Tag: Clinical-Nursing

  • Sullivan University HCA 545

    Sullivan University HCA 545

    1. Consider the $50,000 excess cash. Assume that Gary invests the funds in a one-year CD.
    a.What is the CDs value at maturity (future value) if it pays 10.0 percent (annual) interest?
    b. What would be its future value if the CD pays 5.0 percent interest? It pays 15.0 percent interest?
    c. Bank South offers CDs with 10.0 percent nominal (stated) interest, but compounded semiannually. What is the effective annual rate on this CD? What would the future value be after one year if $50,000 were invested? Sullivan University HCA 545.
    d. The Pensacola Branch of Bank of America offers a 10.0 percent CD with daily compounding. What is the CDs effective annual rate and its value at maturity one year from now if $50,000 is invested? (Assume a 365 day year)

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    2. Rework Parts (a) through (d) of Question 1 assuming that each CD has a five-year maturity.
    a. FV = PV x (1 + i)n
    b. FV = PV x (1 + i)n
    c. FV = PV x (1 +i/m)n x m
    d.FV = PV x (1 +i/m)n x m
    3. Now consider the Surgery Centers goal of having $200,000 available in five years to buy a new patient billing system.
    a. What lump sum amount must be invested today in a CD paying 10.0 percent annual interest to accumulate the needed $200,000?
    b. What annual interest rate is needed to produce $200,000 after five Years if only $100,000 is invested?

    4. Now consider a second alternative for accumulating funds to buy the new billing system. In lieu of a lump sum investment, assume that five annual payments of $32,000 are made at the end of each year.
    a. What type of annuity is this? Sullivan University HCA 545.
    b. What is the present value of this annuity if the opportunity cost rate is 10.0 percent annually? 10.0 percent compounded semiannually?
    c. What is the future value of this annuity if the payments are invested in an account paying 10.0 percent annually? 10.0 percent compounded semiannually?
    d. What annual interest rate is required to accumulate the $200,000 needed to make the purchase assuming a $32,000 annual payment?
    e. What size annual payment would be needed to accumulate $200,000 under annual compounding at a 10.0 percent rate?
    f. Suppose the payments are only $16,000 each, but they are made Every six months, starting six months from now. What would be the future value if the ten payments were invested at 10.0 percent interest? If they were invested at BankSouth at 10.0 percent compounded semiannually? Sullivan University HCA 545.
    5. Assume now that the payments are made at the beginning of each period. Repeat the analysis in Question 4.
    a. An annuity due is a series of cash flows that occur at the beginning of an accounting period.

    6. Now consider the uneven cash flow stream stemming from the lease agreement given in the case.
    a. what is the present (year 0) value of the annual lease cash flows if the opportunity cost rate is 10.0 percent annually?
    What is the value of this cash flow stream at the end of year 5 if the cash flows are invested at 10.0 percent annually? What is the present value of this future value when discounted at 10.0 percent? What does this result indicate about the consistency inherent in the time value analysis? Sullivan University HCA 545.
    c. Does the office renovations and subsequent lease arrangement appear to be a good investment for the company? (Hint: Compare the cost of renovation with the present value of the lease payments)

    7. Now assume that it is five years later and the company was unable to accumulate the $200,000 needed to make the software purchase. Instead, the company is forced to borrow the $200,000. The loan calls for repayment in equal annual installments over a four-year period, with the first payment due at the end of one year. Assuming that the firm can borrow the funds at a 10.0 percent rate, what amount of interest and principal will be repaid at the end of each year of the loan?
    Throughout this case, you have been either discounting or compounding cash flows. Many financial analyses, such as bond refunding decisions, capital investment decisions, and lease decisions, involve discounting projected future cash flows. What is the appropriate rate in such situations? What factors influence the value of this rate? Sullivan University HCA 545.

  • NURS 6630 Approaches to Treatment weekly essay assignment discussions

    NURS 6630 Approaches to Treatment weekly essay assignment discussions
    .

    Week 1 discussion

    Discussion: Foundational Neuroscience

    As a psychiatric mental health nurse practitioner, it is essential for you to have a strong background in foundational neuroscience. In order to diagnose and treat clients, you must not only understand the pathophysiology of psychiatric disorders, but also how medications for these disorders impact the central nervous system. These concepts of foundational neuroscience can be challenging to understand. Therefore, this Discussion is designed to encourage you to think through these concepts, develop a rationale for your thinking, and deepen your understanding by interacting with your colleagues NURS 6630 Approaches to Treatment weekly essay assignment discussions.

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    Learning Objectives

    Students will:

    Analyze the agonist-to-antagonist spectrum of action of psychopharmacologic agents

    Compare the actions of g couple proteins to ion gated channels

    Analyze the role of epigenetics in pharmacologic action

    Analyze the impact of foundational neuroscience on the prescription of medications

    Learning Resources

    Note: To access this week’s required library resources, please click on the link to the Course Readings List, found in the Course Materials section of your Syllabus.

    Required Readings

    Note: All Stahl resources can be accessed through the Walden Library using this link. This link will take you to a log-in page for the Walden Library. Once you log into the library, the Stahl website will appear.

    Stahl, S. M. (2013). Stahl’s essential psychopharmacology: Neuroscientific basis and practical applications (4th ed.). New York, NY: Cambridge University Press *Preface, pp. ix–x NURS 6630 Approaches to Treatment weekly essay assignment discussions

    Note: To access the following chapters, click on the Essential Psychopharmacology, 4th ed tab on the Stahl Online website and select the appropriate chapter. Be sure to read all sections on the left navigation bar for each chapter.

