Extraneous variables may have an influence on the dependent variable. In what ways do researchers attempt to control extraneous variables? Support your answer with current literature.
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Write a review of the article. The review must be based on the importance of digital literacy for nurses in the workplace.
· Properly formatted APA Title page
· Margins – 1” on all sides
· Font – Times New Roman
· Font Size – 12 point
· Font Color- Black
· Line Spacing – Double
· Proper alignment and indentation throughout
· Proper headers and page numbers throughout
· Properly formatted APA reference page
· All aspects of assigned topic are thoroughly examined (500 words minimum self-wrote not counting cited words)
· Language is appropriate with few grammatical errors and no informal English
· High quality sources are cited in APA style as appropriate
· PLAGIARISM FREE
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Pam
Discuss how you feel nurses can positively impact the Healthy people 2020 goals.
Healthy people 2020 has many goals. I feel nurses can greatly impact the healthy people 2020 goals by first teaching patients about prevention. Healthy people goals for global health is one of those preventions. “Improve public health and strengthen U.S. national security through global disease detection, response, prevention, and control strategies.” Disease detection starts with well check-ups with your primary care physician. Nursing strategies include educating patients on the importance of keeping check-up appointments. Any chronic illness to be assessed and any new information to be given to patient verbally or written materials given to patient.
Secondly, we as nurses can introduce health promotion. Healthy people 2020 in immunizations and infectious disease goals, “Increase immunization rates and reduce preventable infectious diseases.” Floor nurses can educate patients before discharge on influenzas, pneumonia, or shingles vaccine. We in the cancer center as nurses give handouts on neutropenia symptoms and how to prevent infection (we have many patients that are or become neutropenic). We handout thermometers and give face masks to our patients. According to NIH.gov, “Nurses must have an evidence-based understanding of the significant effect that can be made through health promotion interventions and communicate this understanding to the public at large. As more people grow in their awareness of activities that lead to good health and become knowledgeable about their own health status and the health of their families, the overall health of the population will improve.” At my hospital where I work we have health screening fairs a few times a year. Other hospitals around our town offer that as well.
According to my current other class Caring for the Community in week 2 it discusses the first level of prevention which is primary prevention. “This is conventional prevention—preventing an undesirable thing from happening. It includes efforts at immunization, nutrition teaching, and education about modes of transmission of communicable disease. For example, encouraging people to protect themselves from the sun’s ultraviolet rays is an example of primary prevention of skin cancer. Other examples in primary prevention include well baby clinics, HIV community education efforts, and programs that discourage substance abuse. In the community, this may involve fitness events, water fluoridation, or even efforts to install sidewalks near schools.”
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Nursing researchers have argued that nurses are taught to value clinical skills over theoretical knowledge. With the focus on medical interventions, laboratory values, and nursing diagnoses, theory is often under-represented. This can cause nurses to react to nursing theory as having little or nothing to do with the profession of nursing.
As you begin your graduate level nursing career, consider the following:
Responses need to address all components of the question, demonstrate critical thinking and analysis, and include peer reviewed journal evidence to support the student’s position.
Please be sure to validate your opinions and ideas with citations and references in APA format.
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In previous weeks we have been reviewing the prevalence, mortality and morbidity associated with breast cancer. This is a topic of extreme public and personal interest. Primary care providers deal with the diagnosis, and the screening of breast cancer on a daily basis. Therefore, in this discussion we will discuss about the importance of understanding the advantages and limitations of its screening
200 apa style
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What is the difference between a group “at risk” for poor health and a group considered a “vulnerable” population? Provide an example of an “at risk” or “vulnerable population” group in the United States and one in another country (or immigrants within the United States).
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In your own workplace, you may find yourself wondering, who should I turn to when I have a practice dilemma? or Where can I go to learn more about this issue? These questions speak to the intricacies of formal and informal organizational structure and leadership.
To prepare:
· Review the information presented in Chapter 12 of the course text. Focus on the information about formal versus informal structure as well as the types of organizational structures.
· Consider the overall structure or hierarchy of your organization or one with which you are familiar. Which organizational structure best describes your organization—line (or bureaucratic), ad hoc, matrix, service line, or flat? Note: It is possible to have a combination of structures in one organization. Is decision making centralized or decentralized in this organization?
· What is the role of committees, task forces, and councils in the organization, and who is invited to join? Consider how this relates to formal and informal leadership.
