Follow the MRU Soap Note Rubric as a guide

Turn it in Score must be less than 15% or will not be accepted for credit, must be your own work and in your own words. You can resubmit, Final submission will be accepted if less than 15%. Copy paste from websites or textbooks will not be accepted or tolerated. Please see College Handbook with reference to Academic Misconduct Statement

Needs help with similar assignment?

We are available 24x7 to deliver the best services and assignment ready within 3-4 hours? Order a custom-written, plagiarism-free paper

Get Answer Over WhatsApp Order Paper Now

Soap Note Assignment|2025

/in /by

Patient information to complete the soap note. please see attachment

39-year-old Male with epigastric pain

Chief Compliant: “I’ve been having this abdominal pain, and it just seems like it won’t go away. It started probably a year ago. It used to happen a few times a week, now it hurts every day.”

History of Present Illness: Mr. Rodriguez is a 39-year-old male that recently immigrated to the United States from Dominican Republic. He complains of epigastric pain that began approximately one year ago. He describes the pain as “burning” and occurring daily. He states that the pain sometimes worsens with eating and sometimes it improves. He states that spicy foods make the pain worsen. He admits to weekly NSAID usage and drinking 3-4 alcoholic beverages a week. He quit smoking 6 months ago. He drinks an herbal tea but does not experience any relief or change in the symptoms. He denies any fever, chills, nausea, hematemesis, hematochezia, or melena.

PMH/Medical/Surgical History: No history of gastrointestinal problems in the past. No history of surgery. No known drug allergies.

Medications: Takes ibuprofen “almost daily” for aches and pains associated with working. Drinks herbal tea meant to improve GI symptoms.

Significant Family History: Patient states family history of heart disease. Father had hypertension and his mother had diabetes.

Social History: Patient denies smoking. Patient states that he quit smoking 6 months ago. Patient states that he drinks 3-4 beers weekly.  No illicit drugs.

Review of Symptoms:

GENERAL:  39-year-old Spanish speaking patient. Language interpreter present. Patient is alert and oriented. Afebrile. Patient denies recent, unexplained weight loss, fever, chills, weakness or fatigue.

HEENT:  Denies headache, change in vision, nose, or ear problems. Denies sore throat.

SKIN:  No change in skin, hair or nails.

CARDIOVASCULAR:  Regular heart rate and rhythm. S1, S2, no murmurs, rubs, or gallops.

RESPIRATORY:  clear to auscultation.

GASTROINTESTINAL:  Soft, flat, non-distended. Normoactive bowel sounds heard in four quadrants. Soft, non-distended, with minimal epigastric tenderness on deep palpation without rebound tenderness or guarding, no hepatosplenomegaly, and no hernia or masses.

GENITOURINARY: Denies problems with urination.

NEUROLOGICAL:  No headache, dizziness, syncope, paralysis, ataxia, numbness or tingling in the extremities. No change in bowel or bladder control.

MUSCULOSKELETAL:  Alert & oriented x3. Denies muscle, back pain, joint pain or stiffness.

HEMATOLOGIC:  Denies anemia, bleeding or bruising.

LYMPHATICS:  No enlarged nodes. Denies history of splenectomy.

PSYCHIATRIC:  Denies history of depression or anxiety. Patient does express concern about paying for medications and follow up visits due to lack of insurance.

ENDOCRINOLOGIC:  Denies sweating, cold or heat intolerance. Denies polyuria or polydipsia..

Objective Data:

  • Temperature: 98.5 Fahrenheit
  • Heart rate: 78 beats/minute, regular
  • Respiratory rate: 16 breaths/minute
  • Blood pressure: 133/82 mmHg
  • Body Mass Index: 24.8 kg/m2- This BMI is within normal range according to the National Heart, Lung, and Blood Institute (2017).

Physical Assessment Findings: Patient is alert, oriented and is cooperative.

HEENT:  PERRLA, no nystagmus noted. Tympanic membranes are intact. External auditory canals are normal. Oral pharynx is normal without erythema or exudate. Tongue and gums are normal.

Lymph Nodes:  Non-palpable

Carotids: equal bilaterally 2+

Lungs:  clear to auscultation

Heart:  Regular rate and rhythm normal S1 and S2.

Abdomen:  soft, non-tender, non-distended, no masses.