    Chapter 1, “Chemical Neurotransmission”

    Chapter 2, “Transporters, Receptors, and Enzymes as Targets of Psychopharmacologic Drug Action”

    Chapter 3, “Ion Channels as Targets of Psychopharmacologic Drug Action”

    Document: Midterm Exam Study Guide (PDF)

    Document: Final Exam Study Guide (PDF)

    Required Media

    Laureate Education (Producer). (2016i). Introduction to psychopharmacology [Video file]. Baltimore, MD: Author.

    Note: The approximate length of this media piece is 3 minutes.

    Accessible player

    Optional Resources

    Laureate Education (Producer). (2009). Pathopharmacology: Disorders of the nervous system: Exploring the human brain [Video file]. Baltimore, MD: Author.

    Note: The approximate length of this media piece is 15 minutes.

    Dr. Myslinski reviews the structure and function of the human brain. Using human brains, he examines and illustrates the development of the brain and areas impacted by disorders associated with the brain.

    Accessible player

    Laureate Education (Producer). (2012). Introduction to advanced pharmacology [Video file]. Baltimore, MD: Author.

    Note: The approximate length of this media piece is 8 minutes.

    In this media presentation, Dr. Terry Buttaro, associate professor of practice at Simmons School of Nursing and Health Sciences, discusses the importance of pharmacology for the advanced practice nurse. NURS 6630 Approaches to Treatment weekly essay assignment discussions.

    Accessible player

    To prepare for this Discussion:

    Review this week’s Learning Resources.

    Reflect on concepts of foundational neuroscience.

    Week 3 discussion

    Discussion: The Impact of Ethnicity on Antidepressant Therapy

    Major depressive disorder is one of the most prevalent disorders you will see in clinical practice. Treatment for this disorder, however, can vary greatly depending on client factors, such as ethnicity and culture. As a psychiatric mental health professional, you must understand the influence of these factors to select appropriate psychopharmacologic interventions. For this Discussion, consider how you might assess and treat the individuals in the case studies based on the provided client factors, including ethnicity and culture.

    Learning Objectives

    Students will:

    Assess client factors and history to develop personalized plans of antidepressant therapy for adult and geriatric clients

    Analyze factors that influence pharmacokinetic and pharmacodynamic processes in adult and geriatric clients requiring antidepressant therapy

    Analyze the impact of ethnicity on antidepressant therapy

    Evaluate efficacy of treatment plans

    Apply knowledge of providing care to adult and geriatric clients presenting for antidepressant therapy

    Learning Resources

    Note: To access this week’s required library resources, please click on the link to the Course Readings List, found in the Course Materials section of your Syllabus NURS 6630 Approaches to Treatment weekly essay assignment discussions.

    Required Readings

    Note: All Stahl resources can be accessed through the Walden Library using this link. This link will take you to a log-in page for the Walden Library. Once you log into the library, the Stahl website will appear.

    Stahl, S. M. (2013). Stahl’s essential psychopharmacology: Neuroscientific basis and practical applications (4th ed.). New York, NY: Cambridge University Press.

    Note: To access the following chapters, click on the Essential Psychopharmacology, 4th ed tab on the Stahl Online website and select the appropriate chapter. Be sure to read all sections on the left navigation bar for each chapter.

    Chapter 7, “Antidepressants”

    Stahl, S. M. (2014b). The prescriber’s guide (5th ed.). New York, NY: Cambridge University Press.

    Note: To access the following medications, click on the The Prescriber’s Guide, 5th ed tab on the Stahl Online website and select the appropriate medication.

    Review the following medications:

    amitriptyline

    bupropion

    citalopram

    clomipramine

    desipramine

    desvenlafaxine

    doxepin

    duloxetine

    escitalopram

    fluoxetine

    fluvoxamine

    imipramine

    ketamine

    mirtazapine

    nortriptyline

    paroxetine

    selegiline

    sertraline

    trazodone

    venlafaxine

    vilazodone

    vortioxetine

    American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.

    Note: Retrieved from Walden Library databases.

    Howland, R. H. (2008a). Sequenced treatment alternatives to relieve depression (STAR*D). Part 1: Study design. Journal of Psychosocial Nursing and Mental Health Services, 46(9), 21–24. doi:10.3928/02793695-20080901-06

    Note: Retrieved from Walden Library databases.

    Howland, R. H. (2008a). Sequenced treatment alternatives to relieve depression (STAR*D). Part 2: Study outcomes. Journal of Psychosocial Nursing and Mental Health Services, 46(19), 21–24. doi:10.3928/02793695-20081001-05

    Note: Retrieved from Walden Library databases. NURS 6630 Approaches to Treatment weekly essay assignment discussions.

    Yasuda, S.U., Zhang, L. & Huang, S.-M. (2008). The role of ethnicity in variability in response to drugs: Focus on clinical pharmacology studies. Clinical Pharmacology & Therapeutics, 84(3), 417–423. Retrieved from https://web.archive.org/web/20170809004704/https://www.fda.gov/downloads/Drugs/ScienceResearch/…/UCM085502.pdf

    To prepare for this Discussion:

    Note: By Day 1 of this week, your Instructor will have assigned you to one of the following case studies to review for this Discussion. To access the following case studies, click on the Case Studies tab on the Stahl Online website and select the appropriate volume and case number.

