Category: Nursing

DDBA 8303 Week 8 Discussion 1: Reflecting on Bias & Discussion 2: Doctoral Study and the Scholar-Practitioner Model

DDBA 8303 Week 8 Discussion 1 Reflecting on Bias To prepare for this Discussion, consider what you have read about bias, as well as your experiences as an independent scholar and doctoral researcher thus far. Reflect on any preconceived biases you might have that would impact your ability to remain objective. By Day 3 Post an evaluation of ethical considerations for independent scholars within the doctoral research process. In your evaluation, do the following: · Briefly describe your problem statement and the topic you have chosen for your individual Doctoral Study. · Analyze any potential biases, assumptions, and attitudes that may impact your Doctoral Study, including how you identified these issues. · Explain potential strategies for addressing and limiting the negative impact of your own biases, assumptions, and attitudes on your study. Be sure to provide scholarly examples to support your explanation. DDBA/8303 Week 8 Discussion 2 Doctoral Study and the Scholar-Practitioner Model To prepare for this Discussion, reflect upon how your Doctoral Study concept has evolved since the beginning of this course and the ways in which you have built a solid foundation for your Doctoral Study project. By Day 4 Post an assessment of the doctoral research process within the context of the scholar-practitioner model. In your assessment, do the following: · Describe how your particular Doctoral Study might bring about improvement on management or business practice. · Reflect on the most important components of the doctoral research process from your perspective as an independent scholar. DDBA 8303 Week 8 Discussion 1: Reflecting on Bias & Discussion 2: Doctoral Study and the Scholar-Practitioner Model

Cognitive Behavioral Theory (CBT) Versus Rational Emotive Behavioral Theory (REBT)

Cognitive Behavioral Theory (CBT) Versus Rational Emotive Behavioral Theory (REBT)

While cognitive behavioral therapy (CBT) and rational emotive behavioral therapy (REBT) have many similarities, they are distinctly different therapeutic approaches. When assessing clients and selecting one of these therapies, you must recognize the importance of not only selecting the one that is best for the client, but also the approach that most aligns to your own skill set. For this Assignment, as you examine the similarities and differences between CBT and REBT, consider which therapeutic approach you might use with your clients.

Rational Emotive Behavioral Theory (REBT) Learning Objectives

Students will:

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Compare cognitive behavioral therapy and rational emotive behavioral therapy

Recommend cognitive behavioral therapies for clients

To prepare:

Review the media in this week’s Learning Resources.

Reflect on the various forms of cognitive behavioral therapy.

The Assignment

In a 1- to 2-page Cognitive Behavioral Theory (CBT) Versus Rational Emotive Behavioral Theory (REBT) paper, address the following:

Briefly describe how cognitive behavioral therapy (CBT) and rational emotive behavioral therapy (REBT) are similar.

Explain at least three differences between CBT and Rational Emotive Behavioral Theory (REBT). Include how these differences might impact your practice as a mental health counselor.

Explain which version of cognitive behavioral therapy you might use with clients and why. Support your approach with evidence-based literature.

Note: The School of Nursing 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 (available at http://writingcenter.waldenu.edu/57.htm). All papers submitted must use this formatting.

The Cognitive Behavioral Theory (CBT) Versus Rational Emotive Behavioral Theory (REBT) Assignment

In a 1- to 2-page Cognitive Behavioral Theory (CBT) Versus Rational Emotive Behavioral Theory (REBT) paper, address the following:

Briefly describe how cognitive behavioral therapy (CBT) and rational emotive behavioral therapy (REBT) are similar.

Explain at least three differences between CBT and REBT. Include how these differences might impact your practice as a mental health counselor.

Explain which version of cognitive behavioral therapy you might use with clients and why. Support your approach with evidence-based literature. (Please use APA formanting Introduction, summary References, ) Cognitive Behavioral Theory (CBT) Versus Rational Emotive Behavioral Theory (REBT).