· Reflect on how decisions are made within a specific department or unit. Which stakeholders provide input or influence the decision-making process? Assess this in terms of formal and informal leadership.
· To support your analysis, consider your own experiences and investigate these matters by speaking with others at the organization and reviewing available documents. Be sure to consider how the concepts of formal and informal structure and leadership relate to one another and are demonstrated in the organization and in the particular department or unit.
Post a depiction of your organization’s formal structure, indicating whether it is best described as line, ad hoc, matrix, service line, flat, or a combination. Describe how decisions are made within the organization and within one department or unit in particular, noting relevant attributes of centralized/decentralized decision making. Explain the influence of formal and informal leadership on decision making within this department or unit.
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Your responses should be in a well-developed paragraph (300-350 words) to each peer. Integrating an evidence-based resource that is different than the one you used for the initial post.
Respectfully agree and disagree with your peers’ responses and explain your reasoning by Including your rationales in your explanation.
The described expectations meet the passing level of 80%. Students are directed to review the Discussion Grading Rubric for criteria, which exceed expectations.
APA format references , atleast 2 each.
Response 1
It is crucial to educate and reassure CF. Perhaps if he understood how his choices affect the discomfort he is having, he would be more likely to adhere to the suggested treatment plan. Gastroesophageal reflux disease (GERD) can be prevented and cured by making straightforward lifestyle and dietary modifications (Cao et. al, 2019). First of all, I would recommend CF consider eliminating his nightly intake of wine as alcohol decreases lower esophageal sphincter (LES) tone; thus allowing for the contents of the stomach to flow back into the esophagus (Woo & Robinson, 2017). Additionally, eating smaller meals, and avoiding caffeine, chocolate, peppermint, and fatty foods can help prevent the acid reflux (Smith, 2018). Furthermore, I would inform CF that his choice to stop smoking was advantageous to his overall health. In relation to GERD, smoking inhibits the production of saliva causing a reduction of saliva in the mouth/throat; saliva helps to counteract the acidity of gastric secretions, thus avoiding smoking is best (Smith, 2018).
The entire class of proton pump inhibitors (PPI) are approved for treatment of GERD since they decrease gastric acid by over 90% (Woo & Robinson, 2017). Omeprazole (Prilosec) 20mg capsule by mouth once daily for a trial period of 4 weeks would be my rational drug choice for CF. Due to his age, negative physical exam, and the fact that he does not take daily medications, omeprazole would not interact with any current medications or put him at a concerning risk for osteoporosis. The benefits of omeprazole include rapid absorption of less than one hour and peak effect within 2 hours (Lexicomp, 2017). I would inform CF about common side effects such as dizziness, headaches, skin rash, constipation, diarrhea, flatulence, and nausea/vomiting (Lexicomp, 2017).
First of all, I would tell CF I wish to see him back in four weeks to discuss his potential experience with side effects, symptom relief including his being awakened at night with symptoms. Should he report his symptoms are controlled during the day and reappear before bed, I would consider adding either a second dose of omeprazole daily or an H2 receptor antagonist before bed (Woo & Robinson, 2017). It is important for CF to understand the efficiency of omeprazole is greatly decreased if not taken on an empty stomach (Lexicomp 2017). Adherence to taking PPI is crucial to attain the optimal gastric acid secretion; therefore, I would reinforce how important it is to stay consistent with his medication regimen (Smith, 2018).
Responsec 2
Modifying lifestyle is the golden management strategy for GERD. Some of the lifestyle modification that could help CF reduce his frequency of GERD includes maintaining a healthy weight as more weight puts pressure on the abdomen causing acid to come out from the stomach to esophagus it is important to maintain a healthy BMI. Stopping smoking, drinking alcohol. Elevating the head of the bed to help him with the heart burn experienced at night using bed wedge decreases significantly the backing of acid from the stomach to esophagus (Johnson, 2016). To wait at least three hours before lying down or sleeping, chew food more slowly and thoroughly to help digest better. Stay away from foods that trigger acid reflux such as spicy foods, caffeine, chocolate high fat and fried foods (Joel E. Richter, 2009). Avoid tight fitting cloths in the waist and to be more physically active, to exercise and avoid sedentary lifestyle.
