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This competency assessment assesses the following Outcome(s):
MN506M1-1: Apply theoretical frameworks and concepts to ethical dilemmas in the advanced practice role.
Assessment Guidelines:
Based on your specialization, use the options below to create an ethical and legal decision-making dilemma involving an advanced practice nurse in the field of administration, education, or a nurse practitioner.
Apply relevant codes of conduct that apply to nursing and the chosen field of the APN.
Describe one ethical principle and one law that could be violated and whether the violation would constitute a civil or criminal act based on facts.
Construct a decision that demonstrates integrity, and that would prevent violation of the ethical principle and prevent the law from being violated.
List three recommendations that will resolve advanced practice nurses’ moral distress in the dilemma you have presented. Support your paper with a minimum of three scholarly references.
Minimum Submission Requirements
All competency criteria must be met to earn a B grade and pass this Course Outcome.
A predefined number of mastery criteria must be met to earn an A grade, indicating mastery of the Course Outcome. See the CLA and Grade Criteria Chart below.
METNOT YET METEthical-Legal Dilemma Competency Creates an ethical legal decision-making dilemma involving an advanced practice nurse. Mastery Ethical Legal decision-making dilemma has sufficient details, addresses the relevant field of the APN, and demonstrates critical thinking. Codes of Conduct Competency Applies relevant codes of conduct that apply to the practice of nursing and your chosen field. Mastery All codes of conduct are identified, all codes of conduct identified are relevant to the chosen APN field. Ethical Principles and Laws Competency Describes one ethical principle and one law that could be violated and whether the violation would constitute a civil or criminal act based on facts. Mastery Describes one ethical principle and one law that could be violated. Identifies correctly if the violation would constitute a civil or criminal act based on facts. Decision Integrity Competency Constructs a decision that demonstrates integrity and that would prevent violation of the ethical principle, and prevent the law from being violated. Lists three recommendations that will resolve advanced practice nurses’ moral distress in the proposed dilemma. Mastery Describes three or more recommendations that will resolve advanced practice nurses’ moral distress in the dilemma presented. All recommendations are pertinent to the APN specialty area. Total Competency Criteria: Total Mastery Criteria:*Not Yet Competent grades convert to an F at term end
*If work submitted for this competency assessment does not meet the minimum submission requirements, it will be returned for revision without being scored. If the work submitted does not meet the minimum submission requirements by the end of the term you will receive a failing score.
Ethical dilemmas are common in healthcare settings. Advanced practice nurses use their advanced nursing knowledge, skill, and judgement to solve ethical dilemmas and provide quality and safe care in primary care settings. Nursing codes of conduct and ethical principles guide nursing practice. Breaking some of these codes and principles may amount to criminal charges; thus, nurses pay hefty fines, lose licenses or serve some time in jail. This essay analyzes an ethical dilemma, nursing code of conduct, ethical decision-making, and recommendations to avoid moral distress.
Ms. Terry, a 16-year-old Hispanic American, comes to the outpatient department accompanied by her furious and fuming mother. She presents complains of lower abdominal pains, and the mother interjects care and claims that she suspects that her daughter is pregnant. The nurse requests Terry’s mother to go to the waiting room, to which she agrees after making demands that she should know all details about her condition. Inside the nurse’s room, Terry confirms that she has been involved in unsafe sex lately but uses a long-term family planning method, hormonal implants, which her mother does not know. She also asks the nurse not to share the information with the mother. She also adds that she feels pain in micturition has vagina discharge with a foul odor. On comprehensive assessment, the doctor diagnoses her with chlamydia and confides with the nurse to provide the best care to the patient. The nurse is torn between sharing this information with the parent because she is a minor or withholding it.
There are several codes of conduct that guide nursing practice. Some of the relevant codes of conduct are a) Nurses maintain public confidence in the nursing profession, b) Nurses act with integrity to maintain patients’ trust, and c) Nurses maintain patients’ trust by providing safe and competent care (Cowin et al., 2019). Nurses use their knowledge, skills, and judgment in assessing patient needs. They are also responsible for upholding relevant laws and regulations regarding patient care. Maintaining patient privacy and confidentiality is paramount. Failure to fulfill these requirements have criminal/law implications. Nurses act promptly to protect and prevent patient harm. These actions include failure to share patients’ information inappropriately. Nurses should understand that they are responsible for their actions. They are also responsible for their health and should take corrective measures when they perceive that the health problems will affect their ability to provide safe and quality patient care (Gágyor et al., 2019). Lastly, nurses should communicate clearly and detail the care interventions and discuss them with their patients.
Confidentiality is an ethical principle that could be violated in this situation. The patient confided in the nurse and doctor. Being a minor, her mother demanded to know everything about her care. Confidentiality breaches can be acceptable in some instances, especially when withholding that information can cause severe harm to patients and others (Pathak & Chou, 2019). However, confidentiality is considered a criminal offense when it causes adverse effects on a patient’s health or safety. Minors have a right to confidentiality (though limited by their dependence on and the involvement of their parents in their care) (Pathak & Chou, 2019).
On the contrary, hospitals, in some instances, can be sued in courts of law for concealing information to prevent disclosure of the information under the Data Protection Act of 2018 section 173 (Price & Cohen, 2019). Healthcare institutions can also be sued for disclosing information that jeopardizes patient safety under the same act. However, care providers should ensure they provide data that does not jeopardize the client’s or institution’s safety.
