Category: Nursing

NURS 6565 Synthesis in Advanced Practice Care – Legal Issues (Negligence/ Malpractice/ Risk Management)

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Legal Issues (Negligence/Malpractice/Risk Management)

Our current health care system is in a fluid state. Change is constant. As health care providers, we strive to deliver optimal, safe care. Ongoing health care research, evidenced-based care, and effective guidelines for practice offer a stabilizing force. Our duty, as health care providers, is to “do no harm.” As providers, Nurse Practitioners (NP) provide preventive, acute, and chronic care, which entails complex management. Understanding legal terminology is essential to the role.

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NURS 6565 Synthesis in Advanced Practice Care – Legal Issues (Negligence/ Malpractice/ Risk Management). Terms such as standard of care, malpractice, and negligence are inevitable and essential components for understanding the legal challenges advanced practice nurses will experience during their careers.

Only 1% of patients actually sue for malpractice in the U.S. and NPs are the least likely to be sued of all providers (Buppert, 2015). Just because an NP is sued does not mean the provider will be reported to the State Board of Nursing. Remember, the State Board of Nursing’s focus is not to protect the NP; their role is to protect the public. In many instances, the NP will be named in a Malpractice Lawsuit and later removed. Unfortunately, their name will be forever in the National Practitioner Data Bank, which we will discuss in further detail during this week’s Discussion.

This week, as you examine legal issues related to Nurse Practitioner Practice, focus on the implications of the legal terms you will be introduced to and how they will impact your day-to-day decisions in regard to patient care and safety. Consider strategies to improve your clinical practice skills and maintain current with legislative issues in your state. NURS 6565 Synthesis in Advanced Practice Care – Legal Issues (Negligence/ Malpractice/ Risk Management).

Buppert, C. (2015). Nurse Practitioner’s Business Practice and Legal Guide (5th ed..). Burlington, MA: Jones & Bartlett. Chapter 7, (pp. 271-284).

Learning Objectives

By the end of this week, students will:

Analyze legal implications for standard of care

Analyze key components of malpractice policies

Analyze collaborative agreements in relation to state rules

Analyze legal implications that exist for failure to adhere to a standard of care

Compare differences in malpractice policy options

Evaluate professional strengths and weaknesses

Evaluate mastery of NP clinical skills

Photo Credit: Tetra Images/Getty Images

Learning Resources

This page contains the Learning Resources for this module. Be sure to scroll down the page to see all of this module’s assigned Learning Resources. NURS 6565 Synthesis in Advanced Practice Care – Legal Issues (Negligence/ Malpractice/ Risk Management).

Required Readings

Agency for Healthcare Research and Quality (2016). National Guideline Clearinghouse. Retrieved from http://www.guidelines.gov

Buppert, C. (2015). Risk Management. In Nurse Practitioner’s Business Practice and Legal Guide (5th ed.) (285 – 302). Burlington, MA: Jones & Bartlett.

This chapter reviews lawsuits, malpractice, the importance of working within practice guidelines, and explains the purpose of the National Practitioner Data Bank.

Buppert, C. (2015). Negligence and Malpractice. In Nurse Practitioner’s Business Practice and Legal Guide (5th ed.) (285 – 302). Burlington, MA: Jones & Bartlett.

This chapter reviews risk management as well as dismissal of the noncompliant patient.

Jordan, L. M., Quraishi, J. A., & Liao, J. (2013). The National Practitioner Data Bank and CRNA Anesthesia-Related Malpractice Payments. American Association of Nurse Anesthetists Journal, 81(3), 178-182.

Note: Retrieved from the Walden Library databases.

Miller, K. P. (2013). The National Practitioner Data Bank: An Annual Update. The Journal for Nurse Practitioners, (9)9, 576-580.

Note: Retrieved from the Walden Library databases.

Stelmach, E. I. (2015). Dismissal of the Noncompliant Patient: Is this What We Have Come to? The Journal for Nurse Practitioners, 11(7), 723-725.

Note: Retrieved from the Walden Library databases.

Watson, E. (2014). Nursing Malpractice: Costs, Trends and Issues. Journal of Legal Nurse Consulting, 25(1), 26-31.

Note: Retrieved from the Walden Library databases.

Westrick, Susan J., & Jacob, N. (2016). Disclosure of Errors and Apology: Law and Ethics. The Journal for Nurse Practitioners, 12(2), 120-126.

Note: Retrieved from the Walden Library databases.

Required Media

Institute of Medicine. (2015, December 7). Assessing Progress on the Implementation of the Recommendations of The Future of Nursing [Video file]. Retrieved from https://www.youtube.com/watch?v=sMOjACA2ats

Note: The approximate length of this media piece is 1 hour. NURS 6565 Synthesis in Advanced Practice Care – Legal Issues (Negligence/ Malpractice/ Risk Management).

Optional Resources

Buppert, C. (2016). Carolyn Buppert-Specialist in Legal and Reimbursement Issues for Nurse Practitioners and Physicians.

Goodwin, B. (2016). You’ve Been Sued for Malpractice: What Happens Next? Urology Times.

Kreimer, S. (2015). Avoiding an EHR-Related Malpractice Suit. Contemporary OB/GYN, December, 39-42.

Discussion: Clinical Challenges for the NP

Each state has laws that differ in regard to the role of the Nurse Practitioner. They also may significantly impact the NP’s practice. Legislative changes may occur annually, bi-annually, or during an emergency legislative meeting at the state or federal level. These legislative sessions and any subsequent changes may significantly impact your scope of practice as a Nurse Practitioner. NURS 6565 Synthesis in Advanced Practice Care – Legal Issues (Negligence/ Malpractice/ Risk Management). Remaining current with the laws in your state is essential. For example, the recent change at the federal level changing hydrocodone-containing drugs from a Schedule III drug to a Schedule II drug has impacted NPs in some states. For states that allow for Nurse Practitioners to write Schedule III-V drugs, these NPs are now unable to write for hydrocodone- containing medications, which significantly impacts their ability to provide care for their patients. The Pearson Report, which is updated almost annually, provides a national overview of each state’s current legislature. As a future NP, you should become familiar with The Pearson Report and stay abreast of state and federal legislation. NURS 6565 Synthesis in Advanced Practice Care – Legal Issues (Negligence/ Malpractice/ Risk Management).

For this Discussion, you will post an explanation that defines the legal implications for standard of care, the key components of a malpractice policy in regard to a case study. Additionally you will explain the collaborative agreements and rules for your state in regard to your NP practice and the case study you select. NURS 6565 Synthesis in Advanced Practice Care – Legal Issues (Negligence/ Malpractice/ Risk Management).

To prepare:

Review the following case studies and select one to research in depth:

Case Study One: Dismissing the non-compliant patient.

Gwen, a 52 year old Caucasian LPN, recently joined your practice as a new patient. She currently has a BMI of 32, B/P of 142/88. Pulse is 89, Respiratory rate is 22, Pulse Ox is 96% on Room Air. She is taking Lisinopril 10mg po daily (when she can remember), Metformin 1000mg po BID and refuses lab work. Her physical exam is unremarkable and foot exam is normal. She refuses all vaccinations including Prevnar and Influenza. Gwen’s last mammogram and pap smear were “years ago.”

Case Study Two: Preventive care, why is it so important to document?

John, a 62 year old attorney, who has been a long-term patient of yours, comes to you to discuss his erectile dysfunction. You note that he has refused lab work for the past two years. He is a 30 pack/year smoker, and has not had a chest x-ray or ECG in three years. He does take his HCTZ 25 mg po daily. His BMI is 29 and all vital signs are within normal limits. He does agree to his Prevnar Vaccine today NURS 6565 Synthesis in Advanced Practice Care – Legal Issues (Negligence/ Malpractice/ Risk Management).

Case Study Three: Patient and professional relationships. NURS 6565 Synthesis in Advanced Practice Care – Legal Issues (Negligence/ Malpractice/ Risk Management).

Jennifer, a 45 year old Caucasian returns to your clinic for a refill of her hydrocodone. She was diagnosed with Ovarian Cancer last year, followed by successful removal and treatment. All vital signs are stable and preventive care is up to date. She wants to discuss filing a lawsuit against the surgeon that initially turned her away and told her she had gastritis and needed to eat healthier.

Review the following articles found in this week’s Learning Resources:

Miller, K. P. (2013). The National Practitioner Data Bank: An Annual Update. The Journal for Nurse Practitioners, (9)9, 576-580.

