Compare and contrast two change theories, and determine which theory makes the most sense for implementing your specific EBP project. Why? Has your mentor used either theory, and to what result?

DERMATOLOGY CASE STUDY

Chief complaint:  “ My right great toe has been hurting for about 2 months and now it’s itchy, swollen and yellow. I can’t wear closed shoes and I was fine until I started going to the gym”.

HPI: E.D a 38 -year-old Caucasian female presents to the clinic with complaint of pain, itching, inflammation, and “yellow” right great toe. She noticed that the toe was moderately itching after she took a shower at the gym. She did not pay much attention. About two weeks after the itching became intense and she applied Benadryl cream with only some relief.  She continued going to the gym and noticed that the itching got worse and her toe nail started to change color. She also indicated that the toe got swollen, painful and turned completely yellow 2 weeks ago. She applied lotrimin  AF cream and it did not help relief her symptoms. She has not tried other remedies.

Denies associated symptoms of fever and chills. 

PMH: Diabetes Mellitus, type 2.

Surgeries: None

Allergies: Augmentin

Medication: Metformin 500mg PO BID.

Vaccination History:  Immunization is up to date and she received her flu shot this year.

Social history: College graduate married and no children. She drinks 1 glass of red wine every night with dinner. She is a former smoker and quit 6 years ago.

Family history:Both parents are alive. Father has history of DM type 2, Tinea Pedis. mother alive and has history of atopic dermatitis, HTN.

ROS:

Constitutional: Negative for fever. Negative for chills.

Respiratory: No Shortness of breath. No Orthopnea

Cardiovascular: Regular rhythm.

Skin: Right great toe swollen, itchy, painful and discolored.

Psychiatric: No anxiety. No depression.

Physical examination:

Vital Signs

Height: 5 feet 5 inches Weight: 140 pounds BMI: 31 obesity, BP 130/70 T 98.0, P 88 R 22, non-labored

HEENT: Normocephalic/Atraumatic, Bilateral cataracts; PERRL, EOMI; No teeth loss seen. Gums no redness.

NECK: Neck supple, no palpable masses, no lymphadenopathy, no thyroid enlargement.

LUNGS: No Crackles. Lungs clear bilaterally. Equal breath sounds. Symmetrical respiration. No respiratory distress.

HEART: Normal S1 with S2 during expiration. Pulses are 2+ in upper extremities. 1+ pitting edema ankle 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: Slow gait but steady. No Kyphosis.

SKIN: Right great toe with yellow-brown discoloration in the proximal nail plate. Marked periungual inflammation. + dryness. No pus. No neuro deficit.

PSYCH: Normal affect. Cooperative.

Labs: Hgb 13.2, Hct 38%, K+ 4.2, Na+138, Cholesterol 225, Triglycerides 187, HDL 37, LDL 190, TSH 3.7, glucose 98.

Assessment:

Primary Diagnosis: Proximal subungual onychomycosis

Differential Diagnosis:  Irritant Contact Dermatitis, Lichen Planus, Nail Psoriasis

Special Lab:

Fungal culture confirms fungal infection.

As an NP student, you need to determine the medications for onychomycosis.

1. According to the AAFP/CDC Guidelines, what antifungal medication(s) should this patient be prescribed, and for how long? Write her complete prescriptions using the prescription writing format in your textbook.

2.  What labs for baseline and follow up of therapy would you order for this patient? Give rationale.

Purpose

The Course Outcome covered this week is CO1.

CO1: Identify theories, concepts, and beliefs related to transcultural nursing. (PO1)

Discussion

We encounter patients after they have explored various avenues of self-help. At times, these avenues involve the use of complementary and alternative medicine (CAM). Our readings this week are very helpful.

1. Select a common (or not so common) illness or condition that affects a specific ethnic group.
2. Identify two (2) CAM therapies that patients are likely to try before seeking (or in addition to) allopathic, osteopathic, or ayurvedic medical intervention for the illness or condition.
3. Discuss the effectiveness of each therapy you identified.