Most states, including this state, say that when adolescents are old enough and give instructions regarding sharing their information, it is regarded as confidential. In this situation, the best decision is to determine the administrative laws and policies if they conform to the state provisions and make a judgment based on those policies (Rainer et al., 2018). This situation involves severe risk to the nurses’ job and their licenses. Thus, there is a need to ensure the institutional and state laws allow confining of the health information.
The national association of clinical nurse specialists (NACNS) recognizes that nurse specialists face many ethical dilemmas in ethical dilemmas. These recommendations for moral distress are derived from the 4Rs moral distress strategy. The first recommendation is for the nurse to determine the severity, possible consequences of various actions, and attitudes of everyone (Shukla et al., 2019). This step helps the APN to make the right decision and avoid distress. The next recommendation is detaching personal feelings, views, and experiences from the situation. This step helps prevent stress bias in decision-making. The last recommendation is staying open to other people’s opinions and approaches and accepting their perceptions (Shukla et al., 2019). The FNP can include the interprofessional team in decision-making to ensure they make the best decision to minimize moral distress associated with ethical dilemmas.
Adolescents in the US are not protected by the laws in the confidentiality of their information. However, some state laws protect their information, as seen above. FNPs should understand laws and regulations that regulate nursing practice and certain ethical dilemmas. These laws help avoid law violations that could jeopardize their practice. They should also intentionally enhance their psychological health to ensure moral distress does not affect their practice.
Cowin, L. S., Riley, T. K., Heiler, J., & Gregory, L. R. (2019). The relevance of nurses and midwives code of conduct in Australia. International Nursing Review, 66(3), 320-328. https://doi.org/10.1111/inr.12534
Gágyor, I., Heßling, A., Heim, S., Frewer, A., Nauck, F., & Himmel, W. (2019). Ethical challenges in primary care: a focus group study with general practitioners, nurses and informal caregivers. Family Practice, 36(2), 225-230. https://dx.doi.org/10.1093/fampra/cmy060
Pathak, P. R., & Chou, A. (2019). Confidential care for adolescents in the US Health Care System. Journal Of Patient-Centered Research And Reviews, 6(1), 46. https://dx.doi.org/10.17294/2330-0698.1656
Price, W. N., & Cohen, I. G. (2019). Privacy in the age of medical big data. Nature Medicine, 25(1), 37-43. https://doi.org/10.1038/s41591-018-0272-7
Rainer, J., Schneider, J. K., & Lorenz, R. A. (2018). Ethical dilemmas in nursing: An integrative review. Journal of Clinical Nursing, 27(19-20), 3446-3461. https://doi.org/10.1111/jocn.14542
Shukla, R., Baker, R., Moody, K., & Allen, J. (2019). Improving Moral Distress and Provider Perceptions with an Integrated Palliative Care Conference in the Neonatal Intensive Care Unit (NICU)(TH370B). Journal of Pain and Symptom Management, 57(2), 394-395. https://doi.org/10.1016/j.jpainsymman.2018.12.092
This competency assessment assesses the following Outcome(s):
MN506M2-2: Analyze ethical-legal principles and dilemmas related to health care.
Using the information from the case study (below), discuss the following issues from the perspective of an APN role:
Standards of care — Which standards of care were violated and who was responsible?
In your role as an educator, administrator, or practitioner, what risk management steps should be taken before or after the incident to alleviate the issue?
Case Study: Malpractice Action Brought by Yolanda Pinellas
Yolanda Pinellas is a 21-year-old female student studying to be a music conductor. She was admitted for chemotherapy. The medication Mitomycin was administered by intravenous infusion through an infusion pump.
During the evening shift, the infusion pump began to beep. The RN found that the IV was dislodged, discontinued the infusion, notified the physician, and provided care to the infusion site. The patient testified that a nurse came in and pressed some buttons, and the pump stopped beeping. She was groggy and not sure who the nurse was or what was done. The documentation in the medical record indicates that there was an IV infiltration.
Two weeks after the event, the patient developed necrosis of the hand, required multiple surgical procedures, skin grafting, and reconstruction. She had permanent loss of function and deformity in her third, fourth, and fifth fingers. The patient alleges that she is no longer able to perform as a musical conductor because of this.
While reviewing charts, the risk manager noted that there were short-staffing issues during the 3 months prior to this incident, and many nurses were working double shifts (evenings and nights) then coming back to work the evening shift again. The risk manager also noted a pattern of using float nurses among several units.
Assessment Requirements:
Before finalizing your work, you should:
Your writing assessment should:
Minimum Submission Requirements.
All competency criteria must be met to earn a B grade and pass this Course Outcome.
A predefined number of mastery criteria must be met to earn an A grade, indicating mastery of the Course Outcome. See the CLA and Grade Criteria Chart below.
METNOT YET METRole of the APN Competency Identifies the role of the APN, content of paper pertains to the identified role. Identifies all standards of care violations pertaining to the identified APN role (administrator, practitioner, or educator). Clearly identifies who violated the standards of care, and how the standards of care were violated. Mastery The individuals responsible for the violations were identified. Each individual’s standards of care violation is described, including how the violation happened. Risk Management Steps Before Competency Identifies risk management steps relevant to the APN role (Administrator, Practitioner, or Educator) before event to prevent such adverse events. Mastery All risk management measures described are relevant to the APN role identified. Risk Management Steps After Competency Identifies risk management steps to be taken that are relevant to the APN role (Administrator, Practitioner, or Educator) after event to prevent future adverse events. Mastery All risk management steps described are relevant to the APN role identified. Total Competency Criteria: Total Mastery Criteria:*Not Yet Competent grades convert to an F at term end
*If work submitted for this competency assessment does not meet the minimum submission requirements, it will be returned for revision without being scored. If the work submitted does not meet the minimum submission requirements by the end of the term you will receive a failing score.
his competency assessment assesses the following Outcome(s):
MN506M3-3: Analyze the effects of contemporary health policy on providers and consumers.
