Category: Nursing

Pap Smear Essay – MN 576 Primary Care of Women’s Health

The third most common cancer in women worldwide is Cervical cancer and is the second most frequent cause of cancer-related mortality with about 300,000 deaths annually (report.nih.gov, 2013). According to Siegel, Naishadham, & Jemal in 2013, there was an estimated 12,340 new cases of invasive cervical cancer in the United States and 4,030 estimated mortality. There was actually a 50% decrease in cancer death the past 30 years due to early detection using the Pap smear that provides detection of precancerous cells and cancerous cells in their earlier stage (Acog.org, 2016c; Vegunta, Kransdorf, & Mayer, 2014). Pap Smear Essay – MN 576 Primary Care of Women’s Health.

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Pap smear is used primarily to identify the cytology of the cervix and vagina and can also be used to identify presence of infection. Cervical cancer takes about 3–7 years for high-grade changes to occur and screening with Pap smear can detect these changes before they become cancer (acog.org, 2016b)

The USPSTF (U.S. Preventive Services Task Force) (2012) recommends screening for cervical cancer in women age 21 to 65 years with cytology (Pap smear) every 3 years if cotesting with HPV (Human Papilloma Virus) is not obtainable (acog.org, 2016b; Langsjoen, et al, 2015). However, beginning at age 30, the women who wants a longer interval of screening should combine cytology and HPV testing every 5 years (acog.org, 2016b; uspreventiveservicestaskforce.org, 2012; Moyer, 2012) because women older than 30 years correlates with increased incidence of high-grade lesions (acog.org, 2016b; Langsjoen, et al, 2015). Pap Smear Essay – MN 576 Primary Care of Women’s Health.

The USPSTF discourages screening for cervical cancer through Pap smear for women younger than 21 years (acog.org, 2016b; uspreventiveservicestaskforce.org, 2012; Moyer, 2012). According to Vegunta, Kransdorf, & Mayer (2014), 90% of HPV infections resolve in 2 years and although women below 20 years have the most incidence of HPV infections, they have minimal risk of developing invasive cervical cancer. Also, false positive can lead to unnecessary treatment that have an adverse effect on childbearing (Mayo, 2012). An example is the loop electrosurgical excision procedure that is linked with preterm delivery and increased risk of premature rupture of membranes (Vegunta, Kransdorf, & Mayer, 2014).

The USPSTF also discourages Pap smear for women older than 65 years who had sufficient prior screening and are considered low risk, as well as those who had hysterectomy with cervical excision without history of High-Grade Precancer or Cervical Cancer (acog.org, 2016b; uspreventiveservicestaskforce.org, 2012; Moyer, 2012). Based on a systematic review, risk of high-grade cervical lesions decreases with age and screening women older than 65 would not provide any benefit (acog.org, 2016b; Vesco, et al., 2014; Moyer, 2012). Sufficient prior screening means that a woman “do not have a history of moderate or severe abnormal cervical cells (dysplasia) or cervical cancer, and have had either three negative Pap test results in a row or two negative co-test results in a row within the past 10 years, with the most recent test performed within the past 5 years” (acog.org, 2016b). The American Congress of Obstetricians and Gynecologists (ACOG) recommends Pap smear screening for women who had hysterectomy but the cervix is not removed (2016b). If the cervix is removed due to cervical cancer, Pap smear screening should be done for the next 20 years after surgery (acog.org, 2016b). However, if the cervix is removed but there is no history of cervical cancer, there is no need for screening (acog.org, 2016b). Frequent Pap smear screening is needed among women who were exposed to diethylstilbestrol before birth or have HIV (human immunodeficiency virus), immunocompromised or history of cervical cancer (acog.org, 2016b). Pap Smear Essay – MN 576 Primary Care of Women’s Health.

Women are still encouraged to follow up for well-woman exam (pelvic exam or internal exam) and check-up for counseling on birth control, vaccination, health screening, and preconception (avog.org, 2016b).

References:

Acog.org (2016a, February). Cervical Cancer Screening. Retrieved from: http://www.acog.org/Patients/FAQs/Cervical-Cancer-Screening

Acog.org (2016b, February). Frequently Asked Questions: Cervical Cancer Screening. Retrieved from: http://www.acog.org/Patients/FAQs/Cervical-Cancer-Screening

Acog.org (2016c). Pap smear (Pap test): Resource Overview. Retrieved from: http://www.acog.org/Womens-Health/Pap-Smear-Pap-Test

Langsjoen, J., Goodell, C., Castro, E., Thomas, J., Kuehl, T. J., Wehbe-Janek, H., & Hinskey, M. (2015). Improving compliance with cervical cancer screening guidelines. Baylor University Medical Center Proceedings, 28(4), 450-453. Retrieved from: http://eds.b.ebscohost.com.lib.kaplan.edu/eds/pdfviewer/pdfviewer?sid=9b9cbb4b-9f33-444c-97e7-7ae16cd77daa%40sessionmgr103&vid=0&hid=112

Moyer, V.A. (2012, June 19). Screening for Cervical Cancer: U.S. Preventive Services Task Force Recommendation Statement. Clinical Guideline. Annals of Internal Medicine, 156(12), 880-891. Retrieved from: file:///C:/Users/ROGELIOMD/Downloads/cervcancerrs.pdf

Report.nih.gov (2013, March 29). Cervical Cancer. Retrieved from: https://report.nih.gov/nihfactsheets/viewfactsheet.aspx?csid=76

 

Siegel, R., Naishadham, D., & Jemal, A. (2013). Cancer statistics, 2013. CA Cancer Journal for Clinicians, 63:11–30.

 

USpreventiveservicestaskforce.org (2012, March). Final Update Summary: Cervical Cancer: Screening. Retrieved from: https://www.uspreventiveservicestaskforce.org/Page/Document/UpdateSummaryFinal/cervical-cancer-screening

 

Vesco, K.K., Whitlock, E.P., Eder, M., et al. (2011, May). Screening for Cervical Cancer: A Systematic Evidence Review for the U.S. Preventive Services Task Force. Rockville (MD): Agency for Healthcare Research and Quality (US). (Evidence Syntheses, No. 86.). Retrieved from: https://www.ncbi.nlm.nih.gov/books/NBK66099/

 

Vegunta, S., Kransdorf, L. N., & Mayer, A. P. (2014). Why more is not always better: New Pap Smear Guidelines. Journal of Women’s Health (15409996), 23(1), 105-106. doi:10.1089/jwh.2013.4634. Retrieved from: http://eds.b.ebscohost.com.lib.kaplan.edu/eds/pdfviewer/pdfviewer?sid=67727849-312e-4fe3-ab1a-4b86648175dc%40sessionmgr120&vid=0&hid=112 Pap Smear Essay – MN 576 Primary Care of Women’s Health

Health Education essay assignments

HD510: Current Health Issues for Health Educators

In this survey course, students study specific critical health topics including specific health conditions, disease prevention, older adults, fitness, complementary and alternative medicine, and more. Students will evaluate current health research and publications and relate the research to health education programs and interventions. Proven strategies and benefits of health education are emphasized.

Quarter Credit Hours: 4 | Prerequisite: None

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HD599: Master’s Capstone in Health Education

This capstone course is the culminating experience for the Master of Science in Health Education. This course builds on the concepts of all the courses students have taken within the program of study. The capstone course provides students with the opportunity to integrate and synthesize the knowledge and skills acquired throughout the coursework in an original comprehensive project, and to assess their level of mastery of the stated outcomes of their degree program in health education. Health Education essay assignments.

Quarter Credit Hours: 4 | Prerequisite: Last term or permission from the Dean

HD625: Health Education Design, Implementation, and Administration

This course acquaints students with the components and essential design elements of comprehensive health education programming. Utilizing the seven areas of responsibilities for the health education specialist, students create programs for community, school, and private settings, learning to identify key constituents and the diversity of funding sources, both public and private. Health Education essay assignments Instruments for measuring outcomes are analyzed for both short- and long-term programs, as well as the essential administrative tasks, functions, and responsibilities required for successful results by the health educator.

Quarter Credit Hours: 4 | Prerequisite: None

Pap Smear Essay – MN 576 Primary Care of Women’s Health

Quiz Submissions – Unit 5 Midterm

Submission View

Random Section 1

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Question 1

2 / 2 points

Which HPV types are most often associated with cervical and anogenital cancer?

