Category: Nursing

Capstone Project: Milestone 1: Practice Issue and Evidence Summary Worksheet

Practice Issue Worksheet Directions

A tutorial with tips for completing this assignment may be viewed at https://atge.webex.com/atge/ldr.php?RCID=4905b26a67572323c11b839e3251c96a (Links to an external site.)Links to an external site. (Links to an external site.)Links to an external site.

Choose the ONE systematic review topic that is of most interest to you, or most relevant to your practice situation, from the required List of Approved Systematic Reviews (Links to an external site.)Links to an external site..

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Follow the grading criteria below to formulate your practice issue, which must be based on the topic of the systematic review you have selected.

Download the required Milestone 1 Practice Issue and Evidence Summary Worksheets (Links to an external site.)Links to an external site. (both worksheets appear in ONE file) to document the practice issue presented and approved by your instructor in the Week 2 Discussions.

Your practice issue will be the same for all three Milestone assignments in this course.

Please type your answers directly into the worksheet Capstone Project: Milestone 1: Practice Issue and Evidence Summary Worksheet.

Evidence Summary Worksheet Directions

Develop an evidence summary by following the grading criteria below.

Document this on the evidence summary portion of the worksheet.

You will use this worksheet to incorporate your evidence summary into your Week 4 Milestone 2 assignment.

Please type your answers directly into the worksheet. Capstone Project: Milestone 1: Practice Issue and Evidence Summary Worksheet.

For this week’s Nurse’s Role in Influencing the Legislative Process Essay project, you’ll answer three questions related to your opportunity as a nurse and an advocate. The first two questions relate to influencing a bill is traveling through the legislative process. The third question refers you to the social determinants of health as described in your course textbook reading and asks you to think specifically on your role as a nurse in influencing social determinants of health.

In a brief paper (no more than 2 typed pages, 1 inch margins, 12 font Times New Roman or Courier New), answer the questions below. Write each question as a new topic area and then follow with a paragraph or two to answer the question Nurse’s Role in Influencing the Legislative Process Essay. You may find it necessary to search for answers to the questions outside of the assigned reading. Be sure to use APA guidelines for writing style, spelling and grammar, and citation of sources.

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Answer the following questions:

What parts of the lawmaking process does a nurse have an opportunity to influence the final bill passage?

List at least two ways that this influence can take place. In your opinion, would one way be preferable over the other?

Reviewing the social determinants of health, select one to respond to this question:

What role can nurses play in promoting health status through policy changes directly affecting this social determinant?

Submission Details:

Submit your response in a 2-page Microsoft Word document (500 words).

Name your document SU_NSG4068_W2_Project_LastName_FirstInitial.doc.

Submit your document to the Submissions Area by the due date assigned.

Cite sources in the APA format on a separate page.

The parts of the lawmaking process where the nurses have a privilege to influence are quite many. First, the nurses can influence the introduction part of a bill by asking the members of the Congress to sponsor the bill. Second, at the hearing stage where the nurses can submit a written authentication to express an opinion and also give a background on the matter and also regulate how the bill will impact their constituent Nurse’s Role in Influencing the Legislative Process Essay. Third, they can influence at the markup stage where the nurses can propose amendments and changes to the law before its recommendation.

However, there are two ways in which the nurses’ influence on the legislative process can take place. First, is through advocacy in the community.  Nurses act as advocates where they offer a link between lawmakers and nursing hence they can influence the health policies. The second way is through direct legislative arena where the nurses attend the health policymaking process (Keleher, & MacDougall, 2015). Nurse’s Role in Influencing the Legislative Process Essay. I prefer advocacy since it involves the refinement of opinions and clarifying key issues by the nursing community thus the nurse influence will represent the interest of the majority and not an individual’s interest like that of legislative arena.

According to Braveman and Gottlieb (2014), social determinants of health refers to the circumstances in the environment where individual were born, are living, learning, worshipping, and playing and its influence to health. Such social determinants include social norms and attitudes, public safety, availability of community-based resources, access to health care services, culture, and literacy. The determinant from the list above which affects the nurses’ role in influencing legislative process is the social norm and attitude.

Social norms and attitude are one of the social determinants of health which affects health policy-making process. Keleher and MacDougall argue that health policy and laws may be ineffective if they do not reflect social norms and the attitude of the community (2015). Social norms find their expression in both formal law and societal expectations Nurse’s Role in Influencing the Legislative Process Essay. The health policy should, therefore, be formulated on the basis that it entirely conforms to the attitude of the people and social norms. Nurses’ influence on the legislative process as advocators are therefore essential to ensure that the laws legislated are within the social norms hence the social determinants determines how the nurses will influence a given bill.

There are many roles of the nurses in promoting the health status such as through direct policy changing that affects norms as a social determinant of health. Mainly, nurses’ influence in health policies should serve as social norms protection. However, when nurses’ advocate for a bill through Congress corrects a problematic behavior in the community, then the social norms as determinants of health will be affected positively (Auerbach, 2013). Nurse’s Role in Influencing the Legislative Process Essay. Social norms are all about customary behavior. For instance, when a nurse seconds or proposes a bill against Female Genital Mutilation, a section of the community will feel that the law is positively affecting the social norm while others feel like they have been betrayed.

In conclusion, nurses play a critical role in the legislative process. Nurse leaders are expected to influence those policies which back to increasing the number of nurses. Additionally, nurses should encourage laws which support technology in nursing. Last but not least, nurses should be aware of new policies and bills which are relating to their profession. Nurse’s Role in Influencing the Legislative Process Essay.

Reference

Auerbach, D.I., Staiger, D.O., Muench, U. & Buerhaus, P.I., 2013. The nursing workforce in an era of health care reform.
New England Journal of Medicine
,
368
(16), pp.1470-1472.

Braveman, P., & Gottlieb, L. (2014). The social determinants of health: it’s time to consider the causes of the causes. 
Public health reports
, 
129
(1_suppl2), 19-31.

Keleher, H., & MacDougall, C. (2015). 
Understanding health
(No. Ed. 4). Oxford University Press. Nurse’s Role in Influencing the Legislative Process Essay.

Tips for Finding a Preceptor & Practicum Site

Finding a Practicum Site & Preceptor

Ask those you have professional relationships with if they have recommendations for you

A physician or FNP you know

Your current place of work, or an affiliate facility

Your own family physician

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Also consider

A retail clinic

http://
npfinder.aanp.org/

Practicum Site Considerations

Practicum Site Selection: Focus Should be on Primary Care

Preceptor Requirements

Patient Population Exposure

NR-511: Differential Diagnosis and Primary Care Practicum

Must take place at a family practice or retail clinic

Core Focus

Formulating differential diagnoses of individuals within the primary care setting

Practicum experiences may include:

Processing client information

Interpreting lab studies

Cardiovascular risk assessment/management

NR-601: Primary Care of the Maturing and Aged Family Practicum

Must take place at a family practice or retail clinic

Core Focus

Common health problems and healthcare needs of the middle-aged and older adult

Further develop your skills related to patient education, protocol development, follow-up and referral Finding a Practicum Site & Preceptor.

Practicum experiences may include:

Older adult cognitive/functional ability assessment

Older adult nutritional assessment

Performance of primary care-related skills within scope of preceptor

NR-602: Primary Care of the Childbearing and Childrearing Family Practicum

Core Focus

Healthcare needs of women and families throughout reproductive and childrearing years

Practicum experiences may include:

Performing well-woman and well-child exams

STD diagnosis and treatment

Performing full pelvic exams

NR-603: Advanced Clinical Diagnosis and Practice across the Lifespan Practicum Finding a Practicum Site & Preceptor

Core Focus

Expand the theoretical and practical knowledge of health assessment principles specific to the role of the FNP

Practicum experiences may include:

Health promotion and prevention of illness

Diagnosis and management of health problems across lifespan

Performance of primary care-related skills within scope of preceptor

NR-661: APN Capstone Practicum

Core Focus

Clinical management skills, case studies, chart reviews, and practice critique, with a capstone product evidencing increasing complex clinical management skills Finding a Practicum Site & Preceptor

Practicum experiences may include:

Performance of primary care-related skills within scope of preceptor

Imbedded national certification exam review program

Developed by APEA, Advanced Practice Education Associates

You may complete your practicums with your current employer as long as …

üPreceptor is not your direct supervisor

üSite provides necessary patient exposure

üPracticum experiences are outside of your typical work area

Scheduling and Time Management

Why Start So Early?