For this assessment, select a local or state health care policy or legislation that was enacted in the last 5 years. Then:
To view the Grading Rubric for this assessment, please visit the Grading Rubrics section of the Course Resources.
Assessment Requirements:
Before finalizing your work, you should:
Your writing Assessment should:
How to Submit:
Submit your assessment to the unit Dropbox before midnight on the last day of the unit.
Minimum Submission Requirements
All competency criteria must be met to earn a B grade and pass this Course Outcome.
A predefined number of mastery criteria must be met to earn an A grade, indicating mastery of the Course Outcome. See the CLA and Grade Criteria Chart below.
METNOT YET METPolicy Identification & Summary Competency Identifies a healthcare policy/legislation, names the policy/legislation and the date of implementation, identifies the state, county or local area pertaining to the policy. Summarizes policy/legislation, all relevant facts are included, and the role of the APN is integrated throughout the paper. Analyzes one strength and one weakness of the policy/legislation. Mastery Identifies and analyzes one strength and one weakness of the policy/legislation. The strength and weakness identified are significant and has major impact on the providers and consumers. Policy Impact on Consumer Stakeholders Competency Discusses impact of policy on all consumer stakeholders. Mastery All the consumer stakeholders are identified, positive and negative impacts are discussed. Policy Impact on Provider Stakeholders Competency Discusses impact of policy on all provider stakeholders. Mastery All the provider stakeholders are identified, positive and negative impacts are discussed. Total Competency Criteria: Total Mastery Criteria:*Not Yet Competent grades convert to an F at term end
*If work submitted for this competency assessment does not meet the minimum submission requirements, it will be returned for revision without being scored. If the work submitted does not meet the minimum submission requirements by the end of the term you will receive a failing score.
Healthcare institutions function under laws, policies, and regulations. These policies and regulations are dynamic and keep changing with changing demands to meet the consumer and provider needs. They also ensure that all individuals receive care with maximum benefit. Advanced practice nurses should be aware of these regulations to implement them in their practice. When these policies arise, they affect consumers and care providers differently. Legislations are statutory laws put in place by the governing body or bodies. This essay discusses recent local/state healthcare legislation and its implications.
Falls are unplanned events that can be prevented because the major causes of falls are environmental factors such as poor lighting, lack of handrails, slippery floors, present obstacles, and high staircases; thus, individuals are unable to climb safely (Kiel et al., 2019). Falls, especially among elderly individuals, have increased lately, provoking the state governments to develop legislation and policies t
This Competency Assessment assesses the following outcome(s): MN507-1: Examine U.S. healthcare policy structures and the role of the nursing leader as a change agent at the public policy table.
Directions
You will decide on a policy issue that needs to be addressed. You may choose a policy issue that interests you. Below are suggested topics for proposed policy change, however if you wish to address another topic please contact your instructor for approval:
You will write a letter using professional business format to one of your Federal legislators outlining what the issue is and why it is important. The letter will address:
Assignment Requirements
Before finalizing your work, you should:
Your writing Assignment should:
Submit your Assignment to the Competency Assessment Dropbox.
Minimum Submission Requirements
If work submitted for this Competency Assessment does not meet the minimum submission requirements, it will be returned without being scored.
CRITERIAMETNOT METCurrent Policy Structure [Current policy structure is discussed, including any relevant historical information about the policy.] Need for Policy Change [Need for policy change is discussed, including specific rationale for change.] Suggested Policy Change [Suggested policy change is discussed, including information about the characteristics of the change that differ from the current policy structure.] Cost Implications if Change Is Implemented [Cost implications are discussed, including both monetary and other potential costs as applicable.] Role of the Nurse as a Change Agent at the Policy Table [Role of the nurse as a change agent at the policy table is discussed, including actions that the nurse can take to influence policy-makers.] Overall # Bold Criteria Met/Not Met [Overall # Mastery Criteria Met/Not Met]The criterion statements in bold are the minimum requirement to show competent performance on the course outcome; all bold criteria must be met to pass this Course Outcome.
The criterion statements in [Brackets] represent mastery achievement. A predefined number of mastery criteria must be achieved to earn an A grade, indicating mastery of the Course Outcome.
The Nursing Affairs Director
American Nurses Association
155 E 44th Street. New York, NY 10017
CC/BCC Block:
Change of Regulations on APRNs in the US States
Dear Sir:
This letter showcases the importance of changing the current policy frameworks regulating APRNs roles in certain states. The federal government lacks a clear framework regulating these important nursing roles (APRNs). The federal government leaves the duty to the state regulations, specifically the state board of nursing under the nursing practice act (NPA). Thus, some states such as Alaska, Arizona, and Colorado are full practice states that allow nurse practitioners to practice independently (Schorn et al., 2022). However, States such as California, Georgia, and Florida fully restrict APRN independent practice.
