Leadership learning experience.

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Leadership learning experience.

(Leadership learning experience.)

Question description

Nursing is a practice discipline that includes direct and indirect care activities that affect health outcomes. As a baccalaureate nursing student, you are developing new competencies in leadership, and in order to achieve mastery, you must apply those competencies to live practice experiences and situations. This Leadership Learning Experience (LLE) is designed to allow you to choose a clinical focus (e.g., practice, policy, education, population) in which you apply your leadership problem–solving skills. The LLE requires engagement with other people within the setting to complete.

You will develop a project within a practice setting that allows you to develop these leadership skills. You will identify a problem area in a practice setting that you specifically want to address (e.g., practice, policy, population, education) that aligns with organizational priorities. Example sources for the problem area may include the following:

• Practice: joint commission standards, core measures as quality indicators, other data

• Policy: legislation, staffing ratio, regulations from state boards

• Population: children with diabetes, adult obesity

• Education: future of nursing, Benner’s recommendations about nursing education

You will focus on a real-life solution for the problem. You should choose a topic that is timely, manageable, and realistic to the current healthcare environment. An external resource person (i.e., manager, clinical leader, clinical educator, policy expert, or population expert) must confirm the relevance of the selected project and your engagement in the setting as part of project completion. As with all projects, you should think how you, as a nurse, function in the following roles: detective, scientist, and manager of the healing environment.

Project Requirements:

Note: Any information that would be considered confidential, proprietary, or personal in nature should not be included. Do not include the actual names of people, stakeholders, or other personally identifiable information. Fictional names should be used. Also, agency-specific data, including financial information, should not be included but should be addressed in a general fashion as appropriate.

Note: Your submission may be in a variety of formats (e.g., report, multimedia presentation).

A. Develop a written proposal by doing the following:

1. Identify a problem or issue related to practice, policy, population, or education that aligns with the organizational priorities you seek to solve.

Note: You may need to meet with the organization/practice setting, your manager, and/or supervisor to help choose a current problem or issue.

a. Explain the problem or issue, including why it is applicable to the area of practice you chose and the healthcare environment.

2. Discuss your investigation of the problem or issue.

a. Include evidence to substantiate the problem or issue (e.g., organizational assessment, national source documents, evidence from a stakeholder).

3. Analyze the state of the situation using current data.

a. Analyze areas that might be contributing to the problem or issue.

4. Propose a solution or innovation for the problem or issue.

a. Justify your proposed solution or innovation based on the results of your investigation and analysis.

5. Recommend resources to implement your proposed solution or innovation.

a. Include a cost-benefit analysis of your proposed solution or innovation.

6. Include a timeline for implementation based on your proposal.

7. Identify key stakeholders and/or appropriate partners that are important for the implementation of your solution or innovation.

a. Discuss why each key stakeholder and/or appropriate partner is important for the implementation of the solution or innovation.

b. Summarize your engagement with the key stakeholders and/or appropriate partners, including the input and feedback you received.

c. Discuss how you intend to work with those key stakeholders and/or appropriate partners in order to achieve success.

8. Discuss how your proposed solution or innovation could be implemented.

a. Discuss how the implementation could be evaluated for success.

B. Explain how you fulfilled the following roles during your process of investigation and proposal development:

1. scientist

2. detective

3. manager of the healing environment

D. When you use sources, include all in-text citations and references in APA format.

Note: For definitions of terms commonly used in the rubric, see the Rubric Terms web link included in the Evaluation Procedures section.

