Controversy, Issues, Challenges, and Regulatory Implications minimum 5 slides.How might issues surrounding the chosen technology be addressed/solved?• Provide statistically significant data or evidence to support your findings.ConclusionSummary• Key points• Discoveries/surprises• Lessons learned by the team
1) Please reply to the following discussion with one reference. Participate in the discussion by asking a question, providing a statement of clarification, providing a point of view with a rationale, challenging an aspect of the discussion, or indicating a relationship between two or more lines of reasoning in the discussion. Cite resources in your responses to other classmates.2) Also, answer the following question in a separate small paragraph with one reference.Question: She tells you she uses topical progesterone, does this make a difference?DiscussionDiscuss the questions that would be important to include when interviewing a patient with this issue, including any risk factors she may have.Some of the questions that the clinician may ask the patient will include the following: At what age did the patient begin menarche? How long has the mass been present? Do you have a history of breast lumps? Did the lump change in size with your menstrual cycle? How long has it been since your last menses? Is there any discharge coming from the nipple? Did you experience recent weight loss? Did you take any hormone replacement therapy (HRT)? Did you have any trauma to the breast? Have you had a mammogram or breast biopsies and when and what were the results? Do you have a family history of breast cancer? Do you have any diagnosis of breast cancer (Hawkins, Roberto-Nichols, & Stanley-Haney, 2016)?Describe the clinical findings that may be present in a patient with this issue. Are there any diagnostic studies that should be ordered on this patient? Why?The patient with the diagnosis will breast cancer may not experience any symptoms in the initial stages of the development of the disease. Indicators that dictate the progression of the disease includes the following symptoms that the person experiences such as a change in the size, shape, or skin changes of the breast, color, skin dimpling, nipple inversion, nipple abnormalities, discharge, and axillary lump (Koo, Wagner, Abel, McPhail, & Rubin, 2017). To detect a difference in the breast, tissue the patient must be examined upright with arms raised, hands pressed against hips, and leaning forward. The axillae and the supraclavicular sites should be assessed when examining the breast tissue. The best technique to use detect a mass when palpating the breast is the vertical strip pattern (Bickley, 2017). The diagnosis of breast cancer is determined through diagnostic mammography and breast biopsy. The use of the diagnostic mammogram assists the clinician in determining the presence of a benign or malignant tumor in woman older than 40 years old. A breast tissue biopsy is used to obtain a large tissue sample of a mass to be examined to determine the presence of cancerous cells in the breast tissue (Koo et al., 2017)List the primary diagnosis and three differential diagnoses for this patient. Explain your reasoning for each.The primary diagnosis:Breast cancer- The diagnostic test revealed that the patient has breast cancer (invasive ductal carcinoma estrogen-receptor positive progesterone-receptor positive) the diagnosis is distinctive due to the risk factor of the patient’s previous history of atypical hyperplasia of the breast. The diagnosis of atypical hyperplasia of the breast is considered a high-risk breast mass that predisposes the patient to breast cancer. Additionally, the patient has a first-degree relation that was diagnosed with breast cancer. The breast biopsy results solidify the diagnosis of breast cancer (Hartmann, Degnim, Santen, Dupont, & Ghosh, 2015).Differential diagnoses:Fibrocystic Disease- The diagnosis for fibrocystic breast disease is a possibility for the patient as she presents with the clinical manifestation of possibly asymptomatic singular or multiple palpable smooth breast mass or a mobile round lump. The fibrocystic breast commonly occurs between the age of 30-50 years of age. The breast changes affiliated with fibrocystic disease comprises of atypical ductal and epithelial hyperplasia (Malherbe & Fatima, 2021). However, this is not the diagnosis as the mass does not change with the onset of the patient’s menses.Fibroadenomas- The diagnosis of fibroadenomas as they are glandular fibrous tissue that occur during the reproductive year which may be associated with hormone production (Williams, 2018). A risk factor related to fibroadenoma is a familial history of breast disease. The mass is typically a benign painless mobile mass. The diagnosis is of fibroadenoma as the lesion does not fluctuate with the presence of the patient’s menses.Breast Lipoma- The differential diagnosis of a breast lipoma is possible they can be benign or cancerous as they are the most common soft tissue tumor. A breast lipoma is a unilateral, smooth, soft, painless mass that occur between the ages of 40 to 60 years of age. The diagnosis is not apparent as the pathologic interpretation of the breast biopsy indicates that the patient has breast cancer cancer (Domino, Baldor, Golding, & Stephens, 2017)Discuss your management plan for this patient, including pharmacologic therapies, tests, patient education, referrals, and follow-ups.The course of treatment for the patient would involve a consult with the oncologist to direct and guide the course of treatment. The oncologist may prescribe Tamoxifen 20 mg twice a day as the form of cancer that the patient has is hormonal estrogen-receptor positive (Hartman et al., 2015). The patient may also have a lumpectomy of the right breast to remove the disease. A follow-up with radiation therapy to ensure eradication of the disease Hartman et al., 2015). She will have a mammogram six to twelve month after radiation. A mammogram one year after that. An annual gynecologic examination. The patient is instructed to not have blood pressure taken on the right arm due to lymphedema. The patient is instructed to observe for new lumps, pain (in bone, chest, stomach), shortness of breath, and headaches.ReferencesBickley, L. S. (2017). Bates’ guide to physical examination and history taking (12th ed.). [South University]. Retrieved from https://digitalbookshelf.southuniversity.edu/#/books/9781496354709/cfi/372!