Question options:

1)

1, 2, and 3

2)

6 and 11

3)

16 and 18

4)

22 and 24

Question 2

2 / 2 points

During a breast exam you note all of the findings below as normal except:

Question options:

1)

asymetrical size

2)

a supernumerary nipple

3)

hyperpigmentation

4)

breasts that move up symmetrically with raising the arms

Question 3

2 / 2 points

A 30-year-old woman presents without symptoms but states that her male partner has dysuria without penile discharge. Examination reveals a friable cervix covered with thick yellow discharge. This description is most consistent with an infection caused by:

Question options:

1)

Chlamydia trachomatis.

2)

Neisseria gonorrhoeae.

3)

human papillomavirus (HPV).

4)

Trichomonas vaginalis.

Question 4

2 / 2 points

The vaccine Gardasil that is used to prevent some strains of HPV infection is recommended in both males and females. Pap Smear Essay – MN 576 Primary Care of Women’s Health.

Question options:

1) True

2) False

Question 5

2 / 2 points

Lesbians may experience which of the following barriers to health care?

Question options:

1)

Homophobia from the healthcare provider

2)

Incorrect knowledge about health care needs of lesbians by healthcare providers

3)

Lack of insurance and/or access under partner’s coverage

4)

All of the above

Question 6

2 / 2 points

Which of the following best describes lesions associated with condyloma acuminatum?

Question options:

1)

verruciform

2)

plaque-like

3)

vesicular-form

4)

bullous

Question 7

2 / 2 points

Presumptive treatment for PID should be initiated in sexually active young women and other women at risk for STDs if they are experiencing pelvic or lower abdominal pain, if no cause for the illness other than PID can be identified, and if one or more of the following minimum clinical criteria are present on pelvic examination: Pap Smear Essay – MN 576 Primary Care of Women’s Health.

Question options:

1)

cervical motion tenderness

2)

uterine tenderness

3)

adnexal tenderness.

4)

All of the above

Question 8

2 / 2 points

How long after contact do clinical manifestations of syphilis typically occur?

Question options:

1)

less than 1 week

2)

1 to 3 weeks

3)

2 to 4 weeks

4)

4 to 6 weeks

Question 9

2 / 2 points

In assessing a woman with disabilities, which of the following terms should be avoided?

Question options:

1)

Crippled

2)

Handicapped

3)

Mentally retarded

4)

All of the above

Question 10

2 / 2 points Pap Smear Essay – MN 576 Primary Care of Women’s Health

The definition of menopause is

Question options:

1)

Frequently skipping period for one year

2)

One year without a period

3)

Onset of hot flashes and night sweats with irregular menstruation

4)

None of the above

Question 11

2 / 2 points

Treatment options for bacterial vaginosis include all of the following except:

Question options:

1)

oral metronidazole.

2)

clindamycin cream.

3)

oral clindamycin.

4)

oral azithromycin.

Question 12

2 / 2 points

Physical examination of a 19-year-old woman with a 3-day history of vaginal itch reveals moderate perineal excoriation, vaginal erythema, and a white, clumping discharge. Expected microscopic examination findings include:

Question options:

1)

a pH greater than 6. 0.

2)

an increased number of lactobacilli.

3)

hyphae.

4)

an abundance of white blood cells. Pap Smear Essay – MN 576 Primary Care of Women’s Health

Question 13

2 / 2 points

Which of the following is a contraindication to estrogen/progestin-containing methods (combined oral contraception [COC], patch [Ortho Evra], or ring [NuvaRing])?

Question options:

1)

mother with a history of breast cancer

2)

personal history of hepatitis A at age 10 years

3)

presence of factor V Leiden mutation

4)

cigarette smoking one pack per day in a 22-year-old

Question 14

2 / 2 points

Recommendations for adolescents with disabilities include a comprehensive sex education program that should be tailored to fit their specific needs.

Question options:

1) True

2) False

Question 15

0 / 2 points

In assessing a 13 year old female, you know that the presence of breast bud  with elevation of breast and papilla; enlargement of areola indicate which Tanner Stage?

Question options:

1)

Stage1

2)

Stage 2

3)

Stage 3

4)

Stage 4

Question 16

2 / 2 points

The Pap test should not be considered a screening test for STDs.

Question options:

1) True

2) False

Question 17

2 / 2 points

Which of the following agents is most active against C. trachomatis?

Question options:

1)

amoxicillin

2)

metronidazole

3)

azithromycin

4)

ceftriaxone

Question 18

2 / 2 points

When performing a bimanual exam all of the following are noted as normal findings except:

Pap Smear Essay – MN 576 Primary Care of Women’s Health Question options:

1)

retoverted uterus

2)

anteflexed uterus

3)

fixed immobile uterus

4)