    Case 1: Volume 1, Case #1: The man whose antidepressants stopped working

    Case 2: Volume 1, Case #7: The case of physician do not heal thyself

    Case 3: Volume 1, Case #29: The depressed man who thought he was out of options

    Review this week’s Learning Resources and reflect on the insights they provide.

    Go to the Stahl Online website and examine the case study you were assigned.

    Take the pretest for the case study.

    Review the patient intake documentation, psychiatric history, patient file, medication history, etc. As you progress through each section, formulate a list of questions that you might ask the patient if he or she were in your office.

    Based on the patient’s case history, consider other people in his or her life that you would need to speak to or get feedback from (i.e., family members, teachers, nursing home aides, etc.).

    Consider whether any additional physical exams or diagnostic testing may be necessary for the patient.

    Develop a differential diagnoses for the patient. Refer to the DSM-5 in this week’s Learning Resources for guidance.

    Review the patient’s past and current medications. Refer to Stahl’s Prescriber’s Guide and consider medications you might select for this patient.

    Review the posttest for the case study.

    Week 7 discussion

    Discussion: Sleep/Wake Disorders

    It is not uncommon to experience a night or two of disrupted sleep when there is something major going on in your life. However, sleep/wake disorders are much more than an occasional night of disrupted sleep. A recent report from the Centers for Disease Control and Prevention estimated that between 50 and 70 million American have problems with sleep/wake disorders (CDC, 2015). NURS 6630 Approaches to Treatment weekly essay assignment discussions. Although the vast majority of Americans will visit their primary care provider for treatment of these disorders, many providers will refer patients for further evaluation. For this Discussion, you consider how you might assess and treat the individuals based on the provided client factors.

    Learning Objectives

    Students will:

    Assess client factors and history to develop personalized therapy plans for clients with sleep/wake disorders

    Analyze factors that influence pharmacokinetic and pharmacodynamic processes in clients requiring therapy for sleep/wake disorders

    Evaluate efficacy of treatment plans for clients presenting for sleep/wake therapy

    Apply knowledge of providing care to adult and geriatric clients presenting for sleep/wake disorders

    Learning Resources

    Note: To access this week’s required library resources, please click on the link to the Course Readings List, found in the Course Materials section of your Syllabus.

    Required Readings

    Note: All Stahl resources can be accessed through the Walden Library using this link. This link will take you to a log-in page for the Walden Library. Once you log into the library, the Stahl website will appear.

    Stahl, S. M. (2013). Stahl’s essential psychopharmacology: Neuroscientific basis and practical applications (4th ed.). New York, NY: Cambridge University Press. NURS 6630 Approaches to Treatment weekly essay assignment discussions.

    To access the following chapters, click on the Essential Psychopharmacology, 4th ed tab on the Stahl Online website and select the appropriate chapter. Be sure to read all sections on the left navigation bar for each chapter.

    Chapter 11, “Disorders of Sleep and Wakefulness and Their Treatment”

    Stahl, S. M. (2014b). The prescriber’s guide (5th ed.). New York, NY: Cambridge University Press.

    To access information on the following medications, click on The Prescriber’s Guide, 5th ed tab on the Stahl Online website and select the appropriate medication. NURS 6630 Approaches to Treatment weekly essay assignment discussions.

    Review the following medications:

    For insomnia

    alprazolam

    amitriptyline

    amoxapine

    clomipramine

    clonazepam

    desipramine

    diazepam

    doxepin

    flunitrazepam

    flurazepam

    hydroxyzine

    imipramine

    lorazepam

    nortriptyline

    ramelteon

    temazepam

    trazodone

    triazolam

    trimipramine

    zaleplon

    zolpidem

    American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.

    Note: Retrieved from Walden Library databases.

    Davidson, J. (2016). Pharmacotherapy of post-traumatic stress disorder: Going beyond the guidelines. British Journal of Psychiatry, 2(6), e16-e18. doi:10.1192/bjpo.bp.116.003707. Retrieved from http://bjpo.rcpsych.org/content/2/6/e16

    To prepare for this Discussion:

    Note: By Day 1 of this week, your Instructor will have assigned you to one of the following case studies to review for this Discussion. To access the following case studies, click on the Case Studies tab on the Stahl Online website and select the appropriate volume and case number NURS 6630 Approaches to Treatment weekly essay assignment discussions.

    Case 1: Volume 2, Case #16: The woman who liked late-night TV

    Case 2: Volume 2, Case #11: The figment of a man who looked upon the lady

    Case 3: Volume 1, Case #5: The sleepy woman with anxiety

    Review this week’s Learning Resources and reflect on the insights they provide.

    Go to the Stahl Online website and examine the case study you were assigned.

    Take the pretest for the case study.

    Review the patient intake documentation, psychiatric history, patient file, medication history, etc. As you progress through each section, formulate a list of questions that you might ask the patient if he or she were in your office.

    Based on the patient’s case history, consider other people in his or her life that you would need to speak to or get feedback from (i.e., family members, teachers, nursing home aides, etc.).

    Consider whether any additional physical exams or diagnostic testing may be necessary for the patient.

    Develop a differential diagnoses for the patient. Refer to the DSM-5 in this week’s Learning Resources for guidance.

    Review the patient’s past and current medications. Refer to Stahl’s Prescriber’s Guide and consider medications you might select for this patient.

    Review the posttest for the case study.

