Choose one of the following discussion question options and answer all questions related to it. 

Option 1: Describe the relationship between stress and health. Describe a stressful situation that you have experienced at work or personally. Provide one approach that would work best in that situation to reduce incidence of experiencing the stress, one psychological conditioning strategy to increase resistance to stress, and at least one way in which to manage stress overall.

Option 2: Read the following case scenario below and answer the following questions:

Mary is a 53-year-old female, recently divorced. The couple had one daughter together who now lives in another state. Most of her social network was related to her ex-husband’s family and friends. She lives in a rural area of Kentucky and has been feeling sad and isolated and presents to the clinic for an annual check-up.

Explain how social support affects mental and physical health.

How might this scenario affect Mary’s mental and physical health?

What screening tool might be utilized here? 

How might you respond to Mary and her situation to guide her in self-management of her health?

1.

A 52-year-old obese Caucasian male presents to the clinic with a 2-day history of fever, chills, and right great toe pain that has gotten worse. Patient states this is the first time that this has happened, and nothing has made it better and walking on his right foot makes it worse. He has tried acetaminophen, but it did not help. He took several ibuprofen tablets last night which did give him a bit of relief. Past medical history positive or hypertension treated with hydrochlorothiazide and kidney stones. Social history negative for tobacco use but admits to drinking “a fair amount of red wine” every week. General appearance: Ill appearing male who sits with his right foot elevated. Physical exam remarkable for a temp of 101.2, pulse 108, respirations 18 and BP 160/88. Right great toe (first metatarsal phalangeal [MTP]) noticeably swollen and red. Unable to palpate to assess range of motion due to extreme pain. CBC and Complete metabolic profile revealed WBC 14,000 mm3 and uric acid 8.9 mg/dl. The APRN diagnoses the patient with acute gout.

Question 1 of 2:

Describe the pathophysiology of gout.   

QUESTION 2

1. A 52-year-old obese Caucasian male presents to the clinic with a 2-day history of fever, chills, and right great toe pain that has gotten worse. Patient states this is the first time that this has happened, and nothing has made it better and walking on his right foot makes it worse. He has tried acetaminophen, but it did not help. He took several ibuprofen tablets last night which did give him a bit of relief. Past medical history positive or hypertension treated with hydrochlorothiazide and kidney stones. Social history negative for tobacco use but admits to drinking “a fair amount of red wine” every week. General appearance: Ill appearing male who sits with his right foot elevated. Physical exam remarkable for a temp of 101.2, pulse 108, respirations 18 and BP 160/88. Right great toe (first metatarsal phalangeal [MTP]) noticeably swollen and red. Unable to palpate to assess range of motion due to extreme pain. CBC and Complete metabolic profile revealed WBC 14,000 mm3 and uric acid 8.9 mg/dl. The APRN diagnoses the patient with acute gout.

Question 2 of 2:

Explain why a patient with gout is more likely to develop renal calculi.  1 points   

QUESTION 3

1. Stan is a 45-year-old man who presents to the clinic complaining of intermittent fevers, joint pain, myalgias, and generalized fatigue. He noticed a rash several days ago that seemed to appear and disappear on different parts of his abdomen. He noticed the lesion below this morning and decided to come in for evaluation. He denies recent international travel and the only difference in his usual routine was clearing some underbrush from his back yard about a week ago. Past medical history non-contributory with exception of severe allergy to penicillin resulting in hives and difficulty breathing. Physical exam: Temp 101.1 ˚F, BP 128/72, pulse 102 and regular, respirations 18. Skin inspection revealed a 4-inch diameter bull’s eye type red rash over the left flank area. The APRN, based on history and physical exam, diagnoses the patient with Lyme Disease. She ordered appropriate labs to confirm diagnosis but felt it urgent to begin antibiotic therapy to prevent secondary complications.  

Question:

What is Lyme disease and what patient factors may have increased his risk developing Lyme disease?  

QUESTION 4

1. A 72-year-old female was walking her dog when the dog suddenly tried to chase a squirrel and pulled the woman down. She tried to break her fall by putting her hand out and she landed on her outstretched hand. She immediately felt severe pain in her right wrist and noticed her wrist looked deformed. Her neighbor saw the fall and brought the woman to the local Urgent Care Center for evaluation. Radiographs revealed a Colles’ fracture (distal radius with dorsal displacement of fragments) as well as radiographic evidence of osteoporosis. A closed reduction of the fracture was successful, and she was placed in a posterior splint with ace bandage wrap and instructed to see an orthopedist for follow up.  

Question:

What is osteoporosis and how does it develop?    

QUESTION 5

1. A 42-year-old woman presents to the clinic with a four-month history of generalized joint pain, stiffness, and swelling, especially in her hands. She states that these symptoms have made it difficult to grasp objects and has made caring for her 6 and 4-year-old children problematic. She admits to increased fatigue, but she thought it was due to her stressful job as well as being a single mother. No significant past medical history but recalls that one of her grandmothers had “crippling” arthritis. Physical exam remarkable for bilateral ulnar deviation of her hands as well as soft, boggy proximal interphalangeal joints. The metatarsals of both of her feet also exhibited swelling and warmth. The diagnosis for this patient is rheumatoid arthritis.