Nursing Research Paper

Question 1 A research question is appropriate for the correlational level of research design. • Question 2 Which of the following types of studies is considered a qualitative study? • Question 3 To be considered researchable, a problem • Question 4 A researcher describes a study as a descriptive study. Which of the following would typically be part of the research methodology for the study? • Question 5 Which of the following would be considered a demographic variable? • Question 6 Identify the independent variable in the following hypothesis: “Cancer patients who receive music therapy complain less frequently of pain and require less pain medication than cancer patients not receiving music therapy.” • Question 7 A friend asks you to explain the difference between a conceptual definition and an operational definition of anxiety. You help her to understand these concepts by providing her with the following operational definition of anxiety. • Question 8 A research hypothesis: • Question 9 Subjects who volunteered to receive an experimental treatment for pancreatic cancer are educated about essential study information, assessed for understanding of this information, and asked to willingly participate in the research study. This process is referred to as: • Question 10 The purpose of an institutional review board (IRB) is to: • Question 11 Which of the following study designs focuses on finding a cause and effect relationship among variables, but uses a lower level of control? • Question 12 One example of a research population with diminished autonomy (vulnerability) would be: • Question 13 Common practice for in-text citations for a single author using APA style includes: • Question 14 In APA format, which one of these statements is not true about the references page: • Question 15 Which of the following questions is important to ask when determining the significance of the research problem? • Question 16 If a researcher wants to understand what it is like to undergo chemotherapy from the patient’s perspective of their lived experience, the study design is: • Question 17 Which of the following is a necessary requirement for experimental designs? • Question 18 In the purpose statement, the researcher should state the • Question 19 Which of the following would be considered to be a research hypothesis? • Question 20 One of the main purposes of conducting a review of the literature before carrying out a research project is to • Question 21 A questionnaire has an ID number in one corner that allows the research team to identify the subject. This is an example of: • Question 22 The concept of causality would be important in which of the following research designs? • Question 23 What is the dependent variable in the following hypothesis? The presence of social support from family affects the pain perception of patients with spinal cord injury while in the hospital. • Question 24 A conceptual definition of a variable is one that is . • Question 25 All of these statements describe the purpose of a research framework EXCEPT. Nursing Research Paper.