    Week 9 discussion

    Discussion: Presentations of ADHD

    Although ADHD is often associated with children, this disorder is diagnosed in clients across the lifespan. While many individuals are properly diagnosed and treated during childhood, some individuals who have ADHD only present with subsyndromal evidence of the disorder. These individuals are often undiagnosed until they reach adulthood and struggle to cope with competing demands of running a household, caring for children, and maintaining employment. For this Discussion, you consider how you might assess and treat individuals presenting with ADHD.

    Learning Objectives

    Students will:

    Assess client factors and history to develop personalized therapy plans for clients with ADHD

    Analyze factors that influence pharmacokinetic and pharmacodynamic processes in clients requiring therapy for ADHD

    Evaluate efficacy of treatment plans

    Apply knowledge of providing care to adult and geriatric clients presenting for antidepressant therapy

    Learning Resources

    Note: To access this week’s required library resources, please click on the link to the Course Readings List, found in the Course Materials section of your Syllabus.

    Required Readings

    Note: All Stahl resources can be accessed through the Walden Library using this link. This link will take you to a log-in page for the Walden Library. Once you log into the library, the Stahl website will appear.

    Clancy, C.M., Change, S., Slutsky, J., & Fox, S. (2011). Attention deficit hyperactivity disorder: Effectiveness of treatment in at-risk preschoolers; long-term effectiveness in all ages; and variability in prevalence, diagnosis, and treatment. Table B. KQ2: Long-term(>1 year) effectiveness of interventions for ADHD in people 6 years and older.

    Stahl, S. M. (2013). Stahl’s essential psychopharmacology: Neuroscientific basis and practical applications (4th ed.). New York, NY: Cambridge University Press.

    To access the following chapters, click on the Essential Psychopharmacology, 4th ed tab on the Stahl Online website and select the appropriate chapter. Be sure to read all sections on the left navigation bar for each chapter.

    Chapter 12, “Attention Deficit Hyperactivity Disorder and Its Treatment”

    Stahl, S. M., & Mignon, L. (2012). Stahl’s illustrated attention deficit hyperactivity disorder. New York, NY: Cambridge University Press.

    To access the following chapter, click on the Illustrated Guides tab and then the ADHD tab. NURS 6630 Approaches to Treatment weekly essay assignment discussions.

    Chapter 4, “ADHD Treatments”

    Stahl, S. M. (2014b). The prescriber’s guide (5th ed.). New York, NY: Cambridge University Press.

    To access information on the following medications, click on The Prescriber’s Guide, 5th ed tab on the Stahl Online website and select the appropriate medication. NURS 6630 Approaches to Treatment weekly essay assignment discussions.

    Review the following medications:

    For ADHD

    armodafinil

    amphetamine (d)

    amphetamine (d,l)

    atomoxetine

    bupropion

    chlorpromazine

    clonidine

    guanfacine

    haloperidol

    lisdexamfetamine

    methylphenidate (d)

    methylphenidate (d,l)

    modafinil

    reboxetine

    American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.

    Note: Retrieved from Walden Library databases.

    Optional Resources

    Hodgkins, P., Shaw, M., McCarthy, S., & Sallee, F. R. (2012). The pharmacology and clinical outcomes of amphetamines to treat ADHD: Does composition matter? CNS Drugs, 26(3), 245–268. doi:10.2165/11599630-000000000-00000

    Psychiatric Times. (2016). A 5-question quiz on ADHD. Retrieved from http://www.psychiatrictimes.com/adhd/5-question-quiz-adhd?GUID=AA46068B-C6FF-4020-8933-087041A0B140&rememberme=1&ts=22072016

    To prepare for this Discussion:

    Note: By Day 1 of this week, your Instructor will have assigned you to one of the following case studies to review for this Discussion. To access the following case studies, click on the Case Studies tab on the Stahl Online website and select the appropriate volume and case number.

    Case 1: Volume 1, Case #13: The 8-year-old girl who was naughty

    Case 2: Volume 1, Case #14: The scatter-brained mother whose daughter has ADHD, like mother, like daughter

    Case 3: Volume 2, Case #21: Hindsight is always 20/20, or attention deficit hyperactivity disorder

    Review this week’s Learning Resources and reflect on the insights they provide.

    Go to the Stahl Online website and examine the case study you were assigned.

    Take the pretest for the case study.

    Review the patient intake documentation, psychiatric history, patient file, medication history, etc. As you progress through each section, formulate a list of questions that you might ask the patient if he or she were in your office.

    Based on the patient’s case history, consider other people in his or her life that you would need to speak to or get feedback from (i.e., family members, teachers, nursing home aides, etc.).

    Consider whether any additional physical exams or diagnostic testing may be necessary for the patient.

    Develop a differential diagnoses for the patient. Refer to the DSM-5 in this week’s Learning Resources for guidance.

    Review the patient’s past and current medications. Refer to Stahl’s Prescriber’s Guide and consider medications you might select for this patient NURS 6630 Approaches to Treatment weekly essay assignment discussions.

    Review the posttest for the case study.

    Week 10 discussion

    Discussion: Influencing Social Change

    Individuals with psychiatric mental health disorders are frequently stigmatized not only by society as a whole, but also by their friends, family, and sometimes healthcare providers. In your role, however, you have the opportunity to become a social change agent for these individuals. For this Discussion, consider how you might make a positive impact for your clients and advocate for social change within your own community.

    Learning Objectives

    Students will:

    Apply strategies to become a social change agent for psychiatric mental health

    Learning Resources

    Note: To access this week’s required library resources, please click on the link to the Course Readings List, found in the Course Materials section of your Syllabus. NURS 6630 Approaches to Treatment weekly essay assignment discussions.