Note: When using sources to support ideas and elements in a paper or project, the submission MUST include APA formatted in-

 
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Comparison of Assessment Tool Constructs

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Comparison of Assessment Tool Constructs

(Comparison of Assessment Tool Constructs)

 In this assignment, you will be comparing the constructs of two assessment tools. Use the Resources provided and the University Library to complete the following:

  • Select an assessment tool from those listed in the Resources area and one additional assessment tool from the literature using the Capella University Library. The assessment tools should measure the same construct. For example, if you select the Beck Anxiety Inventory from the Resources area, you would want to select another tool from the literature that also measures anxiety.
  • Examine the key test measurement constructs of reliability and validity for each tool, and compare these constructs for each tool. You will want to describe the methods used to acquire reliability and validity for each assessment and also discuss how the constructs relate to each other between the two assessment tools.
  • Describe how results on each assessment are interpreted. For example, how are scores interpreted in comparison to group means and norms (for a standardized or norm-referenced test) or to cutoff scores (for criterion-referenced test)? How are scores on this assessment correlated with other tests that measure the same construct?
  • Incorporate a minimum of six scholarly research studies analyzing the effectiveness of each selected assessment tool in professional settings.
  • Based on the review of literature, evaluate which assessment tool has clearer application of measurement concepts.

Please use the Assignment Template listed under Resources to compose your Comparison of Assessment Tool Constructs paper.

THESE ARE THE COMPARISONS, FIRST YOU WILL USE “BECK ANXIETY INVENTORY” AND THEN COMPARE IT WITH ” DETAILED ASSESSMENT of POSTRAUMATIC STRESS”

Beck Anxiety Inventory.

Detailed Assessment of Posttraumatic Stress (DAPS).

REFERENCE

Read Beier & Ackerman’s 2005 article, “Age, Ability, and the Role of Prior Knowledge on the Acquisition of New Domain Knowledge: Promising Results in a Real-World Learning Environment,” from Psychology and Aging, volume 20, issue 2, pages 341–355

[Unit and Assignment Title]

[Learner Name]

[COURSE NUMBER – NAME]

[Date]

[Professor Name]

Abstract

The abstract appears on a page by itself and is in single paragraph using block format and is double spaced. The abstract is a summary of your paper which allows the reader to quickly review what will be covered. Limit the abstract to 150–250 words.

Unit and Assignment Title

Start writing your introduction here (1–2 paragraphs). An effective introduction prepares the reader by identifying the purpose of the paper and providing the organization of the paper. Please double-space and remember to indent all paragraphs throughout your paper. (Not block form!) Aim to keep your writing objective using third person (see handout in the discussion board). Unless required for the specific assignment, please do not include a Table of Contents, as it is not APA style. Review paper guidelines on page requirements and number of sources required (if provided). Unless citing a classic work, aim to cite research articles and texts published within the past five years. Please use headings throughout your paper that are consistent with the paper’s scoring guide (that way you ensure you are adequately addressing all required areas.)

When you finish writing your paper, re-read it to check for errors and make sure your ideas flow well. A helpful tip is to read your paper aloud to yourself. If it does not sound right to your ear – it is not working on paper! Please submit your papers to Turnitin (link in the course homepage) to check for plagiarism. Also, remember as a Capella learner you have free access through iGuide to personal tutoring services with smarthinking.com.

Level 1 Heading: Centered, Boldface, Uppercase and Lowercase Heading

Review the evaluation categories in the scoring guide to ensure you are addressing the ‘Distinguished’ category for all sections of your paper.

Level 2 Heading (if needed): Flushed Left, Boldface, Upper and Lowercase Heading

For papers in this course, this will likely be all the heading levels you will need. You can review the APA Manual, 6th edition, section 3.03 for more guidance.

Conclusion

Please provide a conclusion that summarizes the main ideas of your paper.

 
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Personalized Pregnancy Care Plans

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Personalized Pregnancy Care Plans

(Personalized Pregnancy Care Plans)

NURSING

Discussion: Care Plans for PregnancAfter confirming and dating a pregnancy, you must collaborate with patients to develop a personalized care plan. These pregnancy care plans are integral to prenatal care as they help to ensure the mother and child’s well-being throughout the entire pregnancy. Pregnancy can be a wonderful, yet difficult time for women as a woman’s body goes through many physical, mental, and emotional changes that might be challenging or even overwhelming for some. Whether or not these women share their concerns, as the advanced practice nurse, you must routinely watch for signs and symptoms of any developing physical or mental health issues. By collaborating with patients and discussing concerns, you can modify care plans and often address potential issues before they become a significant health problem. For this Discussion, consider pregnancy care plans for the women in the following case studies:Case Study 1:On 1-15-13, you are seeing a 25-year-old Caucasian female in the clinic because she believes she’s pregnant. Her LMP was 12-1-12. Her home pregnancy test was positive, and she has been having nausea and breast tenderness.