Patients with GERD empirically treated with protein pump inhibitor are well managed with the medication without further diagnostic tests (Dalbir S. Sandhu, 2018). There are about four PPI that he can easily purchase over the counter. To improve the effectiveness and compliance of PPI it is important to tell the patient when to take the medication. Considering the fact that he is having symptoms of heart burn and had tried H2RA’s. There are some factors that ensures the effectiveness on the treatment such as how easily can the patient get the medication, how definite are we with the GERD diagnosis ruling our other causes, how the patient accepts the treatment and how they use their treatment in correct way (such as taking it 30 minutes prior to a meal. Factors that helps us chose the first line of treatment would be his knowledge regarding on how to take the medication and how he continuous to use it and his adherence to the lifestyle changes he is going to make. If his symptoms are not well managed with a PPI two timed daily dose, we consider adding H2RA (Dalbir S. Sandhu, 2018).
When choosing PPI Lansoprazole is more effective than Omeprazole in reducing the acidity in the esophagus indicating different PPI affect the clearance of esophagus and esophageal sphincter differently (Janczewska I et al, 1998). Considering this and lansoprazole having a quick onset improves patients adhering to the treatment. The other thing to keep in mind is metabolism of pantoprazole CYP450 system making it safer (Bordin DS, 2010). We have to be cautious if we are using other drugs that interact with PPI such as clopidogrel it can decrease the effect of the blood thinner increasing the chance of heart attack.
As long-term use of PPI can increase the chances of bone fracture, hypomagnesemia causing tremor, muscle pain and dysrhythmia, pneumonia and increase the risk of C-diff infection we have to be monitor for this side effects. CF need to be counseled on lifestyle change, using the medication correctly and as prescribed, looking out for the side effects and seek medical advice if symptoms worsen.
RUBRIC:
Note: Scholarly resources are defined as evidence-based practice, peer-reviewed journals; textbook (do not rely solely on your textbook as a reference); and National Standard Guidelines. Review assignment instructions, as this will provide any additional requirements that are not specifically listed on the rubric.
Note: The value of each of the criterion on this rubric represents a point range. (example: 17-0 points)
Discussion Question Rubric – 100 PointsCriteriaExemplary
Exceeds ExpectationsAdvanced
Meets ExpectationsIntermediate
Needs ImprovementNovice
InadequateTotal PointsQuality of Initial PostProvides clear examples supported by course content and references.
Cites three or more references, using at least one new scholarly resource that was not provided in the course materials.
All instruction requirements noted.
40 pointsComponents are accurate and thoroughly represented, with explanations and application of knowledge to include evidence-based practice, ethics, theory, and/or role. Synthesizes course content using course materials and scholarly resources to support importantpoints.
Meets all requirements within the discussion instructions.
Cites two references.
35 pointsComponents are accurate and mostly represented primarily with definitions and summarization. Ideas may be overstated, with minimal contribution to the subject matter. Minimal application to evidence-based practice, theory, or role development. Synthesis of course content is present but missing depth and/or development.
Is missing one component/requirement of the discussion instructions.
Cites one reference, or references do not clearly support content.
Most instruction requirements are noted.
31 pointsAbsent application to evidence-based practice, theory, or role development. Synthesis of course content is superficial.
Demonstrates incomplete understanding of content and/or inadequate preparation.
No references cited.
Missing several instruction requirements.
Submits post late.
27 points40Peer Response PostOffers both supportive and alternative viewpoints to the discussion, using two or more scholarly references per peer post. Post provides additional value to the conversation.
All instruction requirements noted.
40 pointsEvidence of further synthesis of course content. Provides clarification and new information or insight related to the content of the peer’s post.
Response is supported by course content and a minimum of one scholarly reference per each peer post.
All instruction requirements noted.
35 pointsLacks clarification or new information. Scholarly reference supports the content in the peer post without adding new information or insight.
Missing reference from one peer post.
Partially followed instructions regarding number of reply posts.
Most instruction requirements are noted.
31 pointsPost is primarily a summation of peer’s post without further synthesis of course content.
Demonstrates incomplete understanding of content and/or inadequate preparation.
Did not follow instructions regarding number of reply posts.
Missing reference from peer posts.
Missing several instruction requirements.
Submits post late.
27 points40Frequency of DistributionInitial post and peer post(s) made on multiple separate days.
All instruction requirements noted.
10 pointsInitial post and peer post(s) made on multiple separate days.