/4/[email protected]Domino, F. J., Baldor, R. A., Golding, J., & Stephens, M. B. (2017). The five-minute clinical consult 2018 (26th ed.). Philadelphia, PA: Wolter Kluwer Health/Lippincott Williams & WilkinsHartmann, L. C., Degnim, A. C., Santen, R. J., Dupont, W. D., & Ghosh, K. (2015). Atypical hyperplasia of the breast-Risk assessment and management options. New England Journal of Medicine, 372(78). Retrieved from https://www.nejm.org/doi/pdf/10.1056/NEJMsr1407164Hawkins, J. W., Roberto-Nichols, D. M., & Stanley-Haney, J. L. (2016). Guidelines for nurse practitioners in gynecologic settings (11th ed.). New York, NY: Springer Publishing CompanyMalherbe, K. & Fatima, S. (2021). Fibrocystic breast disease. StatPearls. Retrieved from https://ncbi.nlm.nih.gov/books/NBK551609/Williams, J. (2018). Education case: Fibroadenoma of the breast. Academic Pathology. https://doi.org/10.1177/2374289518790926
Watch the following videos, then complete the required assignment. Review the document in Course Resources for instructions on accessing the videos. Lab 1 OSCE Clinical Skills Abdominal Pain 12:42 Upon completion of watching the video write up the scenario into a SOAP format. Is there anything you would do differently on your plan? Lab 2 OSCE Clinical Skills Amenorrhea 21:51 Upon completion of watching the video write up the scenario into a SOAP format. Is there anything you would do differently on your plan? How to Submit Submit your SOAP notes to the unit Dropbox before midnight on the last day of the unit. Please submit your Lab directly into the text submission tool located in the Unit Lab Dropbox.
1. Formulate the Research Methods for your selected topic. Make sure that your incorporate all appropriate elements. Please note that all students are to carry out a meta-analysis research method.* the type of research used. Please note that, for this assignment, you can use only the meta-analysis method!* the step-by-step process of the research* the tools used during the research* how were these tools handled.Note: Remember that you should use the past tense, 3rd person, passive voice.2. Post your Research Methods.3. Then, read the posts submitted by two other classmates and provide meaningful feedback for improvement.Topic: Benefits of legalizing Marijuana in the USAttached is the introduction and the literature review.How to write a research methodology:https://expertjournals.com/how-to-write-a-research-methodology-for-your-academic-article/Sample Research MethodClick here to read a sample research method written by an MRU student.For this study, a meta-analysis method was used to synthesize different results found among several studies. The researcher accessed the virtual library through the MRU home page. Then, the researcher accessed the EBSCOhost databases. Once there, the researcher selected both MEDLINE Complete and CINAHL Complete. An advanced search was performed, for which the following keywords were entered in the Boolean search: “IBS”, “STRESS”, and “WOMEN.” The search was limited to references providing full text, peer reviewed, and abstract available. A limitation was set for research published within the last five years, from 2015 to 2020. Additionally, researcher consulted only articles published in English and Spanish. The search provided access to a total of 362 articles, of which only five (5) studies were selected based on their relevance with the topic; the other 357 were discarded.
An important role that the nurse has but is often overlooked is self-reflecting/self-awareness. When the nurse is aware of their own bias and stereotypes it allows them to work on the reason behind why they think in a certain manner. This, then reduces the likelihood of them displaying those biases and stereotypes at work. It is also beneficial for the nurse to be culturally competent especially when it comes to different cultures within the community. Angel Falkner (2018) states, “The nurse should be well informed regarding stereotypes and biases in order to be sensitive to these issues and provide the most unbiased care possible.” As the nurse gains cultural competence it will facilitate the recognition of discrimination based on stereotypes and biases in the healthcare setting.The nurse can address these concepts to ensure health promotion activities are culturally competent by completing a thorough assessment including questions about the patient’s culture such as their beliefs on health, life, and nature as well as their religion and any health promotion strategies they have (Falkner, 2018). The nurse can also incorporate strategies to reduce cultural dissonance such as the LEARN model. The LEARN model focuses on providing empathy to the patient who feels they have experienced cultural dissonance, explaining your own perception of their situation, comparing the different views and their similarities, recommending a treatment plan, and lastly modifying the treatment plan to meet the patient’s needs and preferences. By adding these two strategies into the work environment the nurse will increase her cultural competency thus reducing discrimination based on stereotypes and biases.Using 200-300 words APA format with references to support the discussion.How does the community health nurse recognize bias, stereotypes, and implicit bias within the community? How should the nurse address these concepts to ensure health promotion activities are culturally competent? Propose strategies that you can employ to reduce cultural dissonance and bias to deliver culturally competent care. Include an evidence-based article that address the cultural issue.