Unplanned situations can occur

Scheduling conflicts with preceptors

Practicum sites not delivering as planned

Trouble finding appropriate patient exposure

Clinical Affiliation Agreement

Can take several weeks to months to obtain

Practicum Site Requirements

Contacting Sites & Preceptors

Be Professional

Sites may evaluate you for future employment

Be Prepared

Have your goals, preceptor requirements,  practicum requirements, timeframe and expectations clearly outlined

These can be found in your FNP Practicum Handbook and Toolkit

Be Appreciative Finding a Practicum Site & Preceptor.

Social Determinants of Health Essay

The DISCUSSION ASSIGNMENT provides a forum for discussing relevant topics for this week on the basis of the course competencies covered.

For this assignment, make sure you post your initial response to the Discussion Area by the due date assigned Social Determinants of Health Essay.

To support your work, use your course and text readings and also use the South University Online Library. As in all assignments, cite your sources in your work and provide references for the citations in APA format.

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Start reviewing and responding to the postings of your classmates as early in the week as possible. Respond to at least two of your classmates’ initial postings. Participate in the discussion by asking a question, providing a statement of clarification, providing a point of view with a rationale, challenging an aspect of the discussion, or indicating a relationship between two or more lines of reasoning in the discussion. Social Determinants of Health Essay Cite sources in your responses to other classmates. Complete your participation for this assignment by the end of the week.

Answer one of the following questions:

Increasingly, health policymakers are becoming aware of the social determinants of health and the role they play in prevention disease and promoting health and wellness. In the “Frameworks for Action in Policy and Politics” chapter, examine Box 1-1 (Political Aspects of the Social Determinants of Health) and Figure 1-6 (The Who, What, Where, When, and Why of Nursing’s Policy Influence). Then compare these with the story about Lilian Wald’s work in New York City Social Determinants of Health Essay. Reflect on the “what” of Wald’s strategies. In your opinion, which did she use effectively?

Looking further at the “what” in Figure 1-6 and answer any one of the following questions:

Discuss at least three competencies/strategies that you have used effectively.

Identify three competencies/strategies that you don’t currently use and discuss how you might incorporate them into your advocacy toolbox. Social Determinants of Health Essay.

Review the four recommendations in the IOM report The Future of Nursing: Leading Change, Advancing Health and find your state’s action coalition. Discuss your state’s action coalition’s work as it aligns with these four recommendations. Is each recommendation being addressed? Based on your analysis of the website, how would you describe your state’s progress toward meeting the IOM recommendations? Social Determinants of Health Essay.

Social Determinants of Health

The Institute of Medicine’s report made four specific recommendations for advancing health and leading change on the future of nursing. According to Zangaro (2015), the critical sanction stated that; first, nurses are expected to practice their work to the complete scope of their training. The commendation requires the nurses to remove the scope-of-practice obstacles through expanding Medicare to include advanced nursing and reforming State level regulations. Second, nurses must achieve high levels of education and promote seamless academic progressions (Zangaro, 2015). The number of nurses with baccalaureate and doctorate degrees should be increased. Third, Nurses are expected to be full partners with all health care professions and physicians. The IOM recommends expanding and improving nurses’ collaborative effort. Social Determinants of Health Essay Fourth, IOM recommended improved information structure and better data collection to promote policy-making and effective planning.

My state’s action coalition is the California Action Coalition which is a workforce for implementing the IOM report. The coalition’s work conforms to all the recommendations in the Institute of Medicine’s report. The report published on the Coalition’s website on July 14
th
, 2016 revealed that the suggestions were being addressed through providing the technical support for the future of nurses. The coalition is campaigning for action marks which are initiatives to address all the four IOM recommendations. Social Determinants of Health Essay. Basing on the California Action Coalition’s website, I would describe the state’s progress as noble in meeting the IOM recommendations. According to the testimonials presented on the site, massive changes in the healthcare delivery system have been transformed. The recommendations have been implemented at both local and national levels. The Campaign for Action, priorities for the nursing profession and chartered future directions are the evidenced continued work for future of nursing as stated on the website Social Determinants of Health Essay.

Reference

Zangaro, G. (2015). Presentation to IOM Committee for Assessing Progress on Implementing the Recommendations of the Institute of Medicine Report The Future of Nursing: Leading Change, Advancing Health. 
Washington, DC, July

27
, 2015. Social Determinants of Health Essay.

Differential diagnosis and primary care practicum.

Briefly and concisely summarize the history and physical (H&P) findings as if you were presenting it to your preceptor using the pertinent facts from the case. Use shorthand where possible and approved medical abbreviations. Avoid redundancy and irrelevant information.

Provide a differential diagnosis (minimum of 3) which might explain the patient’s chief complaint along with a brief statement of pathophysiology for each.

Analyze the differential by using the pertinent findings from the history and physical to argue for or against a diagnosis. Rank the differential in order of most likely to least likely Differential diagnosis and primary care practicum.

Identify any additional tests and/or procedures that you feel is necessary or needed to help you narrow your differential. All testing decisions must be supported with an evidence-based medicine (EBM) argument as to why it is necessary or pertinent in this case. If no testing is indicated or needed, you must also support this decision with EBM evidence.

The rest of the information from this case study will be attached as a PDFs file.

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Briefly and concisely summarize the history and physical (H&P) findings as if you were presenting it to your preceptor using the pertinent facts from the case. Use shorthand where possible and approved medical abbreviations. Avoid redundancy and irrelevant information Differential diagnosis and primary care practicum.

· Provide a differential diagnosis (minimum of 3) which might explain the patient’s chief complaint along with a brief statement of pathophysiology for each. NR511: Differential Diagnosis and Primary Care

· Analyze the differential by using the pertinent findings from the history and physical to argue for or against a diagnosis. Rank the differential in order of most likely to least likely.

· Identify any additional tests and/or procedures that you feel is necessary or needed to help you narrow your differential. IF you ordered a test or performed a procedure, identify the corresponding Current Procedural Terminology (CPT) code(s). If not applicable, list n/a. All testing decisions must be supported with an evidence-based medicine (EBM) argument as to why it is necessary or pertinent in this case. If no testing is indicated or needed, you must also support this decision with EBM evidence Differential diagnosis and primary care practicum.

The rest of the information for the HPI, ROS, and physical exams will be in the “my orders” section

Guide to NR511 Case Studies (Week 3 & 6)

Part 1

In Part 1, you are given a patient scenario.  Using the information given, answer the following questions:

 

Briefly and concisely summarize the H&P findings
as if you were presenting it to your preceptor using the pertinent facts from the case. Use shorthand where possible and approved medical abbreviations.  Avoid redundancy and irrelevant information.

Example:

“J.S. is a 34yo male with a CC of acute onset ST x 3 days” [provide additional information from the history that is relevant]. 

 
“Physical exam is significant for” [provide relevant physical exam findings].

 
*Do not simply rewrite the information as it is presented in the case report. This should mimic how you would present this patient to your preceptor.

 

Provide a differential diagnosis (plural) which might explain the patient’s chief complaint
along with a
brief statement of pathophysiology for each
.

 

Example:

 

Diagnosis #1

-Pathophysiology statement

 

Diagnosis #2

-Pathophysiology statement

 
Diagnosis #3

-Pathophysiology statement

Analyze the differential
by using the pertinent findings from the history and physical to argue for or against a diagnosis.
Rank the differential
in order of most likely to least likely.
(This is where you present your argument for EACH DIAGNOSIS in your differential using the patient’s subjective and objective information that was given).

Example:

 
Diagnosis # 1, 2, & 3 (provide an analysis for each of the diagnoses listed above)

A brief
argument
as to why this condition should be considered plus:

-Pertinent positive symptoms which support the diagnosis

-Pertinent negative symptoms which support the diagnosis

Identify any additional tests and/or procedures
that you feel is necessary or needed to help you narrow your differential. All testing decisions must be supported with an EBM argument as to why it is necessary or pertinent in this case.  If no testing is indicated or needed, you must also support this decision with EBM evidence.
(This is where you identify, based on what you know thus far, test or test(s) that you would perform TODAY which would help you narrow your differential diagnosis). Differential diagnosis and primary care practicum.

 

*
Do not list all of the possible tests that can be done. You are being evaluated on your diagnostic reasoning skills as well your ability to make decisions that are in-line with current practice recommendations. Just because a test is available does not mean it needs to be done.

Example:

Let’s say my differential included bronchitis and pneumonia.  In this case, a CXR might be useful in differentiating the 2 conditions.  However, remember that you have to have an EBM argument for this decision Differential diagnosis and primary care practicum. 
So make sure you are telling the reader why this is the best choice based on the literature (i.e., it is not enough to say the test and cite the author & date).
  In this instance, my argument might look like this:  “According to the Infectious Disease Society of America (2012) a CXR is considered the gold standard for diagnosing pneumonia.”  Keep in mind that you also need an EBM argument if you decide NOT to test too. 