    Required Readings

    Angermeyer, M. C., Matschinger, H., & Schomerus, G. (2013). Attitudes towards psychiatric treatment and people with mental illness: Changes over two decades. The British Journal of Psychiatry, 203(2), 146–151. Retrieved from http://bjp.rcpsych.org/content/203/2/146.full

    Bui, Q. (2012). Antidepressants for agitation and psychosis in patients with dementia. American Family Physician, 85(1), 20–22. Retrieved from http://www.aafp.org/journals/afp.html

    Note: Retrieved from from the Walden Library databases.

    Dingfelder, S. F. (2009). Stigma: Alive and well. American Psychological Association, 40(6), 56. Retrieved from http://www.apa.org/monitor/2009/06/stigma.aspx

    Jenkins, J. H. (2012). The anthropology of psychopharmacology: Commentary on contributions to the analysis of pharmaceutical self and imaginary. Culture, Medicine and Psychiatry, 36(1), 78–79. doi:10.1007/s11013-012-9248-0

    Note: Retrieved from from the Walden Library databases. NURS 6630 Approaches to Treatment weekly essay assignment discussions.

    Price, L. H. (2010). Violence in America: Is psychopharmacology the answer? Brown University Psychopharmacology Update, 21(5), 5. Retrieved from http://onlinelibrary.wiley.com/journal/10.1002/(ISSN)1556-7532

    Note: Retrieved from from the Walden Library databases.

    Optional Resources

    Bennett, T. (2015). Changing the way society understands mental health. National Alliance on Mental Illness. Retrieved from http://www.nami.org/Blogs/NAMI-Blog/April-2015/Changing-The-Way-Society-Understands-Mental-Health

    Mechanic, D. (2007). Mental health services then and now. Health Affairs, 26(6), 1548–1550. Retrieved from https://web.archive.org/web/20170605094514/http://content.healthaffairs.org/content/26/6/1548.full

    Rothman, D. J. (1994). Shiny, happy people: The problem with “cosmetic psychopharmacology.” New Republic, 210(7), 34–38.

    To prepare for this Discussion:

    Reflect on how you might influence social change for psychiatric mental health. NURS 6630 Approaches to Treatment weekly essay assignment discussions.

  • NURS 6565 Week 10 Discussion: State Practice Agreements

    NURS 6565 Week 10 Discussion: State Practice Agreements

    Discussion: State Practice Agreements

    This week you will have an opportunity to evaluate state practice agreements in your state and examine issues related to NP practice.

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    To prepare:

    Review practice agreements in your state

    Identify at least two physician collaboration issues in your state

    By Day 3

    Post
    a brief description of the practice agreements for NPs in your state and the two physician collaboration issues that you identified. Explain what you think are the barriers to NPs practicing independently in your state. Finally, outline a plan for how you might address NP practice issues in your state. NURS 6565 Week 10 Discussion: State Practice Agreements.

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

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

    Order description:

    Legal Issues (Negligence/Malpractice/Risk Management)

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

    ORDER A PLAGIARISM-FREE PAPER HERE

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

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

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

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

    Learning Objectives

    By the end of this week, students will:

    Analyze legal implications for standard of care

    Analyze key components of malpractice policies

    Analyze collaborative agreements in relation to state rules

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

    Compare differences in malpractice policy options

    Evaluate professional strengths and weaknesses

    Evaluate mastery of NP clinical skills

    Photo Credit: Tetra Images/Getty Images

    Learning Resources

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

    Required Readings

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

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

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

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

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

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

    Note: Retrieved from the Walden Library databases.

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

    Note: Retrieved from the Walden Library databases.

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

    Note: Retrieved from the Walden Library databases.

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

    Note: Retrieved from the Walden Library databases.

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

    Note: Retrieved from the Walden Library databases.

    Required Media

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

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

    Optional Resources

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

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

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

    Discussion: Clinical Challenges for the NP

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

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

    To prepare:

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

    Case Study One: Dismissing the non-compliant patient.

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

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

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

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

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

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

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

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

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

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

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

    INSTRUCTIONS FOR PAPER:

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

    Identify and briefly summarize the case study you selected

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

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

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

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

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

    University Outcomes

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

    society.

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

    society.

    III. Demonstrate a commitment to lifelong learning.

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

    professional settings.

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

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

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

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

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

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

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

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

    society.

    Program Outcomes

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

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

    nursing profession, and social change

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

    and pertinent research to guide decision-making that demonstrates best

    practices for specialist nursing practice in a global society

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

    healthcare strategies that reduce health disparities by patient/population

    advocacy for access to specialist nursing care

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

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

    written, and information technology for professional delivery of specialist nursing

    care

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

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

    prevent illness/injury

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

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

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

    nursing practice

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

    centered care in accordance with professional practice standards that transform

    health outcomes for diverse populations

    Course Outcomes

    1. Synthesize the role and responsibilities of the nurse practitioner

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

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

    practitioners

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

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

    conditions

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

    advanced practice nurse practitioner

    7. Analyze ethical and legal issues of nurse practitioner practice

    8. Synthesize process for measuring quality performance of nurse practitioners

    Weekly Objectives Alignment Chart

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

    Met In (D#/A# /Other)

    Course Outcome(

    s)

    SoN Outcome

    s

    Program Outcome(

    s) University Outcome(

    s)

