Respectfully agree and disagree with your peers’ responses and explain your reasoning by including your rationales in your explanation. Atleast 2 APA refernces each

Response 1

The purpose of this week’s discussion is to create a treatment plan for V.S. based off the given case study information. V.S. has conjunctivitis of the left eye. The specific goals of treatment for conjunctivitis is to relieve symptoms and to clear the infection (Woo & Robinson, 2020). There are numerous forms of conjunctivitis but given the information the symptoms this is more than likely a form on bacterial conjunctivitis. The discharge color, age of the patient, being immunocompromised with a cold prior, and only one eye being infected suggests this is a bacterial infection (Watson et al., 2018). Treatment therefore would be a broad spectrum ophthalmic antibiotic. I would suggest bacitracin which should not affect the patient’s sulfa allergy (Nguyen, 2020). To monitor success the patient should be seen by his pediatrician within a week to see if symptoms have resolved.
Education to include for this patient would be that the ointment can cause blurred vision directly after administration but should clear soon after (Woo & Robinson, 2020). If symptoms worsen in the affected eye or spread to the unaffected eye the patient should contact his pediatrician for reassessment to see if this condition is viral. If this occurs treatment should be stopped due to risk for a drug resistance (Nguyen, 2020). Another adverse reaction that would cause me to change treatment would be any sign of hypersensitivity such as swelling, hives, nausea, or vomiting. If this occurs I would recommend a medication such as erythromycin in ophthalmic form.
An over the counter method for treating bacterial conjunctivitis would be artificial tears for relief of dryness symptoms and saline flushes to wash out the pus (CDC, 2019). Lifestyle changes would include proper hand hygiene, avoiding touching the eye in general, not sharing things such as glasses, and not rubbing the eye. This is the medication I would choose for this patient due to its low risk of interactions to other drugs and/or foods. 

Response 2

V.S., age 12 Hispanic male, presents with a feeling that there is sand in his eye. He had a cold a week ago and woke up this morning with his left eye crusted with yellowish drainage. On physical examination, he has injected conjunctiva on the left side, no adenopathy, and no vision changes. His vision is 20/20. Fluorescein staining reveals no abrasion. He is allergic to sulfa.

Diagnosis: Conjunctivitis

        The goal of treatment for V.S. would be to clear his infection and make sure he doesn’t rub his eyes because that can cause the infection to get worse and spread to other individuals. According to Azari and Arabi (2020), “bacterial conjunctivitis can spread from person to person, from hand-to-eye contact or via eye contact with contaminated objects. Alternatively, changes in the usual bacteria that live on the conjunctiva can cause conjunctivitis. Bacteria can also spread by large respiratory tract droplets” (p. 374). Bacterial conjunctivitis is most often treated with  ophthalmic antibiotic eyedrops and ointments. Since V.S. is allergic to sulfa, Bleph or antibiotics with similar derivatives would not be utilized because they are sulfacetamide sodium. Ophthalmic fluoroquinolones can be prescribed such as Moxeza (moxifloxacin), Zymar (gatifloxacin), or Romycin (erythromycin).

     The parameters for monitoring success would be to see the alleviation of redness and itchiness in the patient’s eyes. According to Saher et al. (2016), most cases of viral or bacterial conjunctivitis are mild. The infection will usually clear up in 7 to 14 days without treatment and without any long-term consequences. However, in some cases, viral conjunctivitis can take 2 to 3 weeks or more to clear up. I would educate the parents to administer the drug as prescribed. I would urge the parents to continue giving the antibiotics even if the infection seems to subside. According to Shetty et al. (2020), it has been widely accepted that stopping antibiotic treatment early encourages bacteria to develop antibiotic resistance. As a result, current medical advice is to finish taking a prescribed course of antibiotics as recommended by a healthcare professional, even if you start to feel better. 

      I would educate the parents to assist in alleviating some discomfort V.S. can take ibuprofen or another over-the-counter pain killer. He can also use over-the-counter lubricating eye drops (artificial tears) if his eyes feel excessively dry. In addition, a warm, damp washcloth over your eyes for a few minutes. Nausea, diarrhea, and headaches can be adverse effects seen in the agents mentioned above. A second line treatment would be Bacticin (bacitracin). V.S. should be encouraged to drink plenty of water and take his antibiotics with water. According to Azari and Arabi (2020), moxifloxacin should not be taken with dairy products such as milk or yogurt, or with calcium-fortified juice.  They could make the medication less effective.

The field of nursing has changed over time. In a 750‐1,000 word paper, discuss nursing practice today by addressing the following:

1. Explain how the nursing practice has changed over time and how this evolution has changed the scope of practice and the approach to treating the individual.
2. Compare and contrast the differentiated practice competencies between an associate and baccalaureate education in nursing. Explain how the scope of practice changes between an associate and baccalaureate nurse.
3. Identify a patient care situation and describe how nursing care, or approaches to decision‐making, differ between the BSN‐prepared nurse and the ADN nurse.
4. Discuss the significance of applying evidence‐based practice to nursing care and explain how the academic preparation of the RN‐BSN nurse supports its application.
5. Discuss how nurses today communicate and collaborate with interdisciplinary teams and how this supports safer and more effective patient outcomes.

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

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

Training and development prompts a change within an organization. The goal of training is to identify areas for improvement and develop materials and opportunities to educate employees in order to support growth.

For this assignment, you are required to develop a small training exercise. Review your needs assessment and previous observations conducted on your work environment to help identify one area for improvement that would benefit a part of your organization. This training exercise does not need to be implemented, but should include at least one deliverable that you could use during the training exercise. As you are reviewing your organization, consider employee engagement, systems, procedures, communication, and the culture within the organization. These are suggestions for possible areas that could benefit from a training exercise. The training must include the following:

1. What      goal is the organization trying to accomplish?
2. What      processes or procedures will change after the training?
3. Describe      the strategies or actions involved in the training exercise to meet      established goals. What is the expected performance or applications after      the training? How will the strategies drive successful business results      and improve employee performance?
4. How      will the organization provide support to the employees receiving training?      To new employees? Does this support consider strengths and weaknesses      within the organization?

You are required to develop a written description (1,000 words) including one visual for your training exercise. Be sure to take time to analyze your work surroundings and identify a need for further training and development.

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

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

1. review Learning Exercise 8.3 – Using Change Strategies to Increase Sam’s Compliance (located in Chapter 8 of the textbook)
2. Answer the following questions:
   1. What change strategy or combination thereof (rational-empirical, normative-reedeucative or power-coercive) do you believe has the greatest likelihood of increasing Sam’s compliance?
   2. How could you use this strategy?
   3. Who would be involved in this change effort?
   4. What efforts might you undertake to increase the unfreezing so that Sam is more willing to actively participate in such a planned change effort?
3. Your resume should be:
   • Typed according to APA style for margins, formatting and spacing standards.
   • Typed into a Microsoft Word document, save the file, and then upload the file