Stelmach, E. I. (2015). Dismissal of the Noncompliant Patient: Is this What We Have Come to? The Journal for Nurse Practitioners, 11(7), 723-725.

Review endocrine disorders and erectile dysfunction in your Primary Care Medicine text (Gorrol, Ah. & Mulley, A.G., 2009).

Consider strategies and treatment options that would be most effective for these patient scenarios to improve compliance and health outcomes.

Reflect on how to approach the non-compliant patient and the importance of a separate preventive care visit. NURS 6565 Synthesis in Advanced Practice Care – Legal Issues (Negligence/ Malpractice/ Risk Management).

INSTRUCTIONS FOR PAPER:

Write an explanation that addresses the following for the Case study you selected:

Identify and briefly summarize the case study you selected

Explain any legal implications for standard of care related to the case study you selected

Identify and explain the key components of a malpractice policy related to the case study you selected

Explain the collaborative agreements and knowledge the rules for your state in regards to NP practice the case study you selected NURS 6565 Synthesis in Advanced Practice Care – Legal Issues (Negligence/ Malpractice/ Risk Management).

NURS 6565: Synthesis in Advanced Practice Care of Complex Patients in Primary Care Settings

University Outcomes

I. Facilitate positive social change where they work, in their communities, and in

society.

II. Use their knowledge to positively impact their profession, communities, and in

society.

III. Demonstrate a commitment to lifelong learning.

IV. Apply their learning to specific problems and challenges in their workplace and

professional settings.

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V. Demonstrate information literacy.* *Information literacy is defined as the ability to

know when there is a need for information, and being able to identify, locate,

evaluate, and effectively use that information for the issue or problem at hand.

VI. Demonstrate an understanding of the methods of inquiry used in their

professional or academic field. NURS 6565: Synthesis in Advanced Practice Care of Complex Patients in Primary Care Settings.

VII. Practice legal and ethical integrity in their professional work.

VIII. Effectively communicate their ideas and the rationale behind them to others.

IX. Support diversity and multiculturalism within their profession, communities, and

society.

Program Outcomes

1. Synthesize organizational/systems leadership for cost-effective specialist nursing

practice that contributes to high-quality healthcare delivery, advancement of the

nursing profession, and social change

2. Critique evidence-based literature drawing from diverse theoretical perspectives

and pertinent research to guide decision-making that demonstrates best

practices for specialist nursing practice in a global society

3. Integratively assess, diagnose, plan, implement, and evaluate cost-effective

healthcare strategies that reduce health disparities by patient/population

advocacy for access to specialist nursing care

NURS 6565: Synthesis in Advanced Practice Care of Complex Patients in Primary Care Settings

4. Demonstrate ability to effectively communicate using audience-specific oral,

written, and information technology for professional delivery of specialist nursing

care

5. Evaluate health needs of diverse populations for necessary teaching/coaching

functions based on specialist nursing knowledge to restore/promote health and

prevent illness/injury

6. Exhibit ongoing commitment to professional development and value of nursing

theories/ethical principles (altruism, autonomy, human dignity, integrity, social

justice) in accordance with ethically-responsible, legally-accountable specialist

nursing practice

7. Implement specialist nursing roles to promote quality improvement of patient-

centered care in accordance with professional practice standards that transform

health outcomes for diverse populations

Course Outcomes

1. Synthesize the role and responsibilities of the nurse practitioner

2. Analyze issues related to the certification and licensing of nurse practitioners

3. Summarize challenges that impact clinical practice for advanced practice nurse

practitioners

4. Analyze the evolving role of the advanced practice nurse practitioner

5. Apply interprofessional practice in providing care to patients with complex health

conditions

6. Synthesize the process for transitioning from the role of registered nurse to

advanced practice nurse practitioner

7. Analyze ethical and legal issues of nurse practitioner practice

8. Synthesize process for measuring quality performance of nurse practitioners

Weekly Objectives Alignment Chart

Week 1: The Emerging Role of Nurse Practitioners in Diverse Clinical Settings

Met In (D#/A# /Other)

Course Outcome(

s)

SoN Outcome

s

Program Outcome(

s) University Outcome(

s)

MS Essential s (MSE)

Create professional goals to support your transition from RN to NP practice to promote positive social change

A 1, 2 2, 4, 5 3

PO: 1,2, 5 UO: 2, 6

NURS 6565: Synthesis in Advanced Practice Care of Complex Patients in Primary Care Settings

Evaluate mastery of NP clinical skills

PA1 1,2 2, 4, 5 3

PO: 1, 2, 5 UO: 2,6

Evaluate professional strengths and weaknesses

PA2 1,2 2, 4, 5 3

PO:1, 2, 5 UO: 2,6

Analyze practices of advanced practice nurses

PA2 1,2 2, 4, 5 3

PO: 1, 2 UO: 2,6

Week 2: Consequences of Ethical Issues in Advanced Nursing Practice

Met In (D#/A# /Other)

Course Outcome(

s)

Program Outcome(

s) University Outcome(

s)

Evaluate ethics of treating family members

D 7 2 PO: 2 UO: 7

Analyze salient ethical issues in Advanced Nursing Practice

A 7 2 PO: 2 UO:7

Compare ethical dilemmas with state health laws and regulations

D, A 7 2 PO: 2 UO: 7

Outline the process of ethical decision making

A 7 2 PO: 2 UO: 7

Week 3: Ongoing Performance Evaluation

Met In (D#/A# /Other)

Course Outcome(

s)

Program Outcome(

s) University Outcome(

s)

Analyze importance of quality measures

D 8 1, 4, 5 3

PO: 3,5 UO: 4, 8

Evaluate the use of incentive payment for care

D 8 3 PO: 5 UO: 4, 8

Analyze external motivators for incentive payment for care

D 8 3 PO: 5 UO: 4, 8 NURS 6565: Synthesis in Advanced Practice Care of Complex Patients in Primary Care Settings

Apply comprehensive knowledge of nurse practitioner practice

A 8 3 PO: 5 UO: 4, 8

© 2016 Laureate Education, Inc. Page 4 of 7

Week 4: Legal Issues (Negligence/Malprac tice/Risk Management)

Met In (D#/A# /Other)

Course Outcome(

s)

SoN Goals

Program Outcome(

s) University Outcome(

s)

Analyze legal implications for standard of care

D 6,7 1, 4, 5 PO:3 UO:4,5

Analyze key components of malpractice policies

D, A 6,7 1, 4, 5 PO:3 UO:4,5

Analyze collaborative agreements in relation to state rules

D 6,7 1, 4, 5 PO:3 UO:4,5

Analyze legal implications that exist for failure to adhere to a standard of care

A 6,7 1, 4, 5 PO:3 UO: 4,5

Compare differences in malpractice policy options

A 6,7 1, 4, 5 PO:3 UO:4,5

Evaluate professional strengths and weaknesses

PA 1,2 2, 4, 5 3

PO:1, 2, 5 UO: 2,6

Evaluate mastery of NP clinical skills

PA 1,2 3, 2, 4, 5 PO: 1, 2, 5 UO: 2,6

Week 5: Interprofessional Practice

Met In (D#/A# /Other)

Course Outcome(

s)

Program Outcome(

s) University Outcome(

s)

Analyze interprofessional practice

D 5 2 PO: 2 UO: 4

Apply concepts of interprofessional practice in a clinical setting

D 5 2 PO: 2 UO: 4

Create professional cover letters, resumes, and portfolios * *The Assignment

A 3, 6 2 PO: 2 UO:3

© 2016 Laureate Education, Inc. Page 5 of 7

related to this Learning Objective is introduced this week and submitted in Week 10.