 
Part 2

In Part 2 you might be given some additional history, exam or test findings.  Using this information
and
the information in Part 1, answer the following questions:

What is your
primary diagnosis
for this patient?
Tell the reader how you came to this conclusion using the information that you were given (i.e., CXR result, lab result).  Interpret the results into your diagnosis decision (i.e., tell how this information helped you to narrow your differential to the one diagnosis that you chose).

 

Example:

Diagnosis: Pharyngitis, streptococcal

 
Rationale:
The CBC results are normal which rules out infection and anemia. The RSA test was + which tells me that she has a very strong likelihood of streptococcal pharyngitis.

In the case where a diagnosis was made based on clinical presentation and history, explain the criteria with an EBM argument to support.

 

Identify the corresponding ICD-10 Code
for the diagnosis.

 

Example:

 

J02.0

You can find a link to an ICD-10 code finder by going to the Library homepage>Browse guides>Course directory tab>select NR511 from the drop down box>select Go. Otherwise, a google search will provide you with several free options you can use Differential diagnosis and primary care practicum.

 

Provide a treatment plan
for this patient’s primary diagnosis which includes:

 

a)
Medication
–
all prescriptions and OTC medications should be written in RX format with an EBM to support:

Medication Name & Medication Strength

Dispensing quantity:

Sig:

RF:

 

b)
Any additional testing
necessary for this particular diagnosis-t
ypically done when you need more information to confirm a diagnosis or differentiate the diagnosis. Do not state all of the possibilities that are available. To assess your diagnostic reasoning skill, you will need to be decisive.

 

c)
Patient education
–
self explanatory

 

d)
Referral
-self explanatory

 

e)

F/U plan
-include if and when the patient should follow-up

 

*If part of the plan does not warrant an action, you must explain why. ALL medication and testing decisions (or decisions not to treat with medication or additional testing) MUST be supported with an EBM argument as you did in Part 1 Differential diagnosis and primary care practicum.

 

Example:

 

Penicillin VK 500mg, Disp #20, Sig: 1 tab twice daily x 10days; RF: 0 (full RX required)

 

Rationale: Penicillin is the 1
st
line treatment recommendation for Group A Beta-hemolytic streptococcal pharyngitis, based on their narrow spectrum of activity, infrequency of adverse reactions, and modest cost.  (Shulman, Bisno, Clegg, Gerber, Kaplan, Lee, Martin, & Van Beneden, 2012).  My patient has no noted allergies, so PCN VK is appropriate.

 

No additional testing will be performed today.

 

Rationale:  Point of care, rapid strep antigen tests are highly specific (approximately 95%) when compared with throat cultures, so false-positive test results are highly unusual.  Consequently, a therapeutic decision can be confidently made based on the positive result which was reported for this patient in the scenario (Shulman, Bisno, Clegg, Gerber, Kaplan, Lee, Martin, & Van Beneden, 2012) Differential diagnosis and primary care practicum. 

 

Patient instructions:

-take all medication as prescribed (Reference, date)

-F/U in 10-14 days if symptoms are not resolved or sooner if they become worse, etc., (Reference, date)

-Etc..

 

Provide an active problem list
for this patient
based on the information given
in the case.
This is where you list all of the known medical problems of the patient.  This is different than a differential. Differential diagnosis and primary care practicum.

 

Example:

 

Streptococcal Pharyngitis

Hypertension

Obesity

 

 

List your references that were cited above according to APA rules. Format is not graded (Canvas does a poor job in formatting the tabs and spaces) BUT all other APA elements are required.

 

References

Shulman, S., Bisno, A., Clegg, H., Gerber, M., Kaplan, E., Lee, G., Martin, J., & Van Beneden, C. (2012).  Clinical Practice Guideline for the Diagnosis and Management of Group A Streptococcal Pharyngitis:  A 2012 Update by Infectious Diseases Society of America. 
Clinical Infectious Disease, 55(10), e89.
  DOI: 10.1093/cid/cis629 Differential diagnosis and primary care practicum.

Adaptive Response Sample Essay Assignment paper

Assignment: Adaptive Response

As an advanced practice nurse, you will examine patients presenting with a variety of disorders. You must, therefore, understand how the body normally functions so that you can identify when it is reacting to changes. Often, when changes occur in body systems, the body reacts with compensatory mechanisms Adaptive Response Sample Essay Assignment paper. These compensatory mechanisms, such as adaptive responses, might be signs and symptoms of alterations or underlying disorders. In the clinical setting, you use these responses, along with other patient factors, to lead you to a diagnosis.

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Consider the following scenarios:

Scenario 1:

Jennifer is a 2-year-old female who presents with her mother. Mom is concerned because Jennifer has been “running a temperature” for the last 3 days. Mom says that Jennifer is usually healthy and has no significant medical history. She was in her usual state of good health until 3 days ago when she started to get fussy, would not eat her breakfast, and would not sit still for her favorite television cartoon. Since then she has had a fever off and on, anywhere between 101oF and today’s high of 103.2oF. Adaptive Response Sample Essay Assignment paper Mom has been giving her ibuprofen, but when the fever went up to 103.2oF today, she felt that she should come in for evaluation. A physical examination reveals a height and weight appropriate 2-year-old female who appears acutely unwell. Her skin is hot and dry. The tympanic membranes are slightly reddened on the periphery, but otherwise normal in appearance. The throat is erythematous with 4+ tonsils and diffuse exudates. Anterior cervical nodes are readily palpable and clearly tender to touch on the left side. The child indicates that her throat hurts “a lot” and it is painful to swallow. Vital signs reveal a temperature of 102.8oF, a pulse of 128 beats per minute, and a respiratory rate of 24 beats per minute Adaptive Response Sample Essay Assignment paper.

Scenario 2:

Jack is a 27-year-old male who presents with redness and irritation of his hands. He reports that he has never had a problem like this before, but about 2 weeks ago he noticed that both his hands seemed to be really red and flaky. He denies any discomfort, stating that sometimes they feel “a little bit hot,” but otherwise they feel fine. He does not understand why they are so red. His wife told him that he might have an allergy and he should get some steroid cream. Jack has no known allergies and no significant medical history except for recurrent ear infections as a child. He denies any traumatic injury or known exposure to irritants Adaptive Response Sample Essay Assignment paper. He is a maintenance engineer in a newspaper building and admits that he often works with abrasive solvents and chemicals. Normally he wears protective gloves, but lately they seem to be in short supply so sometimes he does not use them. He has exposed his hands to some of these cleaning fluids, but says that it never hurt and he always washed his hands when he was finished Adaptive Response Sample Essay Assignment paper.

Scenario 3:

Martha is a 65-year-old woman who recently retired from her job as an administrative assistant at a local hospital. Her medical history is significant for hypertension, which has been controlled for years with hydrochlorothiazide. She reports that lately she is having a lot of trouble sleeping, she occasionally feels like she has a “racing heartbeat,” and she is losing her appetite. She emphasizes that she is not hungry like she used to be. The only significant change that has occurred lately in her life is that her 87-year-old mother moved into her home a few years ago. Mom had always been healthy, but she fell down a flight of stairs and broke her hip. Her recovery was a difficult one, as she has lost a lot of mobility and independence and needs to rely on her daughter for assistance with activities of daily living. Martha says it is not the retirement she dreamed about, but she is an only child and is happy to care for her mother. Mom wakes up early in the morning, likes to bathe every day, and has always eaten 5 small meals daily. Martha has to put a lot of time into caring for her mother, so it is almost a “blessing” that Martha is sleeping and eating less. She is worried about her own health though and wants to know why, at her age, she suddenly needs less sleep.

To Prepare

Review the three scenarios, as well as Chapter 6 in the Huether and McCance text.

Identify the pathophysiology of the disorders presented in each of the three scenarios, including their associated alterations. Consider the adaptive responses to the alterations.

Review the examples of “Mind Maps—Dementia, Endocarditis, and Gastro-oesophageal Reflux Disease (GERD)” media in this week’s Learning Resources. Then select one of the disorders you identified from the scenarios. Use the examples in the media as a guide to construct a mind map for the disorder you selected. Consider the epidemiology, pathophysiology, risk factors, clinical presentation, and diagnosis of the disorder, as well as any adaptive responses to alterations.

Review the Application Assignment Rubric found under Course Information Adaptive Response Sample Essay Assignment paper.