Question:

Explain why patients with rheumatoid arthritis exhibit these symptoms and how does it differ from osteoarthritis?  

QUESTION 6

1. A 32-year-old Caucasian male presents to the office with complaints of back pain, stiffness, especially in the morning, interrupted sleep due to pain, and difficulty in leaning over to tie his shoes. The patient first noticed these symptoms about 6 months ago but attributed them to his weekend basketball team’s games. He said he is exhausted due to sleep interruption. He has taken acetaminophen with some relief but says the naproxen seems to be working better. Married with 2 small children and works as a bank manager. Physical exam: Lungs clear but decreased chest excursion noted as well as decreased range of motion of hips and forward flexion, rotation, and lateral flexion restricted. Spine radiographs in the office revealed a slight kyphosis along with ankylosis at L5-S1. The APRN suspects the patient may have ankylosing spondylitis (AS). The APRN orders laboratory tests including an HLA-B27. 

Question:

Why did the APRN order an HLA-B27 lab? How would that lab result assist in understanding what ankylosing spondylitis?   

QUESTION 7

1. A 17-year-old male presents to the clinic with a chief complaint of pain in his right elbow. He says the pain is sharp, especially with pronation and supination.  He noticed the pain several weeks ago after his tennis team went to a regional competition. When he rests, the pain seems to go away. The pain is alleviated when he takes Naprosyn. No history of trauma or infection in the elbow. Past medical and social history non contributary. He is a junior at the local high school and just started taking tennis lessons 2 months ago and his coach is working with him on his backhand serve. Focused physical exam revealed point tenderness over the lateral epicondyle which increases with pronation and supination. The APRN diagnoses him with lateral epicondylitis and orders a wrist splint to prevent wrist flexion. 

Question:

Why did the APRN feel a wrist splint would be helpful? What patient characteristics lead to this diagnosis.

QUESTION 8

1. A 24-year-old Caucasian male was brought to the Emergency Room (ER) by Emergency Medical System (EMS) after suffering a “convulsion” episode at work that didn’t stop. Upon arrival to the ER, the patient was noted to be actively seizing with tonic-clonic movements. The patient’s boss accompanied him to the ER and gave a statement that the patient appeared in his usual good health earlier in the morning when they started working at their jobs in an auto parts store. The boss didn’t know of any past medical history. The boss brought along the patients next of kin information, and the patients mother told the ER that the patient has a prior history of seizures but hadn’t had a seizure in several years. The family thought he had “outgrown them.” Past medical history, other than previous seizures, and social history non-contributory. No history of alcohol or drug abuse and had no history of vaping. The ER APRN diagnoses the patient with status epilepticus and along with the ER staff, initiated appropriate treatment.

Question:

What is a seizure and why is status epilepticus so dangerous for patients?   

QUESTION 9

1. A 32-year-old while female presents to the Urgent Care with complaints of blurry vision and “fuzzy thinking” which has been present for the last several weeks or so. She works as an executive for an insurance company and put her symptoms down to the stress of preparing the quarterly report. Today, she noticed that her symptoms were worse and were accompanied by some fine tremors in her hands. She has been having difficulty concentrating and has difficulty voiding. She remembers her eyes were bothering her a few months ago and she went to the optometrist who recommended reading glasses with small prism to correct double vision. She admits to some weakness as well. No other complaints of fevers, chills, upper respiratory tract infections, or urinary tract infections. Past medical and social history noncontributory. Physical exam significant for 4th cranial nerve palsy. The fundoscopic exam reveals edema of right optic nerve causing optic neuritis. Positive nystagmus on positional maneuvers. There are left visual field deficits. There was short term memory loss with listing of familiar objects. The APRN tells the patient that she will be referred to a neurologist due to the high index of suspicion for multiple sclerosis (MS).  

Question:

What is multiple sclerosis and how did it cause the above patient’s symptoms?  

QUESTION 10

1. 61-year-old male complains of intermittent weakness and muscle fatigue that has progressively worsened over the past month. He was an internationally known extreme mountain climber but now he says he has difficulty in getting his morning paper. Initially he thought his symptoms of profound leg weakness and fatigue were due to his age and history of injuries from mountain climbing. Over the past few months, he also reports having noticed “blurriness” when working on his antique train collection or reading for long periods of time. He has developed intermittent double vision that seems to be worse when reading at bedtime. He also reports an occasional “droopy” eye lid. Past medical and social history noncontributory. Physical exam reveals weakness of right extra ocular muscle (EOM) with repetition. There is positive nystagmus and symmetrical upper extremity weakness with fasciculations. Lower extremities within normal limits (WNL).   The APRN suspects the patient has myasthenia gravis (MG).  

Question:

What is the underlying pathophysiology of MG?

