All posts by : chebby

Address the following Short Answer prompts for your Assignment. Be sure to include references to the Learning Resources for this week.

1. In 4 or 5 sentences, describe the anatomy of the basic unit of the nervous system, the neuron. Include each part of the neuron and a general overview of electrical impulse conduction, the pathway it travels, and the net result at the termination of the impulse. Be specific and provide examples.
2. Answer the following (listing is acceptable for these questions):
   • What are the major components that make up the subcortical structures?
   • Which component plays a role in learning, memory, and addiction?
   • What are the two key neurotransmitters located in the nigra striatal region of the brain that play a major role in motor control?
3. In 3 or 4 sentences, explain how glia cells function in the central nervous system. Be specific and provide examples.
4. The synapse is an area between two neurons that allows for chemical communication. In 3 or 4 sentences, explain what part of the neurons are communicating with each other and in which direction does this communication occur? Be specific.
5. In 3–5 sentences, explain the concept of “neuroplasticity.” Be specific and provide examples.

    Generally speaking, Nursing has the largest representation within an acute hospital setting. Nursing is involved in the care of every patient that comes into the hospital. That being said, how nursing document their interactions with patients is a large part of their day. Integrating a new health information technology system should require the input of nursing. Nursing’s input is essential in understanding how the system could require additional workflow changes or updates. Poorly implemented systems can lead to unintended consequences that may have a negative impact on clinical processes and patient outcomes. (Piscotty, 2011)

            When integrating a new system, the System Development Life Cycle (SDLC) model is used. This cycle has five different stages: Planning, Analysis, Design, Implementation, and Maintenance. Each of these stages is essential as you integrate new systems. During the analysis phase, the requirements for the system are teased out from a detailed study of the business needs of the organization. As part of this analysis, workflows and business practices are examined. It may be necessary to consider options for changing the business process. (McGonigle, 2017)

            Nursing is especially crucial when you enter into the implementation stage. The system also was tested by three nurses before implementation. To ensure that the nurses could operate the CDSS correctly, a training manual was developed and provided to the nurses 3 weeks before the implementation date. (Lyerla, 2008) Once you have planned, analyzed, and implemented any new system, occasionally maintenance is required. We need to constantly be evaluating our systems to make sure that we are using it effectively and to its max potential.

            During my time at Homestead Hospital, the operating systems were changed. Nursing was not consulted at the hospital level. The decision to change these systems was made at the corporate level and rolled out to the different facilities in stages. Our hospital was the first and the rollout was rough. We had representatives from the OS company to help facilitate the roll-out 24/7 for 1 week. We needed to constantly refer to them whenever we needed to address a concern or be reminded of how to mitigate certain situations. I think that transition would have been a bit smoother if there were training sessions with the staff prior to roll out. Physicians and nursing could have been trained with time before “go live” and a few issues could have been avoided. Any time that changes are made within an existing system or a new one is implemented, there will be hang-ups. Involving those that would be the most significant users helps in finding any conflicts or adjusting workflows prior to them impacting patient care.

Lyerla F. (2008). Design and implementation of a nursing clinical decision support system to

promote guideline adherence. CIN: Computers, Informatics, Nursing, 26(4), 227–233.

 Identify a theory within Watson’s Caring Theory framework. Discuss why her work is considered a grand theory.   

Module 09 Discussion – Mental Healthcare for Adolescence & Children

Scenario

Ryan is a 12 year old diagnosed with Oppositional Defiant Disorder (ODD). As a small child, Ryan was first diagnosed with Attention Deficit, Hyperactivity Disorder. He had just started preschool and was unable to remain in one place for more than a minute or two. His parents had already had a very difficult time in disciplining him, because he would become very upset and throw temper tantrums when he could not do as he wished. He just seemed to be an unhappy, irritable child. This behavior continued in school. As time progressed, Ryan was diagnosed with Oppositional Defiant Disorder, because he continued to refuse to listen to adults and comply with the rules.

By the age of 12, he has begun to bully and annoy others. His parents have decided that the approaches they have used in the past are not working, and they are more afraid his behavior will only get worse.

Initial Post

Provide explanations for these questions and statements:

• Describe the behaviors apparent for each disorder in this scenario (Attention Deficit Hyperactivity Disorder and Oppositional Defiant Disorder).
• If this behavior becomes worse and Ryan starts to violate the rights of others, what medical diagnosis will be given and why?
• Discuss at least two types of medication appropriate to treat Ryan and support your choices with rationale and credible resources
• Describe why therapy for the parent is important in this scenario including at least two supporting rationales.

In this assignment, students will pull together the capstone project change proposal components they have been working on throughout the course to create a proposal inclusive of sections for each content focus area in the course. For this project, the student will apply evidence-based research steps and processes required as the foundation to address a clinically oriented problem or issue in future practice.