Week 6: Certification, Licensure, and Scope of Practice

Met In (D#/A# /Other)

Course Outcome( NURS 6565: Synthesis in Advanced Practice Care of Complex Patients in Primary Care Settings

s)

Program Outcome(

s) University Outcome(

s)

Analyze NP certification, licensure, and relocation processes

D 2 1, 4, 5 2, 3

PO:3,4 UO: 4,5

Compare Scope of Practice among acute care, family practice and adult gerontology primary care nurse practitioners

D 2 2, 3 PO:4 UO: 4,5,6

Evaluate settings that are appropriate for FNP and AGPCNP graduates

D 2 2, 3 PO:4 UO: 4,5,6

Evaluate certification exam options

A 2 2, 3 PO:4 UO: 4,5

Create plans for passing National Certification Exams

A 2 2, 3 PO:4 UO: 4,5

Analyze state restrictions or limitations for practice

A 2 2, 3 PO:4 UO: 4,5

Week 7: Prescriptive Authority and Drug Enforcement Administration Registration

Met In (D#/A# /Other)

Course Outcome(

s)

Program Outcome(

s) University Outcome(

s)

Analyze appropriate prescriptive authority and DEA registration processes

D 3,7 2, 3 PO:4 UO: 4,5

Analyze safe prescribing practices

D 3,7 2, 3 PO:4 UO: 4,5

Evaluate professional PA 1,2 2, 4, 5, 3 PO:1, 2, 5

© 2016 Laureate Education, Inc. Page 6 of 7

strengths and weaknesses

UO: 2,6

Evaluate mastery of NP clinical skills

PA 1,2 2, 4, 5, 3 PO: 1, 2, 5 UO: 2,6

Week 8: Coding and Billing Issues

Met In (D#/A# /Other)

Course Outcome(

s)

Program Outcome(

s) University Outcome(

s)

Analyze reimbursement issues

D 1,3 2, 4, 5 PO:1 UO: 4,5,6

Compare the impact of reimbursement issues between collaborative practice and independent practice

D 1,3 2, 4, 5 PO:1 UO: 4,5,6

Analyze ethical and legal implications of reimbursement issues

D 1,3 2, 4, 5 PO:1 UO: 4,5,6

Week 9: Professional and Business Practice

Met In (D#/A# /Other)

Course Outcome( NURS 6565: Synthesis in Advanced Practice Care of Complex Patients in Primary Care Settings

s)

Program Outcome(

s) University Outcome(

s)

Evaluate business structures

A 1,3 2, 4, 5 PO: 1 UO: 4,5,6

Create a business plan

A 1,3 2, 4, 5 PO:1 UO: 4,5,6

Analyze costs associated with establishing independent practice

A 1,3 2, 4, 5 PO:1 UO: 4,5,6

Week 10: Leadership Implications

Met In (D#/A# /Other)

Course Outcome(

s)

Program Outcome(

s) University Outcome(

s)

Analyze state NP practice agreements

D 3, 6 1, 4, 5 PO: 3 UO:2

Analyze state physician

D 3, 6 1, 4, 5 PO: 3 UO:2

© 2016 Laureate Education, Inc. Page 7 of 7

collaboration issues

Analyze barriers to NP independent practice

D 3, 6 1, 4, 5 PO: 3 UO:2

Create plan for addressing state NP practice issues

D 3, 6 1, 4, 5 PO: 3 UO:2

Create professional cover letters, resumes, and portfolios

A 3, 6 2 PO: 2 UO:3

Evaluate professional strengths and weaknesses

PA 1,2 2, 4, 5, 3 PO:1, 2, 5 UO: 2,6

Evaluate mastery of NP clinical skills

PA 1,2 2, 4, 5, 3 PO: 1, 2, 5 UO: 2,6

Week 11: Social Change Agents

Met In (D#/A# /Other)

Course Outcome(

s)

Program Outcome(

s) University Outcome(

s)

Evaluate changes needed at the national, state, or community level

D 1,3 2, 4, 5

PO:1,7 UO: 1

Analyze nursing legacies and enacting social change

D 1 2, 4, 5 PO:1,7 UO: 1, 2, 3

Synthesize information from your course and practicum experiences to suggest social change needed in your community

D 1 2, 4, 5 PO:1,7 UO: 1, 2, 3

Legend D = Discussion A = Assignment PA = Practicum Assignment NURS 6565: Synthesis in Advanced Practice Care of Complex Patients in Primary Care Settings

NURS 6565: Quality and
Cost
Measurements essay assignment discussion

NURS 6565: Quality and Cost Measurements

As nurse practitioners continue to expand their role in delivering health care, it is imperative for NPs to provide the data and evidence to demonstrate the impact of NP care on patient outcomes. There are several challenges that advanced practice nurses face to provide quality care and meet productivity goals of an organization. This week it is important to explore the connection of quality care and performance measures. Some questions to consider as we discuss this topic are:

Why are quality measures important?

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What is the difference between quality measures and performance indicators?

What performance measures are used for NP productivity?

Why are incentive plans used in clinical organizations?

To prepare:

Read the article, An Incentive Plan for Advanced Practice Registered Nurses: Impact on Provider and Organizational Outcomes, by Catherine A. Rhodes, Mavis Bechtle, and Molly McNett (2015), ,  Buppert , C. 2015 Measuring Nurse Practitioner Performance and other articles provided NURS 6565: Quality and Cost Measurements essay assignment discussion.

Explore quality measures and identify at least one clinical performance measure, such as the Agency for Healthcare Research and Quality (AHRQ)

To Complete

Post 1 to 2 pages on :  An explanation of the importance of quality measures using the clinical performance measure you identified as an example.

Then, identify the performance measures used for NP productivity in Rhodes, Bechtle, and McNett (2015) article.

Finally, share your opinion on incentive payment for care, including external motivators and at least one business model.

REFERENCES

Rhodes, C. A., Bechtle, M., & McNett, M. (2015). An Incentive Plan for Advanced Practice Registered Nurses: Impact on Provider and Organizational Outcomes. Nursing Economics, 33(3), 125-131.

Buppert, C. (2015). Measuring Nurse Practitioner Performance. In Nurse Practitioner’s Business Practice and Legal Guide (5th ed.) (469 – 478). Burlington, MA: Jones & Bartlett. NURS 6565: Quality and Cost Measurements essay assignment discussion.

Hain, D., & Fleck, L. M. (2014). Barriers to NP practice that impact healthcare redesign. OJIN: The Online Journal of Issues in Nursing, 19(2). NURS 6565: Quality and Cost Measurements essay assignment discussion.

Hamric, A. B., Hanson, C. M., Tracy, M. F., & O’Grady, E. T. (2014). Evidence-Based Practice. In Advanced Practice Nursing: An Integrative Approach (5th ed.) (237-262). St. Louis, MO: Elsevier Saunders.

Stanik-Hutt, J., Newhouse, R. P., White, K. M., Johantgen, M., Bass, E. B., Zangaro, G., . . . Weiner, J. P. (2013). The Quality and Effectiveness of Care Provided by Nurse Practitioners. Journal for Nurse Practitioners, 9(8), 492-500. doi:10.1016/j.nurpra.2013.07.004 v.

Nurs 6521 Pharmacotherapy for Gastrointestinal and Hepatobiliary Disorders Essay Discussion Assignment paper

Gastrointestinal (GI) and hepatobiliary disorders affect the structure and function of the GI tract. Many of these disorders often have similar symptoms such as abdominal pain, cramping, constipation, nausea, bloating, and fatigue. Since multiple disorders can be tied to the same symptoms, it is important for advanced practice nurses to carefully evaluate patients and prescribe treatment that targets the cause rather than the symptom. Once the underlying cause is identified, an appropriate drug therapy plan can be recommended based on medical history and individual patient factors. In this Discussion, you examine a case study of a patient who presents with symptoms of a possible GI/hepatobiliary disorder, and you design an appropriate drug therapy plan.

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Consider the following case study:

Patient HL comes into the clinic with the following symptoms: nausea, vomiting, and diarrhea. The patient has a history of drug abuse and possible Hepatitis C. HL is currently taking the following prescription drugs: Nurs 6521 Pharmacotherapy for Gastrointestinal and Hepatobiliary Disorders Essay Discussion Assignment paper.

Synthroid 100 mcg daily

Nifedipine 30 mg daily

Prednisone 10 mg daily

To prepare:

·        Review this week’s media presentation on pharmacology for the gastrointestinal system.

·        Review the provided case study. Reflect on the patient’s symptoms, medical history, and drugs currently prescribed.

·        Think about a possible diagnosis for the patient. Consider whether the patient has a disorder related to the gastrointestinal and hepatobiliary system or whether the symptoms are the result of a disorder from another system or other factors such as pregnancy, drugs, or a psychological disorder.

·        Consider an appropriate drug therapy plan based on the patient’s history, diagnosis, and drugs currently prescribed.

Post 1 page page APA format  

 
an explanation of your diagnosis for the patient including your rationale for the diagnosis. Nurs 6521 Pharmacotherapy for Gastrointestinal and Hepatobiliary Disorders Essay Discussion Assignment paper.