QUESTION 11

1. A 67-year-old male presents to the clinic along with his family with a chief complaint of having problems with his short-term memory. His family had dismissed these problems and attributed them to the aging process. Over time they have noticed changes in his behavior, along with increased confusion and difficulty completing basic tasks. He got lost driving home from the bowling alley and had to be brought home by the police department. He is worried that he may have Alzheimer’s Disease (AD). Past medical and social history positive for a minor cerebral vascular accident when he was 50 years old but without any residual motor or sensory defects. No history of alcohol or tobacco use. Current medication is clopidogrel 75 mg po qd.  Neurological testing confirms the diagnosis of AD. 

Question:

What is Alzheimer’s Disease and how does amyloid beta factor into the development and progression of the disease?

QUESTION 12

1. A 22-year-old male was an unrestrained front seat passenger of a car traveling at 50 miles per hour. The driver swerved to avoid hitting a deer that darted in front of the car and hit a tree. The patient was ejected from the vehicle. He was awake and alert at the scene when the paramedics arrived, and his pupils were equal and reactive to light. He was placed in a hard-cervical collar per protocol and log rolled onto a long backboard. He was breathing spontaneously at the scene, but pulse oximetry in the EMS unit revealed a SaO2 of 88% on room air. He was placed on 100% oxygen via non-rebreather mask and was taken to a Level I trauma center with the following vital signs: 

Vital signs: BP 90/50, Pulse 48 and regular, Respirations 24 and shallow with some use of accessory muscles, temp 95.2 F rectally. He was awake and answering questions appropriately but says he cannot feel his arms or legs. Glasgow Coma Scale 14. His skin was warm and dry with minor abrasions noted on his arms. According to family members, past medical history noncontributory and social history reveals only occasional alcohol use and no tobacco or vaping history. Full work up in the ED revealed a fracture-dislocation of C4 with assumed complete tetraplegia (formerly called quadriplegia). No other injuries noted He was given several liters of IV fluid, but his blood pressure remained low.  

Question 1 of 2:

Explain the differences between primary and secondary spinal cord injury (SCI)?  

QUESTION 13

1. A 22-year-old male was an unrestrained front seat passenger of a car traveling at 50 miles per hour. The driver swerved to avoid hitting a deer that darted in front of the car and hit a tree. The patient was ejected from the vehicle. He was awake and alert at the scene when the paramedics arrived, and his pupils were equal and reactive to light. He was placed in a hard-cervical collar per protocol and log rolled onto a long backboard. He was breathing spontaneously at the scene, but pulse oximetry in the EMS unit revealed a SaO2 of 88% on room air. He was placed on 100% oxygen via non-rebreather mask and was taken to a Level I trauma center with the following vital signs: 

Vital signs: BP 90/50, Pulse 48 and regular, Respirations 24 and shallow with some use of accessory muscles, temp 95.2 F rectally. He was awake and answering questions appropriately but says he cannot feel his arms or legs. Glasgow Coma Scale 14. His skin was warm and dry with minor abrasions noted on his arms. According to family members, past medical history noncontributory and social history reveals only occasional alcohol use and no tobacco or vaping history. Full work up in the ED revealed a fracture-dislocation of C4 with assumed complete tetraplegia (formerly called quadriplegia). No other injuries noted He was given several liters of IV fluid, but his blood pressure remained low.  

Question 2 of 2:

What is spinal shock and how it is different from neurogenic shock? 

QUESTION 14

1. A 22-year-old male was an unrestrained front seat passenger of a car traveling at 50 miles per hour. The driver swerved to avoid hitting a deer that darted in front of the car and hit a tree. EMS on the scene noted a stellate fracture of the windshield on the passenger side. The patient was non-responsive at the at the scene when the paramedics arrived, and his pupils were unequal with the left pupil larger and sluggish to react to light. He was placed in a hard-cervical collar per protocol and log rolled onto a long backboard. He was breathing spontaneously at the scene, but pulse oximetry in the EMS unit revealed a SaO2 of 78% on room air. He was intubated at the scene for airway protection and transported to a Level 1 trauma center. Glasgow Coma Scale=3 

After a full trauma work up, the patient was diagnosed with an isolated traumatic brain injury with acute subdural hematoma secondary to coup-contrecoup mechanism of injury. He was emergently taken to the operating room for craniotomy after which he was taken to the Intensive Care Unit (ICU) for close monitoring. He had an intracranial bolt for measurements of his intracranial pressure (ICP).

Question 1 of 2:

Explain the differences between primary and secondary traumatic brain injuries (TBIs)? 

QUESTION 15

1. A 22-year-old male was an unrestrained front seat passenger of a car traveling at 50 miles per hour. The driver swerved to avoid hitting a deer that darted in front of the car and hit a tree. EMS on the scene noted a stellate fracture of the windshield on the passenger side. The patient was non-responsive at the at the scene when the paramedics arrived, and his pupils were unequal with the left pupil larger and sluggish to react to light. He was placed in a hard-cervical collar per protocol and log rolled onto a long backboard. He was breathing spontaneously at the scene, but pulse oximetry in the EMS unit revealed a SaO2 of 78% on room air. He was intubated at the scene for airway protection and transported to a Level 1 trauma center. Glasgow Coma Scale=3 

After a full trauma work up, the patient was diagnosed with an isolated traumatic brain injury with acute subdural hematoma secondary to coup-contrecoup mechanism of injury. He was emergently taken to the operating room for craniotomy after which he was taken to the Intensive Care Unit (ICU) for close monitoring. He had an intracranial bolt for measurements of his intracranial pressure (ICP).