To Complete

Write a 2- to 3-page paper excluding the title page, reference page and Mind Map that addresses the following:

For each of the three scenarios explain the pathophysiology, associated alterations and the patients’ adaptive responses to the alterations caused by the disease processes. You are required to discuss all three scenarios within the paper component of this assignment.

Construct one mind map on a selected disorder presented in one of the scenarios. Your Mind Map must include the epidemiology, pathophysiology, risk factors, clinical presentation, and diagnosis of the disorder, as well as any adaptive responses to alterations. Adaptive Response Sample Essay Assignment paper.

Adaptive Response

Advanced nurses can see a wide range of infections and patients from diverse cultures. It is essential for a nurse to differentiate between abnormal and normal body functions. The adaptive response is critical when diagnosing a patient in a clinical setting. This paper will identify adaptive reactions from three patients’ scenarios. The document will further define adaptive responses to depression, allergic contact dermatitis, and pathophysiology as well as the adaptive response of tonsillitis Adaptive Response Sample Essay Assignment paper.

Scenario One: Tonsillitis

The scenario portrays a two-year-old female patient who presents fussiness, hot and dry skin, anorexia and tympanic membrane which is slightly reddened on the periphery. The patient further depicts erythematous throat with diffuse exudate and four plus tonsils. Additionally, the mother states that her temperature ranges from 102.8 degrees to 103.2 degrees. The patient is complaining of throat pain when swallowing. However, the judgment of tonsillitis will base on the clinical results Adaptive Response Sample Essay Assignment paper.

Tonsillitis is a contagion whereby the tonsils irritate (Yamashita et al., 2016). For this infection, the adaptive responses involve a sore throat, pain when swallowing, swollen tonsils, exudate, fever, tender lymph nodes at the neck, headache, stiff neck, lousy breadth as well as a stomachache. Tonsillitis belongs to secondary group A beta-hemolytic Streptococcus (GABHS) and the rising MRSA. McCarthy argues that tonsillitis often affects children from preschool ages to mid-teenage years (2014). According to Chiappini et al. the macrophages which are present in the tonsils engulfs the infected organisms which eventually secretes digestive enzymes that starts to destroy the body (2015) Adaptive Response Sample Essay Assignment paper. Research has revealed that if tonsillitis is not treated, it may result in a condition known as post-streptococcal glomerulonephritis or sometimes rheumatic fever. Adaptive Response Sample Essay Assignment paper.
 

Scenario Two: Allergic Contact Dermatitis

The second scenario describes a twenty-seven-year-old male patient presented with redness and hands imitation after being exposed to harsh solvents and chemicals. The patient claims that his hand is feeling quite hot, but he does not feel any pain. The clinical findings determine the diagnosis of the allergic contact dermatitis. Popple et al. mention that the adaptive response of allergic contact dermatitis involves the edema, pruritus and the erythema (2016) Adaptive Response Sample Essay Assignment paper.

The allergic contact dermatitis is an infection which is caused a specified immune-mediated reaction of the body to a substance which has touched the skin. The patient’s conditions are attributed to his frequent contact with chemicals while working. Some of the elements which cause allergy include dyes, preservatives, and fragrances among other chemicals. The edema in the epidermis sources the separation of the keratinocytes. Popple et al. stipulate that a sensitizing antigen forms when the allergen bounds to a carrier protein and also when the allergen comes in contact with the skin (2016). The Langerhans cells in the skin exhibit the antigen and eventually takes the antigen to the T cells. Consequently, the T cells are prepared which in turn initiates the releasing of the provocative cytokines as well as the indicators of redness. Pruritus and swelling eventually follow thus depicting allergic contact dermatitis. The patient does not use gloves. Therefore he is exposing his hands to dangerous chemicals. It is essential to carry out allergy and patch testing to recognize the allergen so that it can be prevented on time. Allergic contact dermatitis is treated using the topical corticosteroid Adaptive Response Sample Essay Assignment paper.

Scenario Three: Depression

The third scenario depicts a sixty-five-year-old woman presented with topical loss of appetite, racing heartbeat, insomnia, and sleep disturbances. There are critical changes in the woman’s life including the care of her eighty-seven-year-old ailing mother. According to the research, the pathophysiology of depression is not understood. The clinical findings will depict the diagnosis of depression for the patient. A disruption of central nervous system activities is indicated based on the clinical trials Adaptive Response Sample Essay Assignment paper.

Finsterwald and Alberini explain the adaptive responses of depression which includes the loss of appetite, increased heart rate and sleep disturbances (2014). The scholars’ further mention that depression is triggered by a mixture of physical, genetic and biological elements (pg. 18). Many diverse aspects which can source depression comprise of the change in life, drug and substance abuse, alcohol, and trauma Adaptive Response Sample Essay Assignment paper. Depression may sometimes lead to suicide and disruption of social relationships. The treatment of depression depends on the sternness of depression. According to Halverson, the nurse or the physician can prescribe to the patient antidepressant such as Tricyclic antidepressants or selective serotonin reuptake inhibitor (SSRI) (2016) Adaptive Response Sample Essay Assignment paper.

mind map

Reference

Chiappini, N., Cantisani, R., Pancotto, L., Ruggiero, P., Rosa, D., Manetti, A., … & Del Giudice, G. (2015). Innate response activator (IRA) B cells reside in human tonsils and internalize bacteria in vitro. 
PloS one
, 
10
(6), e0129879.

Finsterwald, C., & Alberini, C. M. (2014). Stress and glucocorticoid receptor-dependent mechanisms in long-term memory: from adaptive responses to psychopathologies. 
Neurobiology of learning and memory
, 
112
, 17-29 Adaptive Response Sample Essay Assignment paper.

McCARTHY, J. P., Agre, J. C., Graf, B. K., Pozniak, M. A., & Vailas, A. C. (2014). Compatibility of adaptive responses with combining strength and endurance training. 
Medicine and science in sports and exercise
, 
27
(3), 429-436.

Popple, A., Williams, J., Maxwell, G., Gellatly, N., Dearman, R. J., & Kimber, I. (2016). The lymphocyte transformation test in allergic contact dermatitis: New opportunities. 
Journal of immunotoxicology
, 
13
(1), 84-91. Adaptive Response Sample Essay Assignment paper.

Yamashita, K., Ichimiya, S., Kamakura, R., Nagata, T., Jitsukawa, S., Matsumiya, H., … & Himi, T. (2016). Studies of Tonsils in Basic and Clinical Perspectives: From the Past to the Future. In 
Excellence in Otolaryngology
 (Vol. 77, pp. 119-124). Karger Publishers.

Halverson, J. L. (2016, April 29).
Depression
. Retrieved from Medscape: http://emedicine.medscape.com/article/286759-overview#a3 Adaptive Response Sample Essay Assignment paper.

A literature review analyzes on Obesity based on PICOT Statement Paper and Literature Evaluation Table

While the implementation plan prepares students to apply their research to the problem or issue they have identified for their capstone change proposal project, the literature review enables students to map out and move into the active planning and development stages of the project.

A literature review analyzes how current research supports the PICOT, as well as identifies what is known and what is not known in the evidence A literature review analyzes on Obesity based on PICOT Statement Paper and Literature Evaluation Table. Students will use the information from the earlier PICOT Statement Paper and Literature Evaluation Table assignments to develop a 750-1,000 word review that includes the following sections:

1.Title page

2.Introduction section

3.A comparison of research questions

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4.A comparison of sample populations

5.A comparison of the limitations of the study

6.A conclusion section, incorporating recommendations for further research

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

Literature Evaluation Table

Obesity

Student Name:

Change Topic (2-3 sentences):

 

Criteria

Article 1

Article 2

Author, Journal (Peer-Reviewed), and Permalink or Working Link to Access Article

 

Cochrane, A.J., Dick, B., King, N.A., Hills, A.P. & Kavanagh, D.J. BMC Public health. Retrieved from: https://doi.org/10.1186/s12889-017-4834-2

Foster, C., Moore, J.B., Singletary, C.R. and Skelton, J.A. Wiley Online Library. Retrieved from: http://onlinelibrary.wiley.com /doi/10.1111/cob.12230/full#publication-history

 

Article Title and Year Published

 

Developing dimensions for a multicomponent multidisciplinary approach to obesity management. Published in 2017

 

Clinicalobesity. Physical activity and family-based obesity treatment. Published in 2017

Research Questions (Qualitative)/Hypothesis(Quantitative), and Purposes/Aim of Study

The specific aims of this research were to operationalize a MCMD approach for obesity management and to develop a theoretical model that could guide the approach.