smooth, firm ovary

Question 19

2 / 2 points

Routine screening for C. trachomatis on an annual basis is recommended for all sexually active females aged <25 years . Question options: 1) True 2) False Question 20 2 / 2 points When performing a pelvic examination the first part of the external genitalia exam is Question options: 1) speculum examination 2) palpation 3) inspection 4) cervical sampling Question 21 2 / 2 points In women who have experienced a spinal cord injury, temporary cessation of menses is normal for up to one year following the injury. Question options: 1) True 2) False Question 22 2 / 2 points When counseling a woman about COC use, you advise that: Question options: 1) long-term use of COC is discouraged because the body needs a “rest” from birth control pills from time to time. 2) fertility is often delayed for many months after discontinuation of COC. 3) there is an increase in the rate of breast cancer after protracted use of COC. 4) premenstrual syndrome symptoms are often improved with use of COC. Question 23 2 / 2 points Which of the following terms describes the mechanism of action of imiquimod (Aldara)? Question options: 1) keratolytic 2) immune modulator 3) cryogenic 4) cytolytic Question 24 2 / 2 points Treatment of vulvovaginitis caused by Candida albicans includes: Pap Smear Essay – MN 576 Primary Care of Women’s Health Question options: 1) metronidazole gel. 2) clotrimazole cream. 3) hydrocortisone ointment. 4) clindamycin cream. Question 25 2 / 2 points Screening for osteoporosis with DEXA scan should begin Question options: 1) age 50 2) one year after menopause 3) age 65 4) age 60 Question 26 2 / 2 points What is the approximate incubation period for Neisseria gonorrhoea? Question options: 1) 1 to 5 days 2) 7 to 10 days 3) 18 days 4) 28 days Question 27 2 / 2 points What percentage of anogenital and cervical cancers can be attributed to HPV infection? Question options: 1) less than 30% 2) at least 50% 3) at least 70% 4) 95% or greater Question 28 2 / 2 points Universal screening for chlamydia and gonorrhea in women ≤35 years entering juvenile and adult correctional facilities has been a long-standing recommendation. Pap Smear Essay – MN 576 Primary Care of Women’s Health. Question options: 1) True 2) False Question 29 2 / 2 points A 22-year-old woman taking a 35-mcg ethinyl estradiol COC calls after forgetting to take her pills for 2 consecutive days. She is 2 weeks into the pack. You advise her to: Question options: 1) take the last pill missed immediately, even if this means taking 2 pills today. 2) discard two pills and take two pills today. 3) discard the rest of the pack and start a new pack with the first day of her next menses. 4) continue taking one pill daily for the rest of the cycle. Question 30 2 / 2 points HCV infection is the most common chronic bloodborne infection in the United States, with an estimated 2.7 million persons living with chronic infection Question options: 1) True 2) False Question 31 2 / 2 points Adolescent girls are not candidates for IUD use for contraception Question options: 1) True 2) False Question 32 2 / 2 points About ____ of patients with genital warts have spontaneous regression of the lesions? Question options: 1) 10% 2) 25% 3) 50% 4) 75% Question 33 2 / 2 points Complementary and alternative medicine (CAM) is defined as a group of therapies that are not considered part of Western culture and include all of the following except: Question options: 1) Congugated estrogen 2) Aromatherapy 3) Tai Chi 4) Yoga Question 34 2 / 2 points Which HPV types are most likely to cause genital condyloma acuminatum? Question options: 1) 1, 2, and 3 2) 6 and 11 3) 16 and 18 4) 22 and 24 Question 35 2 / 2 points Which test is performed around the time of ovulation to diagnose the basis of infertility? Question options: 1) Hysterosalpingogram 2) Ultrasonography 3) Laparoscopy 4) Follicle-stimulating hormone (FSH) level Question 36 2 / 2 points The NP is seeing a 30-year-old woman before her routine gynecologic examination, the NP questions that patient about her recent menstrual cycles. Which statement made by the patient should prompt further investigation? Question options: 1) “My flow is very heavy all the time.” 2) “I have occasionally spot in between cycles” 3) “My menstrual cycles varies from 25 to 30 days.” 4) “I have cramping prior to my cycle starting” Question 37 2 / 2 points Women with bacterial vaginosis typically present with: Question options: 1) vulvitis. 2) pruritus. 3) dysuria. 4) malodorous discharge. Question 38 2 / 2 points Treatment options for patients with condyloma acuminatum include all of the following except: Question options: 1) topical acyclovir. 2) cryotherapy. 3) podofilox. 4) trichloroacetic acid. Question 39 0 / 2 points Pap Smear Essay – MN 576 Primary Care of Women’s Health The average onset of perimenopause is between the ages of: Question options: 1) 35 to 40 years. 2) 40 to 45 years. 3) 45 to 50 years. 4) 50 to 55 years. Question 40 2 / 2 points Which of the following is not representative of the presentation of primary syphilis? Question options: 1) painless ulcer 2) localized lymphadenopathy 3) flu-like symptoms 4) spontaneously healing lesion Question 41 2 / 2 points Noncontraceptive benefits of COC use include a decrease in all of the following except: Question options: 1) iron-deficiency anemia. 2) pelvic inflammatory disease (PID). 3) cervicitis. 4) ovarian cancer. Question 42 2 / 2 points In patients who are allergic to azithromycin, an alternative treatment to chlamydia is Question options: 1) Doxycycline 100mg twice daily for 7 days 2) Macrobid 100mg twice daily for 5 days 3) BactimDS  1 PO BID for 3 day 4) All of the above Question 43 2 / 2 points Puberty consists of a series of predictable events, and the sequence of changes in secondary sexual characteristics has been categorized by several groups. The staging system utilized most frequently used to describe these events is Tanner staging. Question options: 1) True 2) False Question 44 2 / 2 points Which of the following may be a useful tool in screening for Female Sexual Disorder (FSD)? Question options: 1) The Female Sexual Function Index 2) The Female Sexual Distress Scale 3) The Orgasmic Disorder Scale 4) A and B Question 45 2 / 2 points Which of the following is found in tertiary syphilis? Question options: 1) arthralgia 2) lymphadenopathy 3) macular or papular lesions involving the palms and soles 4) gumma Question 46 2 / 2 points A patient presents to you with a chief complaint of primary dysmenorrhea, which nonpharmacologic intervention might you recommend she try first? Question options: 1) participating in physical activity 2) increase iron rich foods to replace blood that is lost 3) use of a heating pad on the pelvis for cramping 4) use of an NSAID Question 47 2 / 2 points Which of the following agents is active against N. gonorrhoeae? Pap Smear Essay – MN 576 Primary Care of Women’s Health Question options: 1) ceftriaxone 2) metronidazole 3) ketoconazole 4) amoxicillin Question 48 0 / 2 points A recommended treatment for rectal gonorrhea is: Question options: 1) oral amoxicillin. 2) oral azithromycin. 3) oral ciprofloxacin. 4) ceftriaxone injection. Question 49 2 / 2 points When charting on a patient whom you have noted a breast lump it is important to document Question options: 1) tenderness 2) size 3) location 4) mobility 5) all of the above Question 50 2 / 2 points A 24-year-old woman presents with a 1-week history of thin, green-yellow vaginal discharge with perivaginal irritation. Physical examination findings include vaginal erythema with petechial hemorrhages on the cervix, numerous white blood cells, and motile organisms on microscopic examination. These findings most likely represent: Question options: 1) motile sperm with irritative vaginitis. 2) trichomoniasis. 3) bacterial vaginosis. 4) condyloma acuminatum. Pap Smear Essay – MN 576 Primary Care of Women’s Health

Health Care Administration (HA) Essay assignments

HA510: Organizational Development for Health Care

This course explores organizational behavior, theory, and development as they apply to the health care industry. Topics include, but are not limited to, classic and modern theory, individual behavior and motivation, group dynamics, conflict management, decision making, culture values, and organizational dysfunction. Physician leadership development and change management are also explored.

Quarter Credit Hours: 4 | Prerequisite: None

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HA515: Leadership in Health Care

This course explores organizational theory and behavior essential for successful leadership and management in the health care industry. Emphasis will be placed on communication techniques, self-analysis, and strategies for best practices in order to effectively implement key leadership and management concepts in dynamic health care environments Health Care Administration (HA) Essay assignments. Key values that guide a leader’s personal and professional behavior and influence overall effectiveness will be explored, as well as their impact on overall leadership styles.

Quarter Credit Hours: 4 | Prerequisite: None

HA520: Health Care Financial Management

This course introduces the terminology, theory, concepts and techniques used in the finance functions in health care organizations. Students gain an understanding of the important role of finance in health care organizations and learn various techniques to develop, manage, and control finances. Health Care Administration (HA) Essay assignments. Students interpret financial statements, prepare analyses with cost finding and price setting, and conduct break-even analyses. The course provides students with experience in capital and operating budgets, financial forecasts, and business plan preparation. Students will be expected to expand their utilization of spreadsheet applications.

Quarter Credit Hours: 4 | Prerequisite: None

HA525: Health Law

This course provides analysis of law, the legal system, and current legal problems as they relate to the financing and delivery of health care services. This course covers interrelated legal topics pertinent to health care organizations including contracts, medical malpractice, legal and ethical obligations to provide health care, privileging, medical decision making, tax exemption, antitrust, fraud, and health information management. Health Care Administration (HA) Essay assignments Students are encouraged to discuss how the law supports or hinders current efforts to improve health care delivery systems.

Quarter Credit Hours: 4 | Prerequisite: None

HA530: Human Resources for Health Care Managers

This course provides an analysis and evaluation of how human resource management is applied in different health care settings. The course focuses on the major elements of human resource man­agement, as well as the ways in which it can be used in the strategic planning of the organization. Students investigate ongoing human resources practice and issues from a health care perspective such as recruitment, contract/agreement, training/education/support, retention, performance evalu­ation, compensation, legal and regulatory issues, and strategic planning. Health Care Administration (HA) Essay assignments.

Quarter Credit Hours: 4 | Prerequisite: None

HA535: Health Care Statistics

In this course, you will be introduced to the practical applications of descriptive and inferential statistics for the health industry. You will formulate a data procurement plan by analyzing real-world data. Additionally, you will learn how to effectively disseminate published health research data and apply this new knowledge within the field.

Quarter Credit Hours: 4 | Prerequisite: None

HA540: Health Care Operations and Quality Assessment

This course provides an interdisciplinary perspective on operations and quality management in health care, taking into account the disciplines of organizational behavior and health management research. Special attention is given to causal tools and approaches that are fundamental to total quality management and continuous quality improvement Health Care Administration (HA) Essay assignments.

Quarter Credit Hours: 4 | Prerequisite: None

HA545: Health Policy

This course provides students with an in-depth analysis of health care policy development in the United States of America. Students focus on health care policy formation and evaluation by investigating public policy and politics. Students consider a variety of elements that factor into health policy development such as economics, political science, management, communications, and public health.

Quarter Credit Hours: 4 | Prerequisite: None

HA560: Community Health Assessment

This course provides you with the skills needed to enhance (assess) the health of a community. You will focus on health behaviors, environmental influences, health policy, and economic and health care system issues in health promotion and disease prevention. Health Care Administration (HA) Essay assignments.

Quarter Credit Hours: 4 | Prerequisite: None

HA565: Health Information Management and Assessment

This course provides a comprehensive examination of the principles and practices of the management of health information. The course covers three principal areas of health information management: Health Information Portability and Accountability Act (HIPAA), electronic health information management (e-HIM), and informatics.

Quarter Credit Hours: 4 | Prerequisite: None

HA570: Health Care Ethics

This course provides an examination of both the theory and the principles of ethics within the health care industry. The course covers national standards for the protection of individual’s health information as applied to health plans, health care clearinghouses, and health care providers. Students also learn other health industry regulations that protect employees, patients, and providers. The integration of ethics as the foundation for long-term as well as day-to-day operations of an entity is emphasized. Health Care Administration (HA) Essay assignments.

Quarter Credit Hours: 4 | Prerequisite: None

HA575: Health Care Marketing

This course provides an analysis and evaluation of the principles and concepts of marketing as they apply to health care organizations. The course covers essential elements of marketing as well as direct applications of marketing tools and strate­gies in the dynamic health care environment.