Genital/Pelvic:  unremarkable

Extremities/Pulses:  normal pulse bilaterally

Neurologic:  A&Ox3, cranial nerves intact

Laboratory and Diagnostic Testing:

Fecal Occult Blood Testing: negative

Heliobacter Pylori (H. pylori) serology test: Positive

CBC with differential to test for other conditions such as anemia or pancreatitis.

Upper GI endoscopy: can help to check for damage to the lining of the stomach and to rule out malignancies (National Institutes of Health [NIH], 2017)

Upper GI Series: Commonly used in the past to diagnose peptic ulcers however this test can miss smaller ulcers and does not allow for direct treatment of the ulcer (American College of Gastroenterology, 2017).

Chest x-ray: This test is not normally used due more effective imaging for GI issues, but could be helpful to rule out other diagnoses such as a hiatal hernia or other abnormal anatomy (Chow, 2015).

Diagnosis:

K27 Peptic Ulcer Disease

K21.9 Gastro-esophageal reflux disease without esophagitis

K29.70 Gastritis, unspecified, without bleeding

Source: ICD10Date.com, 2017.

Differential Diagnosis:

  • Diverticulitis
  • Emergent Treatment of Gastroenteritis
  • Esophageal Rupture and Tears in Emergency Medicine
  • Esophagitis
  • Gallstones (Cholelithiasis)
  • Gastroesophageal Reflux Disease
  • Inflammatory Bowel Disease
  • Viral Hepatitis
  • Acute Cholangitis
  • Acute Coronary Syndrome
  • Acute Gastritis
  • Cholecystitis
  • Cholecystitis and Biliary Colic in Emergency Medicine
  • Chronic Gastritis

Source: Epocrates, 2017.

Plan of Care:

Initially, this patient was started on over the counter antisecretory treatment such as an histamine-2 receptor antagonist or a proton pump inhibitor therapy (PPI) (NIH, 2014). At follow up, patient reported no relief in symptoms and tested positive for H. pylori. He was then treated with standard triple therapy (American Family Physician, 2015). At the next follow up he stated that symptoms resolved during antibiotic triple therapy but returned after finishing the regimen. He was then placed on salvage therapy with included another antibiotic, Levofloxacin, a PPI and amoxicillin for 10 days. At follow up the patient was completely symptom free. The patient was educated regarding possible continuation of PPI therapy to alleviate continuing symptoms. He was counseled to avoid NSAIDS, alcohol, spicy foods, smoking and to avoid lying down after eating (American Academy of Family Physicians [AAFP], 2015)

The patient was counseled and educating using the services of a Spanish speaking interpreter and was given Spanish medication and treatment handouts. He was given instructions to recognize worsening symptoms and when to follow up in office.

Medications:

Triple Therapy:

Omeprazole (PPI): 40mg PO QD for 4 weeks

Amoxicillin: 1g PO BID for 10 days

Clarithromycin 500mg PO BID for 10 days

Second Line:

Omeprazole (PPI): 40mg PO QD for 10 days

Amoxicillin: 1g PO BID for 10 days

Levofloxacin 500mg PO QD for 10days

Needs help with similar assignment?

We are available 24x7 to deliver the best services and assignment ready within 3-4 hours? Order a custom-written, plagiarism-free paper

Get Answer Over WhatsApp Order Paper Now

Wgu c489 task 2|2025

/in /by

 

Word 2016 Chapter 6 Using Custom Styles and Building Blocks Last Updated: 9/30/16 Page 1

USING MICROSOFT WORD 2016 Independent Project 6-6

Independent Project 6-6 For this project, you revise a brochure for Emma Cavalli at Placer Hills Real Estate. You update existing styles, create new

styles, apply styles, and create Header, AutoText, and Quick Parts building blocks.

Skills Covered in This Project • Add document properties.

• Modify test and update a style to match

selected text.

• Create new styles.

• Apply styles to selected text.

• Create a Quick Parts building block.

• Create an AutoText building block.

• Insert a document property field.

• Create a Header building block.

• Create a new Header category.

• Assign AutoText building blocks to a category

• Modify Styles pane options

1. Open the CavalliBrochure-06 start file. If the document opens in Protected View, click the Enable

Editing button so you can modify it.

2. The file will be renamed automatically to include your name. Change the project file name if

directed to do so by your instructor, and save it.