NR 511: Smith Family

Meet the Smith Family Smith Family: Mary: 44 mother; Patrick: 42 father, Michael: 9 son; MaryKate: 7 daughter; Paddy: 4 son; Tommy: 4 son (fraternal twins). Also living with the family are Mary’s parents, Katie and John Foley.Katie age 65 and John age 75. Clinic setting: large urban city family practice clinic which employs physicians and nurse practitioners. Part 1 Today is a busy Monday in your family practice clinic. Your first patients of the morning are a mother and daughter who are both clients of the clinic. The entire family has been coming to the clinic for years. You review the chart before entering the room to familiarize yourself with these patients. Both present today with complaints of pink eye. When you enter the room you note a Caucasian woman who appears to be about 40 years old. She is well groomed and appropriately dressed for the weather. There is a young girl standing near her mother reading the eye chart out loud to her mother. The girl is dressed in clean clothes and appears well groomed. Both smile in response to your greeting. You introduce yourself and state you are the nurse practitioner who will see them today for their visit. You begin your interaction as always by asking what brings them in today for the visit. Mom states “MaryKate has had a red eye for two days now. It started in her left eye and then I noticed it spread to her right eye this morning. She’s been complaining of it itching and burning. This morning I had to all this goop in my eye when I woke up and I noticed my eye looks red too. My four year old twins always have pink eye at their preschool so we came in to be checked. “ HPI: Mom describes herself and MaryKate as healthy. No recent illness for herself but states MaryKate is “getting over a cold” that last about a week, runny nose and nasal and seems to be improving. Was given some OTC cold medications for congestion which seemed to help. She did not miss school because she did not have a fever. No one else has been sick at home. PMH Mary: denied past illness or injuries. Hospitalized x 2 for childbirth, no surgeries. NKDA. Drinks alcohol socially, denies tobacco or illicit drug use. Sleeps 6-7 hours/night. No current medications. Takes a daily multivitamin and a B complex supplement. MaryKate: no past illnesses or surgeries. Up to date on vaccinations per the medical record. Social Mary is a high school graduate and works full time at a local business in the ordering department. MaryKate is a second grader at the local parochial school and is considered a good student. Smith family social history Mary and MaryKate live with Patrick her husband, an electrical engineer, Michael, who is 10 and Paddy and Tommy the four year old twins who attend a local preschool 5 days a week. Mary’s parents Katie and John also live in the home. Both are retired and help with childcare and household needs since both parents work full time. Patrick and John both smoke “but not in the house”. Mary has 2 siblings who are in good health. Patrick is an only child whose parents died of old age in their 70s. Katie and John emigrated from Ireland in their 20s and have always lived in this area. Katie has a history of HTN and hyperlipidemia. John has a history of tobacco use since age 10, HTN and hyperlipidemia. They share their home with 2 dogs and a cat. Discussion Part One (Please answer the questions separately for each patient) What further questions do you have for Mary at this visit? Use OLDCARTS to guide your questions. Link the questions to your differential diagnoses. What is your differential diagnosis list for this visit thus far with rationale?Each differential diagnosis should include a one sentence pathophysiology statement supported by the scholarly literature or the course textbook. Link the patient’s presenting symptoms with your differential diagnoses along with rationale. Based on your differential diagnoses list, what focused PE would you perform? What labs or diagnostic tests, if any, would you order? Is there any point of care testing for these differentials? What further questions do you have for MaryKate at this visit? Use your OLDCARTS to guide your questions. Link the questions to your differential diagnoses. What is your differential diagnosis list for this visit thus far with rationale?Each differential diagnosis should include a one sentence pathophysiology statement supported by the scholarly literature, not the textbook. . Link the patient’s presenting symptoms with your differential diagnoses along with rationale. Based on your differential diagnoses list, what focused PE would you perform? What labs or diagnostic tests, if any, would you order? Is there any point of care testing for these differentials.

NR 511: Smith Family

NR 511 Week 4 Discussion

Week 4: Discussion Part One 77 unread replies.3030 replies. Setting: large urban city family practice clinic which employs physicians and nurse practitioners. Your next patient is a work in for abdominal pain. When reviewing the chart you see that this is Patrick Smith, age 42. You met him last month when he brought his mother-in-law in for a sick visit. You remember because you treated him as well for a skin condition. You enter the room and introduce yourself again to Patrick. He is not the jovial man you met last visit; he appears to be uncomfortable as he reaches forward to shake your outstretched hand. Patrick says he is in a lot of pain. He thought it would go away but it is lasting and seems to be getting worse. He is also nauseous. He doesn’t think it is anything that he ate and no one at home has had the stomach flu. It is getting worse as he has been sitting in the office. He cannot find a comfortable position to sit. HPI Woke up at 5 a. m. started out as pain on one side of his back. He thought he pulled a muscle. Now pain is spreading to his stomach and is getting worse. The pain sometimes shoots down into his groin. He feels nauseous. He seems to be going to the bathroom more often. He thinks he might have a fever because he has been sweating. PMH Describes health as good. Has hay fever and psoriasis, medication which was given at last visit worked, not using at this time. No previous back injuries. No daily medications. No herbal medication use. Had his appendix out at age 10.. Previous hospitalization for broken leg requiring traction at age 8. Smokes cigarettes, a pack a day. No ETOH or illicit drug use. Sleeps 5-6 hours a night.NKDA. Immunizations UTD. Social Married, has four children. Lives with his immediate family and in-laws. Works full time as a plumber. Work has been so busy no time lately for regular exercise. Family Parents are deceased. Mother died at age 51 from a brain tumor and father died age 53 leukemia. Has one brother in good health. Discussion Questions Part One: What further questions do you have for Patrick at this visit?? Use OLDCARTS to guide your questions. Link the questions to your differential diagnoses. What is your differential diagnosis list with ICD 10 for this visit thus far? Each differential diagnosis should include a one sentence pathophysiology statement supported by the literature or the textbook. List the patient’s signs and symptoms and include a rationale statement that explains how the diagnosis is appropriate for your patient. Based on your differential diagnoses list, what focused PE would you perform? What labs or diagnostic tests would you order?NR 511 Week 4 Discussion