    MS Essential s (MSE)

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

    A 1, 2 2, 4, 5 3

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

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

    Evaluate mastery of NP clinical skills

    PA1 1,2 2, 4, 5 3

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

    Evaluate professional strengths and weaknesses

    PA2 1,2 2, 4, 5 3

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

    Analyze practices of advanced practice nurses

    PA2 1,2 2, 4, 5 3

    PO: 1, 2 UO: 2,6

    Week 2: Consequences of Ethical Issues in Advanced Nursing Practice

    Met In (D#/A# /Other)

    Course Outcome(

    s)

    Program Outcome(

    s) University Outcome(

    s)

    Evaluate ethics of treating family members

    D 7 2 PO: 2 UO: 7

    Analyze salient ethical issues in Advanced Nursing Practice

    A 7 2 PO: 2 UO:7

    Compare ethical dilemmas with state health laws and regulations

    D, A 7 2 PO: 2 UO: 7

    Outline the process of ethical decision making

    A 7 2 PO: 2 UO: 7

    Week 3: Ongoing Performance Evaluation

    Met In (D#/A# /Other)

    Course Outcome(

    s)

    Program Outcome(

    s) University Outcome(

    s)

    Analyze importance of quality measures

    D 8 1, 4, 5 3

    PO: 3,5 UO: 4, 8

    Evaluate the use of incentive payment for care

    D 8 3 PO: 5 UO: 4, 8

    Analyze external motivators for incentive payment for care

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

    Apply comprehensive knowledge of nurse practitioner practice

    A 8 3 PO: 5 UO: 4, 8

    © 2016 Laureate Education, Inc. Page 4 of 7

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

    Met In (D#/A# /Other)

    Course Outcome(

    s)

    SoN Goals

    Program Outcome(

    s) University Outcome(

    s)

    Analyze legal implications for standard of care

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

    Analyze key components of malpractice policies

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

    Analyze collaborative agreements in relation to state rules

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

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

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

    Compare differences in malpractice policy options

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

    Evaluate professional strengths and weaknesses

    PA 1,2 2, 4, 5 3

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

    Evaluate mastery of NP clinical skills

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

    Week 5: Interprofessional Practice

    Met In (D#/A# /Other)

    Course Outcome(

    s)

    Program Outcome(

    s) University Outcome(

    s)

    Analyze interprofessional practice

    D 5 2 PO: 2 UO: 4

    Apply concepts of interprofessional practice in a clinical setting

    D 5 2 PO: 2 UO: 4

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

    A 3, 6 2 PO: 2 UO:3

    © 2016 Laureate Education, Inc. Page 5 of 7

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

    Week 6: Certification, Licensure, and Scope of Practice

    Met In (D#/A# /Other)

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

    s)

    Program Outcome(

    s) University Outcome(

    s)

    Analyze NP certification, licensure, and relocation processes

    D 2 1, 4, 5 2, 3

    PO:3,4 UO: 4,5

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

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

    Evaluate settings that are appropriate for FNP and AGPCNP graduates

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

    Evaluate certification exam options

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

    Create plans for passing National Certification Exams

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

    Analyze state restrictions or limitations for practice

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

    Week 7: Prescriptive Authority and Drug Enforcement Administration Registration

    Met In (D#/A# /Other)

    Course Outcome(

    s)

    Program Outcome(

    s) University Outcome(

    s)

    Analyze appropriate prescriptive authority and DEA registration processes

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

    Analyze safe prescribing practices

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

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

    © 2016 Laureate Education, Inc. Page 6 of 7

    strengths and weaknesses

    UO: 2,6

    Evaluate mastery of NP clinical skills

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

    Week 8: Coding and Billing Issues

    Met In (D#/A# /Other)

    Course Outcome(

    s)

    Program Outcome(

    s) University Outcome(

    s)

    Analyze reimbursement issues

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

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

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

    Analyze ethical and legal implications of reimbursement issues

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

    Week 9: Professional and Business Practice

    Met In (D#/A# /Other)

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

    s)

    Program Outcome(

    s) University Outcome(

    s)

    Evaluate business structures

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

    Create a business plan

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

    Analyze costs associated with establishing independent practice

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

    Week 10: Leadership Implications

    Met In (D#/A# /Other)

    Course Outcome(

    s)

    Program Outcome(

    s) University Outcome(

    s)

    Analyze state NP practice agreements

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

    Analyze state physician

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

    © 2016 Laureate Education, Inc. Page 7 of 7

    collaboration issues

    Analyze barriers to NP independent practice

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

    Create plan for addressing state NP practice issues

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

    Create professional cover letters, resumes, and portfolios

    A 3, 6 2 PO: 2 UO:3

    Evaluate professional strengths and weaknesses

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

    Evaluate mastery of NP clinical skills

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

    Week 11: Social Change Agents

    Met In (D#/A# /Other)

    Course Outcome(

    s)

    Program Outcome(

    s) University Outcome(

    s)

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

    D 1,3 2, 4, 5

    PO:1,7 UO: 1

    Analyze nursing legacies and enacting social change

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

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

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

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

  • NURS 6565: Quality and Cost Measurements essay assignment discussion

    NURS 6565: Quality and
    Cost
    Measurements essay assignment discussion

    NURS 6565: Quality and Cost Measurements

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

    Why are quality measures important?

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    What is the difference between quality measures and performance indicators?

    What performance measures are used for NP productivity?

    Why are incentive plans used in clinical organizations?