To prepare:

  • Review Chapter 30 of the Schuiling and Likis text and Chapter 2 of the Tharpe et al. text.
  • Review and select one of the two provided case studies. Analyze the patient information.
  • Consider how to date the pregnancy and estimate the date of delivery for the patient in the case study you selected.
  • Based on the dating of the pregnancy, reflect on the appropriate clinical guidelines for procedures and screenings. Think about the implications of any missed procedures or screenings.
  • Determine a plan of care for the patient. Identify procedures, screenings, diagnostic testing, pharmacologic and nonpharmacologic treatments (if appropriate), management strategies, and patient education.

Post the estimated date of delivery for the patient (EDD), in the case study. Include an explanation of how you dated a pregnancy and which of the patient’s factors led to your estimated date of delivery. 

Then, based on the dating of the patient’s pregnancy, explain the appropriate clinical guidelines for procedures and screenings. 

Explain implications of any missed procedures and/or screenings.

Finally, explain a plan of care for the patient, including procedures, screenings, diagnostic testing, pharmacologic and nonpharmacologic treatments, management strategies, and patient education.

Here are some recommended:

1.Schuiling, K. D., & Likis, F. E. (2017). Women’s gynecologic health (3rd ed.). Burlington, MA: Jones and Bartlett Publishers.

2.Tharpe, N. L., Farley, C., & Jordan, R. G. (2017). Clinical practice guidelines for midwifery & women’s health (5th ed.). Burlington, MA: Jones & Bartlett Publishers.

3. Centers for Disease Control and Prevention. (2012b). Women’s health. Retrieved from http://www.cdc.gov/women/

National Institutes of Health. (2012). Office of Research on Women’s Health (ORWH). Retrieved from http://orwh.od.nih.gov/

U.S. Department of Health and Human Services. (2012a). Womenshealth.gov. Retrieved from http://www.womenshealth.gov/

APA FORMAT

SCHOLARLY WRITTEN.

 
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Insanity Defense Legal Standards

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Insanity Defense Legal Standards

(Insanity Defense Legal Standards)

The insanity defense is a legal standard used to argue that a defendant should not be held criminally responsible for their actions due to a severe mental illness at the time of the offense. Legal standards for this defense vary by jurisdiction, but they generally revolve around the concept that the defendant lacked the mental capacity to understand the nature of their actions or to distinguish right from wrong.

In the United States, two main tests are commonly used: the M’Naghten Rule and the Model Penal Code (ALI) Test. The M’Naghten Rule requires proof that, due to a severe mental disorder, the defendant did not know the nature of their act or did not understand it was wrong. The ALI Test, established by the American Law Institute, broadens this to include defendants who lacked substantial capacity to appreciate the criminality of their conduct or to conform their conduct to the law due to mental illness.

Successful use of the insanity defense often results in a verdict of not guilty by reason of insanity (NGRI), leading to commitment to a mental health facility rather than a prison. However, this defense is controversial and often subject to rigorous scrutiny in court.

3:2 Assignment 2: RA 1: Legal Requirements

The insanity defense is as old as it is controversial. There are times when insanity truly applies and times when it is not easy to determine. In either case, the documentation of services provided to these clients is typically heavily scrutinized by attorneys since documentation is the primary means used by courts to measure insanity as it meets legal standards. This assignment will allow you to examine the legal standards for insanity in your jurisdiction in addition to the requirements for the documentation of services provided to these individuals.

Tasks:

Search your state and regulatory boards, professional associations, state psychology boards, and state psychological associations. Use resources from professional literature to support your response. Professional literature may include relevant textbooks; peer-reviewed journal articles; and websites created by professional organizations, agencies, or institutions (.edu, .org, and .gov).