3. Customize the following document properties:

Title: Brochure Company: Placer Hills Real Estate

Author: Emma Cavalli (remove existing author if necessary)

4. Update and apply styles.

a. Select “Emma Cavalli” and update the Heading 1 style to match the selected text.

b. Select “Realtor Consultant” and change the After paragraph spacing to 6 pt.

c. Update the Heading 2 style to match the selected text.

d. Apply the Heading 2 style to the other section headings in the document.

5. Modify a bulleted list, create a new style, and apply a style.

a. Select the bulleted list in the second column.

b. Change the bullet to a check mark (Wingdings, character code 252).

c. Create a style based on the selected text and name the style Check Bullet.

d. Apply the Check Bullet style to the numbered list in the first column.

e. Apply the Check Bullet style to the lines of text in the “Education & Training” section.

6. Save the PHRE logo (bottom right) as a Quick Parts building block with the following properties:

Name: PHRE logo bottom right

Gallery: Quick Parts

Category: General

Description: Insert PHRE logo

Save in: Building Blocks

Options: Insert content only

7. Select the entire table in the third column and save as an AutoText building block with the

following properties:

Name: PHRE beliefs

Gallery: AutoText

Category: General

 

Step 1: Download start file

 

 

 

Word 2016 Chapter 6 Using Custom Styles and Building Blocks Last Updated: 9/30/16 Page 2

USING MICROSOFT WORD 2016 Independent Project 6-6

 

Description: Insert PHRE table

Save in: Building Blocks

Options: Insert content only

8. Edit the header, select “Placer Hills,” and replace it with the Company document property field.

9. Select the table in the header and save it in the Headers gallery with the following properties:

Name: PHRE header landscape

Gallery: Headers

Category: PHRE (create new category)

Description: Insert PHRE header

Save in: Building Blocks

Options: Insert content only

10. Modify the Styles Pane Options to show only those styles in use, sort styles alphabetically, and

apply these settings only in this document.

11. Save and close the document (Figure 6-112). When you exit Word after creating and saving

building blocks, you might be prompted to save these changes. Click Save to save changes.

12. Upload and save your project file.

13. Submit project for grading.

 

6-112 Word 6-6 Completed

Step 2 Upload & Save

Step 3 Grade my Project

 

 

Needs help with similar assignment?

We are available 24x7 to deliver the best services and assignment ready within 3-4 hours? Order a custom-written, plagiarism-free paper

Get Answer Over WhatsApp Order Paper Now

Health Care Policy Reading reflection|2025

/in /by

Complete this week’s assigned readings, chapters from 39 to 43 of the textbook:

Mason, D. J., Leavitt, J.K., Chaffee, M.W. (2016). Policy and Politics: In Nursing and Health Care. (7th• Ed) St. Louis, Missouri: Elsevier, Saunders. ISBN-13: 9780323299886

1- After completing the readings, post a reflection, approximately 2 paragraph in length, discussing your thoughts and opinions about one or several of the specific topics covered in the textbook readings.

2-  Identify which MSN Essential most relates to your selected topic in your discussion.

I have attached the textbook and the MSN Essentials

Needs help with similar assignment?

We are available 24x7 to deliver the best services and assignment ready within 3-4 hours? Order a custom-written, plagiarism-free paper

Get Answer Over WhatsApp Order Paper Now

Health Promotion|2025

/in /by

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 patient’s 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 patient’s 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 patient’s 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 patient’s nutrition and activity levels are missing, recommendations are missing or not based on the patient’s 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)

 

 

 

 

 

 

 

Health History

 

Student Documentation Model Documentation
Identifying Data & Reliability

Tina Jones is a 28 year old African american female AOX4. Pt is reliable historian

 Ms. Jones is a pleasant, 28-year-old African American single woman who presents for a pre-employment physical. She is the primary source of the history. Ms. Jones offers information freely and without contradiction. Speech is clear and coherent. She maintains eye contact throughout the interview.
General Survey

Alert and oriented X4. Feels tired because she was just coming from her other job.

 Ms. Jones is alert and oriented, seated upright on the examination table, and is in no apparent distress. She is well-nourished, well-developed, and dressed appropriately with good hygiene.
Reason for Visit

Presenting to shadow health hospital clinic for a complete health assessment for a pre-employment physical.

 “I came in because I’m required to have a recent physical exam for the health insurance at my new job.”
History of Present Illness

Tina Jones is a 28year old African America female with a history of diabetes and Asthma presenting to get a complete health assessment for a pre-employment physical.