Quarter Credit Hours: 4 | Prerequisite: None

HA599: Master’s Capstone in Health Care Administration

The capstone course is the culminating experience for the Master of Health Care Administration. This course builds on the concepts of all the courses students have taken within the program of study. The capstone course provides students with the opportunity to integrate and synthesize the knowledge and skills acquired through their coursework in an original comprehensive project, and to assess their level of mastery of the stated outcomes of their degree program in health care administration.

Quarter Credit Hours: 4 | Prerequisite: Last term Health Care Administration (HA) Essay assignments

Assignment: The Nurse Leader as Knowledge Worker

NURS 6051:
Transforming Nursing and Healthcare Through Technology

Assignment: The Nurse Leader as Knowledge Worker

The term “knowledge worker” was first coined by management consultant and author Peter Drucker in his book, The Landmarks of Tomorrow (1959). Drucker defined knowledge workers as high-level workers who apply theoretical and analytical knowledge, acquired through formal training, to develop products and services. Does this sound familiar? Assignment: The Nurse Leader as Knowledge Worker

Nurses are very much knowledge workers. What has changed since Drucker’s time are the ways that knowledge can be acquired. The volume of data that can now be generated and the tools used to access this data have evolved significantly in recent years and helped healthcare professionals (among many others) to assume the role of knowledge worker in new and powerful ways.

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In this Assignment, you will consider the evolving role of the nurse leader and how this evolution has led nurse leaders to assume the role of knowledge worker. You will prepare a PowerPoint presentation with an infographic (graphic that visually represents information, data, or knowledge. Infographics are intended to present information quickly and clearly.) to educate others on the role of nurse as knowledge worker. Assignment: The Nurse Leader as Knowledge Worker.

Reference: Drucker, P. (1959). The landmarks of tomorrow. New York, NY: HarperCollins Publishers.

To Prepare
:

Review the concepts of informatics as presented in the Resources.

Reflect on the role of a nurse leader as a knowledge worker.

Consider how knowledge may be informed by data that is collected/accessed.

The Assignment:

Explain the concept of a knowledge worker.

Define and explain nursing informatics and highlight the role of a nurse leader as a knowledge worker.

Develop a simple infographic to help explain these concepts.

NOTE: For guidance on infographics, including how to create one in PowerPoint, see “How to Make an Infographic in PowerPoint” presented in the Resources. Assignment: The Nurse Leader as Knowledge Worker.

Your PowerPoint should Include the hypothetical scenario you originally shared in the Discussion Forum. Include your examination of the data that you could use, how the data might be accessed/collected, and what knowledge might be derived from that data. Be sure to incorporate feedback received from your colleagues’ responses. Assignment: The Nurse Leader as Knowledge Worker.

 

Rubric Grid

Develop a
5- to 6-slide PowerPoint presentation, in APA format with speaker notes that addresses the following:

Explain the concept of a knowledge worker.

Define and explain nursing informatics and highlight the role of a nurse leader as a knowledge worker.

Levels of Achievement:

Excellent 32 (32%) – 35 (35%)

The presentation clearly and accurately explains the concept of a knowledge worker.

The presentation clearly and accurately defines and explains nursing informatics with a detailed explanation of the role of the nurse leader as a knowledge worker. Assignment: The Nurse Leader as Knowledge Worker.

Includes: 3 or more peer-reviewed sources and 2 or more course resources..

Good 28 (28%) – 31 (31%)

The presentation explains the concept of a knowledge worker.

The presentation defines and explains nursing informatics with an explanation of the role of the nurse leader as a knowledge worker.

Includes: 2 peer-reviewed sources and 2 course resources..

Fair 25 (25%) – 27 (27%)

The presentation inaccurately or vaguely explains the concept of a knowledge worker.

The presentation inaccurately or vaguely defines and explains nursing informatics with an inaccurate or vague explanation of the role of the nurse leader as a knowledge worker.

Includes: 1 peer-reviewed sources and 1 course resources. Assignment: The Nurse Leader as Knowledge Worker.

Poor 0 (0%) – 24 (24%)

The presentation inaccurately and vaguely explains the concept of a knowledge worker or is missing.

The presentation inaccurately and vaguely defines and explains nursing informatics with an inaccurate and vague explanation of the role of the nurse leader as a knowledge worker or is missing.

Includes: 1 or fewer resources..

Develop a simple infographic to help explain these concepts
.—

Levels of Achievement:

Excellent 14 (14%) – 15 (15%)

The presentation provides an accurate and detailed infographic that helps explain the concepts related to the presentation..

Good 12 (12%) – 13 (13%)

The presentation provides an infographic that helps explain the concepts related to the presentation..

Fair 11 (11%) – 11 (11%)

The presentation provides an infographic related to the concepts of the presentation that is inaccurate or vague..

Poor 0 (0%) – 10 (10%)  Assignment: The Nurse Leader as Knowledge Worker.

The infographic provided in the presentation related to the concepts of the presentation is inaccurate and vague, or is missing..

Present the hypothetical scenario you originally shared in the Discussion Forum. Include your examination of the data you could use, how the data might be accessed/collected, and what knowledge might be derived from the data. Be sure to incorporate feedback received from your colleagues’ replies.–

Levels of Achievement:

Excellent 32 (32%) – 35 (35%)

The presentation clearly and thoroughly includes the hypothetical scenario originally shared in the Discussion Forum, including a detailed and accurate examination of the data used, how the data might be accessed/collected, and the knowledge that could be derived from the data..

Good 28 (28%) – 31 (31%)

The presentation includes the hypothetical scenario originally shared in the Discussion Forum, including an accurate examination of the data used, how the data might be accessed/collected, and the knowledge that could be derived from the data..

Fair 25 (25%) – 27 (27%)

The presentation includes the hypothetical scenario originally shared in the Discussion Forum, including an examination of the data used, how the data might be accessed/collected, and the knowledge that could be derived from the data that is vague or inaccurate. Assignment: The Nurse Leader as Knowledge Worker.

Poor 0 (0%) – 24 (24%)

The presentation includes the hypothetical scenario originally shared in the Discussion Forum, including an examination of the data used, how the data might be accessed/collected, and the knowledge that could be derived from the data that is vague and inaccurate, or is missing..

Written Expression and Formatting – Paragraph Development and Organization:

Paragraphs make clear points that support well developed ideas, flow logically, and demonstrate continuity of ideas. Sentences are carefully focused–neither long and rambling nor short and lacking substance.–

Levels of Achievement:

Excellent 5 (5%) – 5 (5%)

Paragraphs and sentences follow writing standards for flow, continuity, and clarity..

Good 4 (4%) – 4 (4%)

Paragraphs and sentences follow writing standards for flow, continuity, and clarity 80% of the time..

Fair 3.5 (3.5%) – 3.5 (3.5%)

Paragraphs and sentences follow writing standards for flow, continuity, and clarity 60%- 79% of the time..

Poor 0 (0%) – 3 (3%)

Paragraphs and sentences follow writing standards for flow, continuity, and clarity < 60% of the time.. Written Expression and Formatting – English writing standards: Correct grammar, mechanics, and proper punctuation– Levels of Achievement: Excellent 5 (5%) – 5 (5%) Uses correct grammar, spelling, and punctuation with no errors.. Good 4 (4%) – 4 (4%) Contains a few (1-2) grammar, spelling, and punctuation errors. Assignment: The Nurse Leader as Knowledge Worker. Fair 3.5 (3.5%) – 3.5 (3.5%) Contains several (3-4) grammar, spelling, and punctuation errors.. Poor 0 (0%) – 3 (3%) Contains many (≥ 5) grammar, spelling, and punctuation errors that interfere with the reader’s understanding.. Written Expression and Formatting – The paper follows correct APA format for title page, headings, font, spacing, margins, indentations, page numbers, running head, parenthetical/in-text citations, and reference list.– Levels of Achievement: Excellent 5 (5%) – 5 (5%) Uses correct APA format with no errors.. Good 4 (4%) – 4 (4%) Contains a few (1-2) APA format errors.. Fair 3.5 (3.5%) – 3.5 (3.5%) Contains several (3-4) APA format errors.. Poor 0 (0%) – 3 (3%) Contains many (≥ 5) APA format errors.. Total Points: 100 Name: NURS_5051_Module01_Week02_Assignment_Rubric Possible Resources McGonigle, D., & Mastrian, K. G. (2017). Nursing informatics and the foundation of knowledge (4th ed.). Burlington, MA: Jones & Bartlett Learning. Chapter 1, “Nursing Science and the Foundation of Knowledge” (pp. 7–19)•Chapter 2, “Introduction to Information, Information Science, and Information Systems” (pp. 21–33) Chapter 3, “Computer Science and the Foundation of Knowledge Model” (pp. 35–62) Assignment: The Nurse Leader as Knowledge Worker 24Slides. (2018). How to make an infographic in PowerPoint. Retrieved September 27, 2018, from https://24slides.com/presentbetter/how-make-infographic-powerpoint/ Nagle, L., Sermeus, W., & Junger, A. (2017). Evolving role of the nursing informatics specialist. In J. Murphy, W. Goossen, & P. Weber (Eds.), Forecasting Competencies for Nurses in the Future of Connected Health (212–221). Clifton, VA: IMIA and IOS Press. Retrieved from https://serval.unil.ch/resource/serval:BIB_4A0FEA56B8CB.P001/REF Sweeney, J. (2017). Healthcare informatics. Online Journal of Nursing Informatics, 21(1). Note: You will access this article from the Walden Library databases. Assignment: The Nurse Leader as Knowledge Worker