APRNs are important persons with advanced skills and knowledge. Their skills and expertise allow them to perform advanced roles such as diagnosing and treating conditions within their practice scope. Independent practice allows these individuals to open their clinics and hospitals, bringing these skills closer to the communities and availing advanced care (Ortiz et al., 2018). There is a need to remove the practicing restrictions to utilize their skills to ensure better patient outcomes. It is also crucial to the APRNs’ personal and professional growth.
The proposed change is developing a federal policy that lifts restrictions on APRN and APN roles. The policy will decrease the restriction on these roles and promote their independent practice. Lifting the regulations will ensure these nurses exploit all their knowledge and skills because these restrictions underutilize their expertise and training (Neprash et al., 2021). Thus, it will improve their morale and job satisfaction and promote healthier communities. Therefore, the federal government should develop a policy instructing states to lift practice restrictions on APRNs and APNs.
The costs of implementing the proposed change will be minimal. Allowing APRNs independent practice will reduce the cost of absorbing all of these professionals in hospitals, decreasing healthcare spending. In addition, it will avail specialized services to the communities, further reducing healthcare costs.
As a change agent at the policy table, the nurse plays various roles. They play the advocacy role by ensuring fairness to their profession and the patients. They assess the patients, hospital, and professionals to determine areas of need and provide carefully collected and analyzed data to support their claims (Salvage & White, 2019). They also provide data to validate or refute various policies based on their relevance and merits to the patients. They are change management agents and promote the acceptance of policies in healthcare institutions among peers and other healthcare professionals. Thus, nurses’ involvement as change agents at the policy table is integral.
Sincerely,
Name
Nursing Officer
St. Claire Medical Center
Neprash, H. T., Smith, L. B., Sheridan, B., Moscovice, I., Prasad, S., & Kozhimannil, K. (2021). Nurse practitioner autonomy and complexity of care in rural primary care. Medical Care Research and Review, 78(6), 684-692. https://doi.org/10.1177/1077558720945913
Ortiz, J., Hofler, R., Bushy, A., Lin, Y. L., Khanijahani, A., & Bitney, A. (2018, June). Impact of nurse practitioner practice regulations on rural population health outcomes. In Healthcare (Vol. 6, No. 2, p. 65). Multidisciplinary Digital Publishing Institute. https://doi.org/10.3390/healthcare6020065
Salvage, J., & White, J. (2019). Nursing leadership and health policy: everybody’s business. International nursing review, 66(2), 147-150.
Schorn, M. N., Myers, C., Barroso, J., Hande, K., Hudson, T., Kim, J., & Kleinpell, R. (2022). Results of a National Survey: Ongoing Barriers to APRN Practice in the United States. Policy, Politics, & Nursing Practice, 15271544221076524. https://doi.org/10.1177/15271544221076524
This Competency Assessment assesses the following outcome(s):
MN507-2: Analyze financial models of reimbursement and their effects on patients and health care providers.
Directions
For this Assignment, you will distinguish between Medicare and Medicaid. Your paper must include the following topics:
The word count for your paper, excluding the title page and references page, will be 800–1200 words. You must include a minimum of (5) different scholarly references.
Assignment Requirements
Before finalizing your work, you should:
Your writing Assignment should:
Submit your Assignment to the Competency Assessment Dropbox.
Minimum Submission Requirements
If work submitted for this Competency Assessment does not meet the minimum submission requirements, it will be returned without being scored.
CRITERIAMETNOT METHistory of Medicare and Medicaid [History of Medicare and Medicaid are discussed, including the initial need that was identified for both programs.] Identification of Populations Served by Medicare and Medicaid [Populations served by Medicare and Medicaid are described, specifying which specific populations are applicable to both.] Status of Medicaid Expansion in Student’s Own State [Status of Medicaid expansion in student’s own state is discussed, including any relevant background information for this status.] Reasons That States Choose Not to Expand Medicaid [Reasons that states choose not to expand Medicaid are discussed, including potential financial implications to states.] Role of the Nurse When Interfacing With Medicare and Medicaid Patients [Role of the nurse when interfacing with Medicare and Medicaid patients specific to the student’s specialty track is discussed.] Overall # Bold Criteria Met/Not Met [Overall # Mastery Criteria Met/Not Met]The criterion statements in bold are the minimum requirement to show competent performance on the Course Outcome; all bold criteria must be met to pass this Course Outcome.
The criterion statements in [Brackets] represent mastery achievement. A predefined number of mastery criteria must be achieved to earn an A grade, indicating mastery of the Course Outcome.
This Competency Assessment assesses the following outcome(s):
MN507-3: Recommend Public Policy Options To Meet The Needs Of Various Stakeholders.
Directions:
For this Assignment, you will create a slide and audio presentation in which you will present information to support the passage of HR 5223. You may use PowerPoint, Google Slides, or another presentation software of your choosing. Your audio presentation should put forth a convincing argument based on your research and should be designed as if you were addressing a group of legislators whose support you are trying to obtain.
Your slide and audio presentation must address:
Assignment Requirements
Before finalizing your work, you should:
Your writing Assignment should:
Minimum Submission Requirements
If work submitted for this Competency Assessment does not meet the minimum submission requirements, it will be returned without being scored.