 Ms. Jones reports that she recently obtained employment at Smith, Stevens, Stewart, Silver & Company. She needs to obtain a pre-employment physical prior to initiating employment. Today she denies any acute concerns. Her last healthcare visit was 4 months ago, when she received her annual gynecological exam at Shadow Health General Clinic. Ms. Jones states that the gynecologist diagnosed her with polycystic ovarian syndrome and prescribed oral contraceptives at that visit, which she is tolerating well. She has type 2 diabetes, which she is controlling with diet, exercise, and metformin, which she just started 5 months ago. She has no medication side effects at this time. She states that she feels healthy, is taking better care of herself than in the past, and is looking forward to beginning the new job.
Medications

Metformin 850mg twice daily Yaz birth control daily in the morning Flovent MDI twice daily proventil 90mcg/spray 2 puffs as needed for wheezing

 • Fluticasone propionate, 110 mcg 2 puffs BID (last use: this morning) • Metformin, 850 mg PO BID (last use: this morning) • Drospirenone and ethinyl estradiol PO QD (last use: this morning) • Albuterol 90 mcg/spray MDI 2 puffs Q4H prn (last use: three months ago) • Acetaminophen 500-1000 mg PO prn (headaches) • Ibuprofen 600 mg PO TID prn (menstrual cramps: last taken 6 weeks ago)
Allergies

Penicillin- Rash, hives cats- sneezing, itchy watery eyes, asthma exacebation No Known food allergies No latex allergies

 • Penicillin: rash • Denies food and latex allergies • Allergic to cats and dust. When she is exposed to allergens she states that she has runny nose, itchy and swollen eyes, and increased asthma symptoms.
Medical History

Asthma- diagnosed at age 2 1/2 Diabetes Type 2 – diagnosed at 24 was on metformin but stopped due to side effects

 Asthma diagnosed at age 2 1/2. She uses her albuterol inhaler when she is around cats. Her last asthma exacerbation was three months ago, which she resolved with her inhaler. She was last hospitalized for asthma in high school. Never intubated. Type 2 diabetes, diagnosed at age 24. She began metformin 5 months ago and initially had some gastrointestinal side effects which have since dissipated. She monitors her blood sugar once daily in the morning with average readings being around 90. She has a history of hypertension which normalized when she initiated diet and exercise. No surgeries. OB/GYN: Menarche, age 11. First sexual encounter at age 18, sex with men, identifies as heterosexual. Never pregnant. Last menstrual period 2 weeks ago. Diagnosed with PCOS four months ago. For the past four months (after initiating Yaz) cycles regular (every 4 weeks) with moderate bleeding lasting 5 days. Has new male relationship, sexual contact not initiated. She plans to use condoms with sexual activity. Tested negative for HIV/AIDS and STIs four months ago.
Health Maintenance

Has been eating healthy and trying to stay active by walking 30-40 mins two times per week and also swimming once a week

 Last Pap smear 4 months ago. Last eye exam three months ago. Last dental exam five months ago. PPD (negative) ~2 years ago. Immunizations: Tetanus booster was received within the past year, influenza is not current, and human papillomavirus has not been received. She reports that she believes she is up to date on childhood vaccines and received the meningococcal vaccine for college. Safety: Has smoke detectors in the home, wears seatbelt in car, and does not ride a bike. Uses sunscreen. Guns, having belonged to her dad, are in the home, locked in parent’s room.
Family History

-Father died 2 1/2 ears ago in a car accident. History of high blood pressure,type 2 diabetes and high cholesterol -Mother is still alive. has history of hypertension and high cholesterol. -Brother is overweight -Sister has asthma

 • Mother: age 50, hypertension, elevated cholesterol • Father: deceased in car accident one year ago at age 58, hypertension, high cholesterol, and type 2 diabetes • Brother (Michael, 25): overweight • Sister (Britney, 14): asthma • Maternal grandmother: died at age 73 of a stroke, history of hypertension, high cholesterol • Maternal grandfather: died at age 78 of a stroke, history of hypertension, high cholesterol • Paternal grandmother: still living, age 82, hypertension • Paternal grandfather: died at age 65 of colon cancer, history of type 2 diabetes • Paternal uncle: alcoholism • Negative for mental illness, other cancers, sudden death, kidney disease, sickle cell anemia, thyroid problems
Social History

she does not have any children, has never been pregnant and has never been married. she lives with her mother and sister. currently works but is hoping to start a new jop as an accounting clerk at smith, stevens, steward silver company. drinksa alcohol ocassionally when she goes out with friends