Candidiasis Cutaneous Essay – MN568 Unit 6 Discussion

Candidiasis Cutaneous

Candidiasis cutaneous is an infection caused by
candida.
The organism causes topically infections, but serious disease complications can result from the infection. Common sites of the infection include: oral thrush, infant diaper dermatitis, vaginal infections, groin, toes, fingers, axillae, and perianal area (Dunphy, Winland-Brown, Thomas, & Carter, 2015).
Candida
infection can be systemic infecting the lungs and gastrointestinal tract. Risk factors related to severe complications are secondary to immunocompromised patients following major surgery, immunocompromised patients, and infants.

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Incidence and Prevalence

Women are at greater risk for development of vaginal candidiasis. Vaginal candidiasis often affects women after antibiotic therapy because the medications disrupt normal flora. The most common type of infectious agent is
candida albicans
(Ferri, 2018). Neonates and elderly are at higher risk of the infection. Patients with obesity, diabetes, receiving glucocorticoids, maceration have a higher risk of infection (Wolff, Johnson, Saaverdra, & Roh, 2017). Candidiasis Cutaneous Essay – MN568 Unit 6 Discussion.

Pathophysiology

Cutaneous candidiasis occurs in moist areas of the skin. The fungal infection has two subgroups: cutaneous and chronic (Ferri, 2018). Physical presentation of cutaneous presents with areas of erythema, inflammation and shiny lesions around the perimeter of the erythema. Microscopic presentation of lesions shows yeast forms and sausage-looking forms (Wolff et al., 2017). Areas of the skin affected by cutaneous candidiasis form on the vagina, penile skin, overlapping skin folds, abdomen, nails, oral cavity, axillae, buttocks, and perianal area.

Candidiasis Cutaneous Essay – MN568 Unit 6 Discussion Chronic candidiasis is generally seen in hospitalized patients (Ferri, 2018). Gram stains of samples from the respiratory and gastrointestinal tract shows yeast cell formation. Areas of samples for chronic candidiasis from an endoscopy or lung biopsy will show cytokine secretion of T-cell subtypes (Campois et al., 2015).

Physical Assessment

           
Physical assessment of cutaneous candidiasis presenting on the skin reveals white, flaky patches with surrounding inflammation and erythema Candidiasis Cutaneous Essay – MN568 Unit 6 Discussion. The patient may complain the skin is itchy with pain from the inflammation.

Physical assessment of chronic candidiasis depends on the site of infection. Oral thrush will present with inflammation to the oral membrane with large white patches to the tongue and surrounding membranes. Patients may complain of burning, dry mouth, pain and dysphagia (Ferri, 2018). Diagnostic testing for chronic candidiasis includes cultures for a sputum sample and upper endoscopy with or without a sample.

Evidence-Based Treatment

Treatment for cutaneous candidiasis includes topical antifungal ointment or powder depending on the site of infection. Antifungal medications based on clinical guidelines for treatment are clotrimazole, econazole, and miconazole (Ferri, 2018). Patients with candidiasis of the finger/toenails will present with dystrophic nails with surrounding nail bed erythema with possible nail bed loss. Oral or topical antifungals are indicated depending on the severity of infection in the nail/toe beds. Candidiasis Cutaneous Essay – MN568 Unit 6 Discussion.

Treatment for chronic and reoccurring candidiasis is with use of oral antifungals. Nystatin swish and swallow is used in treatment of oral thrush. Many candidiasis responds to fluconazole single dose in conjunction with a topical antifungal ointment (Ferri, 2018). High doses of fluconazole are indicated in patients with reoccurring infection by oral of intravenous route Candidiasis Cutaneous Essay – MN568 Unit 6 Discussion.

Patient Education

Patients with topical infections should be educated to keep the area clean and dry for prevention and during treatment for candidiasis. Patients should be educated to complete all medications as instructed and to follow-up with provider in two weeks or before if symptoms worsen. Candidiasis Cutaneous Essay – MN568 Unit 6 Discussion.

References

Camporis, T. G., Zucoloto, A. Z., Araujo, E. J., Svidizinski, T. I., Alemeida, R. S., Quirino, F. S.,

Haranp, R. M., & Felipe, I. (2015). Immunological and histopathological characterization

of cutaneous candidiasis.
Journal of Medical Microbiology, 64
, 810-817. doi: 10.1099/

jmm0.000095.

Dunphy, L. M., Winland-Brown, J. E., Porter, B. O. & Thomas, D. J. (2015)
Primary Care: The

art and science of advanced practice nursing
. Philadelphia, PA: F. A. Davis Company.

Ferri, F. F. (2018).
Ferri’s Clinical Advisor 2018: 5 Books in 1
. Philadelphia, PA: Elsevier.

Wolff, K., Johnson, R. A., Saavedra, A. P., & Roh, E. K. (2017).
Fitzpatrick’s Color Atlas and

Synopsis of Clinical Dermatology
. United States of America: McGraw Hill Education. Candidiasis Cutaneous Essay – MN568 Unit 6 Discussion

MN568 Headaches Essay

Headaches

Headaches are classified as primary and secondary. Primary headaches include migraine, tension-type, cluster, and other such as sinus-related or hormonal. Secondary headaches are red flags for trauma, metabolic, neurological or substance withdrawal (Hainer & Matheson, 2013). Secondary headaches can be emergent because of intracranial pressure, infection, or disturbance of homeostasis (Hainer & Matheson, 2013). Sudden onset of headaches and the patient describing the headache as “the worst headache they have ever had” require immediate attention for potential life-threatening causes such as subarachnoid hemorrhage, post lumbar puncture dissection or TIA’s (Dunphy, Windland-Brown, Porter, & Thomas, 2015). MN568 Headaches Essay.

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Pathophysiology

The pathophysiology of headaches is poorly understood. Migraine headaches are believed to be caused by a neurological dysfunction with involvement of the cranial nerves (Ferri, 2018). Not every patient with migraine headaches have been found to also have a neurological dysfunction. Migraine headaches are also believed to have a genetic disposition with an instability of the nervous system; specifically, with serotonin and neurotransmitters (Diener, Holle, Solbach, & Charly, 2016). Migraine headaches are often debilitating to patients. Patients with migraine headaches can experience photophobia, nausea, vomiting and an aura.

Patients with cluster headaches are believed to have an overactive parasympathetic nervous system (Hainer & Matheson, 2013). The headache causes mild-moderate pain and pressure. Hainer and Matheson (2013) describe tension headaches as pericranial myofascial tissues as the likely cause of these headaches. MN568 Headaches Essay.

Cluster headaches are commonly rare and involve brief episodes of severe pain that is unilateral and disturbance of routine activities of daily living. The headache involves a short duration of severe pain. Dunphy et al. (2015) describe triggers of these painful headaches caused by hypersensitized ophthalmic nerve (Dunphy et al., 2015).

Episodic

Cluster headaches are episodic and short duration. MN568 Headaches Essay. The pain is severe and often does not last longer than an hour. The headaches are often misdiagnosed within one year of the first episode (Hainer & Matheson, 2013). The pain of these headaches is deep and may involve the eyes and nose. The patient may experience tearing or nasal congestion.