Develop a 1,250-1,500 written project that includes the following information as it applies to the problem, issue, suggestion, initiative, or educational need profiled in the capstone change proposal:

1. Background
2. Clinical problem statement.
3. Purpose of the change proposal in relation to providing patient care in the changing health care system.
4. PICOT question.
5. Literature search strategy employed.
6. Evaluation of the literature.
7. Applicable change or nursing theory utilized.
8. Proposed implementation plan with outcome measures.
9. Discussion of how evidence-based practice was used in creating the intervention plan.
10. Plan for evaluating the proposed nursing intervention.
11. Identification of potential barriers to plan implementation, and a discussion of how these could be overcome.
12. Appendix section, if tables, graphs, surveys, educational materials, etc. are created.

Review the feedback from your instructor on the Topic 3 assignment, PICOT Question Paper, and Topic 6 assignment, Literature Review. Use this feedback to make appropriate revisions to these before submitting.

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.

PLEASE FOLLOW RUBRICS

 Background of clinical problem are clearly and logically presented. Relevant support and rationale are evident. 

 Clinical problem statement is clearly and logically presented. Relevant support and rationale are evident. 

 Purpose of the change proposal in relation to providing patient care in the changing health care system is logically presented. Relevant support and rationale are eviden 

 Topic and criteria are clearly and logically presented. Relevant support and rationale are evident. 

 Topic and criteria are clearly and logically presented. Relevant support and rationale are evident. 

 Evaluation of literature is clearly and logically presented. Relevant support and rationale are evident. 

 Change or nursing theory is logically presented. Relevant support and rationale are evident. 

Implementation plan and outcome measures are clearly and logically presented. Relevant support and rationale are evident.  

 Use of evidence-based practice in intervention plan is clearly and logically presented. Relevant support and rationale are evident. 

 Plan for evaluating proposed nursing intervention is clearly and logically presented. Relevant support and rationale are evident. 

 Potential barriers and plan to overcome barriers are clearly and logically presented. Relevant support and rationale are evident. 

 Thesis is comprehensive and contains the essence of the paper. Thesis statement makes the purpose of the paper clear. 

 Clear and convincing argument that presents a persuasive claim in a distinctive and compelling manner. All sources are authoritative. 

 Writer is clearly in command of standard, written, academic English. 

 This is the ongoing project discussion portion of this class. My population is geriatric/elderly. The problem is BP…

I will attach previous discussions because it all needs to tie in together

350 words

at least 3 references cited in the discussion.

must be last 5 years

Overview: Dr. Marcia Stanhope (2020) explained that evidence-based public health practice refers to those decisions made by using the best available evidence, data and information systems and program frameworks; engaging community stakeholders in the decision-making process; evaluating the results; and then disseminating that information to those who can use the information.

Practicum Discussion: This week, your assignment will be to incorporate all of the information you have gathered from the community—including the population itself, health data, interviews/conversations with interested community members, and your community assessment, including your Windshield Survey—as well as what you have gathered from scholarly literature to propose measureable interventions. Measureable interventions mean that the results can be measured through some data that could be collected (Stanhope, 2020). This requires thinking in terms of actions and then measuring results. An evaluation of interventions is important to see whether or not they are effective in solving a health care problem. Remember, you will need to use the data you gathered to determine whether or not a problem exists in your community and to then determine whether your interventions might be effective.

Please discuss the following points in your Practicum Discussion:

• Identify one evidence-based behavior change that would promote health in your selected population.
• Suggest one specific culturally sensitive, evidence-based, measureable intervention to address the health problem for your selected population.
• Think in terms of measuring outcomes. What outcomes would you expect to see once the intervention(s) are in place? Be specific.

By Day 4

Post your response to this Discussion.

Support your response with references from the professional nursing literature.

GOAL of PRACTICUM PROJECT

Overall Purpose for Practicum: Develop a potential project to improve the health of a specific population of interest or a population at risk.

This practicum is designed to help you develop as a scholar practitioner and health leader to promote positive social change in your own community. In this practicum experience you will focus on primary prevention of a health problem in your community (see text for definition.)  You already possess the knowledge and skills to help those who are acutely ill. This experience will help learn how to prevent a health problem in a specific population at risk at the community and system level of care (see text for definition). Consequently, because you are well aware of how to care for individuals you will now develop leadership and advocacy skills to improve the health of the community.  Collaborating with other professionals and community members in your community will be the key to a successful practicum and project. Collaborate with each other in the discussions, with your instructor, with health care professionals (nurses and other disciplines), with local and state departments of health, and most importantly with the population you hope to help. As an advocate, you will promote positive social change through collaboration with families, communities, and professionals in the health care system. You will develop a culturally relevant proposal that could improve health outcomes for a specific population at risk in your community. 