CRITERIAMETNOT METCurrent Risks That Healthcare Providers Face From Violence in the Workplace [Current risks that healthcare providers face from violence in the workplace are discussed, including risks to personal safety and identification of high-risk areas.] Information From Professional Nursing Associations That Support Minimizing the Risk of Workplace Violence [Information from professional nursing associations that support minimizing the risk of workplace violence is discussed, including its relevance to HR 5223.] Identification of a Theoretical or Regulatory Model That Would Be Applicable to the Passage of HR 5223 [Identification of a theoretical or regulatory model that would be applicable to the passage of HR 5223 is discussed, including its specific relevance to the bill.] Identification of Stakeholders Who Will Benefit From the Passage of HR 5223 [Identification of stakeholders who will benefit from the passage of HR 5223 is discussed, including how the bill will be relevant to them.] Analysis of How Stakeholders Will Benefit [How stakeholders previously identified will benefit is discussed on both a unit and facility level.] Potential Barriers to Passage of HR 5223 [Potential barriers to passage of HR 5223 and their sources are discussed.] How Barriers Can Be Overcome [How barriers described above can be overcome is discussed, including actions that the nurse can take.] Overall # Bold Criteria Met/Not Met [Overall # Mastery Criteria Met/Not Met]The criterion statements in bold are the minimum requirement to show competent performance on the Course Outcome; all bold criteria must be met to pass this Course Outcome.
The criterion statements in [Brackets] represent mastery achievement. A predefined number of mastery criteria must be achieved to earn an A grade, indicating mastery of the Course Outcome.
MN507M4
This Competency Assessment assesses the following outcome(s):
MN507-4: Synthesize the effect that healthcare reform has on stakeholders
Directions
For this Assignment, you will examine the stakeholders impacted by the implementation of the Affordable Care Act (ACA).
Your paper must include the following topics:
The word count for your paper, excluding the title page and references page, will be 800-1200 words. You must include a minimum of (5) different scholarly references.
Assignment Requirements
Before finalizing your work, you should:
Your writing Assignment should:
Submit your Assignment to the Competency Assessment Dropbox.
Minimum Submission Requirements
If work submitted for this Competency Assessment does not meet the minimum submission requirements, it will be returned without being scored.
CRITERIAMETNOT METDifferentiation Between at Least Three Groups of Stakeholders Impacted by the ACA [Differentiation between groups of stakeholders impacted by the ACA is discussed, specifically identifying each group and the similarities and differences between them as related to the ACA.] Financial Impact of the ACA on Each Group of Stakeholders [Financial impact of the ACA on the previously identified groups of stakeholders is discussed, including potential short- and long-term impacts.] Benefits of the ACA on Each Group of Stakeholders [Benefits of the ACA on groups of stakeholders is discussed, including any financial or other benefits as applicable.] Drawbacks of the ACA on Each Group of Stakeholders [Drawbacks of the ACA on groups of stakeholders are discussed, including financial or other drawbacks as applicable.] Overall # Bold Criteria Met/Not Met [Overall # Mastery Criteria Met/Not Met]The criterion statements in bold are the minimum requirement to show competent performance on the Course Outcome; all bold criteria must be met to pass this Course Outcome.
The criterion statements in [Brackets] represent mastery achievement. A predefined number of mastery criteria must be achieved to earn an A grade, indicating mastery of the Course Outcome.
The Accountable Care Act or the Obamacare is an act that has increased healthcare access for many US citizens and has dramatically addressed the gap in n healthcare access and healthcare coverage. The ACA is an act that was enacted in 2010 and was developed to increase access to healthcare insurance by providing subsidies to help lower premiums for individuals with low household incomes. Medicaid expansion is the primary development under the healthcare law reform. Medicaid raised the eligibility for the program to about 137% of the national poverty level and lifted restrictions on having dependents and pregnant mothers’ access to quality healthcare services (McKenna et al., 2018). The Act has various effects on different stakeholders, as shall be discussed in this essay.
The Act affects stakeholders differently. The primary aim was to increase access to healthcare services because financial barriers have been for long the most significant barriers to access quality healthcare services. ACA requires input from the state and federal governments (implementers), patients (consumers/ beneficiaries), and health care prov
Select one of the case studies below for your assignment. In your discussion, be sure to integrate your knowledge of advanced pathophysiology across the lifespan with the clinical implications for the advanced practice nurse
Case Study Assignment Requirements:
Case Study 3: Genetic and Congenital Disorders
Felicity is a very busy 29-year-old woman in a professional career. She has diabetes mellitus and is also pregnant for the first time. Because of her busy schedule, it was over 3 weeks after missing her menstrual cycle when she visited her family doctor to have the pregnancy confirmed. Felicity became very concerned when her physician asked if she had been taking folic acid. It was all Felicity could do to remember to manage her insulin levels, and taking folic acid supplements was something she had not even considered. Her doctor told her to take 600 ?g of folic acid daily and advised Felicity to return later for maternal serum marker testing.
Before finalizing your work, it is important to:
Pregnancy is a critical issue that requires individuals to manage the health of the mother and the unborn baby. Both have health issues, and some conditions or substances in the mother can be potentially lethal to the baby. According to the CDC, approximately 300,000 babies are born with neural tube defects globally. Van Gool et al. (2018) explain that each woman requires about 400 mcg of folic acid daily, and adequate levels of folic acid in the body help prevent neural tube defects. Folic acid fortified foods are the best interventions. Folic acid and neural tube defects, diabetes and tests in pregnancy, and vulnerability of fetus t teratogens are the focus of this essay.