Acute

Acute headaches are an onset of a severe headache and can be classified as a red flag. Red flag headaches or primary headaches present related to an emergent underlying condition. This type of headaches is often described as the worst headache the patient has ever had MN568 Headaches Essay. A patient who reports this type of headache, especially in the age group of fifty and older are red flags for intracranial hemorrhage, hypertensive emergencies, or potential carotid dissections (Hainer & Matheson, 2013). Acute headaches could also be caused by meningitis, head trauma, or cancerous tumors.

 

Chronic

Chronic headaches are daily tension-type headaches or migraine headaches. The headaches can be hormonal related in nature. Common trigger of a migraine headache may include: hormones such as low estrogen, disturbance in sleep cycle, food/drink agents such as caffeine, artificial sweeteners, processed or canned foods (Dunphy et al., 2015).

Physical Assessment

The nurse practitioner can assist in the determination of an old versus new headache by questioning the patient of the duration and frequency of the headache. Hainer and Matheson (2013) describe criteria of duration and frequency of primary headaches as a migraine is a headache that last of four to seventy-two hours, a cluster headache is brief with a fifteen to one hundred eighty-minute episode that occur numerous with a period of relapse (Hainer & Matheson, 2013). The nurse practitioner should ask specific questioning of duration and frequency of the patients headache for subjective data collection MN568 Headaches Essay.

Hainer and Matheson (2013) describe subjective data that would be a red flag symptom includes: complaints of a sudden severe headache, headache triggers with exertion or cough, neurological symptoms, new onset of headache during or after pregnancy, and complaints of neck stiffness (Hainer & Matheson, 2013).

The collection of an open-ended history and focused questions will assist the nurse practitioner in determining if the headache is primary or secondary. If the headache is primary focused questions will lead diagnostics of a migraine, tension, cluster or other headache MN568 Headaches Essay. A physical assessment with concentration on the neurological system and laboratory tests are essential before a final diagnosis. The physical exam should include assessment of the neurological system and cranial nerves II-X An assessment of the patient’s head and neck in attempts to mimic the pain is important. The physical assessment should be focused to alleviate muscular and skeletal disorders.

It is important for the nurse practitioner to obtain vital subjective data from the patient and complete a thorough physical assessment to distinguish between benign and headaches that require urgent attention. MN568 Headaches Essay.

Red flags through patient data collection and physical assessment that require urgent attention include complaints of a sudden onset of a severe headache, papilledema, altered mental status, high fever, muscle rigidity, nuchal rigidity, and symptoms of a CVA, or TIA (Dunphy et al., 2015).

Evidence-Based Treatment Plan

Diagnostic testing for a definite diagnosis should include a comprehensive blood panel, with electrolytes. Consideration should be taken to check the female patient’s hormone level, thyroid levels and urinalysis to rule out infection. The patient should have a computed tomography (CT) scan with or without contrast completed to the brain to rule out any abnormalities and diagnosis of secondary headaches, or a magnetic resonance imaging (MRI).

Secondary headaches are treated mainly with over-the-counter analgesics. Evidence-based treatment for non-responsive conservative and over-the-counter treatment supports six classifications of medications: beta blockers, antidepressants, calcium channel blockers, antiepileptic, anticonvulsants, and nonsteroidal anti-inflammatory medications (Ferri, 2018). MN568 Headaches Essay.

 

Patient Education

           
Management of headaches is patient-centered. Headaches can be managed with drug therapy. Patient education should include the proper use of the drug therapy and over-the-counter analgesics. Patients should be encouraged to participate in stress relieving activities such as meditation or physical activity that does not aggravate a headache. Complementary therapy such as acupuncture, herbal therapy, and plenty of sleep should be encouraged by the nurse practitioner (Dunphy et al., 2015). MN568 Headaches Essay. The nurse practitioner should encourage the patient to drink plenty of fluids, and to eat a healthy diet rich in vitamin C foods.

Discussion

Headache management should always be closely monitored and follow-up from the nurse practitioner is essential. Treatment plans should be closely monitored for the effectiveness of drug therapy, and potential referral to a specialist for the management of the headaches. MN568 Headaches Essay.

 

References

Diener, H. C., Holle, D., Solbach, K., & Charly, G. (2016). Medication-overuse headache: risk

factors, pathophysiology, and management.
Nature Reviews: Neurology, 12
(10), 575-

Dunphy, L. M., Winland-Brown, J. E., Porter, B. O. & Thomas, D. J. (2015)
Primary Care: The

Art and Science of Advanced Practice Nursing
. Philadelphia, PA: F. A. Davis Company.

Ferri, F. (2018).
Ferri’s Clinical Advisor 2018: 5 books in
1. Philadelphia, PA:  Elsevier.

Hanier, B. L., & Matheson, E. M. (2013). Approach to Acute Headaches in Adults.
American

Family Physician, 15
(87), 682-687. MN568 Headaches Essay.

MN566 NP I Scope of Practice Essay Example Scope of Practice

MN566 NP I – Introduction to Primary Care for the Nurse Practitioner

Scope of Practice

The Advanced Practice Registered Nurse (APRN) Consensus Model standardizes each aspect of the regulatory process for advanced practice registered nurses. MN566 NP I Scope of Practice Essay Example By doing this it increases the state to state mobility for practicing APRNs, the ability to provide needed care will be increased nationwide (Brassard, 2014).  The American Nurses Association has pushed this initiative in order to advance the scope of practice and change licensure laws to ensure unrestricted practice authority for advanced practice registered nurses across the United States.

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At this present time only twenty-three states and the District of Columbia have granted full practice authority to advanced practice registered nurses. Granting full practice authority to advanced practice registered nurses would “promote safety and contribute to the protection of the public and provision of quality care” (Burke, Richardson & Smith, 2017).  Holtschneider (2016) pointed out that practitioners are educators, mentors, leaders, researchers, and advocates. MN566 NP I Scope of Practice Essay Example.

How My Practice is Affected

In order to provide quality, cost effective care to patients, advanced practice registered nurses must be able to practice to the full extent of their education and skills set in every state across the nation (American Nurses Association, n.d.).  Unfortunately, in my home state of Texas, we are forced to work under restrictions as outlined in Tex. Admin. Code §22-11-221.13 (Texas Scope, 2018).  Texas’ state practice and licensure laws require advanced practice nurses to work under the supervision on a physician for the entirety of their careers (AANP, 2018).  This restrictive environment is due in great part to the funding by physician’s groups who are intent on maintaining a physician controlled medical environment MN566 NP I Scope of Practice Essay Example.

Granting full practice authority would change the entire dynamic of health care in the state of Texas and prevent qualified advanced practice registered nurses from pursue careers in other states.   My career will be greatly hampered by these unjust restrictions.  Not only will I be forced to work under physician doing the same work, but I will be forced to accept a significantly lower reimbursement from insurances.

Unless our state legislators wake up and realize that they must remove the restrictions to our practice authority I plan on relocating to another state.  This would be one of the most difficult decisions that I have ever been forced to make in my life.  It would mean leaving all my family and friends. MN566 NP I Scope of Practice Essay Example.

What My Future Holds.

It was not until I began working towards my master’s degree that I learned about practice restrictions and how it would hamper my future clinical practice.  This knowledge has motivated me to become involved in the legislative process to help promote change.  In order to do that we must make it a priority to become fully informed about legislative candidates at all levels of government and their position on licensure restrictions (Newland, 2016).

Soon my career will lead me to another state unless Texas removes the practice restrictions on advanced nurse practitioners.  Regardless of where my path leads, I will be an active participant in the legislative process to help ensure changes that benefit our profession are made.  Without nurses in numbers fighting for our rights, changes will not come. MN566 NP I Scope of Practice Essay Example.

Conclusion

In a country where the primary care physician shortage is becoming increasingly worse each year, to restrict the practice authority of advanced practice registered nurses is detrimental the wellbeing of the nation.  Utilizing APRNs with unrestricted practice authority as primary care health care providers would ensure that more people would have access to affordable, quality care MN566 NP I Scope of Practice Essay Example.  According to Rudner Lugo (2016), nurses will have to work together utilizing grass-root efforts to gain political support from legislators to change the licensure restrictions for APRNs.  If these restrictions are not lifted, the exodus of APRNs to unrestricted states will continue.