Note: Do not discuss an illness or condition about which a classmate has already posted. The diversity will lead to a more robust discussion. There are many examples you may discuss, including sickle-cell disease in African Americans, constipation in the elderly people, or the use of Reiki for mental and emotional healing by Japanese people. Think of others from your practice settings or prelicensure experiences.

Professor’s comment: Hello All,

This is one week I am really looking forward to because you are all experts in this area from all of your work with the patients and families you care for.  We all encounter patients after they have explored various avenues of self-help. At times, these avenues involve the use of complementary and alternative medicine (CAM). I look forward to your choice for an illness that affects an ethnic group that you have worked with and the CAM therapies you identify.

References

American Psychological Association. (2010). Publication manual of the American Psychological Association (6th ed.). Washington, DC: Author.

Andrews, M. M., & Boyle, J. S. (2016). Transcultural concepts in nursing care (7th ed.). Philadelphia: PA: Wolters Kluwer.

The dissemination of EBP results serves multiple important roles. Sharing results makes the case for your decisions. It also adds to the body of knowledge, which creates opportunities for future practitioners. By presenting results, you also become an advocate for EBP, creating a culture within your organization or beyond that informs, educates, and promotes the effective use of EBP. 

To Prepare:

• Review the final PowerPoint presentation you submitted in Module 5, and make any necessary changes based on the feedback you have received and on lessons you have learned throughout the course. 
• Consider the best method of disseminating the results of your presentation to an audience. 

To Complete:

Create a 5-minute, 5- to 6-slide narrated PowerPoint presentation of your Evidence-Based Project.

• Be sure to incorporate any feedback or changes from your presentation submission in Module 5.
• Explain how you would disseminate the results of your project to an audience. Provide a rationale for why you selected this dissemination strategy.

Competencies

• Analyze the evolution of social media standards and practices and how it relates to the potential need for regulation of social media, along with ethical concerns.
• Evaluate psychological theories and their insights into the widely varying opinions and attitudes that are expressed through social media.
• Compare and contrast new social media marketing trends with more traditional forms of advertising.
• Assess the development of societal standards in relation to social media and how this can alter social norms in everyday life.
• Integrate the positive and negative effects of social media making global communication easily accessible.
• Design a personal plan to use social media to benefit the student both personally and professionally as well as minimize online mistakes and their impact.

Instructions

Social media use is critical to a dynamic and competitive brand, whether that brand is something you sell, a group home, a non-profit organization, or your self-image. This project will get you thinking about effective ways to shape your social media tools to make the most of your brand, to keep consumers talking and thinking about your brand, and to get interaction from those you seek to sell to or to help. You will take a look at what you post to social media, possible responses or reactions you will receive, as well as use social media trends and society controls to keep your brand meeting your goals.

Your final project should include a plan for the following: how you will utilize a minimum of four social media sites; what your target audience will be; your use of contacts, outreach, and advertising best practices; your posting do’s and don’ts; and explanations of your choices using the sources from the course and others you find.

If you have a real business, brand, or site to work on, you can start by putting the site profiles into the four social media sites you have chosen (e.g. Facebook, Twitter, etc.). Screenshots will work for these that you have really made. If you don’t really have a business or brand, you do not need to create faux profiles. However, you should write the information you would include in your profile for each one.

In summary, your plan should contain:

• An introduction to your brand or company
• Your social media goals and general goals for the brand
• An analysis of the market comparables — similar businesses/nonprofits/brands, including what has been successful and what hasn’t worked for at least 3 good comparable brands
• Discussion of societal norms for those comparables. What seem to be the “rules” they follow? Is there open or tacit regulation you’ve noticed? Include how you can expand your influence globally by overcoming potential language and culture barriers 
• An analysis of advertising and its necessity along with the type of advertising you would do and why
• An outline of the audience you intend to reach and how to reach them. Be sure to take into account the factors that are in play when attempting to reach an audience that includes a wide range of ages (consider generational differences)
• A plan for how to use your contacts and add new ones when publicizing and staying connected
• A plan for each of four social media sites, including profile information and posting ideas
• Analysis of any of the theories you would use
• A conclusion

Your project lengths will depend on how much depth you put into your analysis of each section, but to give you a general idea, several paragraphs for most of the bullet points is a good length, and should result in a total of around 10 pages