WK 1

I live in a small community located in northwest metropolitan Atlanta, Georgia. The population as of 2019, was 21,760 people. The breakdown of the population is 31% under the age of 18, 14.9% 65 years or older, 51.2% are women. 73% White, 20.8% Black/African American, 12.7% Latino/Hispanic. I am currently practicing at a privately owned hospice company where we provide services to adult patients in their homes and facilities in North Georgia.

Race is a major social determinant of health. African Americans have a higher rate of significant health problems and functional limitations.  Economic resources are also a social determinant of health. As poverty increases, mortality rates increase. Economic resources are also needed to provide basic needs such as housing and food, and is required to obtain health care and medications. Social isolation and loneliness also are social determinants that have profound effects, especially during the COVID 19 pandemic.

As a hospice nurse, the majority of my patients are the geriatric population and the population at risk I am choosing to focus on for this project. The most prevalent health problems include heart disease, respiratory diseases, stroke, cancer, diabetes, and dementia.  Depression is also a problem that occurs, leading to increased suicide rates of the geriatric patient. Injuries or death related to falls is a perpetual problem in the elderly. Malnutrition is widespread and seen in nearly every older patient, which is related to access to food, decreased physical ability to shop, cook, or eat. Malnutrition could also happen due to other comorbid conditions that the senior has such as dementia.

References

U.S. Census Bureau QuickFacts: Cartersville city, Georgia. (n.d.). Www.Census.Gov. Retrieved September 7, 2020, from https://www.census.gov/quickfacts/cartersvillecitygeorgia

Equity and Social Determinants of Health Among Older Adults | American Society on Aging. (n.d.). Www.Asaging.Org. Retrieved September 7, 2020, from https://www.asaging.org/blog/equity-and-social-determinants-health-among-older-adults#:~:text=Race%20long%20has%20been%20known%20to%20be%20a

10 common elderly health issues – Vital Record. (2018, June 25). Vital Record. https://vitalrecord.tamhsc.edu/10-common-elderly-health-issues/

WK2

According to the CDC (FastStats – Hypertension, 2019), 63.1% of adults age 60 and over have high blood pressure, which is three times higher than adults aged 20-44. Georgia ranks #33rd in the nation.  (Explore High Blood Pressure in the United States | 2019 Annual Report, n.d.). High blood pressure is one of the leading risk factors in heart attack and stroke.

As a person ages, the size of the liver decreases, and the blood flow is reduced, which reduces how quickly the liver metabolizes medication. Kidney size is reduced, and blood flow is less, resulting in low renal clearance (Beers Criteria: Some Medications to Avoid in the Elderly, 2012). Because of these physiological changes, controlling blood pressure in geriatric patients can be challenging. Cognitive impairments due to age-related dementia can result in medication noncompliance and not being able to recognize symptoms of hyper/hypotension. Physical limitations result in difficulty going to regular doctor appointments, regular physical activity, and not being able to cook a healthy heart diet, all leading to uncontrolled blood pressure.

The geriatric patient needs to be closely monitored due to drug sensitivity. Because of increased sensitivity to medication, orthostatic hypotension is a significant concern for the elderly population. Orthostatic hypotension can result in falls, syncope, or death. (Arik & Yavuz, 2014)

In looking for information for this discussion, I utilized Google Scholar for my search engine. I found much of my statistics through CDC website.

References

ARIK, G., & YAVUZ, B. B. (2014). Hypertension in Older Adults-Geriatrician Point of View. Journal of Gerontology & Geriatric Research, 03(05). https://doi.org/10.4172/2167-7182.1000182

Beers Criteria: Some Medications to Avoid in the Elderly. (2012). Tmc.Edu. https://www.uth.tmc.edu/HGEC/GemsAndPearls/medications_BeersCriteria.html

Explore High Blood Pressure in the United States | 2019 Annual Report. (n.d.). America’s Health Rankings. Retrieved September 13, 2020, from https://www.americashealthrankings.org/explore/annual/measure/Hypertension

FastStats – Hypertension. (2019). https://www.cdc.gov/nchs/fastats/hypertension.htm

WK3

We all know the top risk factors for getting or becoming more severely ill from Covid-19 include age, heart disease, or diabetes. Surprisingly, there may be a genetic link to being more susceptible or getting more severely sick from Covid-19 according to researchers. (Willingham, 2020).  Researches have recently tied the severity and susceptibility of COVID-19 to two genetic links associated with a person’s immune system. One is a persons blood type, the other is a gene that regulates chemokines (Willingham, 2020). Researchers warn that this genetic knowledge is not 100% and does not factor in the social and economic inequalities that increase risk of susceptibility and severity, rather it reveals information about the disease susceptibility which may help identify therapeutic drugs to target those biological pathways and lead the way to a cure for the entire populations, not just those with specific genes (Willingham, 2020).  Chromosome 3 hold genes that encode chemokines to attract immune cells and proteins that interact with our gatekeeper into cells, angiotensin-converting enzyme 2, also known as ACE2 (Willingham, 2020).  On chromosome 9 lies DNA that determines a person’s blood type.  Compared with other blood types, type A are at a higher risk of getting Covid-19 and have a 1.5 times higher risk of respiratory failure and those with type O had the lowest chance of all blood types for getting Covid-19 or experiencing respiratory failure (Willingham, 2020). 