References

AANP. (2018). State Practice Environment. Retrieved from
https://www.aanp.org/advocacy/state/state-practice-environment

American Nurses Association. (n.d.). Nursing Scope of Practice. Retrieved from
https://www.nursingworld.org/practice-policy/scope-of-practice/

Brassard, A. (2014). Overview and Summary: APRN Roles: Opportunities and Challenges for Practice and Education. Online Journal of Issues in Nursing, 19(2), 10.
https://doi.org/10.3912/OJIN.Vol19No02ManOS

Burke, K. G., Richardson, C., & Smith, B. A. (2017). Implementing Nursing Professional Development. Journal for Nurses in Professional Development, 33(5), 269-271. doi:10.1097/nnd.0000000000000375

Holtschneider, M. E. (2016). Implementing the Nursing Professional Development Practitioner Scope and Standards of Practice 2016 Revisions. Journal for Nurses in Professional Development, 32(5), 269–270.
https://doi.org/10.1097/NND.0000000000000285

Newland, J. (2016). Editor’s Memo. The 28th Annual APRN Legislative Update beyond the 50 states. Nurse Practitioner, 41(1), 8. doi:10.1097/01.npr.0000475960.38934.73

Rudner Lugo, N. (2016). Full Practice Authority for Advanced Practice Registered Nurses is a Gender Issue. OJIN, 21(2). doi:10.3912/OJIN.Vol21No02PPT54

Texas Scope of Practice Policy – State Profile. (2018). Retrieved from
http://scopeofpracticepolicy.org/states/tx/#

MN566 NP I Scope of Practice Essay Example

Disorders of Renal Function MN551 Case Study.

MN551: Advanced Physiology and Pathophysiology Across the Life Span

Case Study 5: Disorders of Renal Function

Case study number five is focused on a forty-four-year-old man named Fred.  Fred stays healthy and fit by working outside.  After working outside one particularly warm summer day, he returned home only to begin experiencing lower back discomfort and unexplained nausea later that evening.  Having lost his appetite due to the nausea and unable to enjoy the dinner that his wife had prepared, he decided to go to bed early.

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Later that night his symptoms worsened.  He began complaining of excruciating stomach, back and groin pain.  The pain would come in waves that would be followed by diaphoresis and vomiting.  Once his pain eased, his wife rushed him to the hospital to be evaluated. Disorders of Renal Function MN551 Case Study.

After being evaluated and having abdominal scans, emergency room physicians diagnosed him with renal calculi in the right ureter or right urolithiasis.  With a diagnosis the hospital physicians and staff can work with Fred and his wife on a plan of care and begin treatment.  Based on medical literature it is critical that renal disorders are properly diagnosed and treated to prevent further renal injury.

Mechanism of Stone Formation in the Kidney.

There are four different types of kidney stones: calcium, uric acid, struvite, and cystine.  The precise mechanism of forming kidney stones or urolithiasis is not completely understood despite significant research (Evan, Worcester, Coe, Williams & Lingeman, 2015).  Research has shown that a nidus is required along with a urinary environment conducive to the crystallization of components found in kidney stones (Grossman & Porth, 2014).

It has been hypothesized that the kidneys become supersaturated with crystalline liquid structures that they cannot break down.   These crystalline liquid structures begin to precipitate together rapidly to form solid particles. The solid particles begin binding together and arrange into a crystal pattern in a process known as crystal nucleation (Jena, Panigrahi & Dey, 2016).  Varying in size and shape, the crystals adhere to the renal tubular epithelial cells (Chaiyarit & Thongboonkerd, 2017).  Disorders of Renal Function MN551 Case Study  Then the crystals begin to form an adhesive agglomeration within the renal tubules.  It is at this point that the kidney stone causes a restriction or blockage of the renal tubules.

Role of Citrate in the Kidneys.

Citrate is a tricarboxylic acid that is a natural byproduct of the citric acid cycle in renal cells (Grossman & Porth, 2014).  Citrate makes the renal environment unfavorable to stone formation by reducing the supersaturation and increasing the pH of urine (Kaygisiz, 2017).  This effectively inhibits the crystallization of calcium salts thus reducing to probability of forming calcium oxalate stones.

Studies have noted that individuals with a lower urinary citrate excretion or hypocitraturia have higher incidences of kidney stone formation (Coe, Worcester & Evan, 2016).  It has also been shown that citrate therapy inhibits the growth and reduces the reoccurrence of new stone formation in the kidneys (Phillips, Hanchanale, Myatt, Somani, Nabi & Biyani, 2015).  The most effective way to prevent the formation of kidney stones is to maintain the acid-base balance within the bladder. Disorders of Renal Function MN551 Case Study.

Calcium Supplements and Calcium Oxalate Stones.

According to Grossman and Porth (2014), seventy-five to eighty percent of kidney stones are calcium stones.   A differential diagnosis of hypercalciuria is a common indicator of calcium kidney stones.  Patients who have an excessive amount of calcium excreted through the urine may also have a supersaturation of urinary calcium salts (Sorensen, 2014).

Patients are completely dependent on their dietary intake for the absorption of calcium.  If their intake is too low, then there can be in increase of urinary oxalate.  Calcium supplementation helps to bind oxalate in the intestine and effectively reduce its absorption (Grossman & Porth, 2014). Disorders of Renal Function MN551 Case Study.

Hydronephrosis.

Swelling in one or both kidneys resulting from a buildup of urine is hydronephrosis.  This condition can lead to kidney damage and/or failure if not treated.  The amount of damage depends on duration, severity and location of the obstruction (Grossman & Porth, 2014).

One cause for this condition is an obstruction in the ureters preventing the outflow of urine to the bladder.  A second cause of this condition occurs when urine in the bladder refluxes into the kidney causing an enlargement of the renal pelvis (Hydronephrosis, 2017).  Both causes result in renal injury but diagnosed and treated early can reverse the damage.

Relating to this case study the probable location of the kidney stone related blockage would be the ureteropelvic junction.  Fred exhibited symptoms consistent with hydronephrosis which included complaints of pain in his back, abdomen and groin.  He also was suffering from nausea and vomiting. Disorders of Renal Function MN551 Case Study.

Back Pressure in the Kidneys.

For this paper the focus of case study number five is on an obstruction caused by a kidney stone.  Back pressure occurs in the kidneys because of hydronephrosis caused by an obstruction, or reflux.  This condition causes a back or buildup of pressure in the kidneys.  If the condition persists, the kidneys will begin to suffer damage or nephropathy.

Progressive atrophy and damage of the kidney is caused by the dilation of the renal pelvis and calices which occurs because of the continued glomerular filtration.  The back pressure continues to build because of this ongoing filtration and the kidney’s inability to release the urine due to the blockage.  Renal vasculature becomes compressed when the increased pressure in the renal pelvis is forced back through the kidney’s collecting ducts (Grossman & Porth, 2014).

This back pressure causes a restriction in blood flow to the kidneys causing ischemic damage and intrarenal pelvic pressure which combined result in mechanical damage to the nephrons.  This causes the progressive destruction of nephrons.  Disorders of Renal Function MN551 Case Study. Remaining nephrons work to compensate by increasing their function until the assault is halted or the remaining nephrons are destroyed.  According to Grossman and Porth (2014, pg. 1089), “in advanced cases the kidneys can become thin walled cystic structures with parenchymal atrophy, total obliteration of the pyramids and thinning of the cortex.”

Conclusion.

In case study number five, it is clear through medical literature and research that time is of the essence when diagnosing and treating with renal disorders.  In this case study, Fred had worked outside in the heat all day.  His early symptoms could have easily been mistaken for exhaustion, pulling a back muscle or dehydration.

Patients who delay seeking help are at greater risk for renal injury that could result in permanent damage and renal failure.  One specific condition that can devastate a patient’s renal health if left untreated is hydronephrosis.  The damage from this condition can destroy the kidney’s nephrons and lead to renal failure. Disorders of Renal Function MN551 Case Study.

Despite the abundance of research into the formation of renal stone formation, there is still more to be learned.  Health care providers should educate patients about the causes, signs and symptoms of kidney stones.  As evidenced by medical literature, it is clear that early diagnosis and treatment can potentially slow, stop and reverse renal injury.

