List specific pharmacotherapeutic treatment goals for L. P. Should the CNP order any labs for L. P. at this time? Why?

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L. P., age 23, is a Hispanic woman who graduated from college last year. She reports to the CNP in her local community mental health center. She began working as an accountant 1 month after graduating. Approximately 2 months ago, she moved into a two-bedroom apartment with another woman who works at the same accounting firm. She states that her roommate recommended that she see a doctor to find out if she has anemia or “some sort of fatigue syndrome.” She states that she has felt “restless” and “on edge” for most of the past 9 months. She becomes easily fatigued and irritable and has difficulty concentrating and falling asleep. She states that sometimes her mind “just goes blank,” and she is worried that her work performance is no longer excellent. She reports that all her life she had good grades in school and was very successful in everything she attempted. Although she has been “a worrier from the day I was born,” now she worries more than she ever has and feels nervous “all the time.” L. P. reports that she has a good relationship with her boyfriend, but they do not get to see each other very often because he is attending graduate school 100 miles away. She reports having a satisfying sexual relationship with him. She denies having any problems with relationships with her parents, roommate, or peers. She denies having any financial worries unless she is fired from her job for poor work performance. She reports that she has always been healthy and has taken good care of herself. The only medication she takes is birth control pills, which she has taken for the past 4 years without any adverse effects.

What is L. P.’s likely diagnosis?
List specific pharmacotherapeutic treatment goals for L. P.
Should the CNP order any labs for L. P. at this time? Why?
What drug therapy would the CNP likely prescribe? Why?
What are the parameters for monitoring the success of the therapy?
Describe specific patient monitoring based on the prescribed therapy.
List one or two adverse reactions for the selected agent that would cause the CNP to change therapy.
L. P. returns to see the CNP after six weeks, complaining of still feeling anxious and had heard of a medication called Klonopin that she would like to try; how should the CNP respond to her request?
What health promotion activities should be recommended for this patient?
What is L. P.’s long-term prognosis?

Discuss specific patient education you would provide to J. T.’s parents based on the prescribed therapy.

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J. T., who is a Native American male, age 8, is always interrupting his teacher, jumping out of his seat in class, fidgeting relentlessly, and butting into other children’s games. At home, he runs around recklessly and is uncontrollable. His mother comes to the CNP in the Pediatric Clinic and wonders why he will not listen. She is concerned because his grades at school are dropping. After medical evaluation, you find nothing wrong with J. T. physically, and he is taking no other medications. Through questioning, you determine that he has trouble concentrating on his homework, often forgets he has homework, loses pieces of games frequently, and hates to sit and read. His mother is unsure of the time frame over which these behaviors developed, but she thinks it has been since her second child was born 5 years ago. While in your office, J. T. did not seem to be hyperactive or inattentive, but you notice he is easily distracted by people passing in the hallway because the door is slightly ajar.

Diagnosis: Attention-Deficit Hyperactive Disorder (ADHD)

Discuss specific goals for pharmacotherapy for treating J. T.’s ADHD.
Discuss the first-line drug therapy for J. T., and why.
Discuss monitoring parameters you would institute for J. T.’s parents and his teachers.
Discuss specific patient education you would provide to J. T.’s parents based on the prescribed therapy.

Describe and discuss your plan of care for this patient with both short-term and long-term plans considering current social supports and health-care access.

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Marisol Arroyo, age 23 y.o., and unmarried, accompanies her mother, Julia, who is a 68 y.o., divorced Latina female, to her appointment with her primary care Nurse Practitioner. Both Marisol and her mother, who live together, have noted that her ever-present forgetfulness seems to be worsening. Just yesterday she walked to the corner store for a few items, which she obtained, but even though she had been to this store many times over the years, she found herself unable to get home without directions. Marisol also notes that her mother’s hygiene is changing, that she is becoming more and more quarrelsome, and that she forgets information she had been told as little as 10 minutes earlier. The Nurse Practitioner is attempting to rule out whether this patient may have some form of dementia or delirium.

In this discussion:
1.Describe and discuss the unique pathophysiology of Dementia of the Alzheimer’s Type.
2.If this patient is diagnosed with Alzheimer’s dementia, describe and discuss with your colleagues a potential clinical course, and prognosis for her.
3.Describe and discuss your plan of care for this patient with both short-term and long-term plans considering current social supports and health-care access.

Include citations from the text or the external literature in your discussion posts.

APA 7

What is a medical home? Pay for performance? How do these relate to reimbursement for APNs?

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What is a medical home? Pay for performance? How do these relate to reimbursement for APNs?

Create a visual representation of your model using a graphic organizer of your choice (flow chart, concept map, etc.).