 Never married, no children. Lived independently since age 19, currently lives with mother and sister in a single family home, but will move into own apartment in one month. Will begin her new position in two weeks at Smith, Stevens, Stewart, Silver, & Company. She enjoys spending time with friends, reading, attending Bible study, volunteering in her church, and dancing. Tina is active in her church and describes a strong family and social support system. She states that family and church help her cope with stress. No tobacco. Cannabis use from age 15 to age 21. Reports no use of cocaine, methamphetamines, and heroin. Uses alcohol when “out with friends, 2-3 times per month,” reports drinking no more than 3 drinks per episode. Typical breakfast is frozen fruit smoothie with unsweetened yogurt, lunch is vegetables with brown rice or sandwich on wheat bread or low-fat pita, dinner is roasted vegetables and a protein, snack is carrot sticks or an apple. Denies coffee intake, but does consume 1-2 diet sodas per day. No recent foreign travel. No pets. Participates in mild to moderate exercise four to five times per week consisting of walking, yoga, or swimming.
Mental Health History

Denies any history of depression or suicidal thoughts. denies any problems with mood. no overall safety concerns.

 Reports decreased stress and improved coping abilities have improved previous sleep difficulties. Denies current feelings of depression, anxiety, or thoughts of suicide. Alert and oriented to person, place, and time. Well-groomed, easily engages in conversation and is cooperative. Mood is pleasant. No tics or facial fasciculation. Speech is fluent, words are clear

 

Needs help with similar assignment?

We are available 24x7 to deliver the best services and assignment ready within 3-4 hours? Order a custom-written, plagiarism-free paper

Get Answer Over WhatsApp Order Paper Now

Pre Briefing Simulation And Drug Cards|2025

/in /by

 INSTRUCTION

Please keep in mind you will also be required to recognize a variety of signs and symptoms linked to abnormalities in these skills.

Therefore, in order to prepare for the simulation, you are required to complete the Pre-Briefing questions & Drug Cards below and submit to the faculty facilitating the simulation prior to the start of pre-briefing. If you do not complete the pre-briefing questions below and submit to faculty facilitating the simulation prior to the start of pre-briefing, you will not be permitted to participate in the simulation.

PART 1  QUESTIONS   

SCENARIO OVERVIEW: 

Keola Akana is a 70-year-old male with a history of heart failure. He was admitted to the medical-surgical unit early on Monday morning for medication adjustment, monitoring, and cardiac rehabilitation. The scenario takes place on Monday at 0900, at which time morning medications are due.

1. What are the nutritional implications, key assessment findings, and nursing interventions for a patient with hypokalemia?

2. What are the signs and symptoms of digoxin toxicity and how would the nurse assess for these symptoms? In your response, be sure to include specific body systems.

3. How would the nurse provide family-centered care?

PLEASE USE REFERENCE LESS THAN 5 YEARS OLD AND APA FORMAT NEEDED.

PART 11 QUESTIONS

SCENARIO OVERVIEW: 

Keola Akana is a 70-year-old male with a history of heart failure. He was admitted to the medical-surgical unit early on Monday morning for medication adjustment, monitoring and cardiac rehabilitation.  During this scenario, students will have the opportunity to assess and manage medication administration for a patient experiencing digoxin toxicity.

FOR EACH OF THE FOLLOWING DRUGS BELOW THAT WAS PRESCRIBED FOR THE ABOVE PATIENT WITH HEART FAILURE, WRITE OUT IN DRUG CARD FORMAT FOLLOWING THE HEADING BELOW

1) THE INDICATION, (2) DOSAGE, (3) CONTRAINDICATION, (4) SIDE EFFECTS, (5) ADVERSE EFFECTS AND (6) NURSING CONSIDERATION

⦁ Patient: Keola Akana Drug Lists

Lasix 40 mg po now and daily

Potassium Chloride CR 10 mEq po daily

Digoxin 0.25 mg po now and daily

Atenolol 50mg po now and daily

Acetaminophen 650 mg po Q 4 hrs PRN mild pain or temp greater than 101.3

IV saline flush Q 8hrs and PRN

N:B: SEE THE ATTACHED SAMPLE OF THE DRUG CARD LIST

Needs help with similar assignment?

We are available 24x7 to deliver the best services and assignment ready within 3-4 hours? Order a custom-written, plagiarism-free paper

Get Answer Over WhatsApp Order Paper Now