Discussion Part Two

On further questioning Patrick has no report of further headaches, no fever, or vision changes. No report of nasal congestion, or discharge. No report of wheezing or shortness of breath with rest, palpitation, dizziness or enlarged lymph nodes. No reports of heartburn, or indigestion. Position changes and Tums did not relieve the pain, he did not try to take any other medication, he did not think he could keep it down if he tried because he is so nauseous. Physical exam: VS Height: 5 feet 9 inches weight: 198 pounds T- 98.9, BP 160/96, P 100, R 22, oxygen saturation: 98%. Reports current pain as 8/10. Describes back and stomach pain as throbbing. The pain seems come in waves and at time shoots down into his groin. General Alert, oriented and cooperative. HEENT: head normocephalic. Hair thick and distribution throughout scalp. Sclera clear, conjunctiva white. Tympanic membranes gray and intact with light reflex noted. Pinna and tragus nontender. Nares patent without exudate. Oropharynx moist, no lesions or exudate. Tonsils ¼ bilaterally. Teeth in good repair, no cavities noted. Neck supple. No lymphadenopathy. Thyroid midline, small and firm without palpable masses. Cardiopulmonary: Heart S1 and S2 noted, no murmurs, noted. Lungs clear to auscultation bilaterally. Respirations unlabored. Abdomen appears slightly distended, symmetric with no visible masses. RLQ scar noted. Decreased bowel sounds noted. No vascular sounds. Tympany noted in all four quadrants on percussion. Abdomen is soft, no organomegaly, no masses or tenderness. Positive CVAT on right side. Urinalysis: Positive WBCs, Small blood. Trace protein, pH 7.0 specific gravity 1.030, negative nitrites, negative ketones, negative glucose CBC: WBC 6000 mm3 RBC 5 million Hbg 15g Hct 46% MCV 90 fL MCHC 35 g/dL You send Patrick to the in-house ultrasonographer. The report states “a 5mm smooth round calculus is noted at the junction of the ureter and the bladder: Discussion Part Two: Calculate Patrick’s BMI, does the finding impact his diagnosis or treatment? Summarize the history and results of Patrick’s physical exam and then answer the additional case study questions below. List the primary diagnosis with ICD10 code. Include your evidence-based rationale for choosing the primary diagnosis. The diagnostic rationale in the assessment section should include your patients’ symptoms, exam findings and the interpretation of all presented lab findings. Include one evidence-based journal article or clinical guideline that supports your rationale for each patient. Develop a complete evidence-based treatment (EBP) plan for each patient that includes medications, any additional diagnostic tests, patient education, possible referrals, and a plan for follow up with you, the PCP. Each step of the plan must include an in-text citation to an approved reference as listed on the Reference Guidelines document. The guidelines for SOAP note documentation is located under Course Resources and can assist you in writing this post and your SOAP note. Answer these additional questions in this post regarding this case: What should the NP do if Patrick continues to come back for pain medication? What are possible warning signs of prescription drug abuse? List three of the twelve 2016 CDC recommendations that would help the provider in handling this case. NR 511 Week 4 Discussion.