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Research the various change models used by organizations today. After assessing these models, create a change model conducive to your field, and that will work within your organization’s culture. This model should serve to implement a strategic process that can help your organization integrate a change and respond to the internal or external driving forces that affect organizational success.

Create a visual representation of your model using a graphic organizer of your choice (flow chart, concept map, etc.). The design of your model will be unique and relevant to your organization, based on a critical analysis of its culture and behavior. However, your model must demonstrate the necessary steps for realistic implementation. Your model will be assessed on the quality of strategic implementation you design, the support you present for your model, and inclusion of the following concepts:

Methods to evaluate the need for change
Approach and criteria for choosing individuals or teams necessary for a change initiative
Communication strategies
Strategies to gather stakeholder support and overcome resistance
Implementation strategies
Sustainability strategies
Once you have created your model, prepare a 15-20 slide PowerPoint presentation to present your model and demonstrate how this model is relevant to your organization and why it will work well within your organization’s culture. In conclusion, discuss why this model will lead to sustainable change when most change initiatives fail. You will utilize this change model for your final paper.

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

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

The name of my organization is Grady Hospital. The Change Initiative I would like you to use is Kotter’s eight step change initiative.

Critically analyse the care delivered to a patient you have nursed and the impact this care had on the achievement of Person Centred Outcomes.

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Utilising the Care Processes Construct of the McCormack and McCance Person Centred Framework (2010 or 2017), critically analyse the care delivered to a patient you have nursed and the impact this care had on the achievement of Person Centred Outcomes.

 

Explain the importance of ongoing curriculum evaluation, why it is important, and for whom it is important.

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Requirements
Consider curriculum evaluation and address the following:

Explain the importance of ongoing curriculum evaluation, why it is important, and for whom it is important.
List criteria that are important to consider in curriculum evaluation.
Explain how and why pilot testing can be used in curriculum evaluation.
Provide examples of both short-term and long-term curriculum evaluations for process improvement, and explain why are both types necessary to curriculum development.
Describe how to apply evidence-based nursing concepts, theories, and best practices to improve curriculum development.
Identify the appropriate accreditation body for a selected curriculum and describe appropriate accreditation evaluation criteria.
For example, a school of nursing might be accredited by CCNE or ACEN, whereas a hospital staff development program might be accredited by JCAHO, HFAP, or others. Use APA 7 edition

How does a nurse know what (if any) knowledge in a research study is usable for clinical practice?

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How does a nurse know what (if any) knowledge in a research study is usable for clinical practice? What would a critical thinker look for in the evidence before deciding to change? What influence do credibility and clinical significance have on your decisions to integrate research-based evidence into your practice?

Describe the effects of local, state, and federal policies or legislation on your nursing scope of practice, within the context of this problem.

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In a 5-7 page written assessment, define the patient, family, or population health problem that will be the focus of your capstone project. Choose one of these two topics:
**This topic is a family member, Megan, who has type1 diabetes, diagnosed at 7y/o and is now 23y/o** OR the topic can be Patient Safety Risks related to Nurse Burnout***
Instructions–Complete this assessment in two parts:
-Part 1
Define the patient, family, or population health problem that will be the focus of your capstone project. Assess the problem from a leadership, collaboration, communication, change management, and policy perspective and establish your evidence and research base to plan, implement, and share findings related to your project.
-Part 2
Connect with the patient, family, or group you’ll work with during your practicum. During this portion of your practicum, plan to spend at least 2 hours meeting with the patient, family, or group and, if desired, consulting with subject matter and industry experts of your choice. Use the Practicum Focus Sheet [PDF] provided for this assessment to guide your work and interpersonal interactION(attached).

Define a patient, family, or population health problem that’s relevant to your practice.
Summarize the problem you’ll explore.
Identify the patient, family, or group you intend to work with during your practicum.
Provide context, data, or information that substantiates the presence of the problem and its significance and relevance to the patient, family, or population.
Explain why this problem is relevant to your practice as a baccalaureate-prepared nurse.
Analyze evidence from peer-reviewed literature and professional sources that describes and guides nursing actions related to the patient, family, or population problem you’ve defined.
Note whether the authors provide supporting evidence from the literature that’s consistent with what you see in your nursing practice.
Explain how you would know if the data are unreliable.
Describe what the literature says about barriers to the implementation of evidence-based practice in addressing the problem you’ve defined.
Describe research that has tested the effectiveness of nursing standards and/or policies in improving patient, family, or population outcomes for this problem.
Describe current literature on the role of nurses in policy making to improve outcomes, prevent illness, and reduce hospital readmissions.
Describe what the literature says about a nursing theory or conceptual framework that might frame and guide your actions during your clinical practicum.
Explain how state board nursing practice standards and/or organizational or governmental policies could affect the patient, family, or population problem you’ve defined.
Describe research that has tested the effectiveness of these standards and/or policies in improving patient, family, or population outcomes for this problem.
Describe current literature on the role of nurses in policy making to improve outcomes, prevent illness, and reduce hospital readmissions.
Describe the effects of local, state, and federal policies or legislation on your nursing scope of practice, within the context of this problem.
Propose leadership strategies to improve outcomes, patient-centered care, and the patient experience related to the patient, family, or population problem you’ve defined.
Discuss research on the effectiveness of leadership strategies.
Define the role that you anticipate leadership must play in addressing the problem.
Describe collaboration and communication strategies that you anticipate will be needed to address the problem.
Describe the change management strategies that you anticipate will be required to address the problem.

