What are the similarities between graft versus host disease and graft rejection? What are the pathophysiologic differences between graft versus host disease and graft rejection?

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Week 2 | Lesson 4 Discussion

An adult patient with a chronic myelogenous leukemia sits down with you to discuss his questions and concerns about his upcoming bone marrow transplant. He has already received some educational materials and participated in a family conference during which health team members described the procedure and potential complications. He has been told that he has a risk of graft rejection or graft versus host disease (GVHD), but he does not understand the distinction (Chapter 12, Learning Objectives 1, 2, 10, 11).

  1. What are the similarities between graft versus host disease and graft rejection?
  2. What are the pathophysiologic differences between graft versus host disease and graft rejection?
  3. How would these differences be manifested clinically?
  4. Studies have shown a protective effect of mild to moderate GVHD in cancer patients who have had a bone marrow transplant. Based on your understanding, can you explain these findings?

After reading Chapter 2 (pages 25-27) in your ebook, discuss how pharmacogenomics affects drug response in people. Also, construct a concept map to illustrate how pharmacogenomics affects drug response in people with various illnesses.

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Chapter 2 Discussion

After reading Chapter 2 (pages 25-27) in your ebook, discuss how pharmacogenomics affects drug response in people. Also, construct a concept map to illustrate how pharmacogenomics affects drug response in people with various illnesses. Use the articles attached below to support your response.

Book | Abrams’ Clinical Drug Therapy: Rationales for Nursing Practice, 12e

Determine the legislative intent of the bill you have reviewed. Identify the proponents/opponents of the bill. Identify the target populations addressed by the bill. Where in the process is the bill currently? Is it in hearings or committees?

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LEGISLATION GRID AND TESTIMONY/ADVOCACY STATEMENT

As a nurse, how often have you thought to yourself, If I had anything to do about it, things would work a little differently? Increasingly, nurses are beginning to realize that they do, in fact, have a role and a voice.

Many nurses encounter daily experiences that motivate them to take on an advocacy role in hopes of impacting policies, laws, or regulations that impact healthcare issues of interest. Of course, doing so means entering the less familiar world of policy and politics. While many nurses do not initially feel prepared to operate in this space effectively, the reward is the opportunity to shape and influence future health policy.

To Prepare:

  • Select a bill that has been proposed (not one that has been enacted) using the congressional websites provided in the Learning Resources.
  • The Assignment: (1- to 2-page Legislation Grid; 1-page Legislation Testimony/Advocacy Statement)
  • Be sure to add a title page, an introduction, purpose statement, and a conclusion. This is an APA paper.

Part 1: Legislation Grid

Based on the health-related bill (proposed, not enacted) you selected, complete the Legislation Grid Template. Be sure to address the following:

Determine the legislative intent of the bill you have reviewed.
Identify the proponents/opponents of the bill.
Identify the target populations addressed by the bill.
Where in the process is the bill currently? Is it in hearings or committees?

Part 2: Legislation Testimony/Advocacy Statement

Based on the health-related bill you selected, develop a 1-page Legislation Testimony/Advocacy Statement that addresses the following:

Advocate a position for the bill you selected and write testimony in support of your position.
Explain how the social determinants of income, age, education, or gender affect this legislation.
Describe how you would address the opponent to your position. Be specific and provide examples.
At least 2 outside resources and 2-3 course specific resources are used.

How might the bill impact your own nursing practice if passed? If not passed? How might you communicate your concerns about or support for this bill to peers and legislators based on nursing practice, standards, or patient outcomes?

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Healthcare Policy week 3

This assignment will be in the format of a PowerPoint presentation (Bullet points and ‘Best Practices for PowerPoint’ should be used).
You are developing this presentation as if you were going to communicate your analysis to your colleagues regarding a current federal bill you believe may be of interest to nurses.

Go to https://www.govtrack.us/congress/bills/subjects/health/6130Links to an external site. (This is a required site for this assignment.)
Choose a current health-related federal bill of interest from the required site. Read through the bill and develop a summary of the main points in your own words. Include the bill number and name. (You may also use H.R. or S.R. as these are bills in the resolution phase).
Here is a link to our U.S. legislative process (bill to law) for review if you need to review how a bill becomes a law: https://www.congress.gov/legislative-processLinks to an external site.

For those not familiar with the development of a PowerPoint slideshow, the following link to the Microsoft Office 365 Training may be helpful.
Include the following information in your presentation
Title slide (Your name, NR451, session, Healthcare Policy assignment)
Bill name and number (indicate either H.B./H.R. or S.B./S.R.)
Bill summary (in your own words)

Address how this bill might relate to a professional nursing practice standard if passed? If not passed? (Choose one standard from the ANA Scope and Standards of Practice textbook)
How might the bill impact your own nursing practice if passed? If not passed?
How might you communicate your concerns about or support for this bill to peers and legislators based on nursing practice, standards, or patient outcomes?
How might this bill impact your community if passed?

What is the patient’s medical problem? Is the problem acute? Chronic? Critical? Reversible? Emergent? Terminal? What are the goals of treatment? In what circumstances are medical treatments not indicated?

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Nursing Question

Consider the “Four Topics Approach” (or Four Box method) to ethical decision making on page 61, Table 2.1 in Butts (below). Apply this model to a challenging situation in your nursing career that required you to consider the ethical dimensions of the patient case and the role you played in providing care. Specifically apply and address the questions within each topic area as they pertain to your situation.