Then, describe an appropriate drug therapy plan based on the patient’s history, diagnosis, and drugs currently prescribed.
(Note this is a pharmacology class make sure medicine is appropriate and will work with pt’s current med list)

 

Readings

·        Arcangelo, V. P., & Peterson, A. M. (Eds.). (2013). 
Pharmacotherapeutics for advanced practice: A practical approach
 (3rd ed.). Ambler, PA: Lippincott Williams & Wilkins.

o   Chapter 28, “Nausea and Vomiting” (pp. 392–409)

This chapter focuses on the etiology of nausea and vomiting, as well as body systems that impact or trigger nausea and vomiting. It also covers various drugs used to treat nausea and vomiting including the process of selecting, administering, and managing drug therapy for patients.

o   Chapter 29, “Gastroesophageal Reflux Disease and Peptic Ulcer Disease” (pp. 410–423)

This chapter begins with an overview of risk factors, symptoms, and clinical stages of gastroesophageal reflux disease (GERD). It then examines drugs used to treat GERD and peptic ulcer disease (PUD), including proper dosages, possible adverse reactions, contraindications, and special considerations. Nurs 6521 Pharmacotherapy for Gastrointestinal and Hepatobiliary Disorders Essay Discussion Assignment paper.

o   Chapter 30, “Constipation, Diarrhea, and Irritable Bowel Syndrome” (pp. 424–453)

This chapter begins by exploring disorders associated with constipation and diarrhea, as well as drugs used in treatment. It also covers the pathophysiology of irritable bowel syndrome and related drug therapies.

o   Chapter 31, “Inflammatory Bowel Disease” (pp. 454–471)

This chapter examines the causes, pathophysiology, and diagnostic criteria of inflammatory bowel disease (IBD), Crohn’s disease, and ulcerative colitis. It also identifies drugs used to treat IBD, including proper dosage, adverse reactions, and special considerations.

·        Starr, S., & Raines, D. (2011). Cirrhosis: Diagnosis, management, and prevention. 
American Family Physician
, 
84
(12), 1353–1359.

Retrieved from the Walden Library databases. Nurs 6521 Pharmacotherapy for Gastrointestinal and Hepatobiliary Disorders Essay Discussion Assignment paper.

This article examines the clinical presentation, pathophysiology, diagnosis, management, and prevention of cirrhosis. It also provides methods for managing complications of cirrhosis.

·        Drugs.com. (2012). Retrieved from 
http://www.drugs.com/

This website presents a comprehensive review of prescription and over-the-counter drugs including information on common uses and potential side effects. It also provides updates relating to new drugs on the market, support from health professionals, and a drug-drug interactions checker. .

NURS 6512 Walden University Exam test questions

A nurse recalls an example of an immune-complex-mediated disease is:

Question 2

1 out of 1 points

When a patient asks the nurse what hypersensitivity is, how should the nurse respond? Hypersensitivity is best defined as:

Question 3

1 out of 1 points

A 35-year-old male is diagnosed with lobar pneumonia (lung infection). Which of the following exudates would be present in highest concentration at the site of this advanced inflammatory response? NURS 6512 Walden University Exam test questions.

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Question 4

1 out of 1 points

A 10-year-old male presents to his primary care provider reporting wheezing and difficulty breathing. History reveals that both of the child’s parents suffer from allergies. Which of the following terms would be used to classify the child? NURS 6512 Walden University Exam test questions.

Question 5

1 out of 1 points

A 20-year-old male shoots his hand with a nail gun while replacing roofing shingles. Which of the following cell types would be the first to aid in killing bacteria to prevent infection in his hand?

Question 6

1 out of 1 points

An 8-year-old female presents with edema of the cutaneous and mucosal tissue layers. Her mother reports that the condition is recurrent and seems to occur more often during stressful situations. The child is diagnosed with hereditary angioedema. Which of the following is deficient in this child? NURS 6512 Walden University Exam test questions.

Question 7

1 out of 1 points

Which patient will develop active immunity? A patient who:

Question 8

1 out of 1 points

A child fell off the swing and scraped the right knee. The injured area becomes painful. What else will the nurse observe upon assessment? NURS 6512 Walden University Exam test questions.

Question 9

1 out of 1 points

A 30-year-old male is having difficulty breathing and has been spitting blood. He reports that he began experiencing this reaction after cleaning his pigeons’ cages. Testing reveals he is suffering from allergic alveolitis. Which of the following is he experiencing?

Question 10

1 out of 1 points

A 45-year-old male presents with persistent, severe stomach pain. Testing reveals a peptic ulcer. Further laboratory tests reveal the presence of Helicobacter pylori. Which of the following is of concern for this patient? NURS 6512 Walden University Exam test questions

Question 11

1 out of 1 points

After teaching about stress, which information indicates a correct understanding of stress?

Question 12

0 out of 1 points

A 30-year-old female presents to her primary care provider reporting fatigue, excessive sweating, and increased appetite. Physical examination reveals protruding eyes, and laboratory testing reveals hyperthyroidism secondary to autoantibody production. This disorder falls into the category of type _____ hypersensitivity.

Question 13

1 out of 1 points

Stress induces sympathetic stimulation of the adrenal medulla. This causes the secretion of catecholamines, which include:

Question 14

1 out of 1 points

A 5-month-old child is admitted to the hospital with recurring respiratory infections. A possible cause of this condition is:

Question 15

1 out of 1 points

Which of the following patients would be at greatest risk for basal cell carcinoma?

Question 16

1 out of 1 points

An infant develops a fever secondary to a bacterial infection. Which of the following most likely triggered the fever?

Question 17

0 out of 1 points

A 50-year-old female experiences decreased blood pressure, decreased oxygen delivery, cardiovascular shock, and subsequent death. A complication of endotoxic shock is suspected. Which of the following is the most likely cause?

Question 18

1 out of 1 points

Which of the following individuals would be at greatest risk for an opportunistic infection?

Question 19

1 out of 1 points

When a patient presents at the emergency department for an allergic reaction, the nurse recognizes the most severe consequence of a type I hypersensitivity reaction is:

Question 20

1 out of 1 points

Which of the following hormones activates adrenergic receptors?

Question 21

1 out of 1 points

During inflammation, the liver is stimulated to release plasma proteins, collectively known as:

Question 22

1 out of 1 points

Exhaustion occurs if stress continues and _____ is not successful. NURS 6512 Walden University Exam test questions.

Question 23

1 out of 1 points

When the maternal immune system becomes sensitized against antigens expressed by the fetus, what type of immune reaction occurs?

Question 24

1 out of 1 points

When histamine is released in the body, which of the following responses would the nurse expect?

Question 25

1 out of 1 points

A patient presents with poison ivy on the extremities, face, and buttocks. This condition is an example of:

Question 26

1 out of 1 points

A 70-year-old female with osteoporosis fractures her leg at a location of preexisting abnormality. She reports that the fracture occurred following a minor fall. Which of the following best describes the fracture? NURS 6512 Walden University Exam test questions.

Question 27

1 out of 1 points

A 4-month-old female is diagnosed with atopic dermatitis (AD). Which of the following assessment findings by the nurse will most likely support this diagnosis?

Question 28

1 out of 1 points

A 34-year-old female was recently diagnosed with RA. Physical examination revealed that inflammation started in the:

Question 29

1 out of 1 points

The final stage of gout, characterized by crystalline deposits in cartilage, synovial membranes, and soft tissue, is called: NURS 6512 Walden University Exam test questions.

Question 30

1 out of 1 points

A 2-month-old female develops diaper dermatitis. A nurse will monitor this patient for which secondary infection that frequently accompanies diaper dermatitis?

Question 31

1 out of 1 points

A 40-year-old female is diagnosed with SLE. Which of the following findings would be considered a symptom of this disease?

Question 32

1 out of 1 points

A 30-year-old female complains of fatigue, arthritis, rash, and changes in urine color. Laboratory testing reveals anemia, lymphopenia, and kidney inflammation. Assuming a diagnosis of SLE, which of the following is also likely to be present? NURS 6512 Walden University Exam test questions.

Question 33

1 out of 1 points

Rubella, rubeola, and roseola are common communicable diseases caused by _____ infection.