Question 2 of 2:

The APRN is called by the ICU staff because the patient’s ICP has risen to 22 mmHg. The APRN recognizes the urgent need to lower the ICP. The APRN institutes measures to decrease the ICP and increase the cerebral perfusion pressure (CPP). What are the factors that determine CPP?   

QUESTION 16

1. A 68-year-old man was brought to the emergency department by his family. During his routine morning walk he noticed a sudden onset of left facial numbness associated with a dull headache on the right posterior aspect of his head. He was staggering to the right side and feeling unsteady and nauseated, with no vomiting. He telephoned his wife, who noticed his speech was slow and slurred, but there was no word-finding difficulty. His family immediately took him to the hospital. There was a history of hypertension, hypercholesterolemia, ischemic heart disease (MI and PCI with bare metal stent in 2007) and probable transient ischemic attack (TIA) at the time of cardiac intervention. His medication included atenolol, ramipril, simvastatin, aspirin and clopidogrel.

Within one hour, the patient’s symptoms had totally resolved. The diagnosis of transient ischemic attack was made, and the patient was discharged to home with instructions to contact his healthcare provider (HCP) for follow-up.

Question:

Why did the patient’s symptoms totally resolve?

QUESTION 17

1. An 83-year-old man presents with a history of atrial fibrillation (AF), hypertension, and diabetes. His daughter, who accompanied the patient, states that yesterday the patient had a period when he could not speak or understand words, and that approximately 4 weeks prior he staggered against a wall and was unable to stand unaided because of weakness in his legs. She states that both instances lasted approximately a half-hour. She was unable to persuade her father to go to the emergency room either time. Today he suffered another episode of right sided weakness, dysarthria, and difficulty with speech. Past medical history: Hypertension for 15 years, well controlled; diabetes for the past 10 years, and hyperlipidemia. Medications: Diltiazem CD 300 mg daily; lisinopril 40 mg daily; metformin 500 mg twice daily; aspirin 81 mg daily and atorvastatin 20 mg po qhs.  

Social history: reported former smoker with 40 pack year history. Alcohol -drinks one beer a day. Denies any other substance abuse. Review of systems: Denies dyspnea, dizziness, or syncope; complains that he cannot move or feel his right arm or leg. Difficulty with speech.  

Physical exam: Vitals: height = 70 inches; weight = 185 pounds; body mass index = 26.5; BP = 134/82 mm Hg; heart rate = 88 bpm at rest, irregularly irregular pattern.  

HEENT remarkable for expressive aphasia, eyes with contralateral homonymous hemianopsia. 

No loss of sensation but unable to voluntarily move right arm or leg. 

The patient was diagnosed with a right middle cerebral artery vascular accident (CVA) secondary to atrial fibrillation (AF) 

Question:

How does atrial fibrillation contribute to the development of a CVA?    

QUESTION 18

1. A 57-year-old male construction worker comes to the clinic with a chief complaint of pain in his right hip. The pain has progressively gotten worse over the last 2 months and he has been having trouble sleeping. There is little pain in the morning, but he is a bit stiff. The pain increases as the day wears on.  has taken acetaminophen without any relief but states that the ibuprofen does work a little bit. He is anxious since the hip pain has limited his ability to work and he is afraid that his boss will fire him if he cannot perform his usual duties. There is no history of past trauma or infection in the joint. Past medical history noncontributory. Social history without history of alcohol, tobacco, or illicit drug use. Physical exam remarkable for decreased range of motion of the right hip. BMI 34 kg/m2. Radiographs in the office demonstrated asymmetrical joint space narrowing of the right hip with osteophyte formation. Several areas of the hip showed bone-on-bone contact with loss of the articular cartilage. The APRN tells the patient he has osteoarthritis (OA) and refers the patient to an orthopedist for evaluation of his need for a total hip replacement.  

Question:

Describe how osteoarthritis develops and forms and distinguish primary osteoarthritis from secondary arthritis?   

QUESTION 19

1. A 34-year-old Caucasian female presents to the clinic with a chief complaint of widespread pain in her joints and muscles. She states that her skin seems sensitive and sometimes it hurts to be touched. She has had extreme fatigue for the past 4 months. She admits to being depressed and it unable to sleep well. She has had to drop out of her gardening club due to pain. She says that bright lights and loud noises really bother her. Past medical history noncontributory. Social history is significant for her divorce from her husband 14 months ago. She is the mother of 2 small children and works as an administrative assistant as the local insurance company. Physical exam remarkable for tender points over her posterior supraspinatus muscles, occiput, trapezius, gluteal area, and sacroiliac joints bilaterally. The APRN tells the patient that she most likely has fibromyalgia, based on her physical exam.  