8 pointsMinimum of two post options (initial and/or peer) made on separate days.
7 pointsAll posts made on same day.
Submission demonstrates inadequate preparation.
No post submitted.
6 points10OrganizationWell-organized content with a clear and complex purpose statement and content argument. Writing is concise with a logical flow of ideas.
5 pointsOrganized content with an informative purpose statement, supportive content, and summary statement. Argument content is developed with minimal issues in content flow.
4 pointsPoor organization and flow of ideas distract from content. Narrative is difficult to follow and frequently causes reader to reread work.
Purpose statement is noted.
3 pointsIllogical flow of ideas. Prose rambles. Purpose statement is unclear or missing.
Demonstrates incomplete understanding of content and/or inadequate preparation.
No purpose statement.
Submits assignment late.
2 points5APA, Grammar, and SpellingCorrect APA formatting with no errors.
The writer correctly identifies reading audience, as demonstrated by appropriate language (avoids jargon and simplifies complex concepts appropriately).
Writing is concise, in active voice, and avoids awkward transitions and overuse of conjunctions.
There are no spelling, punctuation, or word-usage errors.
5 pointsCorrect and consistent APA formatting of references and cites all references used. No more than two unique APA errors.
The writer demonstrates correct usage of formal English language in sentence construction. Variation in sentence structure and word usage promotes readability.
There are minimal to no grammar, punctuation, or word-usage errors.
4 pointsThree to four unique APA formatting errors.
The writer occasionally uses awkward sentence construction or overuses/inappropriately uses complex sentence structure. Problems with word usage (evidence of incorrect use of thesaurus) and punctuation persist, often causing some difficulties with grammar. Some words, transitional phrases, and conjunctions are overused.
Multiple grammar, punctuation, or word usage errors.
3 pointsFive or more unique formatting errors or no attempt to format in APA.
The writer demonstrates limited understanding of formal written language use; writing is colloquial (conforms to spoken language).
The writer struggles with limited vocabulary and has difficulty conveying meaning such that only the broadest, most general messages are presented.
Grammar and punctuation are consistently incorrect. Spelling errors are numerous.
Submits assignment late.
2 points5Total Points100
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The Assignment
Respond to at least two of your colleagues by providing at least two ways that their strategies may be expanded or improved.
Support your responses with evidence-based literature with at least two references in each colleague’s response with proper citation.
Colleagues Response # 1
Treating Childhood Abuse
The number of incidents that Child Protective Services (CPS) investigates annually in the United States is over two million alleged incidents of child abuse, 18 percent of physical abuse, 650,000 are confirmed to be physical violence, and neglect or abuse claims 1500 lives of children each year, with 80 percent being children under the age of four. Psychological and somatic symptoms, as well as psychological and medical diagnosis, including depression, anxiety disorders, eating disorders, posttraumatic stress disorder (PTSD), chronic pain syndromes, chronic fatigue syndrome, and irritable bowel disorder, have been correlated with childhood violence.
From exposure to traumatic incidents in which they are victims of physical and sexual assault, domestic violence, motor vehicle accidents, serious medical disease, natural or human-created disasters, a large number of children and adolescents can experience PTSD (Sadock, Sadock, & Ruiz, 2017).
Assessing for Abuse
Identification and assessment of childhood abuse can be a complex process. It needs careful consideration of the situation involving alleged childhood abuse. A detailed interview is used in policies used to assess childhood abuse. In evaluating childhood violence evaluation, both physical examination and behavioral review should be assessed during the interview. A conducive environment should be created to enable the client to feel comfortable so as to be forthcoming with information. The client and the therapist should develop a good relationship. Prevention, early identification of violence with intervention restrict incidence, and avoid further development of trauma.
Trauma screening refers to a brief method, centered survey to evaluate if a person has undergone one or more traumatic events, has reactions to such events, has particular mental or behavioral health needs, and requires referral for a thorough trauma-informed mental health evaluation. Screening and screening questionnaires and clinical interviews are techniques that help in evaluating for violence. The questionnaires can help diagnose a high-risk parent or caregiver who can mistreat a child or teenager and can determine whether they are at risk of abuse, are sexually abused or have been abused in the past.