In your conclusion, discuss the impact of the Four Topics process. Did applying these principles shape your decision making in any way? Does this seem like a valid process for you to apply in your practice?

Your paper should be 1-2 pages. Adhere to APA formatting throughout, and cite any outside sources you may use.

Review the rubric for further information on how your assignment will be graded.

TABLE 2-1 Four Topics Method for Analysis of Clinical Ethics Cases

Medical Indications: The Principles of Beneficence and Nonmaleficence
1. What is the patient’s medical problem? Is the problem acute? Chronic? Critical? Reversible? Emergent? Terminal?

2. What are the goals of treatment?

3. In what circumstances are medical treatments not indicated?

4. What are the probabilities of success of various treatment options?

5. In sum, how can this patient be benefited by medical and nursing care, and how can harm be avoided?
Patient Preferences: The Principle of Respect for Autonomy
1. Has the patient been informed of benefits and risks, understood this information, and given consent?

2. Is the patient mentally capable and legally competent, and is there evidence of incapacity?

3. If mentally capable, what preferences about treatment is the patient stating?

4. If incapacitated, has the patient expressed prior preferences?

5. Who is the appropriate surrogate to make decisions for the incapacitated patient?

6. Is the patient unwilling or unable to cooperate with medical treatment? If so, why?
Quality of Life: The Principles of Beneficence and Nonmaleficence and Respect for Autonomy
1. What are the prospects, with or without treatment, for a return to normal life, and what physical, mental, and social deficits might the patient experience even if treatment succeeds?

2. On what grounds can anyone judge that some quality of life would be undesirable for a patient who cannot make or express such a judgment?

3. Are there biases that might prejudice the provider’s evaluation of the patient’s quality of life?

4. What ethical issues arise concerning improving or enhancing a patient’s quality of life?

5. Do quality-of-life assessments raise any questions regarding changes in treatment plans, such as forgoing life-sustaining treatment?

6. What are plans and rationale to forgo life-sustaining treatment?

7. What is the legal and ethical status of suicide?
Contextual Features: The Principles of Justice and Fairness
1. Are there professional, interprofessional, or business interests that might create conflicts of interest in the clinical treatment of patients?

2. Are there parties other than clinicians and patients, such as family members, who have an interest in clinical decisions?

3. What are the limits imposed on patient confidentiality by the legitimate interests of third parties?

4. Are there financial factors that create conflicts of interest in clinical decisions?

5. Are there problems of allocation of scarce health resources that might affect clinical decisions?

6. Are there religious issues that might influence clinical decisions?

7. What are the legal issues that might affect clinical decisions?

8. Are there considerations of clinical research and education that might affect clinical decisions?

9. Are there issues of public health and safety that affect clinical decisions?

10. Are there conflicts of interest within institutions and organizations (e.g., hospitals) that may affect clinical decisions and patient welfare?

Identify a clinical topic of concern that you think could benefit from a change of practice. Propose an independent nursing practice intervention as a change to current practice.

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Communication and Influence-the Power of Evidence

Carefully Read these Check-In Assignment Preparation Instructions prior to completing the Change Process PICOT questionnaire for grading.

Read through the Week 6 Assignment page in the Week 6 Module and reach out to your instructor with any questions.
Identify a clinical topic of concern that you think could benefit from a change of practice.
Propose an independent nursing practice intervention as a change to current practice.

Using the PICOT format develop each element of the PICOT (See Week 2 Illustration part of the lesson for a PICOT example from Nurse Daniel)
Avoid using topics that are broad or are not able to be implemented as an independent nursing intervention as a BSN nurse.

Write a three-page paper about a specific health belief system that is common to a population.

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Discussion essay

Write a three-page paper about a specific health belief system that is common to a population.

Include the origins of the health beliefs.
Discuss the health implications of the health beliefs (e.g., are they a potentially harmful?).
How will you integrate the health beliefs into your nursing care?

Describe whether or not conflict is constructive or destructive. How can good leadership affect the outcome of a conflict? What is the difference between problem resolution and negotiation and under what circumstances would you use one or the other?

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Research Paper assignment: Conflict.

Answer the following questions in your paper.
Describe whether or not conflict is constructive or destructive.
How can good leadership affect the outcome of a conflict?
What is the difference between problem resolution and negotiation and under what circumstances would you use one or the other?

Describe a communication style you used in a recent professional interaction. Describe the interaction and why you used that style. Was this style effective for the interaction?

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Effective Communication

Instructions:
After reading chapter 9 in your textbook,

Describe a communication style you used in a recent professional interaction.
Describe the interaction and why you used that style.
Was this style effective for the interaction?
Additionally, describe one barrier to effective communication you would most like to improve in yourself.

Response suggestions:

Offer suggestions in communication described by your classmates based on your experiences and readings
Responses need to address all components of the question, demonstrate critical thinking and analysis and include peer-reviewed journal evidence to support the student’s position.

Discuss clinical manifestations associated with the disease process, including the relationships between the pathophysiologic processes and the clinical manifestations. (How do the clinical manifestations occur?).

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Pulmonary Alteration

The purpose of this assignment is to explore the function of the pulmonary system and the pathophysiology of pulmonary disorders. Prepare a three-page paper. Utilize at least five scholarly and current references to support your writing.

  • Chronic obstructive pulmonary disease—chronic bronchitis
  • Discuss clinical manifestations associated with the disease process, including the relationships between the pathophysiologic processes and the clinical manifestations. (How do the clinical manifestations occur?)
  • Explain the clinical implications for an individual with the disorder.