Write a 3- to 4-page paper, including the following:

· What are the legal requirements in your jurisdiction regarding the documentation of data provided by a forensic psychology professional? If not-guilty-by-reason-of-insanity (NGRI) and guilty-but-mentally-ill (GBMI) evaluations are not recognized by your jurisdiction, review the legal requirements in a jurisdiction where they are the standard.

· What are the specific laws and rules regarding the documentation of psychological services?

· What are the differences between the requirements for clinical work and the requirements for forensic work, if any?

· What standards are used in your jurisdiction for an insanity plea?

· Do the insanity standards identify mental disease or defect with any exclusions, such as substance use? Explain.

 
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Coping with Unexpected Disability

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Coping with Unexpected Disability

(Coping with Unexpected Disability)

Coping with an unexpected disability involves navigating a profound life change that requires emotional, physical, and psychological adjustments. Initially, it’s crucial to allow oneself to grieve the loss of former abilities, acknowledging feelings of anger, sadness, or frustration as valid parts of the healing process. Seeking support from family, friends, or support groups can provide comfort and a sense of community, reducing feelings of isolation.

Professionally, working with healthcare providers, including physical and occupational therapists, can aid in adapting to new physical limitations and maximizing independence. Mental health professionals, such as psychologists or counselors, can help in addressing emotional challenges and developing coping strategies. Embracing assistive technologies and adaptive equipment can significantly improve quality of life, enabling greater autonomy and participation in daily activities.

It’s also essential to focus on strengths and set realistic goals, celebrating small victories along the way. Engaging in hobbies, volunteering, or finding new interests can provide a sense of purpose and fulfillment. Developing a positive outlook, despite the challenges, fosters resilience. By integrating these approaches, individuals can adapt to their new circumstances, finding new ways to lead a meaningful and enriched life.

Living With A Disability

When Shelly saw Ms. Jones in a wheelchair, she felt sorry for her. She said a little prayer of thanks that she could walk and move freely without any hindrance. However, feeling badly for a person and actually sitting in the wheelchair for another vantage point is very different.

Imagine that you suffered an accident six months ago. The accident left you partially paralyzed from the waist down. You are currently seeking counseling from a professional specializing in working with individuals who have disabilities. It has been a difficult six months. Your central concerns relate to the emotional and physical adjustments you must now make in relation to your family, job, and future plans. You are permanently in a wheelchair and have limited use of your legs but full use of your arms and upper body.

  • Identify three major issues that you think you would need to work through in therapy. Explain what aspect of each issue is problematic for you.
  • Explain how your views on intimacy, usefulness, and security will change for you to make the necessary adjustments for living with the disability.
  • How well do you think you would cope with this situation if you faced something similar in real life?

Your response should be at least two pages long. All written assignments and responses should follow APA rules for attributing sources.

 
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Z-Score and T-Score Analysis

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Z-Score and T-Score Analysis

(Z-Score and T-Score Analysis)

Follow Instructions,250 Words APA Format,References And Citacions.

Comment 1

Z-tests are used to compare the collected data of a defined population and the sample.  The z-score tells you how far, in standard deviation, a data point is from the mean or average of a data set. A z-test compares a sample to a defined population. Normally, a z-test identifies issues with larger samples that are being studied (n > 30). Z-tests are also useful when testing out a hypothesis. Generally, they are most useful when the standard deviation is known.

T-tests are calculations used to test a hypothesis. However, t-tests are used to determine the statistical difference between two independent sample groups. In other words, a t-test analyzes how likely the difference between two samples occurs due to random chance. Usually, t-tests are most appropriate to use when dealing with problems with a limited or small sample size (n < 30).

One-sample T-tests are used to compare the mean average between the sample and the population studied. The test is also applied compare the difference between the mean of the sample and the mean of the population. Z-tests always use normal distribution and should be used when the standard deviation is known after the data is collected.

Comment 2.

A z-score and a t- score are both used in hypothesis testing. Generally, in elementary stats and AP stats, you’ll use a z-score in testing more often than a t score.