Demonstrate a deep and systematic understanding of the fundamental principles of the sciences that underpin and are applied to nursing and health.

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Assignment task
You are required to write a 2,500-word essay at level 8 that offers a coherently articulated account that discusses case study (1) George that is in Scenario.

·        Students should critically discuss the case study exploring the bio/psycho/social aspect focussing on the Myocardial infarction.

.

The student will develop the ability to articulate a sound rationale supported by empirical evidence when referring to clinical nursing practices. The role of the nurse should be integrated and form an essential aspect of this assignment.

The assignment should address and cover the issues within learning outcomes LO1 – LO4 below.
This assignment has been designed to provide you with an opportunity to demonstrate your achievement of the following module learning outcomes:
LO 1 Demonstrate a deep and systematic understanding of the fundamental principles of the sciences that underpin and are applied to nursing and health.
LO 2 Demonstrate a conceptual understanding of health as a human experience, through analysis and discourse, mediated by the individual, social and global contexts.
LO 3 Comprehend professional values as they broaden their knowledge, understanding and experience of nursing, in accordance to the Directive 2005/36/European law
LO 4 Demonstrate a comprehensive and critical understanding of knowledge and its application in an alternative field of practice.
TASK REQUIREMENTS (The suggested structure of the essay) :
 

Ø  A personalised title should indicate YOUR FIELD OF NURSING (MENTAL HEALTH NURSING) and the focus of the reflection is Myocardial infarction.

Ø  Introduction (Approximately, 250-300 words) This will acknowledge the scenario you are addressing (but it should not repeat the scenario). Summarise the aspects (Myocardial infarction) of the case scenario you will be critically discussing.

Ø  Main body (Approximately 1,900-2,000 words*) In this you should consider how the bio/psycho/social aspects of the individual should be addressed with a focus on the physical health (Myocardial infarction). You should state what the challenges may be, and how you could ensure that all George needs are met. Must cover all the 4 Learning Outcomes (LO1 – LO4)

Ø  Conclusion and recommendations (Approximately, 250-300 words*) This should include a summary and an evaluation of your interventions plus a consideration of how this will influence your future practice.

Ø  Reference List
 
SCENARIO

(Note: Confidentiality is maintained by using pseudonyms, Nursing and Midwifery Council, 2019)

Please remember the suggested plan provided above when reading this.
 

George is 72 years of age. He has experienced very good health during his lifetime and keeps himself active in his garden. Over the last few years George has suffered with bouts of clinical depression since retirement and has seen his GP for antidepressant medication to help with this. George has always enjoyed a few glasses of beer at the pub with his friends. His wife worries about him as she thinks he loses track of how much he drinks. He has on occasions come home having drunk too much.

One evening, whilst watching television, George experiences a central pain in his chest. He reaches over and opens a packet of antacid tablets for his indigestion. Two hours later the pain is still there, and George decides to take himself to bed. Another hour passes and the pain continues, making George feel frightened. He gets up to call the doctor and falls to the floor. He is unrousable for a moment and then he opens his eyes and is aware of what is happening. George’s wife calls 999 and he is taken to the local Accident and Emergency department.

George is admitted to the coronary care unit with an inferior myocardial infarction. He is stabilised over three days and then is transferred to your medical ward.

George is extremely anxious about his situation. He has not been in hospital since he had glandular fever as a child. His wife says that he faints at the sight of blood. George is very worried about moving and tends to lie in bed when he can. Over the next few days his mental state appears to deteriorate. He becomes quite withdrawn, sleeps a lot, has a poor appetite and his wife is worried that his mood is low. He feels that his heart has been seriously damaged and he does not want to strain it at all. At times he wonders if life is worth living.