Maladaptive Responses to Immune Disorders Discussion Paper

Maladaptive responses to disorders are compensatory mechanisms that ultimately have adverse health effects for patients. For instance, a patient’s allergic reaction to peanuts might lead to anaphylactic shock, or a patient struggling with depression might develop a substance abuse problem. To properly diagnose and treat patients, advanced practice nurses must understand both the pathophysiology of disorders and potential maladaptive responses that some disorders cause.

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Consider immune disorders such as HIV, psoriasis, inflammatory bowel disease, and systemic lupus E. What are resulting maladaptive responses for patients with these disorders? Maladaptive Responses to Immune Disorders Discussion Paper.

To Prepare

· Review Chapter 6 and Chapter 8 in the Huether and McCance text. Reflect on the concept of maladaptive responses to disorders.

· Select two of the following immune disorders: HIV, psoriasis, inflammatory bowel disease, or systemic lupus E (SLE). Maladaptive Responses to Immune Disorders Discussion Paper.

· Identify the pathophysiology of each disorder you selected. Consider the compensatory mechanisms that the disorders trigger. Then compare the resulting maladaptive and physiological responses of the two disorders.

· Select one of the following factors: genetics, gender, ethnicity, age, or behavior. Reflect on how the factor might impact your selected immune disorders. Maladaptive Responses to Immune Disorders Discussion Paper.

Post
 a brief description of the pathophysiology of your selected immune disorders. Explain how the maladaptive and physiological responses of the two disorders differ. Finally, explain how the factor you selected might impact the pathophysiology of each disorder. Maladaptive Responses to Immune Disorders Discussion Paper.

Breast Cancer Concept Map

Summary of three patient education priorities

Physical assessment

Based on CC’s assessment summary she is at high risk of breast cancer given the history of the disease in the family. It would be crucial that a physical assessment is carried out by a professional to determine the likelihood of a lump in her breasts. Research indicates that although people have been given a tutorial to understand how the physical examination is carried out, most may not do it right (Colditz & Bohlke, 2014).

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Health promotion

The BMI of the patient is high indicating a higher chance of acquiring breast cancer also given her age. The practitioner should propose a change of diet and more exercise to maintain a healthier body. Alcohol has also been shown to increase chances of acquiring breast cancer to those at risk (Scoccianti et al., 2014). The patient should, therefore, cut on the daily wine intake.

Coping Mechanisms

The patient is at high risk of getting breast cancer and presence of susceptibility gene can be detected using molecular diagnostics (Colditz & Bohlke, 2014). The patient should be educated on what to expect and the change in the quality of life after diagnosis. This helps in coping with the disease when it occurs. Breast Cancer Concept Map

Summary of three patient education priorities

Physical assessment

Based on CC’s assessment summary three patient priorities emerge: diabetes, heart disease and breast cancer. She is at high risk of breast cancer given the history of the disease in the family and the link between breast cancer and type 2 diabetes (Colditz & Bohlke, 2014). It would be crucial that a physical assessment is carried out by a professional because of the cystic breast disease and the likelihood of a lump in her breasts. A yearly mammogram is important to detect cancer early, when it is most treatable. Reliable self-breast examination, research indicates that although people have been given a tutorial to understand how the physical examination is carried out, most may not do it right (Colditz & Bohlke, 2014). Alcohol has also been shown to increase chances of acquiring breast cancer to those at risk (Scoccianti et al., 2014). CC should therefore, cut on the daily wine intake.

Health promotion

The hemoglobin A1c level predisposes her for high risk of diabetes, also given her family history. The practitioner should propose a life style change of diet and more exercise to maintain a healthier body.

Coping Mechanisms

With diabetes, CC is at high risk of getting heart disease. The complication that begins when the arteries get narrow (atherosclerosis), and reduce function in different parts of the body: heart, brain, legs. These complications include coronary heart disease (CHD), stroke, peripheral arterial disease, nephropathy, retinopathy, and possibly neuropathy and cardiomyopathy. Therefore, clinicians place diabetes alongside the other major risk factors as important causes of cardiovascular disease (CVD) (Colditz & Bohlke, 2014). CC should be educated on what to expect and the change in the quality of life after diagnosis. This helps in coping with the disease when it occurs. Breast Cancer Concept Map.