 

Identify family-centered strategies to be implemented by clinicians providing care for children and adolescents with obesity.

Design (Type of Quantitative, or Type of Qualitative)

 

Qualitative study.

Used a computerized qualitative data management system, nVivo (QSR, N8, 2010), to construct conceptual frameworks from the large volume of data generated by the convergent interviews.

 

Employed both qualitative and quantitative studies.

 

Setting/Sample

 

The stakeholders involved in the study are patients, practitioners, educators, and researchers.

 

Children and adolescents with obesity.

Methods: Intervention/Instruments

 

We used qualitative action research methods, including convergent interviewing and observation, to assist the process of inquiry.

 

Methods utilized here are statements, summations and recommendations from professional organizations involved in child and adolescent physical activity, exercise and health.

 

Analysis

 

A preliminary step in the research analysis was to determine whether or not stakeholders believed that current obesity approaches have not been effective. A second step was to identify whether stakeholders endorsed the development of a multicomponent multidisciplinary (MCMD) approach for obesity management as recommended by position papers.

 

The analysis of this review has focused on exercise and activity as a component of family-based obesity interventions, which also support the guidelines detailed here, including: encouraging and promoting increased physical and decreased sedentary activity; sports and organized/structured exercise programs; play and family activities; and high level of parent involvement.

Key Findings

 

The key finding of this research was to source problems and solutions reported by researchers, educators, policy influencers, practitioners and patients, to coproduce a MCMD approach to obesity management that addressed a number of practice issues or thematic concerns.

 

The key finds have been summarized guidelines by domains of: aerobic activity, muscle strengthening, bone strengthening, child developmental status and age, clinical settings, inclusion of family and recommendations for those with overweight and obesity.

 

Recommendations

 

Endorsed the development of a multicomponent multidisciplinary (MCMD) approach for obesity management as recommended by position papers.

 

60 min of PA a day for children/teens.

Most of the 60 min should be either moderate- or vigorous intensity aerobic PA.

Muscle-strengthening PA three times a week.

Bone-strengthening PA at least three times a week.

Families need to set a positive example by leading an active lifestyle. Make PA part of your family’s daily routine by taking family walks or playing active games together, make PA fun etc.

 

 

Explanation of How the Article Supports EBP/Capstone Project

 

 

This article seeks to explain the multidisciplinary approaches used in the EBP examination of skills, knowledge, beliefs, and recommendations by the stakeholders in managing obesity.

 

 

This article supports and explains how obesity can be prevented by providing guidance for the amount of physical activity that children should acquire and how many days a week aerobics, bone strengthening and muscle strengthening activities should occur.

 

 

 

Criteria

Article 3

Article 4

Author, Journal (Peer-Reviewed), and

Permalink or Working Link to Access Article

 

Carayol. J., Chabert, C., Di Cara, A., Armensie, C., Vlasesia, A. & Haper. J. Nature Communications Article. Retrieved from: https://www.nature. com/articles/s41467-017-02182-z#Abs1

Martin, A., Booth, J.N., Laird, Y., Sproule, J., Reilly, J.J. & Saunders, D.H. Cochrane Database. Retrieved from: ttp://onlinelibrary.wiley.com/doi/ 10.1002/14651858.CD009728.

pub3/full

 

 

Article Title and Year Published

 

Protein quantitative trait locus study in obesity during weight-loss identifies a leptin regulator. Published in 2017

Physical activity, diet and other behavioural interventions for improving cognition and school achievement in children and adolescents with obesity or overweight. Published in 2018

 

Research Questions (Qualitative)/Hypothesis (Quantitative), and Purposes/Aim of Study

 

How can proteome analysis provide new insights into the molecular mechanisms of complex traits like obesity?

Healthy weight interventions for improving thinking skills and school performance in children and teenagers with obesity? The aim of this Cochrane Review was to find out if healthy weight interventions can improve thinking skills and school performance in children and teenagers with obesity.

 

Design (Type of Quantitative, or Type of Qualitative)

 

Evidence based quantitative study. protein quantitative trait locus (pQTL) analysis.

 

Evidence based randomized and quasi-randomized controlled trials (RCTs) of behavioural interventions for weight management in children and adolescents with obesity or overweight.

 

Setting/Sample

 

932 Caucasian overweight or obese subjects were recruited in clinical centers from eight European countries. Participants followed an initial 8 weeks weight loss intervention on a low-calorie formula diet (LCD 3300 kJ/day, ca. 800 kcal) The mean weight loss during LCD was 10.3 kg.

Sample included 18 studies (59 records) of 2384 children and adolescents with obesity or overweight. Eight studies delivered physical activity interventions, seven studies combined physical activity programmes with healthy lifestyle education, and three studies delivered dietary interventions. The studies took place in 10 different countries. Two were carried out in children attending preschool, 11 were conducted in primary/elementary school-aged children, four studies were aimed at adolescents attending secondary/high school and one study included primary/elementary and secondary/high school-aged children.

Methods: Intervention/Instruments

 

This study is part of the Diet, Obesity, and Genes (DIOGenes) intervention study. The method used here is a two-step pQTL-mapping strategy combined with eQTL mapping to limit the multiple testing burden and gain greater insight in the mechanism underlying the GWAS signal.

 

Did randomized and quasi-randomized controlled trials (RCTs) of behavioural interventions for weight management in children and adolescents with obesity or overweight.  Used CENTRAL, MEDLINE and 15 other databases.

Analysis

 

To address the issue of obesity, they design a large-scale protein quantitative trait locus (pQTL) analysis based on a set of 1129 proteins from 494 obese subjects before and after a weight loss intervention.

Physical activity and healthy eating benefit a healthy body weight and improve thinking skills and school performance in children with a healthy weight. Studies found that healthy-weight interventions can reduce obesity in children and teenagers, but it is unknown if and how well healthy-weight interventions can improve thinking skills and school performance in children and teenagers with obesity.

 

Key Findings

 

Using data from a dietary intervention study in obese patients this study has identified multiple 
cis-
pQTL and 
trans
-pQTL signals associated with BMI at baseline and after the intervention.

The findings indicate that changing knowledge about nutrition, and changing the food offered in schools can lead to moderate improvements in general school achievement of teenagers with obesity, when compared to standard school practice. However, we need more high-quality healthy-weight interventions that test thinking skills and school performance, as well as health outcomes.

 

Recommendations

 

No specific recommendations are found in the study.

 

Future obesity treatment and prevention studies in clinical, school and community settings should consider assessing academic and cognitive as well as physical outcomes.

 

Explanation of How the Article Supports EBP/Capstone

 

The study has revealed that proteome analysis can provide new insights into the molecular mechanisms of complex traits like obesity.

This article may support my project to explain the importance of changing knowledge about nutrition, and changing the food offered compared to standard practice.

 

 

Criteria

Article 5

Article 6

Author, Journal (Peer-Reviewed), and

Permalink or Working Link to Access Article

 

Torti, J., Liug, T., Borowitz, M., Johnson, JA., Sharma, AM., & Cambell-Shere, DL. BMC Family Practice. Retrieved from: https://link.springer.com/article/10.1186/s12875-017-0596-2

 

Ogden, C. L., Carroll, M. D., Kit, B. K., & Flegal, K. M.  Jama Network Journals. Retrieved from: https://jamanetwork.com

/journals/jama/fullarticle/1832542

 

Article Title and Year Published

 

The 5As team patient study: patient perspectives on the role of primary care in obesity management. Published in 2017

 

Prevalence of Childhood and Adult Obesity in the United States. Published in 2014

 

Research Questions (Qualitative)/Hypothesis (Quantitative), and Purposes/Aim of Study

To assess whether lifestyle interventions to improve school achievement, cognitive function and/or future success in children and adolescents with obesity or overweight.

 

The aim of this article is to provide the most recent national estimates of childhood obesity, analyze trends in childhood obesity between 2003 and 2012, and provide detailed obesity trend analyses among adults.

 

Design (Type of Quantitative, or Type of Qualitative)

 

Qualitative research employing semi-structured interviews and thematic analysis.

 

National Health and Nutrition Examination Survey (NHANES 2011-2012) includes Data Source and Methods: Personal interviews, physical examinations, laboratory tests, nutritional assessment and DNA repository.

 

Setting/Sample

 

 

Sample of 28 patients from a cohort of 255 patients living with obesity and receiving care to support their weight management in a large Primary Care Network of family practices.

 

Weight and height or recumbent length were measured in 9120 participants in the 2011-2012 nationally representative National Health and Nutrition Examination Survey.