Question 34

1 out of 1 points

Researchers now believe that RA is:

Question 35

1 out of 1 points

What common symptom should be assessed in individuals with immunodeficiency?

Question 36

1 out of 1 points

A 50-year-old male recently underwent a liver transplant and is taking immunosuppressive drugs. He now has painful vesicular eruptions on the face and trunk. He reports that he had chickenpox as a child. Which of the following is the most likely diagnosis based on his chicken pox history?

Question 37

1 out of 1 points

Copy of A 5-year-old female was diagnosed with seropositive juvenile rheumatoid arthritis (RA). The treatment option for this disease is termed:

Question 38

1 out of 1 points

A 70-year-old female presents with a hip fracture. She is diagnosed with osteoporosis. One factor that most likely contributed to her condition is:

Question 39

1 out of 1 points

A 42-year-old female presents with raised red lesions with a brownish scale. She was diagnosed with discoid lupus erythematosus. A clinician recalls this disorder is related to: NURS 6512 Walden University Exam test questions.

Question 40

1 out of 1 points

The nurse would expect the occurrence of scabies to occur more commonly among children who:

Sunday, March 13, 2016 6:02:30 PM EDT NURS 6512 Walden University Exam test questions

Pharmacotherapy for Gastrointestinal and Hepatobiliary Disorders Essay Assignment paper

Gastrointestinal (GI) and hepatobiliary disorders affect the structure and function of the GI tract. Many of these disorders often have similar symptoms such as abdominal pain, cramping, constipation, nausea, bloating, and fatigue. Since multiple disorders can be tied to the same symptoms, it is important for advanced practice nurses to carefully evaluate patients and prescribe treatment that targets the cause rather than the symptom. Once the underlying cause is identified, an appropriate drug therapy plan can be recommended based on medical history and individual patient factors. In this Discussion, you examine a case study of a patient who presents with symptoms of a possible GI/hepatobiliary disorder, and you design an appropriate drug therapy plan.

ORDER A CUSTOM-WRITTEN PAPER NOW

Consider the following case study:

Patient HL comes into the clinic with the following symptoms: nausea, vomiting, and diarrhea. The patient has a history of drug abuse and possible Hepatitis C. HL is currently taking the following prescription drugs:

Synthroid 100 mcg daily

Nifedipine 30 mg daily

Prednisone 10 mg daily

To prepare:

·        Review this week’s media presentation on pharmacology for the gastrointestinal system.

·        Review the provided case study. Reflect on the patient’s symptoms, medical history, and drugs currently prescribed. Pharmacotherapy for Gastrointestinal and Hepatobiliary Disorders Essay Assignment paper.

·        Think about a possible diagnosis for the patient. Consider whether the patient has a disorder related to the gastrointestinal and hepatobiliary system or whether the symptoms are the result of a disorder from another system or other factors such as pregnancy, drugs, or a psychological disorder.

·        Consider an appropriate drug therapy plan based on the patient’s history, diagnosis, and drugs currently prescribed.

Post 1 page page APA format  

 
an explanation of your diagnosis for the patient including your rationale for the diagnosis.

Then, describe an appropriate drug therapy plan based on the patient’s history, diagnosis, and drugs currently prescribed.
(Note this is a pharmacology class make sure medicine is appropriate and will work with pt’s current med list)

 

Readings

·        Arcangelo, V. P., & Peterson, A. M. (Eds.). (2013). 
Pharmacotherapeutics for advanced practice: A practical approach
 (3rd ed.). Ambler, PA: Lippincott Williams & Wilkins.

o   Chapter 28, “Nausea and Vomiting” (pp. 392–409)

This chapter focuses on the etiology of nausea and vomiting, as well as body systems that impact or trigger nausea and vomiting. It also covers various drugs used to treat nausea and vomiting including the process of selecting, administering, and managing drug therapy for patients.

o   Chapter 29, “Gastroesophageal Reflux Disease and Peptic Ulcer Disease” (pp. 410–423)

This chapter begins with an overview of risk factors, symptoms, and clinical stages of gastroesophageal reflux disease (GERD). It then examines drugs used to treat GERD and peptic ulcer disease (PUD), including proper dosages, possible adverse reactions, contraindications, and special considerations. Pharmacotherapy for Gastrointestinal and Hepatobiliary Disorders Essay Assignment paper.

o   Chapter 30, “Constipation, Diarrhea, and Irritable Bowel Syndrome” (pp. 424–453)

This chapter begins by exploring disorders associated with constipation and diarrhea, as well as drugs used in treatment. It also covers the pathophysiology of irritable bowel syndrome and related drug therapies.

o   Chapter 31, “Inflammatory Bowel Disease” (pp. 454–471)

This chapter examines the causes, pathophysiology, and diagnostic criteria of inflammatory bowel disease (IBD), Crohn’s disease, and ulcerative colitis. It also identifies drugs used to treat IBD, including proper dosage, adverse reactions, and special considerations.

·        Starr, S., & Raines, D. (2011). Cirrhosis: Diagnosis, management, and prevention. 
American Family Physician
, 
84
(12), 1353–1359.

Retrieved from the Walden Library databases.

This article examines the clinical presentation, pathophysiology, diagnosis, management, and prevention of cirrhosis. It also provides methods for managing complications of cirrhosis.

·        Drugs.com. (2012). Retrieved from 
http://www.drugs.com/

This website presents a comprehensive review of prescription and over-the-counter drugs including information on common uses and potential side effects. It also provides updates relating to new drugs on the market, support from health professionals, and a drug-drug interactions checker. Pharmacotherapy for Gastrointestinal and Hepatobiliary Disorders Essay Assignment paper.

Pharmacotherapy for Gastrointestinal and Hepatobiliary Disorders

Gastrointestinal (GI) and hepatobiliary disorders affect the structure and function of the GI tract. Many of these disorders often have similar symptoms such as abdominal pain, cramping, constipation, nausea, bloating, and fatigue. Since multiple disorders can be tied to the same symptoms, it is important for advanced practice nurses to carefully evaluate patients and prescribe treatment that targets the cause rather than the symptom. Once the underlying cause is identified, an appropriate drug therapy plan can be recommended based on medical history and individual patient factors. Pharmacotherapy for Gastrointestinal and Hepatobiliary Disorders Essay Assignment paper. In this Discussion, you examine a case study of a patient who presents with symptoms of a possible GI/hepatobiliary disorder, and you design an appropriate drug therapy plan.

Consider the following case study:

Patient HL comes into the clinic with the following symptoms: nausea, vomiting, and diarrhea. The patient has a history of drug abuse and possible Hepatitis C. HL is currently taking the following prescription drugs:

Synthroid 100 mcg daily

Nifedipine 30 mg daily

Prednisone 10 mg daily

To prepare:

•Review this week’s media presentation on pharmacology for the gastrointestinal system.

•Review the provided case study. Reflect on the patient’s symptoms, medical history, and drugs currently prescribed.

•Think about a possible diagnosis for the patient. Consider whether the patient has a disorder related to the gastrointestinal and hepatobiliary system or whether the symptoms are the result of a disorder from another system or other factors such as pregnancy, drugs, or a psychological disorder. Pharmacotherapy for Gastrointestinal and Hepatobiliary Disorders Essay Assignment paper.

•Consider an appropriate drug therapy plan based on the patient’s history, diagnosis, and drugs currently prescribed.

Post on or before Day 3 an explanation of your diagnosis for the patient including your rationale for the diagnosis. Then, describe an appropriate drug therapy plan based on the patient’s history, diagnosis, and drugs currently prescribed.

RESOURCES:

Required Resources

To access required library resources,  click on the link to the Course Readings List, found in the Course Materials section of your Syllabus.

Readings

•Arcangelo, V. P., & Peterson, A. M. (Eds.). (2013). Pharmacotherapeutics for advanced practice: A practical approach (3rd ed.). Ambler, PA: Lippincott Williams & Wilkins.

?Chapter 28, “Nausea and Vomiting” (pp. 392–409)

This chapter focuses on the etiology of nausea and vomiting, as well as body systems that impact or trigger nausea and vomiting. It also covers various drugs used to treat nausea and vomiting including the process of selecting, administering, and managing drug therapy for patients.

?Chapter 29, “Gastroesophageal Reflux Disease and Peptic Ulcer Disease” (pp. 410–423)

This chapter begins with an overview of risk factors, symptoms, and clinical stages of gastroesophageal reflux disease (GERD). It then examines drugs used to treat GERD and peptic ulcer disease (PUD), including proper dosages, possible adverse reactions, contraindications, and special considerations Pharmacotherapy for Gastrointestinal and Hepatobiliary Disorders Essay Assignment paper.