Epidemiology is derived from the observations and inquiries of pioneers, such as Hippocrates, John Snow, Pasteur, and Koch, who have contributed immeasurably to the history of epidemiology. The discoveries and achievements of these epidemiological pioneers have played an important role in evolving epidemiology and disease control.

Discuss the impact of at least one major historical contribution on current epidemiological practices. Explain how history can potentially shape and impact our future work in public health and clinical medicine. Epidemiology.

FB Patient Encounter – Florence Blackman iHuman Case

Step 1: Complete
 i-Human Patients® Case for Florence Blackman.

Access
 i-Human Patients® by clicking the Exercise tab.

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Click
 the Cases tab to complete the i-Human Patients® Case for FB.

Interview FB to obtain her complete patient history.

Document your findings in i-Human Patients®.

Complete a health assessment and focused physical exam based on current evidence.

Document your health assessment and focused physical exam findings and develop a problem list for FB.

Note:
 You must attempt and score a cumulative 70% on the i-Human Patients® assessments in weeks 1, 3, and 5 to successfully complete the required lab component of the course.

Step 2: Interpret
 the data.

Determine
 which tests you would expect to see for FB based on the results of the history, exam, and problem list.

Evaluate
 the test results to determine the actual and/or potential diseases for which FB is at risk.

Create
 a 350-word summary note explaining how you arrived at FB’s problem list.

Provide relevant assessment results (questions and answers).

Cite the lab results that correlate with the assessment findings.

Click
 the Assignment Files tab to submit your summary, evidence-based assessment guidance, and interview results documentation. FB Patient Encounter – Florence Blackman iHuman Case.

Nursing: Demand for safe, high-quality, and effective health care services

As health care delivery in the United States continues to evolve, either through mandates, improved technologies and training, or other drivers, nurses remain at the forefront in facilitating the success of new initiatives. In 2010, the Institute of Medicine formed a committee of experts to address the following question:

“What roles can nursing assume to address the increasing demand for safe, high-quality, and effective health care services?”

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 In the final report of the committee, The Future of Nursing: Leading Change, Advancing Health, the authors stated:

This report offers recommendations that collectively serve as a blueprint to

(1) ensure that nurses can practice to the full extent of their education and training,

(2) improve nursing education,

(3) provide opportunities for nurses to assume leadership positions and to serve as full partners in health care redesign and improvement efforts, and

(4) improve data collection for workforce planning and policy making. (p. 10)

For this Discussion, you will focus on the research recommendations presented by the committee concerning the role of nurses as leaders. The committee members believe that answers to these research questions are needed to advance the profession of nursing and to further expand their role in health care reform and improvement. Nursing: demand for safe, high-quality, and effective health care services.

To prepare:

•Review Chapter 7 in The Future of Nursing: Leading Change, Advancing Health report provided in the Learning Resources. Focus on the information in Box 7.3, “Research Priorities for Transforming Nursing Leadership.”

(I am leaning toward one of these 2 – • Identification of the characteristics of mentors that have been (or could be) most successful in recruiting and training diverse nurses and nurse faculty. • Identification of the influence of nursing on important health care decisions at all levels.)

•Select one of the research priorities listed in Box 7.3 that is of particular interest to you and applicable to your career interests. Consider the benefits and challenges of researching and addressing this priority in nursing.

•Using the Walden library, identify two to three current articles that address your selected research priority. Consider the current state of research efforts on this priority. Nursing: demand for safe, high-quality, and effective health care services.

•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?

Post a description of the priority you selected and the benefits and challenges of further researching this area. Provide an overview of the articles you found (using appropriate APA citations) relating to this priority, and 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. Nursing: demand for safe, high-quality, and effective health care services