Question 1 of 2:

What are the underlying causes of fibromyalgia?    

QUESTION 20

1. A 34-year-old Caucasian female presents to the clinic with a chief complaint of widespread pain in her joints and muscles. She states that her skin seems sensitive and sometimes it hurts to be touched. She has had extreme fatigue for the past 4 months. She admits to being depressed and it unable to sleep well. She has had to drop out of her gardening club due to pain. She says that bright lights and loud noises really bother her. Past medical history noncontributory. Social history is significant for her divorce from her husband 14 months ago. She is the mother of 2 small children and works as an administrative assistant as the local insurance company. Physical exam remarkable for tender points over her posterior supraspinatus muscles, occiput, trapezius, gluteal area, and sacroiliac joints bilaterally. The APRN tells the patient that she most likely has fibromyalgia, based on her physical exam.  

Question 2 of 2:

The APRN tells the patient that the tender points are no longer used to diagnose FM. She suggests that the patient takes the Widespread Pain Index (WPI) and the Symptom Severity Inventory (SSI). The patient asks the APRN what these tests are for. What is the APRN’s best answer?

1) Minimum 7 full pages (Follow the 3 x 3 rule: minimum three paragraphs per part)

Parts 6, and 7 must be different. Different writing and perspective, but always answering questions objectively

              Part 1: Minimum 1 page

              Part 2: minimum 1 page

              Part 3: minimum 1 page

              Part 4: minimum 1 page 

              Part 5: Minimum 1 page

              Part 6: minimum 1 page

              Part 7: minimum 1 page

Submit 1 document per part

2)¨******APA norms

          All paragraphs must be narrative and cited in the text- each paragraphs

          Bulleted responses are not accepted

          Dont write in the first person 

          Dont copy and pase the questions.

          Answer the question objectively, do not make introductions to your answers, answer it when you start the paragraph

         Submit 1 document per part

3)****************************** It will be verified by Turnitin (Identify the percentage of exact match of writing with any other resource on the internet and academic sources, including universities and data banks) 

********************************It will be verified by SafeAssign (Identify the percentage of similarity of writing with any other resource on the internet and academic sources, including universities and data banks)

4) Minimum 3 references per part not older than 5 years

5) Identify your answer with the numbers, according to the question.

Example:

Q 1. Nursing is XXXXX

Q 2. Health is XXXX

6) You must name the files according to the part you are answering: 

Example:

Part 1.doc 

Part 2.doc 

__________________________________________________________________________________

 Part 1: Community Nursing

In thinking of five social determinants of health as identified in Healthy People 2020

1. List and identify (Define) the social determinants specifically that may be barriers to home care and case or care management services. Explain your answer with examples.

Part 2:  Nursing and the Aging Family  

1.      Describe at least three possible reasons that reimbursement is provided for medical procedures for pain relief rather than for comforting strategies that nurses could provide.

2.     Describe two safety risks that could result from the following health problems: hypertension, arthritis, right-sided weakness, and Alzheimer’s disease.

Part 3:

1. Select two essential psychomotor skills for a clinical course or courses in nursing and explain them. 

2. Discuss how you might collaborate with an LRC person to facilitate student performance with the skills you selected.

Part 4:

After your graduation, you will be in an academic or clinical field. Depending on your field choice, 

1. Discuss one nursing theory and identify the effect the implications of this theory could have on nursing administration, management, or education.

Part 5:

1. What are the challenges  with validity and trustworthiness in qualitative research?

2. What steps for implement to ensure qualitative research is reliable?

Part 6:

Review these two articles.

Connelly, L. M. (2014). Use of theoretical frameworks in research. MEDSURG Nursing, 23(3), 187-188.

Green, H. E. (2014). Use of theoretical and conceptual frameworks in qualitative research. Nurse Researcher, 21(6), 34-38.

Next, review the evidence you are collecting for your proposed study (See File 1). 

1. Which theories have others cited? 

2. Are you seeing a common theme? 

3. Next construct a conceptual map (see p. 138 in your textbook). Use Microsoft Word or Microsoft PowerPoint and include this as an attachment. Be sure you have defined the concepts and included relational statements.

Part 7:

Review these two articles.

Connelly, L. M. (2014). Use of theoretical frameworks in research. MEDSURG Nursing, 23(3), 187-188.

Green, H. E. (2014). Use of theoretical and conceptual frameworks in qualitative research. Nurse Researcher, 21(6), 34-38.

Next, review the evidence you are collecting for your proposed study (See File 2). 

1. Which theories have others cited? 

2. Are you seeing a common theme? 

3. Next construct a conceptual map (see p. 138 in your textbook). Use Microsoft Word or Microsoft PowerPoint and include this as an attachment. Be sure you have defined the concepts and included relational statements.