George makes good progress and is going to be discharged in 2 days’ time. His medication on discharge will be Aspirin, Simvastatin and Ramipril. He has agreed to participate in the cardiac rehabilitation programme.  However, his mood remains low and he still has symptoms of anxiety and clinical depression.
Referencing and research requirements
 

Please reference your work according to the Harvard style as defined in Cite Them Right Online (http://www.citethemrightonline.com). This information is also available in book form: Pears, R. and Shields, G. (2016) Cite them right: the essential reference guide. 10th edn. Basingstoke: Palgrave Macmillan. Copies are available via the university library.

Please ensure you have current and contemporary references and supporting evidence in your essay, for example, you will be expected to use a current and valid UK health care policy.

A minimum of 25 references is indicated although this is indicative and at academic level 8, students are expected to demonstrate a wide range of reading.

As this is an essay at level 8 academic writing, the sources need to be reliable and journal articles need to be peer reviewed and robust.
How your work will be assessed
Your work will be assessed on the extent to which it demonstrates your achievement of the stated learning outcomes for this assignment (see above) and against other key criteria, as defined in the University’s institutional grading descriptors. If it is appropriate to the format of your assignment and your subject area, a proportion of your marks will also depend upon your use of academic referencing conventions.

Ø  This assignment will be marked according to the grading descriptors for level 8. A copy of this grid can be found in the NS711 20S1 Assessment folder.

Ø  Presentation /10 (see below),

Ø  Text should be Ariel Font 12, left hand justified only and an additional line space between paragraphs.

Ø  The word count for this assignment is 2,500 words, excluding the reference list. Please note the University guidelines which stipulate that you may submit 10% over or under this word count 2,250-2,750 words. Word count excluding the reference list should be at the start of the assignment.

Ø  Write in an appropriately formal academic style, avoiding contractions (e.g., don’t, won’t, etc.) and informal or spoken forms of language.

Ø  Headings and sub-headings should be not be used.

Ø  Referencing (HARVARD REFERENCING) /15 (how you use the references and how you record them, aim at having more than one reference to support our arguments. It is insufficient merely to offer unsubstantiated assertion and discussion.  It is very important that your work is supported by authoritative and appropriate academic / professional reference material to demonstrate critical argument and indicate the breadth and depth of your reading / research.)

Ø Knowledge and understanding /15 (knowledge of the needs of the individual from the broadening perspective, that is, in considering the scenario, students need to consider the physical aspects – Myocardial infarction

Ø  Integrating academic learning with practice /15 (how you are using theory to support your arguments.)

Ø  Analysis /15 (whether or not you have considered more than one aspect of scenario and are their different perspectives.)

Ø  Synthesis and Evaluation /15 (This will be seen within the text, are you asking and answering appropriate questions that are based on the scenario.)

Ø  Independent Perspective /15 (This will mainly be seen in the conclusion, especially how this work will influence your future practice.

Ø  The assignment should comply with the University Confidentiality policy. Be sure not to identify any individual or organisation directly or by implication in your work (NMC, 2018). Equally, unless crucial to the argument and/or where the information is already in the public domain, refer to organisations only in the most general terms, e.g., an NHS trust.

 

 

Before you submit
 

·         Please use the provided checklist below to make sure you are ‘fit to submit’ your work

·         We recommend you use this checklist as soon as you get this assignment brief to help you plan your work

 

Fit to Submit:  Assignment Checklist
This brief assignment checklist is designed to help you avoid some of the most common mistakes students make in their coursework.

HAVE YOU READ THE ASSIGNMENT BRIEF?

IF NOT, DO IT NOW!

In it you will find details of the assessment task, word count, the assessment criteria your work is marked against, and the learning outcomes – the basis for the assessment strategy in each module.

Students often lose marks by forgetting some of the more straightforward elements of their assignments. We recommend that you “tick off” each of the points below as you prepare your work for submission. If you need any help, ask your tutor and / or visit https://bucks.ac.uk/students/academicadvice/assessment-and-examination

TICK

 

Have you read and understood the assessment criteria

Have you met the learning outcomes? You will lose marks and your work may

even be failed if you have not.

Have you demonstrated you can think and write critically in the completed work? 

This means you have supported your arguments/explanations appropriately e.g.

using relevant academic sources and you have offered discussion points which

extends your own or others’ viewpoints to make reasoned conclusions /

judgements.

Have you maintained an academic tone throughout your work? Is your work formal,

focused, developed and clear?

 

Have you checked that the referencing in your assignment is in line with your

programme requirements?

Have you proof-read your work and used spellcheck software to check your spelling

and grammar?

Have you checked the presentation of your work is as specified by your tutor, for

example, are font size, colour, style, line spacing and margins as the tutor

specified?

Have you kept to the word count (or equivalent)? If you are not sure, check with your

   tutor.

 

Can you confirm that the work submitted is your own and not plagiarised?