    To prepare:

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

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

    To Complete

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

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

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

    REFERENCES

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

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

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

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

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

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

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

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

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    Consider the following case study:

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

    Synthroid 100 mcg daily

    Nifedipine 30 mg daily

    Prednisone 10 mg daily

    To prepare:

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

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

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

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

    Post 1 page page APA format  

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

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

     

    Readings

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

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

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

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

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

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

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

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

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

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

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

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

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

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

  • NURS 6512 Walden University Exam test questions

    NURS 6512 Walden University Exam test questions

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

    Question 2

    1 out of 1 points

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

    Question 3

    1 out of 1 points

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

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    Question 4

    1 out of 1 points

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

    Question 5

    1 out of 1 points

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

    Question 6

    1 out of 1 points

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

    Question 7

    1 out of 1 points

    Which patient will develop active immunity? A patient who:

    Question 8

    1 out of 1 points

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

    Question 9

    1 out of 1 points

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

    Question 10

    1 out of 1 points

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

    Question 11

    1 out of 1 points

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

    Question 12

    0 out of 1 points

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

    Question 13

    1 out of 1 points

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

    Question 14

    1 out of 1 points

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

    Question 15

    1 out of 1 points

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

    Question 16

    1 out of 1 points

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

    Question 17

    0 out of 1 points

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

    Question 18

    1 out of 1 points

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

    Question 19

    1 out of 1 points

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

    Question 20

    1 out of 1 points

    Which of the following hormones activates adrenergic receptors?

    Question 21

    1 out of 1 points

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

    Question 22

    1 out of 1 points

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

    Question 23

    1 out of 1 points

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

    Question 24

    1 out of 1 points

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

    Question 25

    1 out of 1 points

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

    Question 26

    1 out of 1 points

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

    Question 27

    1 out of 1 points

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

    Question 28

    1 out of 1 points

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

    Question 29

    1 out of 1 points

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

    Question 30

    1 out of 1 points

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

    Question 31

    1 out of 1 points

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

    Question 32

    1 out of 1 points

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

    Question 33

    1 out of 1 points

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

    Question 34

    1 out of 1 points

    Researchers now believe that RA is:

    Question 35

    1 out of 1 points

    What common symptom should be assessed in individuals with immunodeficiency?

    Question 36

    1 out of 1 points

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

    Question 37

    1 out of 1 points

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

    Question 38

    1 out of 1 points

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

    Question 39

    1 out of 1 points

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

    Question 40

    1 out of 1 points

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

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

  • Building a Health History Essay Discussion Post – Nurs 6512 Wk 1

    Building a Health History Essay Discussion Post – Nurs 6512 Wk 1

    Building a Health History

    Effective communication is vital to constructing an accurate and detailed patient history. A patient’s health or illness is influenced by many factors, including age, gender, ethnicity, and environmental setting. As an advanced practice nurse, you must be aware of these factors and tailor your communication techniques accordingly. Doing so will not only help you establish rapport with your patients, but it will also enable you to more effectively gather the information needed to assess your patients’ health risks.

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    For this Discussion, you will take on the role of a clinician who is building a health history for one of the following new patients:

    ·        76-year-old Black/African-American male with disabilities living in an urban setting Building a Health History Essay Discussion Post – Nurs 6512 Wk 1

    ·        Adolescent Hispanic/Latino boy living in a middle-class suburb

    ·        55-year-old Asian female living in a high-density poverty housing complex

    ·        Pre-school aged white female living in a rural community

    ·        16-year-old white pregnant teenager living in an inner-city neighborhood

    To prepare:

    With the information presented in Chapter 1 in mind, consider the following:

    ·        How would your communication and interview techniques for building a health history differ with each patient?

    ·        How might you target your questions for building a health history based on the patient’s age, gender, ethnicity, or environment?

    ·        What risk assessment instruments would be appropriate to use with each patient? Building a Health History Essay Discussion Post – Nurs 6512 Wk 1.

    ·        What questions would you ask each patient to assess his or her health risks?

    ·        Select 
    one
     patient from the list above on which to focus for this Discussion.

    ·        Identify any potential health-related risks based upon the patient’s age, gender, ethnicity, or environmental setting that should be taken into consideration.

    ·        Select 
    one
     of the risk assessment instruments presented in Chapter 1 or Chapter 26 of the course text, or another tool with which you are familiar, related to your selected patient.

    ·        Develop 
    at least five
    targeted questions you would ask your selected patient to assess his or her health risks and begin building a health history. Building a Health History Essay Discussion Post – Nurs 6512 Wk 1.

    Post a 1 page paper APA format
     1.
    a description of the interview and communication techniques you would use with your selected patient.

    2.
    Explain why you would use these techniques.

    3
    Identify the risk assessment instrument you selected, and justify why it would be applicable to the selected patient.

    4
    Provide at least five targeted questions you would ask the patient.

     

    Readings

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

    o   Chapter 1, “The History and Interviewing Process” (pp. 1–21)

    This chapter explains the process of developing relationships with patients in order to build an effective health history. The authors offer suggestions for adapting the creation of a health history according to age, gender, and disability. Building a Health History Essay Discussion Post – Nurs 6512 Wk 1.

    o   Chapter 26, “Recording Information” (pp. 616–631)

    This chapter provides rationale and methods for maintaining clear and accurate records. The authors also explore the legal aspects of patient records.