Folic acid deficiency is a potentially harmful condition to the unborn baby. The most common congenital problem is neural tube defects such as anencephaly and spina bifida (Kallem et al., 2018). They occur when bones in the spinal code have developmental problems when they fail to develop or properly fuse, interfering with the integrity of the spinal cord and the brain. The mechanism is somewhat unclear. However, scientists claim that folic acid stimulates cellular methylation reactions preventing neural tube defects (van Gool et al., 2018). The absence of folic acid leads to slower methylation reactions, leading to incomplete bone formation and fusion hence disorders in the neural tube. However, the mechanism is still unclear, and more research is necessary to determine the mechanism and develop other methods of preventing neural tube defects.
Diabetes complicates pregnancy and can be an issue of concern in Felicity’s case. Reputable bodies such as the CDC and WHO have identified diabetes as a leading cause of congenital anomalies (Kallem et al., 2020). Diabetes leads to various complications in pregnancy, such as macrosomia babies, respiratory distress syndrome, preterm birth, and baby hypoglycemia soon after birth. Besides these complications, diabetes causes congenital disorders such as orofacial defects, heart disorders, limbs, spine, and vertebral malformations. Neural tube defects are significantly higher in diabetic mothers than in the general population.
Maternal serum marker testing is a standard test in pregnancy used to detect fetal disorders. Kagan et al. (2022) explain that serum marker tests are vital in detecting neural tube defects such as anencephaly and spina bifida, Down syndrome, Patau syndrome, Edwards syndrome, and other congenital anomalies. The test is vital in decision-making regarding pregnancy and for corrective actions. The first benefit of the test is to prepare the mother for the baby psychologically. The mother learns of the baby’s health status, arrays fears, and prepares to live with a child (Kagan et al., 2022). Giving birth to children with congenital disorders can be challenging, but informing the mother increases preparatory actions for proper coping.
Serum marker tests also enable the healthcare provider and the parents to take corrective actions. In many instances, healthcare providers perform surgeries on babies before they’re born to correct anomalies such as Spinal Bifida (Kagan et al., 2022). The corrections give babies a better chance at life and significantly improve their quality of life. The serum maker test also allows healthcare providers and patients to make life decisions. For example, these parties may decide to terminate children with severe anomalies such as anencephaly. Such decisions are made when letting the babies survive to term does not change the health or state of the unborn baby. Maternal Serum marker testing is a non-invasive procedure that other contemporary tests should accompany to make a definitive diagnosis (Kagan et al., 2022).
Monitoring the fetus’s weight is integral for all diabetic mothers. According to the CDC, most diabetic women give birth to macrosomia babies, and the situation is worsened by poor glycemic control. HbA1c tests are essential for this client, in addition to routine random and fasting blood sugars for prompt management (Kallem et al., 2020). The intention is to ensure the levels remain within the normal range or below 6.5% as much as possible. Other tests in the first trimester are ultrasounds to determine nuchal translucency and nasal bone determination. An ultrasound is used to detect the fetal structure, location, and abnormalities of the pelvis and the reproductive organs (Kagan et al., 2022). Ultrasounds and serum markers are used to countercheck miscalculated dates.
Unborn babies are most vulnerable to teratogens in the first trimester, specifically from 4-8 weeks after concepts. During this period, the body systems usually form; hence it is easy to distort normal development processes. Organogenesis is a crucial stage in which the systems undergo programmed development, and many teratogens in this stage affect the development of organs (CDC, 2020). The heart begins to develop at around 3-4 weeks, and teratogens at this time can prevent its development or leads to congenital disorders such as transposition of great vessels and coarctation of the aorta (CDC, 2020). Teratogens that interfere with the development of vital organs, including the liver, brain, and heart, may not survive and suffer intrauterine fetal death.
Amelia can also result from teratogens for four weeks. Organs like the lungs system and the brain develop but mature progressively. The baby cannot produce enough surfactant until about 26 weeks gestation hence the need (Kaleelullah & Garugula, 2021). Surfactant leads to lung maturity before birth. Preterm delivery requires hastening the process to prevent the baby from developing respiratory distress syndrome from alveoli collapse. Teratogens in the first trimester, especially in organogenesis, can cause many congenital disorders, including failure of organs to develop.
According to the world health organization, many medications used to prevent nausea and vomiting (such as thalidomide) profound in this stage were found to cause the most congenital anomalies. Other drugs, such as Diethylstilbestrol, used to prevent miscarriage, were identified as potentially teratogenic (Kaleelullah & Garugula, 2021). In the second and third trimesters, teratogens find already developed organs and organ systems and can hardly affect the structure. Muacevic et al. (2021) explain that teratogens can potentially affect the integrity of organs and organ systems, prevent further development and maturity, and even cause the malfunction of already formed organs. Thus, the baby is most vulnerable to teratogens in the first trimester, between 4 and 8 weeks. The mother is most vulnerable at this stage hence the need to ensure they have enough stores of vital minerals such as folic acid and Vitamin E. They should also be reviewed to ensure they are not taking potentially teratogenic drugs.
Folic acid deficiency and diabetes are leading risk factors for congenital anomalies. Folic acid supplementation and proper diabetes management are essential interventions in preventing congenital disorders such as neural tube defects and down syndrome.