 

Methods: Intervention/Instruments

 

The 5As Team intervention study (5AsT) is a longitudinal randomized control trial with convergent mixed-methods evaluation. A literature review analyzes on Obesity based on PICOT Statement Paper and Literature Evaluation Table

 

The intervention method used is approved by NHANES physical examination which is approve by National Center for Health Statistics Research Ethics Review Board, weight and height were measured in a standardized fashion. For children younger than 2 years, recumbent length was measured instead of standing height. In 2011-2012, 1.5% (141) of examined participants were missing weight and height or length measurements.

 

Analysis

 

 

The patient-physician relationship plays an important role in the adequacy of obesity management. Patients have clear expectations of substantive conversations with their primary care team. Complex conditions affect weight and patients require assistance tailored to individual obesity drivers. Current services provide support in important ways but are not yet meeting patient needs for individual plans, advanced education, and follow-up opportunities.

 

Analyses of trends in obesity prevalence among middle and high school students have shown mixed results. Data from many countries have shown a decline or stabilization of obesity levels, especially in children. Analysis of time trends depends on what is chosen as the initial point of examination.

 

 

Key Findings

 

This study helped understanding of patients’ perception of if, when, and how primary care clinicians and resources can support weight management.

 

Overall, there have been no significant changes in obesity prevalence in youth or adults between 2003-2004 and 2011-2012.

Recommendations

 

Patients expressed the need for weight management that is tailored to their individual set of comorbidities and provides strategies that are realistic and sustainable under their personal circumstances.

 

Obesity prevalence remains high and thus it is important to continue surveillance.

Explanation of How the Article Supports EBP/Capstone Project

 

This article highlights the importance of family based health programs and patients’ perspectives on the role of primary care in obesity management and their experience with existing resources, with a view to develop an improved understanding of this perspective, and more effective management strategies.

 

This article advocates the importance of continuous monitoring or surveillance of factors affecting obesity in US that enforces the need to implement and practice evidence based practices to curtail obesity in US

 

Criteria

Article 7

Article 8

Author, Journal (Peer-Reviewed), and

Permalink or Working Link to Access Article

 

Swift, D. L., Johannsen, N. M., Lavie, C. J., Earnest, C. P., & Church, T. S. ELSEVIER Publication. Retrieved from: http://www.online pcd.com/article/S0033-0620(13)00165-5/fulltext

 

Skinner, A. C. & Skelton, J. A. The JAMA Network Journals. Retrieved from: https://jamanetwork.com/journals/jamapediatrics /article-abstract/1856480

Article Title and Year Published

 

The role of exercise and physical activity in weight loss and maintenance. Published in 2014

Prevalence and trends in obesity and severe obesity among children in the United States. Published in 2014

 

Research Questions (Qualitative)/Hypothesis (Quantitative), and Purposes/Aim of Study

 

What are the roles of Physical Activity(PA) and Exercise Training (ET) in the prevention of weight gain, initial weight loss, weight maintenance, and the obesity paradox?

 

To examine the prevalence of obesity and severe obesity over time for 14 years of the continuous National Health and Nutrition Examination Survey, 1999 to 2012, and to examine differences in the trends by age, race/ethnicity, and sex.

Design (Type of Quantitative, or Type of Qualitative)

 

Evidence based qualitative review on weight loss from different modalities of exercise training and physical activities.

Evidence based qualitative case studies taken from National Health and Nutrition Examination Survey includes Data Source and Methods.

Setting/Sample

 

This article settings shows the amounts of physical activity based on goals for maintaining health, prevention of weight gain, promoting clinically significant weight loss, and prevention of weight gain after successful weight loss based on the American College of Sports Medicine position stand of Appropriate Physical Activity Intervention Strategies for Weight Loss and Prevention of Weight Regain for Adults.

 

A literature review analyzes on Obesity based on PICOT Statement Paper and Literature Evaluation Table Representative sample (N = 26 690) of children in the United States, ages 2 to 19 years, in repeated cross-sections of the National Health and Nutrition Examination Survey, 1999 to 2012.

Methods: Intervention/Instruments

 

STRRIDE; Studies of a Targeted Risk Reduction Intervention through Defined Exercise. DREW; Diabetes Aerobic and Resistance Exercise.  PA; Physical activity and ET; exercise training are the methods employed in this study.

 

In this study, data came from the repeated cross-sections of the NHANES, 1999 to 2012. The NHANES is a stratified, multistage probability sample of the civilian, noninstitutionalized population of the United States. It includes an in-home questionnaire on a variety of demographic and health-related topics, a computer-assisted interview, and an examination component consisting of a thorough physical examination including measured height and weight.

 

Analysis

 

The weight loss from ET programs without caloric restriction are very heterogeneous, based on the present literature patients who engage in a PA program may experience modest weight loss.

 

Nationally representative data do not show any significant changes in obesity prevalence in the most recently available years. But trends across 1999 to 2012 are positive overall and within certain subgroups. Prevalence rates for all categories of obesity increased among most groups from 2009 to 2010 and 2011 to 2012, although these differences are not statistically significant.

Key Findings

 

Exercise training, regardless of weight loss, provides numerous health benefits especially for overweight and obese individuals at risk for CV diseases or with current CV conditions.

 

The findings reflect those of earlier work using the NHANES where younger children and nonwhite participants were at greater risk for obesity and severe obesity.  The greater prevalence rates of class 2 and class 3 obesity are particularly notable in adolescents and non-Hispanic black individuals. Additionally, overweight and obesity at all levels of severity are increasing significantly among Hispanic girls and non-Hispanic black boys.

 

Recommendations

 

Clinicians should attempt to encourage participants to adhere to ET programs over the long-term regardless of the amount of weight loss achieved, as CV benefits are readily achieved in the absence of weight loss. Clinicians can also advocate the use of caloric restriction in weight management plans. Importantly, PA contributes to the negative energy balance seen with caloric restriction

 

Although our results suggest that the prevalence of obesity is continuing to level off, research is needed to determine which, if any, public health interventions can be credited with this stability.

 

Explanation of How the Article Supports EBP/Capstone

 

Throughout this literature review, from various ways, it reveals need for intervention, like that found in this EBP project, to combat rising levels of Obesity.

 

This article is very important to demonstrate because the high prevalence and upward trend of more severe forms of obesity will likely require more intensive interventions than can be done through widespread public health efforts.

 

Introduction

Obesity is a weight related condition that is described as BMI value exceeding 30. It is caused by physical activity and dietary changes linked with societal and environmental factors that act in concert with inadequate supportive education, distribution, marketing, environmental, food processing, transport, urban planning, agriculture, and health policies. Perhaps the most significant aspect of obesity is that it is a health risk factor that predisposes individuals to non-communicable chronic ailments such as stroke and apnea (Ogden et al., 2014; Skinner & Skelton, 2014; Swift et al., 2014). Based on this awareness, there is a need to adopt a preventive strategy when addressing obesity, with the focus being on children since they are at a young age when the condition is easily managed.

A comparison of research questions

The eight research articles answered a range of questions in a bid to improve awareness of the nature of obesity. Cochrane et al. (2017) asked two questions. The first question is: Can a MCMD approach be operationalized for obesity management? The second question is: Is it possible to develop a theoretical approach to guide the operationalization? A literature review analyzes on Obesity based on PICOT Statement Paper and Literature Evaluation Table. Foster et al. (2017) asked the question: Do family-centered strategies exist that can be implemented by clinicians providing care for children and adolescents with obesity? Carayol et al. (2017) asked the question: How can proteome analysis provide new insights into the molecular mechanisms of complex traits like obesity? Martin et al. (2018) asked the question: Can healthy weight intervention improve thinking skills and school performance in children and teenagers with obesity? Torti et al. (2017) asked the question: Can lifestyle intervention improve school achievement, cognition and/or future success in children and adolescents with obesity or overweight? Ogden et al. (2014) asked two questions. The first question is: What is the national of childhood obesity? The second question is: What are the childhood obesity trends between 2003 and 2012? Swift et al. (2014) asked the question: What are the roles of Physical Activity (PA) and Exercise Training (ET) in the prevention of weight gain, initial weight loss, weight maintenance, and the obesity paradox? Skinner and Skelton (2014) asked two questions. The first question is: What is the prevalence of obesity and severe obesity over time for 14 years of the continuous National Health and Nutrition Examination Survey, 1999 to 2012? The second question is: Are there differences in differences in the obesity trends by age, race/ethnicity, and sex? The research questions from the eight selected journal articles are all concerned with obesity management, with the focus being on its occurrence among children. There relevance to the current research is highlighted by the fact that they all address the same topic (obesity) for the same population (children).