Media Exposure
Media visibility can be helpful, but it has several drawbacks as well. An advantage of the media is that it can serve as a place for people to interact and exchange thoughts about the risks of child violence and prevention. Social networking and the internet also encourage abuse-victim children to find resources to aid coping. Their emotional health will benefit from their receiving support. Media networks’ limitation can also be gateways for the perpetration of child exploitation and exposure to sex predators. It allows children easy access to the attacker which can lead to cyberbullying and sexual assault.
Colleagues Response # 2
Treating Childhood Abuse
Child abuse is a horrifying problem and is the third leading cause of death in children between the ages of one and four (Kodner & Wetherton, 2013). Practitioners need to persistently assess children for possible abuse and neglect. The practitioner must know how to assess for abuse and what risk factors to look for. Emotional and behavioral difficulties in children place them at a high risk for abuse and children that have abuse and trauma often have mental health issues (Christian, 2015). Psychiatric Mental Health Nurse Practitioners (PMHNP) must know how to assess children because of the increased risk of abuse.
Assessing Children for Abuse
Assessment of abuse in children varies by age and cognitive level. In pre-verbal children, it is important to look for signs and symptoms of abuse, how they act during play, and the relationship between the child and their parents (Stanford Medicine, 2020). Symptoms in this age group can be behavioral, such as excessive crying or bedwetting, or physical, such as poor hygiene or poor weight gain (Stanford Medicine, 2020). In verbal children, it is suitable to ask age-appropriate questions (Stanford Medicine, 2020). It is important that practitioners don’t ask leading questions and only ask questions that are necessary (Stanford Medicine, 2020). Some questions include, “what happens when you do something your parents don’t like” or “has anyone ever touched you in a way that you don’t like” (Stanford Medicine, 2020)? It is important to examine the child’s history to look for patterns of abuse and risk factors for abuse (Kodner & Wetherton, 2013). A physical exam can also be a part of the assessment piece for abuse and neglect (Kodner & Wetherton, 2013). PMHNPs do not often do a complete physical exam, but they can assess visually and ask about pain and medical issues. Lastly, the PMHNP should document and report any concerns when necessary (Kodner & Wetherton, 2013). Prevention and early detection of child maltreatment are essential to the outcome of the situation.
Media and Social Media
Exposure to media and social media can influence patients, especially teenagers. Social media is popular with teenagers and carries with it many dangers for children today. Social media allows teens to constantly compare themselves to others and decrease social interactions. Isolation can be especially dangers for kids that are abused or neglected at home because they have fewer relationships where they can reach out for help. Social media increases the potential for cyberbullying, trolling, identity issues, and fake news (Baccarella et al., 2018). All of these can negatively affect teenagers, especially those who are being mistreated. When teenagers are immersed in social media they have fewer outlets that they can find reprieve.
Media and social media can also be positive. It can allow teenagers to find groups and support online. Teens might also be more willing to reach out to someone about abuse and neglect online instead of in person. They can search for resources and numbers to call for help. Media can be used to spread news about resources and help concerning abuse and neglect. Media and social media have good and bad things depending on how it is utilized.
Mandatory Reporting
In the case study for this week, Morgan confides in the PMHNP that he was molested by his cousin, as a child and was neglected by his family. Morgan is 19 years old and is disclosing past abuse as a child and the family member has already served a sentence for molesting him and other children. Because the patient is technically an adult and is no longer in harm, the practitioner is not mandated to report the information.
In Michigan, where I will be practicing, practitioners are mandatory reporters. If a practitioner is seeing a child who discloses abuse or neglect we must report suspensions of abuse or neglect to the Department of Health and Human Services immediately (Michigan.gov, 2020). The reporter can remain anonymous and can also be punished if they fail to report abuse (Michigan.gov, 2020). It is important that practitioners report all abuse or suspected abuse to prevent potential harm from occurring.
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The benchmark assesses the following competencies:
1.4 Participate in health care policy development to influence nursing practice and health care.
Research public health issues on the “Climate Change” or “Topics and Issues” pages of the American Public Health Association (APHA) website. Investigate a public health issue related to an environmental issue within the U.S. health care delivery system and examine its effect on a specific population.
Write a 750-1,000-word policy brief that summarizes the issue, explains the effect on the population, and proposes a solution to the issue.
Follow this outline when writing the policy brief:
Include three peer-reviewed sources and two other sources to support the policy brief.
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.
You are required to submit this assignment to LopesWrite. Refer to the LopesWrite Technical Support articles for assistance.
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