Center for Disease Control and Prevention (CDC), (2021). Congenital Anomalies of the Nervous System. Birth Defects Surveillance Toolkit. https://www.cdc.gov/ncbddd/birthdefects/surveillancemanual/index.html
Kagan, K. O., Sonek, J., & Kozlowski, P. (2022). Antenatal screening for chromosomal abnormalities. Archives of Gynecology and Obstetrics, 1-11. https://doi.org/10.1007/s00404-022-06477-5
Kaleelullah, R. A., & Garugula, N. (2021). Teratogenic Genesis in Fetal Malformations. Cureus, 13(2). https://doi.org/10.7759/cureus.13149
Kallem, V. R., Pandita, A., & Pillai, A. (2020). Infant of diabetic mother: what one needs to know? The Journal of Maternal-Fetal & Neonatal Medicine, 33(3), 482-492. https://doi.org/10.1080/14767058.2018.1494710
Muacevic, A., Adler, J., Kaleelullah, R., & Garugula, N. (2021). Teratogenic Genesis in Fetal Malformations. Cureus, 13(2). https://doi.org/10.7759/cureus.13149
van Gool, J. D., Hirche, H., Lax, H., & De Schaepdrijver, L. (2018). Folic acid and primary prevention of neural tube defects: A review. Reproductive Toxicology, 80, 73-84. https://doi.org/10.1016/j.reprotox.2018.05.004
Select one of the case studies below for your assignment. In your discussion, be sure to apply knowledge of the physiologic alterations in bodily systems in response to disease processes
Case Study Assignment Requirements
Case Study 4: Disorders of Blood Flow and Blood Pressure Regulation
Deborah is 56 years old, smokes a half a pack of cigarettes a day, and is overweight. Her friend wants her to come to a local women’s fitness class she attends once a week. She knows Deborah’s dad had died of an acute myocardial infarction when he was 56, and she fears, seeing Deborah’s lifestyle, the same fate awaits her friend. What she did not know was that Deborah had also been to her doctor for her annual physical where she was told her LDLs were 180 mg/dL, HDLs were 36 mg/dL, and cholesterol was 239 mg/dL.
Before finalizing your work, it is important to:
Select one of the case studies below for your assignment. In your discussion, be sure to evaluate the presence and effects of alterations in the homeostatic state secondary to gender, genetic, ethnic, and temporal variables.
Case Study Assignment Requirements
Case Study 2: Respiratory Tract Infections, Neoplasms, and Childhood Disorders
Patricia was called at work by a woman at the local day care center. She told Patricia to come and pick up her son because he was not feeling well. Her son, 3½-year-old Marshall, had been feeling tired and achy when he woke up. While at daycare, his cheeks had become red, and he was warm to touch. He did not want to play with his friends, and by the time Patricia arrived, he was crying. Later that afternoon, Marshall’s condition worsened. He had fever, chills, a sore throat, runny nose, and a dry hacking cough. Suspecting Marshall had influenza, Patricia wrapped him up and took him to the community health care clinic.
Before finalizing your work, it is important to:
Select one of the case studies below for your assignment. In your discussion, be sure to discuss developing collaborative relationships with clients when teaching concepts concerning pathological states to individuals and families.
Case Study Assignment Requirements
Case Study 5: Disorders of Endocrine Control of Growth and Metabolism
Bertha is a 71-year-old woman who takes daily medication for Hashimoto thyroiditis. Last winter, she developed pneumonia. Although she did her best to run errands for her husband, she became tired easily and needed to rest frequently. One day, after shoveling the snow outside, her husband came inside to find Bertha lying on the sofa covered in blankets. Her face appeared puffy and her eyelids hung. When he spoke to her, Bertha’s voice was hoarse and her words did not make sense to him. Her respirations were also shallow and slow. Suspecting low thyroid hormone levels were causing the signs, her husband called for an ambulance.
Before finalizing your work, it is important to:
Unit 2 Assignment Directions
Choose one prescription drug that has a generic available (the pharmacy MUST sell both the generic and the brand of the chosen drug) and one over-the-counter (OTC) drug you would be likely to recommend to patients. Next locate one pharmacy from each of the four different types listed below:
Do not use any drugs on the pharmacy’s four dollar or other special price list. If the pharmacy has a “club card,” coupons or other special way of getting lower cost, do not use this cost. The cost you are examining is the “cash price” for uninsured patients.
Compare the cash cost of the brand and the generic of the prescription drug, and the OTC drug brand and generic making sure that the dose (milligrams, micrograms, etc.), form (caps, tablets, etc.), and number of pills are the same. (Example: Synthroid .05 milligrams and levothyroxine .05 milligrams, prescription for 30 pills. Tylenol 500 mg. and Acetaminophen 500mg, 100 gel caps.)
Include the city and state of the pharmacies.
Submission
The assignment can be in any form you choose including narrative, table, etc. No cover page or reference page is required. Here is a sample table:
Cash Price at Pharmacy A AddressCash Price at Pharmacy B AddressCash Price at Pharmacy C AddressCash Price at Pharmacy D AddressBrand name Rx Generic RX OTC Brand OTC GenericTo view the Grading Rubric for this Assignment, please visit the Grading Rubrics submodule under Course Resources.
Assignment Requirements:
Before finalizing your work, you should:
Part 2 – paper – I page
Post your cost comparison document from Unit 2. Assuming you might prescribe this drug for your patient, how would you minimize cost or assist the patient in getting the medication at the lowest cost possible. What resources are available to reduce drug costs? Find at least 3 resources for free or reduced cost medications.