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

    o   Chapter 1, “Medicolegal Principles of Documentation” (pp. 1–12 and abbreviations, pp. 18)

    o   Chapter 2, “The Comprehensive History and Physical Exam” (pp. 19–36)

    ·        Deeks, A., Lombard, C., Michelmore, J., & Teede, H. (2009). The effects of gender and age on health related behaviors. 
    BMC Public Health
    ,
     
    9
    , 213–220.

    Retrieved from the Walden Library databases Building a Health History Essay Discussion Post – Nurs 6512 Wk 1.

    This article describes a study that sought to determine the effects of gender and age on health-related behaviors. In the study, the authors also investigated the effects of screening practices, health beliefs, and perceived future health needs.

    ·        Delpierre, C., Lauwers-Cances, V., Datta, G. D., Berkman, L., & Lang, T. (2009). Impact of social position on the effect of cardiovascular risk factors on self-rated health. 
    American Journal of Public Health
    , 
    99
    (7), 1278–1284.

    Retrieved from the Walden Library databases.

    This study assessed the influence of education level on the association between self-rated health and cardiovascular risk factors. The authors explain their methods and results, and they provide recommendations for similar studies in different countries and cultures.

    ·        Lee, D. W., Neumann, P. J., & Rizzo, J. A. (2010). Understanding the medical and nonmedical value of diagnostic testing. 
    Value in Health
    , 
    13
    (2), 310–314.

    Retrieved from the Walden Library databases. Building a Health History Essay Discussion Post – Nurs 6512 Wk 1.

    The authors of this article detail their attempts to develop a framework for defining the potential value of diagnostic testing. The authors also discuss the implications of their framework for health care delivery systems.

    ·        University of Michigan Medical School. (2003). 
    Geriatric functional assessment
    .

    Retrieved from 
    http://www.med.umich.edu/lrc/coursepages/m1/HGD/GeriatricFunctionalAssess.pdf

    This article provides an exercise that emphasizes accurate functional status assessments and effective communication with older patients. The authors recommend tools and techniques to be used when caring for older patients.

    Note about Uploading Media:

    Please refer to the 
    Kaltura Media Uploader
     page located in the course navigation menu.. The documents on this page provide guidance on how to upload media for your Health Assessment Videos assignments for this course.

    Building a Health History Essay Discussion Post – Nurs 6512 Wk 1 Optional Resources

    ·        LeBlond, R. F., Brown, D. D., & DeGowin, R. L. (2009). 
    DeGowin’s diagnostic examination
     (9th ed.). New York, NY: McGraw- Hill Medical.

    o   Chapter 2, “History Taking and the Medical Record” (pp. 15–33) Building a Health History Essay Discussion Post – Nurs 6512 Wk 1.

  • STRAYER HSA 525 Health Financial Management Assignments

    STRAYER HSA 525 Health Financial Management Assignments

    Assignment Exercise 4-1: Contractual Allowances

    Physician office revenue for visit code 99214 has a full established rate of $72.00. Of ten different payers, there are nine different contracted rates, as follows:

    Payer Contracted Rate

    FHP $35.70

    HPHP 58.85

    MC 54.90

    UND 60.40

    CCN 70.20

    MO 70.75

    CGN 10.00

    PRU 54.90

    PHCS 50.00

    ANA 45.00

     

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    For each payer, compute the contractual allowance.

     

    Assignment Exercise 4-2 Revenue Sources and Grouping Revenue

    The Metropolis Health System has revenue sources from operations, donations, and interest income. The revenue from operations is primarily received for services. MHS groups its revenue STRAYER HSA 525 Health Financial Management Assignments

    first by cost center. Within each cost center the services revenue is then grouped by payer.

    For each of the six situations, indicate its number(1 through 6). Then place and X in the column(s) that represent the correct revenue source(s) for the item. The six situations are:

    (1) ICU stay billed to employee’s insurance program.-

    (2) Lab test paid for by an individual.-

    (3) Pathology work performed for the state.-

    (4) ICU stay billed to member’s health plan.-

    (5) ICU stay billed for Medicare beneficiary.-

    (6) Series of allergy tests run for eligible Medicaid beneficiary.-

     

    Medicare
     
    Medicaid
     
    Other Public
     
    Patients
     
    Commercial
     
    Managed

    Programs Insurance
     
    Care Contracts

    (1)

    (2)

    (3)

    (4)

    (5)

    (6)

     

    Assignment Exercise 5-1 Grouping Expenses by Cost Center

    The Metropolis Health System’s Rehabilitation and Wellness centre offers outpatient therapy and return-to-work services plus cardiac and pulmonary rehabilitation to get people back to a normal way of living. The Rehabilitation and Wellness Center expenses include the following:

    · Nursing Salaries

    · Physical Therapist Salaries

    · Occupational Therapist Salaries

    STRAYER HSA 525 Health Financial Management Assignments

    · Cardiac Rehab Salaries

    · Patient Education Coordinator Salary

    · Nursing Supplies

    · Physical Therapist Supplies

    · Occupational Therapist Supplies

    · Cardiac Rehab Supplies

    · Pulmonary Rehab Supplies

    · Training Supplies

    · Clerical Office Supplies

    · Employee Education

    Decide how many cost centers should be used for the above expenses at the Center and where each expense should be located.

    Assignment Exercise 5-2

    Find a listing of expenses by diagnosis or by procedure. The source of the list can be internal or external. Comment upon whether you believe the expense grouping used is appropriate. Would you have grouped the expenses in another way? STRAYER HSA 525 Health Financial Management Assignments