?Chapter 30, “Constipation, Diarrhea, and Irritable Bowel Syndrome” (pp. 424–453)

This chapter begins by exploring disorders associated with constipation and diarrhea, as well as drugs used in treatment. It also covers the pathophysiology of irritable bowel syndrome and related drug therapies.

? Chapter 31, “Inflammatory Bowel Disease” (pp. 454–471)

This chapter examines the causes, pathophysiology, and diagnostic criteria of inflammatory bowel disease (IBD), Crohn’s disease, and ulcerative colitis. It also identifies drugs used to treat IBD, including proper dosage, adverse reactions, and special considerations.

•Starr, S., & Raines, D. (2011). Cirrhosis: Diagnosis, management, and prevention. American Family Physician, 84(12), 1353–1359.

Retrieved from the Walden Library databases Pharmacotherapy for Gastrointestinal and Hepatobiliary Disorders Essay Assignment paper.

This article examines the clinical presentation, pathophysiology, diagnosis, management, and prevention of cirrhosis. It also provides methods for managing complications of cirrhosis.

•Drugs.com. (2012). Retrieved from https://www.drugs.com/

This website presents a comprehensive review of prescription and over-the-counter drugs including information on common uses and potential side effects. It also provides updates relating to new drugs on the market, support from health professionals, and a drug-drug interactions checker.

Media

•Laureate Education, Inc. (Executive Producer). (2012). Pharmacology for the gastrointestinal system. Baltimore, MD: Author. Pharmacotherapy for Gastrointestinal and Hepatobiliary Disorders Essay Assignment paper.

This media presentation outlines drug treatment options for disorders of the gastrointestinal system.

Note: The approximate length of this media piece is 2 minutes.

Gastrointestinal (GI) and hepatobiliary disorders affect the structure and function of the GI tract. Many of these disorders often have similar symptoms such as abdominal pain, cramping, constipation, nausea, bloating, and fatigue. Since multiple disorders can be tied to the same symptoms, it is important for advanced practice nurses to carefully evaluate patients and prescribe treatment that targets the cause rather than the symptom. Once the underlying cause is identified, an appropriate drug therapy plan can be recommended based on medical history and individual patient factors. In this Discussion, you examine a case study of a patient who presents with symptoms of a possible GI/hepatobiliary disorder, and you design an appropriate drug therapy plan Pharmacotherapy for Gastrointestinal and Hepatobiliary Disorders Essay Assignment paper.

Consider the following case study:

Patient HL comes into the clinic with the following symptoms: nausea, vomiting, and diarrhea. The patient has a history of drug abuse and possible Hepatitis C. HL is currently taking the following prescription drugs:

· Synthroid 100 mcg daily

· Nifedipine 30 mg daily

· Prednisone 10 mg daily

To prepare:

· Review this week’s media presentation on pharmacology for the gastrointestinal system.

· Review the provided case study. Reflect on the patient’s symptoms, medical history, and drugs currently prescribed.

· Think about a possible diagnosis for the patient. Consider whether the patient has a disorder related to the gastrointestinal and hepatobiliary system or whether the symptoms are the result of a disorder from another system or other factors such as pregnancy, drugs, or a psychological disorder.

· Consider an appropriate drug therapy plan based on the patient’s history, diagnosis, and drugs currently prescribed Pharmacotherapy for Gastrointestinal and Hepatobiliary Disorders Essay Assignment paper.

With these thoughts in mind:

Post
 an explanation of your diagnosis for the patient including your rationale for the diagnosis. Then, describe an appropriate drug therapy plan based on the patient’s history, diagnosis, and drugs currently prescribed

Discussion:
Pharmacotherapy for Gastrointestinal and Hepatobiliary Disorders

Gastrointestinal (GI) and hepatobiliary disorders affect the structure and function of the GI tract. Many of these disorders often have similar symptoms such as abdominal pain, cramping, constipation, nausea, bloating, and fatigue. Since multiple disorders can be tied to the same symptoms, it is important for advanced practice nurses to carefully evaluate patients and prescribe treatment that targets the cause rather than the symptom. Once the underlying cause is identified, an appropriate drug therapy plan can be recommended based on medical history and individual patient factors. In this Discussion, you examine a case study of a patient who presents with symptoms of a possible GI/hepatobiliary disorder, and you design an appropriate drug therapy plan Pharmacotherapy for Gastrointestinal and Hepatobiliary Disorders Essay Assignment paper.

Consider the following case study:

Patient HL comes into the clinic with the following symptoms: nausea, vomiting, and diarrhea. The patient has a history of drug abuse and possible Hepatitis C. HL is currently taking the following prescription drugs:

Synthroid 100 mcg daily

Nifedipine 30 mg daily

Prednisone 10 mg daily

To prepare:

Review this week’s media presentation on pharmacology for the gastrointestinal system.

Review the provided case study. Reflect on the patient’s symptoms, medical history, and drugs currently prescribed.

Think about a possible diagnosis for the patient. Consider whether the patient has a disorder related to the gastrointestinal and hepatobiliary system or whether the symptoms are the result of a disorder from another system or other factors such as pregnancy, drugs, or a psychological disorder. Pharmacotherapy for Gastrointestinal and Hepatobiliary Disorders Essay Assignment paper.

Consider an appropriate drug therapy plan based on the patient’s history, diagnosis, and drugs currently prescribed.

With these thoughts in mind:

By Day 3

Post
 an explanation of your diagnosis for the patient including your rationale for the diagnosis. Then, describe an appropriate drug therapy plan based on the patient’s history, diagnosis, and drugs currently prescribed.

 

Points to follow when writing a paper:

Please all bullets points, bold, red and highlighted area must be attended to.

A clear purpose statement (The purposeof this paper is to…) is required in the introduction of all writings.

Please review all rubrics.

Check APA format/setting.

Please personalized where necessary.

Refrain from direct quote

Class Rules

Avoid public facing sites like university web pages or foundation pages (such as the American Cancer Society or the Alzheimer’s Association) and medical sites designed for consumption by the general public (such as Mayo Clinic or WebMD).

 

you are required to cite scholarly resources including peer-review journals and current practice guidelines
.

May use https://www.ahrq.gov/professionals/clinicians-providers/guidelines-recommendations/index.html

Writer must be familiar with nursing pharmacology. Pharmacotherapy for Gastrointestinal and Hepatobiliary Disorders Essay Assignment paper.

Rules for writing (FYI)

Whether writing a discussion posting or a paper, keep a few things in mind—

1) I am looking for an explanation at the cellular or molecular level (whenever possible).

 2) I am not looking for pathophysiological explanations that we would give to patients (e.g. “your heart just isn’t pumping the right way). While this explanation is acceptable for patient teaching, it will not cut it in a course titled “advanced pathophysiology.” To be very specific- I am looking for you to tell me the precise aberrancies (or theorized aberrancies) which inexorably lead to disease states. Thanks. Pharmacotherapy for Gastrointestinal and Hepatobiliary Disorders Essay Assignment paper.

COH 315: Principles of Epidemiology – Final Part 1

Calculations and Interpretations: Answer the following questions in the space provided. Show all of your work.