Z-scores are a conversion of individual scores into a standard form. The conversion is based on your knowledge about the population’s standard deviation and mean. A z-score tells you how many standard deviations from the mean your result is. You can use your knowledge of normal distributions (like the 68 95 and 99.7 rule) or the z-table to determine what percentage of the population will fall below or above your result.  Like z-scores, t-scores are also a conversion of individual scores into a standard form. However, t-scores are used when you don’t know the population standard deviation.

You use the z-score test if:
Population normal and variance known (for any sample size)

1. Population normal, variance unknown and   n > 30 n>30 (due to CLT)

2. Population binomial,  n p > 10 np>10,   n q >10 nq>10

You use the   t- score test if:
1. Population normal, variance unknown and   n < 30 n<30

2. No knowledge about population or variance and   n < 30 n<30, but sample data looks normal / passes tests etc. so population can be assumed normal.

 
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Assignment Criminal Justice.

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Assignment Criminal Justice.

(Assignment Criminal Justice.)

Complete this week’s Practice Activity.

Matching exercises give you an opportunity to practice definitions and develop logical and critical thinking skills. By using such techniques as inversion, diversion, and the process of elimination, you are able to greatly increase the probability of answering questions correctly. This is an important skill to have, as it is commonly found on nearly all standardized tests and increases critical thinking.

The objective of this exercise is to understand legal restraints on police action and instances of police abuse of power.

Unit 4 Practice Activity – Part A

The objective of this exercise is to understand legal restraints on police action and instances of police abuse of power.

Unit 4 Practice Activity – Part B

Complete the Unit 4 Assignment: Operational Strategies Presentation

Review Chapter 6 in your text.

Create a 6–8 slide PowerPoint presentation with audio narration and speaker notes.

In the presentation:

  • Describe and explain each of the following five core operational strategies (one strategy for each slide):
    • Preventative patrol
    • Routine incident response
    • Emergency response
    • Criminal investigation
    • Problem solving
  • Describe and explain one ancillary operational strategy such as support services.
  • Explain how law enforcement agencies utilize operational strategies to achieve crime fighting goals.

The PowerPoint presentation should have the following characteristics:

  • Bullets for your main points.
  • Must include speaker notes to fully explain what is being discussed in the slide bullet points as though you are presenting to an audience.
  • Must include narration. You will use the speaker notes for each slide’s narration.
  • No more than 10 minutes in length.
  • Contains a title and references slide.
  • Research from at least two reliable sources to support the main message, including graphics.NOTE: Sources should be from beyond the text material, including one from the Library and one from a credible online resource, and discuss how you evaluated the credibility of the resources used.
  • Research and visuals are cited in APA citation format, both in-text and on a References slide. You need to quote material taken directly from a source. The same standards for documenting sources that apply to an essay, apply to a presentation. Go to the APA Style® Central website for a digital library of APA Style quick guides and tutorials to refine your writing.
  • Designed with a live audience in mind in order to inform your viewers about the topic.

Speaker Notes

To learn more about creating speaker notes in PowerPoint, review the webpage below.

GCF Learn Free (2015). PowerPoint 2010-Slide Basics: Goodwill Community Foundation, Inc. Retrieved from https://www.gcflearnfree.org/powerpoint2010/slide-basics/6/

Recording Narration

Record your narration using the instructions here.

Keep in mind that the final recording should be in Standard English and include a highly developed and sustained viewpoint and purpose. The presentation should be highly ordered, logical and unified. Oral delivery techniques, including word choice and oral expressiveness, should display exceptional content, organization, and style, and should lead the audience to a dynamic and supported conclusion.

Directions for Submitting Your Assignment

Compose your Assignment in Microsoft® PowerPoint® and save it in the following format: Last name First name Assignment. (Example: Smith John_Unit_4_Assignment). Submit your Assignment to the Unit 4 Assignment Dropbox by the end of Unit 4.

 
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Creating Marketing Strategy Plan

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Creating Marketing Strategy Plan

(Creating Marketing Strategy Plan)

Question description

At the end of this course, you will have created a marketing plan for a hypothetical product-based company. Each assignment focuses on a different section of the overall marketing plan. For Assignment 1, you will compile information on the company’s background information, an environmental analysis, your company’s short and long-term goals, and a SWOT analysis.

