Use APA 6th Edition Format and support your work with at least 3 peer-reviewed references within 5 years of publication. Remember that you need a cover page and a reference page. All paragraphs need to be cited properly. Please use headers.  All responses must be in a narrative format and each paragraph must have at least 4 sentences. Lastly, you must have at least 2 pages of content, no greater than 4 pages, excluding cover page and reference page. 

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 woman’s 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 drug–drug or drug–food 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.?

 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 non–insulin-dependent, diabetes mellitus. With type 2 diabetes, the body either resists the effects of insulin or doesn’t produce enough insulin to maintain a normal blood glucose level. The patient lives with her adult daughter, two grandchildren, and five great-grandchildren. The nurse’s goals are to use culturally appropriate diet education to repattern the patient’s 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 patient’s family doesn’t 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 patient’s eating habits, for example, type of food, method of preparation, amount eaten, etc.?
4. Each of the patient’s children, grandchildren, and great-grandchildren is obese. How would you involve the patient’s family in the plan of care and motive them to lose weight as well?

As an advanced practice nurse, one can engage in activism in order to achieve desired policy change at various levels including their own organization. Examine the following questions.

 #1) should nurses be unionized and

 #2) how does being unionized impact a workforce culture of safety?

#3) Be sure to  include one MSN Essential in your discussion that relates to this topic.

  all discussion posts must be minimum 250 words, references must be cited in APA format, and must include minimum of 2 scholarly resources published within the past 5-7 years. 

APA format. 350 words and use only scholar authors. Please read all information.

Post a description of the focus of your scenario. Describe the data that could be used and how the data might be collected and accessed. What knowledge might be derived from that data? How would a nurse leader use clinical reasoning and judgment in the formation of knowledge from this experience?

To Prepare:

• Reflect on the concepts of informatics and knowledge work as presented in the Resources.
• Consider a hypothetical scenario based on your own healthcare practice or organization that would require or benefit from the access/collection and application of data. Your scenario may involve a patient, staff, or management problem or gap.

 Reference

McGonigle, D., & Mastrian, K. G. (2017). Nursing informatics and the foundation of knowledge (4th ed.). Burlington, MA: Jones & Bartlett Learning.

• Chapter 1, “Nursing Science and the Foundation of Knowledge” (pp. 7–19)
• Chapter 2, “Introduction to Information, Information Science, and Information Systems” (pp. 21–33)
• Chapter 3, “Computer Science and the Foundation of Knowledge Model” (pp. 35–62)

2. Article 

Nagle, L., Sermeus, W., & Junger, A. (2017). Evolving role of the nursing informatics specialist. In J. Murphy, W. Goossen, & P. Weber (Eds.), Forecasting Competencies for Nurses in the Future of Connected Health (212–221). Clifton, VA: IMIA and IOS Press. Retrieved from https://serval.unil.ch/resource/serval:BIB_4A0FEA56B8CB.P001/REF 

3, Sweeney, J. (2017). Healthcare informatics. Online Journal of Nursing Informatics, 21(1).
Note: You will access this article from the Walden Library databases.

Each week you will be expected to provide the following information to your community practice instructor through your journal entries:

1. What are your upcoming week’s specific learning goals and objectives?
2. What is your upcoming week’s detailed schedule at your community practice experience placement?
3. Were there any placement items/issues that occurred this week that you feel your instructor should be aware of that are private in nature and are more appropriately shared here than in the discussion board with your classmates?
4. Give a brief description of an objective you worked on this week. Make sure to cite at least one reference showing how your objective relates to the public health knowledge you’ve studied during this course or the public health course. You may choose to reference your e-text, journal articles, or videos you’ve studied during these courses or you may find an outside reference on your own to further enhance your public health knowledge and practices.

Remember, your journal entries are an important aspect of clinical learning as they serve to help you reflect upon and get the most out of your community practice experience. Therefore, your journal entry should include the who, what, where, and when of your community practice experience. Remember, this should simulate a dialogue that would normally take place face-to-face with your community practice experience instructor.