Research the health-illness continuum and its relevance to patient care. In a 750-1,000 word paper, discuss the relevance of the continuum to patient care and present a perspective of your current state of health in relation to the wellness spectrum. Include the following:

1. Examine the health-illness continuum and B.discuss why this perspective is important to consider in relation to health and the human experience when caring for patients.
2. Explain how understanding the health-illness continuum enables you, as a health care provider, to better promote the value and dignity of individuals or groups and to serve others in ways that promote human flourishing.
3. Reflect on your overall state of health. B.Discuss what behaviors support or detract from your health and well-being. C. Explain where you currently fall on the health-illness continuum.
4. Discuss the options and resources available to you to help you move toward wellness on the health-illness spectrum. A.Describe how these would assist in moving you toward wellness (managing a chronic disease, recovering from an illness, self-actualization, etc.).

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. 

Benchmark InformationThis benchmark assesses the following competency:RN-BSN5.1. Understand the human experience across the health-illness continuum.

Topic 1: Disease Outbreak

Select an infectious disease and research the CDC website for information about the disease including: 

• its natural history,
• presenting symptoms, and
• outbreak characteristics
• Identify an occurrence of the disease by searching the Internet for recent reports of this disease and compare that episode or occurrence with information from the CDC website.
• How closely did that outbreak resemble the case definition?

 I NEED A RESPONSE TO THIS ASSIGNMENT 

ZERO PLAGIARISM

3 REFERENCES

 According to Wheeler (2014), cognitive behavioral therapy (CBT) is effective and widely used for the treatment of psychiatric disorders and mental health issues such as depression, anxiety, personality disorders, and substance abuse in group, family, and individual therapy. Therapists use CBT to focus on specific problems, feelings, thoughts, and behaviors in order for the client to recognize negative thoughts and behaviors affecting their lives (Wheeler, 2014). Gonzalez-Prendes and Resko (2012) state that maladaptive behavior and emotions are caused by faulty thinking patterns. Self-monitoring, goal setting, and problem solving are strategies of CBT (Gonzalez-Prendes & Resko, 2012). According to Gonzalez-Prendes and Resko (2012), individuals experience a reduction in symptoms with more realistic, balanced thinking as a result of becoming more aware of negative patterns and cognitions when CBT is utilized in therapy.

        The goal of using CBT in group therapy is to change or decrease thoughts that provoke anxiety and symptoms that maintain behaviors through the use of cognitive and behavioral strategies (Safak et al., 2014). In group CBT, individuals learn skills to help themselves feel better, cope with and manage their difficulties, and decrease their risk for future relapse of symptoms (Wolgensinger, 2015). Group therapy is more cost-effective and allows therapists to provide therapy to more individuals during their sessions (Thiruchselvam, 2020). Group therapy offers individuals social support. Individuals in groups that utilize a CBT approach find it helpful to meet others with similar issues, since they are able to help one another and share their experiences (Wolgensinger, 2015).   

        The use of CBT in family therapy is more cost-effective than individual therapy and is comprised of fewer individuals than group therapy (Nichols & Davis, 2020). Family therapy that utilizes CBT helps the clients examine and restructure the thoughts and perceptions family members have (Nichols & Davis, 2020). The cognitions, emotions, and behavior of individuals can cause conflict within a family. According to Nichols and Davis (2020), family CBT assumes that individuals in a family influence and are influenced by the other family members. The behaviors of one member of a family prompt behavior, cognitions, and emotions in other family members, which then cause reactive cognitions, behavior, and emotions in the original family member (Nichols& Davis, 2020). Therapists that use family CBT promote collaborative relationships and work toward getting the family to function better as a whole.

        The identification of altered cognition between family members can be modified with the use of CBT (Nichols & Davis, 2020). An example from practicum is a family, consisting of a father, mother and teenage son who attend family counseling every other week. The family is seeking counseling to find ways to cope with the son’s behaviors and disregard for authority within the home. The parents state the son has total disregard for consequences of his actions. The son states his parents are too controlling and micromanage everything he does. In family CBT, the cognitions, emotions, and behaviors are seen as having a mutual influence on one another (Nichols & Davis, 2020).  CBT would benefit this family since it promotes a collaborative relationship and increases cooperation in treatment (Nichols & Davis, 2020). The family was encouraged to journal their thought and emotions, which were discussed during therapy sessions. The importance of communication within the family was discussed and they were encouraged to talk about their thoughts and emotions without arguing or verbally attacking one another. Communication skills can be strengthened with family therapy through exploring roles and behaviors and how they affect the family as a whole.

         Challenges that counselors might encounter when using CBT in a group setting include getting all individuals to participate without monopolizing the group and maintaining cohesiveness between group members. Individuals in group therapy may not be willing to share their personal experiences or express their emotions freely (Wolgensinger, 2015). To ensure the effectiveness of group therapy, the therapist should select members that are willing to participate and share their experiences with the other individuals in the group. When selecting individuals to participate in a group, the therapist should also be mindful of the characteristics of the group members (Wolgensinger, 2015). The characteristics and personalities of group members play an important role in the atmosphere of the group and cohesion of group members.

References

Gonzalez-Prendes, A., & Resko, S. M. (2012). Cognitive-behavioral therapy. In S. Ringel & J. Brandell (Eds.), Trauma: Contemporary directions

       in theory, practice, and research (pp. 14-40). Thousand Oaks, CA: SAGE Publications, Inc. http://dx.doi.org/10.4135/9781452230597.n2

Nichols, M., & Davis, S. D. (2020). The essentials of family therapy (7th ed.). Pearson.