For information on Website analytics, visit Google Analytics at http://www.google.com/analytics/why/.

Note: You may create and / or make all necessary assumptions needed for the completion of this assignment.

Write a five to six (5-6) page paper in which you:

  1. Write an introduction to your company. Describe your company, its location, and the product it makes or the service it provides.
  2. Develop an environmental analysis that includes competitive, economic, political, legal, technological, and sociocultural forces.
  3. Determine the primary and secondary target markets for your company. Next, analyze the primary and secondary target markets that you identified for your company. Be sure to cover the 4Ps, 5Cs and STP.
  4. Decide the main goals that you would like to achieve within the next year (short term) and the mains goals that you would like to achieve within the next five (5) years (long term). Determine the most appropriate ways to measure both short- and long-term goals. Note: Consider the following metrics: tracking downloads of Website content, Website visitors, increases in market share, customer value, new product adoption rates, retention, rate of growth compared to competition and the market, margin, and customer engagement.
  5. Develop both a SWOT analysis and needs analysis for your product. Each analysis should examine four (4) strengths, weaknesses, opportunities, and threats for your company.
  6. Use at least four (4) academic resources as quantitative marketing research to determine the feasibility of your product / service. These resources should be industry specific and relate to your chosen product / service. Note: Wikipedia and other Websites do not qualify as academic resources.

In Assignment 2, using the same company from Assignment 1, you will focus on the company’s mission, introduction, and branding.

Note: You may create and /or make all necessary assumptions needed for the completion of this assignment.

Write a four to five (4-5) page paper in which you:

  1. Develop a branding strategy for your product that covers the brand name, logo, slogan, and at least one (1) brand extension.
  2. Assemble a marketing strategy for your product, and determine an appropriate time table to implement your plan). Provide a rationale for your response.
  3. Prepare a positioning statement. Include a perceptual map that shows your company’s position against its competitors. From this map, create a statement that depicts your position. For example, “Our product is the fastest in its class for half the price.” Note: See pp. 54 – 55 in the textbook for examples of perceptual maps. You may use Microsoft Word, PowerPoint, or other equivalent software to create your perceptual map.
  4. Examine the relevant consumer behavior for your target market. Explain the main reasons why the brand name, logo, slogan, brand extension, as well as the positioning statement and marketing strategy are right for the identified target market.
  5. Develop your company’s mission statement and company introduction.
  6. Use at least three (3) academic resources as quantitative marketing research to determine the feasibility of your product / service. These resources should be industry specific and relate to your chosen product / service. Note: Wikipedia and other Websites do not qualify as academic resources.

To conclude your marketing plan, in Assignment 3, you will describe the company’s, marketing strategy, implementation strategy, expansion plan, social media strategy, monitoring methods, and integrated marketing communication strategy.

Note: You may create and / or make all necessary assumptions needed for the completion of this assignment.

Write a six to seven (6-7) page paper in which you:

  1. Develop the company’s branding, pricing, and distribution strategy.
  2. Classify the company’s major competitors as inter- or intra-competitors. Categorize the competitors’ major strengths and weaknesses.
  3. Develop the differentiation strategy in relation to the closest competitor.
  4. Establish whether the company’s intention is to be a leader or follower within the industry.
  5. Specify two (2) social media and / or media tools that you would use as you develop your plan. Justify each of your chosen tools.
  6. Suggest the integrated marketing communications that are most relevant for your marketing plan. Relate each marketing communication to your company’s advertising strategy.

Use at least five (5) academic resources that address sustainability and monitoring of effective marketing plans and determine the applicability for your hypothetical company. These resources should be industry specific and relate to your chosen product / service. Note: Wikipedia and other Websites do not qualify as academic resources.