A comparison of sample populations

Cochrane et al. (2017) applied a qualitative research approach that recruited patients, researchers, educators, and practitioners who were identified as stakeholders. Although the exact number of participants is not mentioned, the research concedes that a large volume of data was generated from interviews and observations.  Foster et al. (2017) applied a mixed methodology approach that included elements of both qualitative and quantitative research in which children and adolescents with diabetes were recruited as the study participants. Carayol et al. (2017) applied a quantitative approach in which932 Caucasian overweight or obese subjects were recruited in clinical centers from eight European countries A literature review analyzes on Obesity based on PICOT Statement Paper and Literature Evaluation Table. Martin et al. (2018) applied a literature review approached in which 18 studies applying evidence-based randomized and quasi-randomized controlled trials on children and adolescents with obesity or overweight were evaluated. Torti et al. (2017) applied a qualitative research approach that employed semi-structured interviews and thematic analysis on 28 patients from a cohort of 255 patients living with obesity and receiving care to support their weight management. Ogden et al. (2014) relied on data from National Health and Nutrition Examination Survey for 2011-2012 in which 9120 participants were recruited. Swift et al. (2014) relied on evidence-based qualitative review on weight loss from different modalities of exercise training and physical activities. Skinner and Skelton (2014) evaluated evidence-based qualitative case studies that had recruited 26,690 US children aged 2 to 19 years from 1999 to 2012. The present study will make use of these aspects by focusing on recruiting the participants from the population of interest (children with diabetes).

A comparison of the limitations of the study

The eight articles do not mention their limitations. Still, a notable limitation in the qualitative studies is that they recruited a small number of participants. Recruiting a large sample of participants will improve the results generalizability. Another limitation on the studies is that they did not focus on the children with obesity. Instead, they focused on mixed populations that included a range of age groups from children to adults. The present research will address the two limitations by recruiting a large sample of participants and focusing on children as a sample since the study population is children with obesity A literature review analyzes on Obesity based on PICOT Statement Paper and Literature Evaluation Table.

Conclusion (with recommendations)

One must accept that obesity is a source of concern since it presents a high risk factor for other to non-communicable chronic ailments. In addition, one must acknowledge that the best strategy for addressing obesity is to focus on children, ensuring that they develop into healthy adults. Eight research studies have been present that contribute to the current research topic, but their results are limited by their focus on mixed populations and small sample recruited for qualitative studies. The present research will address the limitations by recruiting a large sample of participants to improve results generalizability, and focusing on children with obesity as the population sample. The intention is to present evidence that supports an efficient and effective strategy for improving obesity management results among children A literature review analyzes on Obesity based on PICOT Statement Paper and Literature Evaluation Table.

.

References

Carayol. J., Chabert, C., Di Cara, A., Armensie, C., Vlasesia, A. & Haper. J. (2017). Protein quantitative trait locus study in obesity during weight-loss identifies a leptin regulator.
Nature Communications 8
, 2084 (2017). Retrieved from https://www.nature.com/articles/s41467-017-02182-z#Abs1

Cochrane, A. J., Dick, B., King, N. A., Hills, A. P. & Kavanagh, D. J. (2017). Developing dimensions for a multicomponent multidisciplinary approach to obesity management.
BMC Public Health
, 17, 814. Retrieved from https://doi.org/10.1186/s12889-017-4834-2

Foster, C., Moore, J. B., Singletary, C. R. and Skelton, J. A. (2017). Clinicalobesity. Physical activity and family-based obesity treatment.
Wiley Online Library
, 8(1), 68-79. Retrieved from http://onlinelibrary.wiley.com/doi/10.1111/cob.12230/full#publication-history

Martin, A., Booth, J. N., Laird, Y., Sproule, J., Reilly, J. J. & Saunders, D. H. (2018). Physical activity, diet and other behavioural interventions for improving cognition and school achievement in children and adolescents with obesity or overweight. 1-185.
Cochrane Database

of Systematic Reviews
. Retrieved from http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD009728.pub3/full

Ogden, C. L., Carroll, M. D., Kit, B. K., & Flegal, K. M. (2014). Prevalence of Childhood and Adult Obesity in the United States.
Jama Network Journals
, 311(8), 806-814. Retrieved from https://jamanetwork.com/journals/jama/fullarticle/1832542 A literature review analyzes on Obesity based on PICOT Statement Paper and Literature Evaluation Table.

Skinner, A. C. & Skelton, J. A. (2014). Prevalence and trends in obesity and severe obesity among children in the United States.
The JAMA Network Journals
, 168(6), 561-566. Retrieved from https://jamanetwork.com/journals/jamapediatrics /article-abstract/1856480

Swift, D. L., Johannsen, N. M., Lavie, C. J., Earnest, C. P., & Church, T. S. (2014). The role of exercise and physical activity in weight loss and maintenance.
ELSEVIER Publication
, 56(4), 441-447. Retrieved from: http://www.online pcd.com/article/S0033-0620(13)00165-5/fulltext

Torti, J., Liug, T., Borowitz, M., Johnson, J. A., Sharma, A. M., & Cambell-Shere, D. L. (2017). The 5As team patient study: patient perspectives on the role of primary care in obesity management.
BMC Family Practice
, 18(19). Retrieved from https://link.springer.com/article/10.1186/s12875-017-0596-2 A literature review analyzes on Obesity based on PICOT Statement Paper and Literature Evaluation Table.

Systems Theory in nursing sample essay assignment: Application: Systems Theory

As noted in the Learning Resources, systems theory provides a meaningful and beneficial means of examining challenges in health care organizations. To do this effectively, however, it is essential to assess all system components, as some may be relatively healthy while others are problematic.

For this Assignment, you apply systems theory to the examination of a problem in a department or a unit within a health care organization. (Note: You may use the same problem you identified for the Discussion as long as it meets the criteria for this assignment.)

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To prepare:

Review the Meyer article, “Nursing Services Delivery Theory: An Open System Approach,” in this week’s Learning Resources. Focus especially on the information presented in Table 1 (p. 2831) and Figure 2 (p. 2833).

Reflect on your organization or one with which you are familiar. Within a particular department or unit in this organization, identify a problem the staff is encountering Systems Theory in nursing sample essay assignment.

Using Table 1 in the Meyer article as a guide, analyze the department or unit, identifying inputs, throughput, output, cycles of events, and negative feedback. Consider whether the problem you have selected relates to input, throughput, output, cycles of events, and/or negative feedback.

Think about how you could address the problem: Consider what a desired outcome would be, then formulate related goals and objectives, and translate those goals into policies and procedures.

Research professional standards that are pertinent to your identified problem.

Reflect on the organization’s mission statement and values. In addition, consider how addressing this problem would uphold the mission and values, while improving the organizational culture and climate. (Depending on the organization you have selected, you may have explored these in the Week 1 Discussion.) Systems Theory in nursing sample essay assignment.

To complete:

By Day 7

Write a 3- to 5-page paper (page count does not include title and reference page) that addresses the following:

Describe a department or unit within a health care organization using systems theory terminology. Include a description of inputs, throughput, output, cycles of events, and negative feedback.

Describe the problem you identified within the department or unit using an open- systems approach, and state where the problem exists using the systems theory model (input, throughput, output, cycles of events, or negative feedback) Systems Theory in nursing sample essay assignment.

Based on this information, explain how you would address the problem as follows:

Formulate a desired outcome.

Identify goals and objectives that would facilitate that outcome.

Translate those goals and objectives into policies and procedures for the department or unit.

Describe relevant professional standards.

Explain how your proposed resolution to the problem would uphold the organization’s mission and values and improve the culture and climate.

Reminder: The School requires that all papers submitted include a title page, introduction, summary, and references. The Sample Paper provided at the Walden Writing Center provides an example of those required elements. All papers submitted must use this formatting. Systems Theory in nursing sample essay assignment.

Applying Systems Theory

Introduction

Systems theory describes a structured approach for evaluating an organization with the intention of identifying problems and presenting a viable solution. In fact, it simplifies the organization into mathematical equations and models that show clear causal and reaction relationships (Hayes, 2014). The present discussion makes use of the systems theory in understanding a medical facility as an organization, presenting an existing nursing problem within the facility, and proposing a viable solution Systems Theory in nursing sample essay assignment.

Question 1. Describing the department using systems theory terminology to include a description of inputs, throughput, output, cycles of events, and negative feedback.