Safak, Y., Karadere, M. E., Ozdel, K., Ozcan, T., Turkcapar, M. H., Kuru, E., & Yucens, B. (2014). The effectiveness of cognitive behavioral

         group psychotherapy for obsessive-compulsive disorder. Turkish Journal of Psychiatry, 25(4), 225-233. https://doi.org/10.5080/u7510

Thiruchselvam, T., Patel, A., Daros, A. R., Jain, E., Asadi, S., Laposa, J. M., Kloiber, S., & Quilty, L. C. (2020). A multidimensional investigation

          of anxiety sensitivity and depression outcomes in cognitive-behavioral group therapy. Psychiatry Research, 293, 1-8.

          https://doi-org.ezp.waldenulibrary.org/10.1016/j.psychres.2020.113446

Wheeler, K. (Eds.). (2014). Psychotherapy for advanced practice psychiatric nurse: A how-to guide for evidence-based practice (2nd ed.).

         Springer Publishing Company.

Choose one of the following case study descriptions and answer the following questions:

Case study 1: Adolescent male (17) with cough. Admits to smoking cigarettes and occasional marijuana.

Case study 2: Adult Female (29) Lives near and works in sugar cane fields. Family Hx asthma.

Case study 3: Elderly male (80) with COPD (Emphysema).

1. What questions would you ask the client to elicit pertinent information that would assist in developing a health promotion plan?

2. What evidence-based practice health promotion nursing interventions (strategies) would you suggest for this patient?

3. What resources and/or technology applications could be provided to guide the patient in self-management of their condition? Be specific by providing an actual, usable app or website.

Please review the Discussion Rubric for detailed requirements of your posts.

Write a five-paragraph argumentative essay with the following topic:

Can marijuana help cancer patients and other people who suffer from constant pain?

Take your stance and defend your claim.   

 Introduction 

      Thesis statement

 Supporting paragraph 1

 Supporting paragraph 2

Counterview along with Rebuttal

 Conclusion

Plagiarism is academic misconduct. Avoid copying and pasting any outside source. 

POST 1

L. Thorpe

Discussion 1 Learning Online

Strategy for Success Academic

Academic engagement is a multidimensional effort that encompasses the cognitive desire to excel by investing time and effort into time management (Aparicio et al., 2017). As a nursing health care professional, the demands and skills needed to manage a busy schedule require careful planning. The single most useful tool that has contributed to my overall success thus far is time management. Arguedas et al. (2016) point out there is a need to integrate good time management skills in preparing for academic success. Academic success requires focus and educational planning as procrastination reduces academic success. Procrastination is a prevailing phenomenon in the academic settings with a wide range of negative consequences. Procrastination can negatively influence a student’s well-being and performance. Another common barrier to being successful is inadequate time management and procrastination (Arguedas et al., 2016). Often individuals put off things to the very last moment even after knowing that it will put them in turmoil. Personally, my success stems from always working ahead. Delaying things to the last-minute always results in anxiety and distress. Time and planning ahead can be a kind resource that can increase productivity. Time management is all about how we manage ourselves. It is about finding the smartest and most rewarding way to use every spare time, which includes every waking hour, minute, and second of each day.

Beneficial Strategy

Good time management skills are essential for students as no one knows the unexpected emergencies that may arise each day. Students need to have practical time management skills daily and weekly for optimal academic success (Cohen & Baruth, 2017). Increasing the quality of activities performed in a limited period of time is the main aim of time management. Prioritizing daily tasks is essential for managing a student’s time effectively (McDaniel et al., 2016). Deciding on how individuals spend their time is critical in making ourselves productive and more organized. This requires setting goals, prioritizing, planning, and organizing minimizing time-wasting. While time management is beneficial, success utilizing technology is crucial. Learning how to navigate technology will boost and empower students as current technologies are effective in advanced education. Learning how to navigate an online research platform will only accelerate one skill in becoming more proficient.

References

Aparicio, M., Bacao, F., & Oliveira, T. (2017). Grit in the path to e-learning success. Computers in Human Behavior, 66, 388-399. https://doi.org/10.1016/j.chb.2016.10.009

Arguedas, M., Daradoumis, T., & Xhafa, F. (2016). Analyzing the effects of emotion management on time and self-management in computer-based learning. Computers in Human Behavior, 63, 517-529. https://doi.org/10.1016/j.chb.2016.05.068

Cohen, A., & Baruth, O. (2017). Personality, learning, and satisfaction in fully online academic courses. Computers in Human Behavior, 72, 1-12. https://doi.org/10.1016/j.chb.2017.0 2.030

McDaniel, S. C., Houchins, D. E., & Robinson, C. (2016). The effects of check, connect, and expect on behavioral and academic growth. Journal of Emotional & Behavioral Disorders, 24(1), 42–53. https://doi.org/10.1177/1063426615573262

POST 2

P. Mediros

Walden University and AACN: Social Change 

On evaluating the similarities in the focus of social change amongst Walden University and the AACN’s competencies, I discovered that both concepts are outlined on the advancement of both human and social outcomes. Walden University (2020) social change message is defined as “a deliberate process of creating and applying ideas, strategies, and actions to promote the worth, dignity, and development of individuals, communities, organizations, institutions, cultures, and societies”. On the contrary, the AACN (2006) envisions the DNP graduate to identify potential systemic changes, implement improvements in the care of the particular patient population to improve the overall outcome of patient care. Meanwhile also “demonstrating practice expertise, specialized knowledge, and expanding the responsibility and accountability in the care and management of individuals and families” (AACN, 2006). 