 
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Enhancing Practice Through CDS

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Enhancing Practice Through CDS

(Enhancing Practice Through CDS)

Clinical Decision Support & Evidence-Based Practice

Question description

To prepare:

  • Review this week’s Learning Resources on CDS systems, EBP, and clinical guidelines. Focus on the Hammond, Jaffe, and Kush article, “Healthcare Standards Development: The Value of Nurturing Collaboration” and consider how CDS systems could be used to achieve integration of standards, guidelines, and EBP within your specialization area.
  • Identify at least two databases that can be considered “gold standards” for current research and EBP recommendations within your specialization area.
  • Identify at least two condition-specific clinical guidelines that are applicable to your specialization area. One possible resource for locating clinical guidelines is http://www.guidelines.gov
  • Consider how the databases and guidelines you identified could be integrated into a CDS system. For example, would you recommend an alert system, a side panel within an electronic health record (EHR) system, a separate computer or device for health care professionals to consult at their discretion, or an alternative system?
  • Reflect on the benefits and disadvantages of the type of CDS system you selected to integrate your EBP databases and clinical guidelines.

To complete:

Write a 2- to 3-page paper that addresses the following:

  • Identify the two databases you selected as “gold standards” for EBP within your specialization area. Justify your selections.
  • Identify the two condition-specific clinical guidelines you selected, and explain their significance within your specialization area.
  • Explain how the databases and guidelines you identified could be integrated into a CDS system. Describe the type of system you would recommend, and justify your recommendation.
  • Identify at least two benefits and at least two challenges of the CDS system you recommended.

Cite at least three references using APA style.

Resources:

1. Bredemeyer, J., & Androwich, I. (2012). Transitional research: Generating evidence for practice. In D. McGonigle & K. G. Mastrian (Eds.), Nursing informatics and the foundation of knowledge (pp. 471–485). Burlington, MA: Jones and Bartlett.

2. McGonigle, D., & Mastrian, K. G. (2015). Nursing informatics and the foundation of knowledge (3rd ed.). Burlington, MA: Jones and Bartlett Learning.

3. Brokel, J. M. (2009). Infusing clinical decision support interventions into electronic health records. Urologic Nursing, 29(5), 345–352.

4. Glaser, J. (2008). Clinical decision support: The power behind the electronic health record. Healthcare Financial Management, 62(7), 46–48, 50–51.

5. Kesselheim, A. S., Cressweel, K., Phansalkar, S., Bates, D. W., & Shiekh, A. (2011). Clinical decision support systems could be modified to reduce “alert fatigue” while still minimizing the risk of litigation. Health Affairs, 30(12), 2310–2317.

 
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Clinical Scenarios and Diagnoses

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Clinical Scenarios and Diagnoses

(Clinical Scenarios and Diagnoses)

NR 507 Week 3 Discussion (Parts 1, 2, 3) + Quiz Answers

NR 507 Week 3 Discussion

PART No. 1:

A 17-year-old African American from the inner city complains of severe chest and abdominal pain. Upon examination the attending physician performs and EKG, chest x-ray, and an abdominal and chest clinical examination and finds nothing. Assuming, she is drug seeking he sends her home. She comes back to the ER four hours later and now you see the patient. She explains that she was running track this past afternoon at school and that despite being very hot (100 F) she pushed on. Afterwards, she starts feeling extensive pain in her chest and abdomen.  She has jaundiced eyes, her blood pressure is 98/50, pulse is 112, T = 99.9 F, R = 28. The pain seems out of proportion to the physical findings.

· What is your list of differential diagnoses in this case and explain how each of these fits with the case patient as described above. Be sure to list at least three (3) pertinent differential diagnoses. Indicate which of these you would select as the most likely diagnosis and explain why.

· Now, as she is in the ER she begins to exhibit stroke like features. ? Does this change your differential?

· How do you treat this patient now? Are they any preventative actions that could have been taken?

PART No. 2:(Clinical Scenarios and Diagnoses)

Jesse is a 57-year-old male who presents with gradual onset of dyspnea on exertion and fatigue. He also complains of frequent dyspepsia (GERD) with nausea and occasional epigastric pain. He states that at night he has trouble breathing especially while lying on his back (Orthopnea). This is relieved by him sitting up. His vitals are 180/110, P = 88, T = 98.0 F, R = 20.

· Write three (3) differential diagnoses in this case and explain how each item in your differential fits and how it might not fit.