By 2050 the population of adults 65 and older is expected to be 83.7 million, almost double the population in 2012 (Journal of the American Geriatrics Society). The minority population of older adults is expected to rise from 20.7% in 2012 to 39.1% in 2050 with the largest increase in Asian, Native Hawaiian, and other Pacific Islander populations , and the Hispanic population over 65 will have doubled (Journal of the American Geriatrics Society).  This means that our elderly care will also have to be ethnically diverse, culturally sensitive, and unbiased.

Culturally sensitive interventions that would be top priority would be asking the patient their preferred language and offering interpreter service in that language for any education (Journal of the American Geriatrics Society, 2016).  This is important with any education but can be lifesaving for Covid-19 prevention education. It is equally important to know the patient’s education level, cognition, and hearing to ensure understanding as well as knowing if they have a surrogate or who all will be involved in decision making (Journal of the American Geriatrics Society, 2016).  Customizing care to and individual’s cultural and language preferences will result in a more positive health outcome for this diverse population (Journal of the American Geriatrics Society, 2016).

Achieving High-Quality Multicultural Geriatric Care. (2016). Journal of the American Geriatrics Society, 64(2), 255-260.  https://doi.org/10.1111/jgs.13924

Willingham, E. (2020). Genes May Influence Covid-19 Risk, New Studies Hint.  Scientific America. Retrieved from: https://www.scientificamerican.com/article/genes-may-influence-covid-19-risk-new-studies-hint/#:~:text=Combing%20through%20the%20genome%2C%20researchers,2%20coronavirus%20into%20our%20cells

Please follow the instruction below

Zero plagiarism

5 references

When you wake in the morning, you may reach for your cell phone to reply to a few text or email messages that you missed overnight. On your drive to work, you may stop to refuel your car. Upon your arrival, you might swipe a key card at the door to gain entrance to the facility. And before finally reaching your workstation, you may stop by the cafeteria to purchase a coffee.

From the moment you wake, you are in fact a data-generation machine. Each use of your phone, every transaction you make using a debit or credit card, even your entrance to your place of work, creates data. It begs the question: How much data do you generate each day? Many studies have been conducted on this, and the numbers are staggering: Estimates suggest that nearly 1 million bytes of data are generated every second for every person on earth.

As the volume of data increases, information professionals have looked for ways to use big data—large, complex sets of data that require specialized approaches to use effectively. Big data has the potential for significant rewards—and significant risks—to healthcare. In this Discussion, you will consider these risks and rewards.

To Prepare:

• Review the Resources and reflect on the web article Big Data Means Big Potential, Challenges for Nurse Execs.
• Reflect on your own experience with complex health information access and management and consider potential challenges and risks you may have experienced or observed.

By Day 3 of Week 5

Post a description of at least one potential benefit of using big data as part of a clinical system and explain why. Then, describe at least one potential challenge or risk of using big data as part of a clinical system and explain why. Propose at least one strategy you have experienced, observed, or researched that may effectively mitigate the challenges or risks of using big data you described. Be specific and provide examples.

NOTE!!!!!!!!!!!!!!

 For 7th edition APA – which is what we are using – one of the big changes is in the use of et al – you have to use it now if you have MORE than two authors.  Previously it was more than five 

  In general, scholarly sources have clear authors and dates.  So try to avoid sources with no apparent author and no date. Usually this is a problem for web site materials – not so much for sources in the library. Rule of thumb – use the library most of the time.  Remember if there is no author noted, the website owner is the author – so the American Nurses Association is considered the author of the Code of Ethics, for example. 

Please summarize nursing journal article attached below. 
APA Format!

This assignment builds on your first assignment.  We are going to investigate the food you ate in greater detail focusing on energy and the micronutrients.  For this assignment, you will complete the attached worksheet using your food record and your Food Daily Report from Assignment 1.

Download the worksheet to your computer.  Answer the questions using your food record and Food Detail Report from Assignment 1

Please see all attachments 

In dramatic movies and TV shows they will occasionally show an injured character flatlining. The doctors will then call for the “paddles” and shock the person to restart the heart. Is this the correct treatment protocol for asystole? Briefly explain your answer.

Please post your answer and also respond to the answers of at least two of your fellow students.