Relates to my Professional/Academic Goal

            Walden University and AACN efforts of social change relates heavily on my professional and academic goals. As I have mentioned in prior postings, I am a practitioner in a critical care setting, a high-stressed environment, critically ill patients with a variety of disease processes, and constant change occurring. It is exceptionally important to continuously allow for change to occur and to adapt to it. When one becomes resistant to change, it can only result in growth restrictions. I personally believe that if you do not get out of your comfort zone, then you cannot allow for growth to occur. As timid and uncertain my path may direct me, I strongly believe that the change is the ultimate growth process to succeed both professionally and academically. For example, deciding to advance my career path by enrolling the DNP program was frightful for me; especially committing to a long hall of educational demands. 

Two Goals for Incorporating Social Change within my Professional/Academic 

My ultimate goals are to become a scholarly practitioner and practice at the highest level of nursing. Brown (2005), describes the direct practice of APN is characterized by the use of holistic perspective, therapeutic partnerships to facilitate informed decision making, positive lifestyle change, use of diverse, evidence-based interventions in health and illness management.  I plan on utilizing scientific knowledge and practice expertise to deploy social change and promote high quality patient outcomes.  

References

American Association of Colleges of Nursing (AACN). (2006). The Essentials of Doctoral Education for Advanced Nursing Practice. Washington, DC: Author. Retrieved from http://www.aacnnursing.org/DNP/DNP-Essentials

Brown, S.J. (2005). Advanced practice nursing: An integrative Approach (3rd ed.), 134-185. Philadelphia, PA: Elsevier Saunders

Walden University. (2020). Social Change. Retrieved on Dec. 6, 2020 from https://catalog.waldenu.edu/content.php?catoid=176&navoid=62600

AN EXAMPLE OF HOW THE REPLY COMMENT LOOKS.

The management of time and self-regulation is critical to academic success (Oettingen et al., 2015). Managing a calendar and organizing time is not a strong attribute many individual processes. Time management is about how one manages self. Individuals cannot manage time at the last minute. Time management works well by organizing and prioritizing the activities, which are of prime importance for providing quality care and maintaining a personal and professional balance (Arguedas et al., 2016). Effective time management has been found to lead to a host of positive consequences reaching from high academic achievement. Deciding on how one spends time is very important in making oneself productive and organized. Time management is setting and achieving one’s goals and reducing the stress that results from poor time management. As a student, whenever time management is limited, one is unable to think critically to prioritize tasks, which tends to result in missing assignments.

References

Arguedas, M., Daradoumis, T., & Xhafa, F. (2016). Analyzing the effects of emotion management on time and self-management in computer-based learning. Computers in Human Behavior, 63, 517-529. https://doi.org/10.1016/j.chb.2016.05.068

Oettingen, G., Kappes, H. B., Guttenberg, K. B., & Gollwitzer, P. M. (2015). Self-regulation of time management: Mental contrasting with implementation intentions. European Journal of Social Psychology, 45, 218-229. https://doi.org/10.1002/ejsp.2090

Week 4: Advocacy Letter

Submit Assignment

Purpose:

The purpose of this assignment is to provide an opportunity for students to apply and disseminate information based on the status of public health policies and practices designed to address important public health problems, concerns, and implications for nursing practice.

Requirements:

Through this assignment, the student will write a letter to their legislator (House of Representatives or Senator) on a public health topic. The student will state relevant statistics in the area, indicate how this issue is affecting nursing practice, and describe the action the student would like the legislator to take in regards to a current bill, or in support of the issue. Please see the attached document for full instructions.  See the sample letter for a template to use. 

NR442_Faculty Assignment_Advocacy Letter (1).docx

sampleletter (1).pdf

Rubric

Advocacy Letter RubricAdvocacy Letter RubricCriteriaRatingsPtsThis criterion is linked to a Learning OutcomePurpose and IdentityPurpose and Identify (includes correct identification of the legislator based on address)15.0 pts
This criterion is linked to a Learning OutcomeBackgroundIncludes:
Two statistics
Affected population20.0 pts
This criterion is linked to a Learning OutcomeRequest of legislator:• Solution identified and is realistic10.0 pts
This criterion is linked to a Learning OutcomeGrammar and Construction• Proper grammar and mechanics
• Correct spelling
• Websites or resources for statistics
• Word count5.0 pts
Total Points: 50.0PreviousNext