1. Evidence of an increased risk of lung cancer associated with cigarette smoking was sought by Doll and Hill. In one study, 649 lung cancer cases were matched by age, and gender to 649 controls; 647 of the cases and 622 of the control had a history of smoking cigarettes. COH 315: Principles of Epidemiology.

a. Name the type of study.

b. Create the appropriate 2X2 table for the study. (2 points)

Lung Cancer Controls

Smokers 647 622

Nonsmokers 2 27

Total 649 649

c. Calculate the appropriate measure of association for the study. (4 points)

d. Interpret the results. (2 points)

2. In another study, the smoking habits of 34,445 male physicians were obtained by mailed questionnaires. Deaths among these physicians over the subsequent years were identified though contact with the office of the Registrar General. The death rates from lung cancer of these physicians classified by smoking habits were :

Standardized Death Rates per 1000 Persons Aged 35 or More per Year

Nonsmokers 0.07

ORDER A PLAGIARISM-FREE PAPER HERE

Cigarette Smokers 0.96

a. Name the type of study. (2 points)

b. Calculate the Relative Risk for smokers as compared to nonsmokers. (6 points)

c. Interpret the results (2 points) COH 315: Principles of Epidemiology

Annual Death Rates per 100,000 Persons

Exposure Category Lung Cancer Coronary Heart Disease

Heavy Smokers 166 599

Nonsmokers 7 422

a. Calculate the relative risk from Lung Cancer Mortality for Heavy Smokers compared to non smokers. ( 4 points)

b. Calculate the attributable risk of Lung Cancer from smoking. (4 points)

c. Interpret the results. (2 points)

d. Calculate the percent attributable risk of Coronary Heart Disease due to smoking (4 points)

e. Interpret the results. (2 points)

3. Convert the following incidence rates to attributable risk using the additive model: (5 points)

Incidence Rates Relative Risks

Factor A Factor A

_ + _ +

Factor B – 3.0 9.0

_____________________________________ __________________________________

+ 15.0 21.00

4. Calculate the concordance rate for the following data: (5 points)

Twin 1

Has Leukemia Does Not Have Leukemia

Twin 2 Has Leukemia 14 1

Does Not Have Leukemia 26 36

COH 315: Principles of Epidemiology

Discussion: Digestive Disorders

Many patient symptoms can be tied to multiple disorders, which may lead to misdiagnoses. For instance, consider two digestive disorders of the gastrointestinal tract—inflammatory bowel disease and irritable bowel syndrome. These two disorders are commonly confused because they present similar symptoms. As an advanced practice nurse, you must know the differences to properly diagnose and treat the disorders. Discussion: Digestive Disorders. How does the pathophysiology of inflammatory bowel disease compare to the pathophysiology of irritable bowel syndrome? How do treatments for the two disorders compare?

ORDER A PLAGIARISM-FREE PAPER HERE

To Prepare

· Review Chapter 36 in the Huether and McCance text and Chapter 13 in the McPhee and Hammer text.

· Identify the pathophysiological mechanisms of inflammatory bowel disease and irritable bowel syndrome. Think about similarities and differences between the disorders.

· Consider common treatments for inflammatory bowel disease and irritable bowel syndrome. Reflect on whether treatments for one disorder would work for the other disorder.

· Select one of the following patient factors: genetics, gender, ethnicity, age, or behavior. Reflect on how the factor you selected might impact the pathophysiology of and treatments for each disorder.

write

· An explanation of the pathophysiological mechanisms of inflammatory bowel disorder and irritable bowel syndrome, including similarities and differences. (
I am looking for an explanation at the cellular or molecular level (whenever possible) Discussion: Digestive Disorders.

· Then describe common treatments, addressing whether treatments for one disorder would work for the other disorder.

· Finally, explain how the patient factor you selected might impact the pathophysiology of and treatments for each disorder.

Points to follow when writing a paper Discussion: Digestive Disorders:

· Please all bullets points, bold, red and highlighted area must be attended to.

· A clear purpose statement (The purpose of this paper is to…) is required in the introduction of all writings.

· Please review all rubrics.

· Check APA format/setting.

· Your final paragraph should be a summary of the key points of your paper.

· Please personalized where necessary.

Refrain from direct quote

Class Rules

Avoid public facing sites like university web pages or foundation pages (such as the American Cancer Society or the Alzheimer’s Association) and medical sites designed for consumption by the general public (such as Mayo Clinic or WebMD).

you are required to cite scholarly resources including peer-review journals and current practice guidelines
.

May use https://www.ahrq.gov/professionals/clinicians-providers/guidelines-recommendations/index.html

Writer must be familiar with nursing pharmacology Discussion: Digestive Disorders.

Rules for writing (FYI)

Whether writing a discussion posting or a paper, keep a few things in mind—

1) I am looking for an explanation at the cellular or molecular level (whenever possible).

2) I am not looking for pathophysiological explanations that we would give to patients (e.g. “your heart just isn’t pumping the right way). While this explanation is acceptable for patient teaching, it will not cut it in a course titled “advanced pathophysiology.” To be very specific- I am looking for you to tell me the precise aberrancies (or theorized aberrancies) which inexorably lead to disease states Discussion: Digestive Disorders. Thanks.

Urinary Tract Infections Essay Example

Urinary Tract Infections

Urinary tract infections (UTIs) are caused by bacteria—most often 
Escherichia coli
. However, certain viruses, fungi, and parasites can also lead to infection. The infection can affect the lower and upper urinary tract, including the urethra, prostate (in males), bladder, ureter, and kidney. Due to the progression of the disease and human anatomy, symptoms present differently among the sexes as well as among age groups. It is important to understand how these factors, as well as others, impact the pathophysiology of UTIs. Advanced practice nurses must have this foundation in order to properly diagnose patients.

ORDER A PLAGIARISM-FREE PAPER HERE

To Prepare

· Review Chapter 30 in the Huether and McCance text. Identify the pathophysiology of lower and upper urinary tract infections. Consider the similarities and differences between the two types of infections.

· Select two of the following patient factors: genetics, gender, ethnicity, age, or behavior Urinary Tract Infections Essay Example. Reflect on how the factors you selected might impact the pathophysiology of the infections, as well as the diagnosis of and treatment for the infections.

Write

· a description of the pathophysiology of lower and upper urinary tract infections, including their similarities and differences. (
I am looking for an explanation at the cellular or molecular level (whenever possible).

· Then explain how the factors you selected might impact the pathophysiology of the infections, as well as the diagnosis of and treatment for the infections.

Points to follow when writing a paper:

· 
Please all bullets points, bold, red and highlighted area must be attended to.

· A clear purpose statement (The purpose of this paper is to…) is required in the introduction of all writings.

· Please review all rubrics.

· Check APA format/setting.

· Your final paragraph should be a summary of the key points of your Urinary Tract Infections Essay Example paper.

· Please personalized where necessary.

Refrain from direct quote

you are required to cite scholarly resources including peer-review journals and current practice guidelines
.

May use https://www.ahrq.gov/professionals/clinicians-providers/guidelines-recommendations/index.html

Rules for writing (FYI)

Whether writing a discussion posting or a paper, keep a few things in mind—

1) I am looking for an explanation at the cellular or molecular level (whenever possible).

2) I am not looking for pathophysiological explanations that we would give to patients (e.g. “your heart just isn’t pumping the right way). While this explanation is acceptable for patient teaching, it will not cut it in a course titled “advanced pathophysiology.” To be very specific- I am looking for you to tell me the precise aberrancies (or theorized aberrancies) which inexorably lead to disease states Urinary Tract Infections Essay Example. Thanks.

Nurs 6512 Health Assessment Discussion Wk 6 – Assessing the Heart, Lungs, and Peripheral Vascular System

Assessing the Heart, Lungs, and Peripheral Vascular System

Take a moment to observe your breathing. Notice the sensation of your chest expanding as air flows into your lungs. Feel your chest contract as you exhale. How might this experience be different for someone with chronic lung disease or someone experiencing an asthma attack?

In order to adequately assess the chest region of a patient, nurses need to be aware of a patient’s history, potential abnormal findings, and what physical exams and diagnostic tests should be conducted to determine the causes and severity of abnormalities.

ORDER A PLAGIARISM-FREE PAPER HERE

In this Discussion, you will consider how a patient’s initial symptoms can result in very different diagnoses when further assessment is conducted. Nurs 6512 Health Assessment Discussion Wk 6 – Assessing the Heart, Lungs, and Peripheral Vascular System.

Note:
 By 
Day 1
 of this week, your Instructor will have assigned you to one of the video case studies in this week’s Learning Resources titled 
Advanced health assessment and diagnostic reasoning
. Also, your Discussion post should be in the SOAP Note format, rather than the traditional narrative style Discussion posting format. Refer to Chapter 2 of the Sullivan text and the Comprehensive SOAP Template in the Week 4 Learning Resources for guidance. 
Remember that not all comprehensive SOAP data are included in every patient case.

To prepare:

With regard to the case study you were assigned:

·        Review this week’s Learning Resources and consider the insights they provide.

·        Consider what history would be necessary to collect from the patient.

·        Consider what physical exams and diagnostic tests would be appropriate to gather more information about the patient’s condition. How would the results be used to make a diagnosis?

·        Identify 
at least five
 possible conditions that may be considered in a differential diagnosis for the patient.