As a medical practitioner, I am employed at the New York Firefighters Burn Center where I offer nursing services. The facility has the primary function of properly evaluating, diagnosing, and providing the appropriate medical care for burns victims. Systems Theory in nursing sample essay assignment. To carry out this function, the department has employed personnel in different medical professions. These professional include pharmacists, laboratory technicians, nurses, surgeons, physicians and so on. This multidisciplinary team works in concert to ensure that every patient admitted to the facility gets the best possible care that relieves their conditions, while facilitating their speed recovery. This implies that the facility devotes much resources towards retaining sufficient personnel, who are supported by equipment and medication to facilitate the care provided to the patients. For that matter, the combination of resources, staff, equipment and medication can be considered as the facility’s input towards the provision of medical care. Additionally, the services offered in managing the patients’ burns is the throughput. That is because the input has been ordered and systemized to give medical services as the objective. Understandably, the number of patients who receive the medical services at the facility is the output. That is because the patient volume is a measure of the facility’s effectiveness in offering medical services for burn patients. Since the facility has to be financially sustainable, the profits and earnings that it receives act as the cycle of events. The facility’s performance indicators to include feedback offered by patients and their family members act as the negative feedback for the facility. Effectiveness in pain management would form the core of the feedback (Hayes, 2014; Cherry & Jacob, 2013) Systems Theory in nursing sample essay assignment.

Question 2. Describing the problem using an open- systems approach, and stating where the problem exists using the systems theory model (input, throughput, output, cycles of events, or negative feedback)

Although the facility is dedicated to offering high quality care that includes burns and pain management, there has been general negative feedback that shows the facility’s ineffectiveness in managing some of the patients’ pain. In fact, the patients (in their negative feedback) report that the nurses either incorrectly evaluate their pain, or manage their pain. The result is that these patients are left unsatisfied with the nursing services offered in the facility. This leads to the facility assessment that its pain evaluation and management approaches are inadequate and requires revision. To be more succinct, the shortfalls in perception concerning pain evaluation and management effectiveness has caused the facility’s performance indicators to suffer (Leonard et al., 2013). Maddy (2015) expounds on the problem of ineffective pain evaluation and management by indicating that it is not unique to any one facility. Instead, it is a common problem that medical facilities face Systems Theory in nursing sample essay assignment. This is because the training that medical personnel receives only primes them to register approximately 20% of the information they would need to carry out the correct evaluation. This means that the nursing personnel at New York Firefighters Burn Center miss as much as 80% of the information they require. This means that they must develop strategies to acquire the previously lost information to allow them make the correct pain evaluation and management. At least, this applies to nursing personnel who are required to apply assertive strategies when collecting and dissemination information on pain evaluation, particularly when they join the multidisciplinary team in critically reviewing the collected information. As such, the nursing personnel would take on a leadership position that allows them to develop an acceptable solution by collecting all the required information and not just 20% of the information. By taking on a leadership position in implementing a solution, nurses would ensure that the facility develops an acceptable solution that is viable enough to be implement while leaving room for feedback to be offered to improve pain evaluation and management (Pope & Deer, 2017) Systems Theory in nursing sample essay assignment.

Question 3. Explaining how the problem will be addressed.

Desired outcome

The problem has been identified as inadequate pain evaluation and management as reflected in the negative feedback from the patients. As a result, the desired outcome is to have adequate pain evaluation and management. Systems Theory in nursing sample essay assignment.

Goal and objective that will facilitate the desired outcome

The goal is to increase the number of patients who visit the facility since this would improve revenues and profits. The patient numbers will increase if the facility receives positive reviews from patients who would influence others to consider the facility as the beast place to have their pain evaluated and managed.

Translating the goal and objective into policies and procedures for the department

This will take the form of collecting correct pain information by actively engaging the patients to understand what they feel. Systems Theory in nursing sample essay assignment. In addition, it would require developing a solution in order of priority that could be drug interactions, adverse reactions, addictive effects, and costs. Besides that, the situation should be reviewed regularly to update the department’s procedures and standards.

Describing the relevant professional standards

All through the process of initiating the changes to achieve the desired outcome, the nurses (and other medical personnel) will ensure that focus does not shift away from effective pain management. Any task that is beyond the nurses’ capacity will be assigned to the relevant persons with the necessary capability. Also, the nurses will receive training that allows them to evaluate approximately 100% of the patients’ pain. That is because it was already acknowledged that nurses miss as much as 80% of the information required to correctly evaluate the patients’ pain (Maddy, 2015). As a result, the facility nurses will establish an evaluation baseline, scrutinize the current evaluation approaches, prepare a suitable response for the identified shortcoming, and implement the response to focus in correctly evaluating the patients’ pain to include the unaddressed pain (Pope & Deer, 2017).

Explaining how the proposed resolution to the problem would uphold the organization’s mission and values and improve the culture and climate

The proposed solution is to improve the nurses’ capacity to evaluate the patients’ pain. Correctly evaluating the pain means that nurses will understand what the patients are experiencing, communicate the same to the multidisciplinary team, and apply an appropriate response the relieves the patients’ pain. This will guarantee the patients offer positive feedback and no longer complain about ineffective pain management or unaddressed pain. This ensures that the facility offers high quality medical care, and positive reviews that results in high patient numbers that translate into high profits and earnings Systems Theory in nursing sample essay assignment.

Conclusion

One must accept that systems theory is a useful tool for understanding New York Firefighters Burn Center as an organization. That is because it simplifies the facility into mathematical equations showing causal relationships that shift from input through transitory and augmenting stage to the output. Using the theory, the facility is shown to have a problem with pain management based on reports from patients. The proposal is made that the problem should be addressed by improving the nurses’ capacity to evaluate the patients’ pain. As a result, the discussion makes use of the systems theory in understanding a medical facility as an organization, presenting an existing nursing problem within the facility, and proposing a viable solution Systems Theory in nursing sample essay assignment.

References

Cherry, B. & Jacob, S. (2013).
Contemporary Nursing, Issues, Trends, & Management
(6
th
ed.). Amsterdam: Elsevier Health Sciences.

Hayes, J. (2014).
The Theory and Practice of Change Management
(4
th
ed.). New York, NY: Palgrave Macmillan.

Huber, D. (2013).
Leadership and Nursing Care Management
(5
th
ed.). St, Louis, MO: Elsevier/Saunders.

Leonard, S., Lewis, R., Freedman, A. & Passmore, J. (2013).
The Wiley-Blackwell Handbook of the Psychology of Leadership, Change, and Organizational Development
. Hoboken, NJ: John Wiley & Sons.

Maddy, G. (2015).
Nurse-Pain Management (PMCN) Specialty Review and Study Guide
. Treasure Island, FL: StatPearls Publishing, LLC.

Pope, J. & Deer, T. (2017).
Treatment of Chronic Pain Conditions: A comprehensive handbook
. New York, NY: Springer. Systems Theory in nursing sample essay assignment.

Pathophysiology sample essay

Ann is a 32-year-old married female who presents to her nurse practitioner reporting lower abdominal pain, cramping, slight fever, and dysuria of 3 days duration.

History includes:

LMP 2 weeks ago (regular)

Reports oral contraceptive use

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Reports pain in lower abdomen with cramping and pain on urination for 3 days

Denies any GI problems, reports regular bowel movements.

Denies vaginal discharge

Ann is married and in a monogamous relationship. Has one child age 2

Reports no use of condoms/sexual intercourse 2-3 times per week

Denies any history of STDs

Physical Exam reveals:

Temp 100. 6, P 80 BP 100/62 Wt. 125 Ht. 5’3’’

HEENT WNL

No CVA tenderness

Pain in lower quadrants with light palpation.

Positive inguinal lymphadenopathy

External genitalia without lesions or discharge Pelvic exam reveals minimal cervical mucopus Bimanual exam reveals uterine and adnexal tenderness and cervical motion pain.

Uterus anterior, midline, smooth, not enlarged

1. Based on the above case what is your diagnosis and what is an appropriate CDC-recommended therapeutic regimen for this patient? Pathophysiology sample essay.

Research priority for transforming nurse leadership:Identification of the influence of nursing on important health care decisions at all levels.

Reflect on how the research findings for your area of priority impact nurses as leaders in organizations and health care reform. Why is research on this priority important?

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Post a description of the Identification of the influence of nursing on important health care decisions at all levels. the benefits and challenges of further researching this area. Provide an overview of the articles you found (using appropriate APA citations not older than 5 yrs) relating to Identification of the influence of nursing on important health care decisions at all levels. highlight any key findings. Explain how continued research in this area could strengthen the ability of nurses to lead in both individual organizations and as advocates of health care reform. Research priority for transforming nurse leadership:Identification of the influence of nursing on important health care decisions at all levels.