· What tests would you order? What immediate treatment would you consider giving this patient and what treatment when he went home? Assume your first differential is definitive.

· Now, he comes back to your clinic 3 months later and both his ankles are slightly swollen. What possible explanations are there for this observation? CHF now involving right side Must order Echo with EKG and Nuc stress test, labs Pro BNP.

PART No. 3:(Clinical Scenarios and Diagnoses)

A new patient is brought into the office for their annual evaluation. The child is a 6-year-old and appears a bit small for their age but not so small that any alarm bells are set off.  The vitals are: P = 116, R = 22, T = 98.6 F, BP = 110/50. (The normal vitals in a 6-year-old are P = 75 – 120, R = 16 – 22, T = 98.6 , BP = (85-115)/(48-64).  Examination of the lungs is normal, HEENT is normal, as is the abdominal exam. The heart however, seems laterally displaced and there appears to be only a continuous murmur which can be described as crescendo/decrescendo systolic murmur that extends into diastole. Because, you were trained at Chamberlain College of Nursing you immediately know that this is probably a patent ductus arteriosus.

· Explain the murmur from a mechanistic view of the hearts physiological functioning?

· What is the epidemiology of a patent ductus arteriosus?

· How is a patent ductus arteriosus treated?

NR 507 Week 3 Quiz Answers:(Clinical Scenarios and Diagnoses)

1. The underlying disorder of _____ anemia is defective secretion of intrinsic factor, which is essential for the absorption of vitamin B12.(Points : 2)

2. What is the pathophysiologic process of aplastic anemia? (Points : 2)

3. The body compensates for anemia by (Points : 2)

4. A woman complains of chronic gastritis, fatigue, weight loss, and tingling in her fingers. Laboratory findings show low hemoglobin and hematocrit levels, and a high mean corpuscular volume. These findings are consistent with _____ anemia. (Points : 2)

5. In hemolytic anemia, jaundice occurs only when (Points : 2)

6. Symptoms of polycythemia vera are mainly the result of (Points : 2)

7. Which proinflammatory cytokines are responsible for the development and maintenance of DIC? (Points : 2)

8. Which of the following is a description consistent with acute lymphocytic leukemia (ALL)? (Points : 2)

9. Heparin-induced thrombocytopenia (HIT) is described as a(n) (Points : 2)

10. Which of the following is a description consistent with chronic lymphocytic leukemia (CLL)? (Points : 2)

11. Hemolytic disease of the newborn can occur if the mother is (Points : 2)

12. Polycythemia occurs in a fetus because (Points : 2)

13. The type of anemia that occurs as a result of thalassemia is (Points : 2)

14. The sickle cell trait differs from sickle cell disease in that the child with sickle cell trait (Points : 2)

15. Hemophilia B is caused by clotting factor _____ deficiency. (Points : 2)

16. What is the name of the disorder in which levels of bilirubin remain excessively high in the newborn and are deposited in the brain?(Points : 2)

17. An individual who is demonstrating elevated levels of troponin, creatine kinase (CK), and lactic dehydrogenase (LDH) is exhibiting indicators associated with: (Points : 2)

18. What alteration occurs in injured endothelial cells that contributes to atherosclerosis? (Points : 2)

19. Which of the following is manufactured by the liver and primarily contains cholesterol and protein? (Points : 2)

20. Cardiac cells can withstand ischemic conditions and still return to a viable state for how many minutes? (Points : 2)

21. When does systemic vascular resistance in infants begin to rise? (Points : 2)

22. An infant has a loud, harsh, holosystolic murmur and systolic thrill that can be detected at the left lower sternal border that radiates to the neck. These clinical findings are consistent with which congenital heart defect? (Points : 2)

23. Which congenital heart defects occur in trisomy 13, trisomy 18, and Down syndrome? (Points : 2)

24. The foramen ovale is covered by a flap that creates a check valve allowing blood to flow unidirectionally from the _____ to the _____.(Points : 2)

25. Which heart defect produces a systolic ejection murmur at the right upper sternal border that transmits to the neck and left lower sternal border with an occasional ejection click? (Points : 2)

 
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