HIV predominantly infects T-helper cells, cells that are responsible for coordinating B- and T-cell activity. Based on this information, explain why HIV-infected individuals are at a very high risk for developing microbial infections. List the causative agent (virus) and discuss its properties. Name and briefly discuss 3 diseases that AIDS patients are more likely to contract.(Terminology to use: opportunistic pathogens, T and B cell purposes, CD4 cells, retrovirus, reverse transcription)Now that we have studied the various types of vaccines, consider the current resurgence of diseases like the measles. How can we convince the general public and possibly even ourselves, that immunization is a necessary preventative measure for diseases that have serious complications? Is there a different schedule that we should consider? Are some forms of vaccines safer than others? Should we spread out the inoculation schedule to prevent confusion of a young person? (Include terms such as live attenuated, killed or inactive, subunit, toxoid, conjugate, complications of measles, risks to others if uninoculated, risks to individuals that do get inoculated). You are encouraged to use your text and outside sources to develop your informed answer. Use facts and concepts.Construct a paragraph or two describing the interrelationship among a bacterial pathogen, the affected host, and potential antimicrobial drugs in the development of an appropriate antimicrobial treatment. Pick a pathogen, suggest tests that should be performed on that pathogen to determine the specific drugs and give reasons why they would be appropriate. (Terminology to incorporate: narrow-spectrum, broad-spectrum, MIC, Kirby-Bauer, therapeutic index, selective toxicity, drug mechanism)Conduct additional research on the use of triclosan and other chemical agents in antimicrobial products today. Develop an opinion on whether this process should continue, providing evidence to support your stance.
Using the following table—search the 5 databases based on your PICOT Question—under findings note the number of relevant articles found—you may not find something in every database. Under features discuss what you liked about that database. ON the discussion board summarize your search—attach your chart for those that would like to see your search. You may not find what you are looking for in every search—and that is OK—but you must search every database to see what may be out there.Be sure to spend some time in Library Search it is setup just like an EBSCO database and gives you the experience of learning how to navigates databases, and provides you with a larger pool of information within which to search.Ensure you are meeting the requested components for this discussion assignment when formatting your initial discussion posting. I expect to see a summary discussion about your experience searching for evidence: what databases were useful, how many articles did you find in each, and what were your key words utilized. The table is supplemental information.Contact a librarian if you are having problems with your search–they are the experts and really like helping students!
EthicsPHI 1600Read Chapter 2 and watch Week 3 Lectures. Choose a contemporary moral issue in our society (week 3 folder) and apply the ethical principle of Utilitarianism toapprovethis moral issue. You must pick a moral issue that youstrongly supportand apply the utilitarian claims (week 3 folder) to back up your arguments. The paper must be done in MLA/APA format with a minimum of 500 words (quotes are not included in the word count).*You must apply the Four major points of Utilitarianism (week 3 Lecture) apply Bentham’s Felicific Calculus 9 (week 3 folder) and apply the utilitarian claims (week 3 folder).
Jane Doe has a promising career at University Hospital. In six months of working, she has been promoted to Associate Director and tasked with overseeing consumer quality and satisfaction, which will be used to support the hospital’s new vision and mission. This is Jane’s first big assignment, which is to develop a campaign aimed toward adult learners across several departments. However, her project is at risk due to a 32-year veteran on her team, named John Doster, who is reluctant to participate.Jane must find a way to leverage power and influence in order to encourage and motivate John to increase his performance and participation to ensure success of the project.Discuss the following:What are the sources of power for Jane? And for John?What influence tactics can Jane utilize in order to get John on board?Which power bases should Jane draw on to help her influence John?How does Jane use influence to get John to be more concerned about the organizational success than his own needs or desires?Your posts will be graded on how well they meet the Discussion Requirements posted in the “Before You Begin” section. Please review this section as well as the discussion scoring rubric.
Advanced Practice Nursing Decisions that Cause Moral DistressYou identified an ethical dilemma in Unit 1. Present your dilemma to the ethics committee of your institution. Outline an ethical theory or model you wish the committee to consider when reviewing this case. What arguments do you have to support the use of this model? Discuss the role of the ethics committee in this particular ethical dilemma.