References

Chaiyarit, S., & Thongboonkerd, V. (2017). Defining and Systematic Analyses of Aggregation Indices to Evaluate Degree of Calcium Oxalate Crystal Aggregation.
Frontiers in Chemistry, 5
, 113. http://doi.org/10.3389/fchem.2017.00113

Coe, F. L., Worcester, E. M., & Evan, A. P. (2016). Idiopathic hypercalciuria and formation of calcium renal stones.
Nature Reviews Nephrology, 12
(9), 519-533. doi:10.1038/nrneph.2016.101

Evan, A. P., Worcester, E. M., Coe, F. L., Williams, J., & Lingeman, J. E. (2015). Mechanisms of Human Kidney Stone Formation.
Urolithiasis, 43
(0 1), 19–32.
http://doi.org/10.1007/s00240-014-0701-0

Grossman, S. C., & Porth, C. (2014).
Porth’s pathophysiology: Concepts of altered health states
(9th ed.). Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins.

Hydronephrosis. (2017, February 03). Retrieved from
https://www.kidney.org/atoz/content/hydronephrosis

Jena, S. C., Panigrahi, P. N., & Dey, S. (2016). Urolithiasis: Critical Analysis of Mechanism of Renal Stone Formation and Use of Medicinal Plants as Antiurolithiatic Agents.
Asian Journal of Animal and Veterinary Advances, 11
(1), 9-16. doi:10.3923/ajava.2016.9.16 Disorders of Renal Function MN551 Case Study

Kaygısız, O. (2017). Metaphylaxis in Pediatric Urinary Stone Disease.
Updates and Advances in Nephrolithiasis – Pathophysiology, Genetics, and Treatment Modalities
. doi:10.5772/intechopen.69982

Phillips, R., Hanchanale, V. S., Myatt, A., Somani, B., Nabi, G., & Biyani, C. S. (2015). Citrate salts for preventing and treating calcium containing kidney stones in adults.
Cochrane Database of Systematic Reviews
. doi:10.1002/14651858.cd010057.pub2

Sorensen, M. D. (2014). Calcium intake and urinary stone disease.
Translational Andrology and Urology, 3
(3), 235–240.
http://doi.org/10.3978/j.issn.2223-4683.2014.06.05

Last Name, F. M. (Year). Article Title.
Journal Title
, Pages From – To.

Last Name, F. M. (Year).
Book Title.
City Name: Publisher Name. Disorders of Renal Function MN551 Case Study

MN566 Introduction to Primary Care Midterm Quiz

Unit 5

Your quiz has been submitted successfully.

Subsection

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Question 1

1 / 1 point

Which of the following would be considered the research design for Level IV evidence?

Question options:

Single descriptive or qualitative study

Opinion of authorities and expert committees

Systematic review of randomized clinical trial studies

Well-designed case Control or Cohort Study Level

Question 2

MN566 Introduction to Primary Care Midterm Quiz

1 / 1 point

It is always important to consider the pathological process that could be causing the patients problems. Choose all that should be considered when creating your differential list using a mnemonic..

Question options:

Inflammatory

Neoplastic

toxic or metabolic

infectious

congenital

traumatic

Question 3

0 / 1 point

Choose all that should be considered when ordering a diagnostic test.

Question options:

patients request for test to be done

cost

sensitivity and specificity of the test

convenience of test

Will the outcome of the test change your plan of care

diagnosis by exclusion

Question 4

MN566 Introduction to Primary Care Midterm Quiz

1 / 1 point

Which of the following would be considered the research design for Level I evidence?

Question options:

Single, well-designed randomized clinical trial

Systematic review of randomized clinical trial studies

Well-designed controlled trials without randomization

Systematic reviews of descriptive or qualitative studies

Question 5

1 / 1 point

The Goals of Diagnostic Reasoning is to:(choose all that apply)

Question options:

Solve a problem

establish a relationship with your patient

screen for disease and illness

promote healthy lifestyles

support research

Question 6

1 / 1 point

Using mnemonics for gathering a health history can be helpful when trying to analyse the symptoms presented and create a differential list.Which mnemonic will give you the most comprehensive approach to collecting your history?

Question options:

OLDCARS

COLDSPA

MEDLIST

OLDCARTS

Question 7

1 / 1 point

A 37 year old man that was diagnosed with cluster headaches and takes high doses of aspirin.

Indicate the appropriate course of action :

Question options:

head CT

head MRI C.

neither for the following patient.

All of the above

Question 8

1 / 1 point

Generalized patterns of nursing care are represented in The Circle of Caring Model as:(choose all that apply)

Question options:

self care

Patience

listening

courage

Authentic presence

advocacy

knowing

commitment

Question 9

1 / 1 point

Choose all the following that are essential in developing clinical practice guidelines:

Question options:

Identification of A topic

Enlist and expert panal

Review of literature ‘D. Rate evidence

Draft a proposal

External review of draft

Revised draft based on recommendations

Question 10

1 / 1 point

Applying evidence at the point of care requires:

Question options: MN566 Introduction to Primary Care Midterm Quiz

Readily available evidence-based resources

Ability to review research literature

Single articles in journals

Current textbooks

Question 11

0 / 1 point

Identify the choice that best completes the statement or answers the question.

Which of the following are parts of evidence-based practice?

Question options:

Clinician

Patient

Evidence

All of the above

Question 12

0 / 1 point

Different kinds of thinking and learning also include the Affective Domain. This model described by Krathwohl (1964), is :

Question options:

Complex to include conceptual knowledge

A metacognitive model

Based on an organized hierarchy

Based on an individual’s commitment to living and valuing

Question 13

1 / 1 point

When evaluating a patient with a an acute headache all of the following observations would indicate the absence of a more serious underlying condition except:

Question options:

Onset of headache with exertion, coughing or sneezing

History of previous headaches

Supple neck

normal neurological examination result.

Question 14

1 / 1 point

What are the questions you should ask yourself before using clinical guidelines in your practice? All are correct except (mark the ones that apply)

Question options:

How strong are the recommendations

Are the guidelines applicable to my patients

Can I get reimbursed for using these guidelines

Are the guidelines clinically important

Are these guidelines from a reliable source

How old are these guidelines

Question 15

1 / 1 point

The Circle of Caring Model is a new and more contemporary approach to medicine. Choose the characteristics that best describe this model of care in the primary care setting. MN566 Introduction to Primary Care Midterm Quiz.

Question options:

AIl includes both traditional nursing as well as traditional medical practice

It is a transformative model

It considers both assessment and patient outcomes

It is a patient centered model

All of the Above

Question 16

1 / 1 point

Which of the following would be considered the research design for Level V evidence?

Question options:

Systematic review of randomized clinical trial studies

Well-designed controlled trials without randomization

Systematic reviews of descriptive or qualitative studies

Single descriptive or qualitative study

Question 17

1 / 1 point

Understanding other factors that can be causing the patients problems include:. Choose all that should be considered

Question options:

Demographics

Age

Gender

weight

medications

education

Question 18

1 / 1 point

MN566 Introduction to Primary Care Midterm Quiz

The Circle of Caring Model has grown out of and is rooted in the assumption that caring is the central concept in nursing and is uniquely known and expressed in nursing.

Question options:

True

False

Question 19

1 / 1 point

Bloom’s (1956) taxonomies of learning includes all of the following except:

Question options:

the cognitive domain

the communication and leadership domain

the affective domain

psychomotor domain

Question 20

1 / 1 point

Diagnostic test should be the deciding factor when making your final diagnosis.

MN566 Introduction to Primary Care Midterm Quiz Question options:

True

False

Question 21

1 / 1 point

Practice Standards are designed to be flexible and can be tailored to be used in any medical arena.

Question options:

True

False

Question 22

1 / 1 point

Indicators that a headache can be the presenting symptom of a serious illness and may require neuroimaging include all the following except:

Question options:

Headaches that occur periodically in clusters

Increase frequency and severity of headaches

Headaches causing confusion, dizziness and or lack of coordination.

Headaches causing you to wake at night.

Question 23

1 / 1 point

Practice guidelines are designed to:

Question options:

Be inflexible

Be utilized in every circumstance

Provide a reference point for decision making

Be created by a professional organization to guide the practice of a profession

Question 24

1 / 1 point

Nursing research should be utilized by:

MN566 Introduction to Primary Care Midterm Quiz Question options:

Nurses at the bedside

Advanced practice nurses

Nurse researchers

Nurses at all levels of practice

Question 25

1 / 1 point

Clinicians who use clinical guidelines are responsible for reviewing their usefulness in their practice.

Question options:

True

False

Attempt Score:

22 / 25 – 88 %

Overall Grade
 (highest attempt)
:

22 / 25 – 88 %

 

Done

MN566 Introduction to Primary Care Midterm Quiz