Note:
 Before you submit your initial post, replace the subject line (“Discussion – Week 6”) with “Review of Case Study” identifying the number of the case study you were assigned. Nurs 6512 Health Assessment Discussion Wk 6 – Assessing the Heart, Lungs, and Peripheral Vascular System.

Post a 1 page APA
SOAP Note format

1.      a description of the health history you would need to collect from the patient in the case study you were assigned (
See attached case study below
)

2.      Explain what physical exams and diagnostic tests would be appropriate and how the results would be used to make a diagnosis.

3.      List five different possible conditions for the patient’s differential diagnosis, and justify why you selected each.

Readings

·        Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2015). 
Seidel’s guide to physical examination
 (8th ed.). St. Louis, MO: Elsevier Mosby.

o   Chapter 13, “Chest and Lungs” (pp. 260-293)

This chapter explains the physical exam process for the chest and lungs. The authors also include descriptions of common abnormalities in the chest and lungs.

o   Chapter 14, “Heart” (pp. 294-331)

The authors of this chapter explain the structure and function of the heart. The text also describes the steps used to conduct an exam of the heart.

o   Chapter 15, “Blood Vessels” (pp. 332-349)

This chapter describes how to properly conduct a physical examination of the blood vessels. The chapter also supplies descriptions of common heart disorders.

·        Dains, J. E., Baumann, L. C., & Scheibel, P. (2016). 
Advanced health assessment and clinical diagnosis in primary care 
(5th ed.). St. Louis, MO: Elsevier Mosby.

o   Chapter 8, “Chest Pain” (pp. 81–96)

This chapter focuses on diagnosing the cause of chest pain and highlights the importance of first determining whether the patient is in a life-threatening condition. It includes questions that can help pinpoint the type and severity of pain and then describes how to perform a physical examination. Finally, the authors outline potential laboratory and diagnostic studies.

o   Chapter 11, “Cough” (pp. 118-147)

A cough is a very common symptom in patients and usually indicates a minor health problem. This chapter focuses on how to determine the cause of the cough through asking questions and performing a physical exam.

o   Chapter 14, “Dyspnea” (pp. 159–173)

The focus of this chapter is dyspnea, or shortness of breath. The chapter includes strategies for determining the cause of the problem through evaluation of the patient’s history, through physical examination, and through additional laboratory and diagnostic tests.

o   Chapter 26, “Palpitations” (pp. 310-317)

This chapter describes the different causes of heart palpitations and details how the specific cause in a patient can be determined.

o   Chapter 33, “Syncope” (pp. 390-397)

This chapter focuses on syncope, or loss of consciousness. The authors describe the difficulty of ascertaining the cause, because the patient is usually seen after the loss of consciousness has happened. The chapter includes information on potential causes and the symptoms of each. Nurs 6512 Health Assessment Discussion Wk 6 – Assessing the Heart, Lungs, and Peripheral Vascular System.

·        Sullivan , D. D. (2012). 
Guide to clinical documentation
 (2nd ed.). Philadelphia, PA: F. A. Davis.

o   Chapter 6, “Outpatient Charting and Communications” (pp. 119–141)

Note:
 Download these Adult Examination Checklists and Physical Exam Summaries to use during your practice cardiac and respiratory examination.

·        Seidel, H. M., Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2011). 
Physical exam summary: Blood vessels
. In 
Mosby’s guide to physical examination 
(7th ed.). St. Louis, MO: Elsevier Mosby.

This Blood Vessels Physical Exam Summary was published as a companion to 
Seidel’s guide to physical examination
 (8th ed.), by Ball, J. W., Dains, J. E., & Flynn, J. A. Copyright Elsevier (2015). From https://evolve.elsevier.com/

·        Seidel, H. M., Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2011). 
Adult examination checklist: Guide for cardiovascular assessment
. In 
Mosby’s guide to physical examination
(7th ed.). St. Louis, MO: Elsevier Mosby.

This Adult Examination Checklist: Guide for Cardiovascular Assessment was published as a companion to 
Seidel’s guide to physical examination
 (8th ed.), by Ball, J. W., Dains, J. E., & Flynn, J. A. Copyright Elsevier (2015). From https://evolve.elsevier.com/

·        Seidel, H. M., Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2011). 
Adult examination checklist: Guide for chest and lung assessment
. In 
Mosby’s guide to physical examination 
(7th ed.). St. Louis, MO: Elsevier Mosby.

This Adult Examination Checklist: Guide for Chest and Lung Assessment was published as a companion to 
Seidel’s guide to physical examination
 (8th ed.), by Ball, J. W., Dains, J. E., & Flynn, J. A. Copyright Elsevier (2015). From https://evolve.elsevier.com/ Nurs 6512 Health Assessment Discussion Wk 6 – Assessing the Heart, Lungs, and Peripheral Vascular System.

·        Seidel, H. M., Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2011). 
Physical exam summary: Chest and lungs
. In 
Mosby’s guide to physical examination 
(7th ed.). St. Louis, MO: Elsevier Mosby.

This Chest and Lungs Physical Exam Summary was published as a companion to 
Seidel’s guide to physical examination
 (8th ed.), by Ball, J. W., Dains, J. E., & Flynn, J. A. Copyright Elsevier (2015). From https://evolve.elsevier.com/

·        Seidel, H. M., Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2011). 
Physical exam summary: Heart.
 In 
Mosby’s guide to physical examination 
(7th ed.). St. Louis, MO: Elsevier Mosby.

This Heart Physical Exam Summary was published as a companion to 
Seidel’s guide to physical examination
 (8th ed.), by Ball, J. W., Dains, J. E., & Flynn, J. A. Copyright Elsevier (2015). From https://evolve.elsevier.com/

·        McCabe, C., & Wiggins, J. (2010a). Differential diagnosis of respiratory disease part 1. 
Practice Nurse
,
40
(1), 35–41.

Retrieved from the Walden Library databases.

This article describes the warning signs of impending deterioration of the respiratory system. The authors also explain the features of common respiratory conditions.

·        McCabe, C., & Wiggins, J. (2010b). Differential diagnosis of respiratory diseases part 2. 
Practice Nurse
, 
40
(2), 33–41.

Retrieved from the Walden Library databases. Nurs 6512 Health Assessment Discussion Wk 6 – Assessing the Heart, Lungs, and Peripheral Vascular System.

The authors of this article specify how to identify the major causes of acute breathlessness. Additionally, they explain how to interpret a variety of findings from respiratory investigations.

·        SkillStat Learning, Inc. (2014). 
The 6 second ECG
. Retrieved from 
http://www.skillstat.com/tools/ecg-simulator#/-home

This interactive website allows you to explore common cardiac rhythms. It also offers the Six Second ECG game so you can practice identifying rhythms.

·        University of Virginia. (n.d.). 
Introduction to radiology: An online interactive tutorial
. Retrieved from
http://www.med-ed.virginia.edu/courses/rad/index.html

This website provides an introduction to radiology and imaging. For this week, focus on cardiac radiography and chest radiology.

Media

·        Laureate Education. (Producer). (2012). 
Advanced health assessment and diagnostic reasoning
. Baltimore, MD: Author. Nurs 6512 Health Assessment Discussion Wk 6 – Assessing the Heart, Lungs, and Peripheral Vascular System.

 

Exam Results

Exam Results: Scenario 2

Vital signs:

Temperature: 97.9 oral

Respiratory rate: 32, labored

Heart rate: 112, tachycardic

BP right arm: 148/88

Oxygen saturation: 90% on room air

Weight: 210 lbs, stable

Skin: Cool, diaphoretic

Thorax and lungs: Thorax symmetrical; diminished breath sounds right middle and lower lobes; no rales, rhonchi, or wheezes; breath sounds vesicular with no adventitious sounds left lung

Cardiovascular: Heart rate is irregular with good S1, S2; no S3 or S4; no murmur

Abdomen: Protuberant with normoactive bowel sounds auscultated x4 quadrants Nurs 6512 Health Assessment Discussion Wk 6 – Assessing the Heart, Lungs, and Peripheral Vascular System

Peripheral vascular: Right calf with 2+ edema, erythema; warmth and tenderness on palpation noted; left lower extremity without edema or erythema; 2+ dorsalis pedis pulses bilaterally

Neurologic: Anxious; awake, alert, and oriented to person, place, and time Nurs 6512 Health Assessment Discussion Wk 6 – Assessing the Heart, Lungs, and Peripheral Vascular System.