Also read: MN553 Unit 4 Assignment Case Study
Rubric Title: MN553 Unit 3 Assignment Rubric
Part 2
The US government uses trillions every year on prescription drugs. Medication costs may be significantly high for the uninsured, and there is a need to reduce costs, especially for the uninsured. King et al. (2019) state that coupon savings are a practical way of saving on drug costs. Pharmacies such as Walmart and Walgreens offer huge discounts for drugs, and these drugs can be sold for as low as four dollars. GoodRx is also a good coupon saving for prescription drugs and helps reduce drug costs significantly. However, the method is unreliable because it is inconsistent and unpredictable.
Rajkumar (2020) states that high drug costs mainly result from monopolies in drug production. The development of non-profit generic manufacturing companies owned by the state is a good strategy for reducing drug costs. Generic drugs are the preferred medication by most insurance plans, and they have significantly lower costs than the brand drugs (Rajkumar, 2020). Brand drugs are expensive, yet they contain similar components to generic drugs. The healthcare provider can prescribe generic medication to reduce costs. Drugs in the same class can have variable costs. Westerholf et al. (2022) note that different medications with similar efficacies can have different costs, and a healthcare provider can prescribe the cheaper drug to save on costs.
In addition, different pharmacies have different prices, as seen above. Some pharmacies have high prices, which can be almost twice that of others. Choosing a different pharmacy for the preferred drug is vital and can help save on costs (Rikhi, 2021). The process can be tiresome because drugs have different costs in different locations, even for the same store. For example, Kroger pharmacy has the cheapest acetaminophen drugs, and Target has the most affordable price for Tylenol. As a healthcare provider, guiding the patient to acquire the drug from the cheapest pharmacy is integral to reducing medication costs. A keen analysis is thus integral before prescribing drugs for uninsured patients. These methods discussed can help lower drug costs for uninsured patients. A healthcare provider can discuss with their patient to determine the best methods to use to reduce drug costs.
King, G. J., Chao, X., & Duenyas, I. (2019). Who benefits when prescription drug manufacturers offer copay coupons? Management Science, 65(8), 3758-3775. https://doi.org/10.1287/mnsc.2018.3123
Rajkumar, V. S. (2020). The high cost of prescription drugs: causes and solutions. Blood Cancer Journal, 10(6), 1-5. https://doi.org/10.1097/ACM.0000000000002604
Rikhi, R. (2019). Transparency of medication costs: A method of building patient trust. Academic Medicine, 94(5), 615. https://doi.org/10.1038/s41408-020-0338-x
Westerhof, L., Misher, A., & Fulbright, A., (2022). Pharmacist Strategies for Addressing Medication Cost Barriers to Equitable Health in Primary Care. Journal of the American College of Clinical Pharmacy. https://doi.org/10.1002/jac5.1648
Your patient is a 23-year-old female. She presents with coughing and wheezing which she stated started about three weeks ago. She is currently 25 weeks pregnant. Her last prenatal visit was one month ago in another state. She has an appointment with the prenatal care provider next week, however her respiratory symptoms brought her to your office today.
History – Chickenpox as a child. Asthma as a child, diagnosed at age 8 for which she used a SABA when needed. She has not had the need to use an inhaler since she was 19. She takes only her prenatal vitamin. No other acute or chronic problems. She advises you that she is up to date on all immunizations except she has not had a flu shot (it is October).
Social – Non-smoker, no drug use. She relocated to your state two weeks ago to get away from an abusive domestic situation. She has no support network in this area and has not yet found employment. She has no medical insurance.
HPA – Non-productive cough x 3 weeks. Wheezing audible from across the room. She states it is like this all day and wakes her from sleep every night. She reports that she is fatigued even in the morning. No other complaints.
PE/ROS – Pt appears disheveled but clean. Wheezing in all lung fields. T 98, P 82 regular, R 28 no stridor. FH 130 regular. The remainder of the exam is WNL.
02 98% and FEV 70%
Directions:
Healthcare providers face various challenges in diagnosing patients who come with different problems in the hospital. Nurses must perform a comprehensive assessment entailing detailed health history and physical examination for a definitive diagnosis. Some conditions have similar characteristics hence the need for careful review and consideration of differential diagnosis. More so, each disease has specific management depending on the cause and severity. Healthcare providers leverage both pharmacologic and non-pharmacologic treatment methods for better patient outcomes. This essay analyzes pharmacological and non-pharmacologic asthma management and community resources.
Wheezing is a persistent coarse whistling sound produced by the narrowed upper airways. It results from inflammation in the trachea or bronchi caused by allergic reactions, infections, or physical obstructions (such as a tumor or foreign body) of the larger upper airways. A diagnosis causing wheezing must thus be from an infectious or allergic cause causing swelling or narrowing of the upper airway. The patient reports a non-productive cough. Other symptoms such as sputum, a runny nose, malaise, and body ache associated with upper respiratory infections are absent. Barnes (2018) state that asthma and chronic obstructive pulmonary disease are the primary cause of recurrent wheezing. However, signs of inflammation are missing, thus ruling out infection.
The patient has a history of asthma diagnosed in childhood. She stopped taking her medications at 19. According to existing evidence, asthma relapses are common even after defeating at around 18. The major risk factors are weakened immunity (pregnancy or missed flu vaccination), traveling, and exposure to precipitating/ causative factors (Trivedi & Denton, 2019). The asthma signs and symptoms have been on and off since childhood, and this incident is a relapse. For this patient, the diagnosis is chronic mild intermittent asthma- an upper respiratory condition that causes narrowing of the airway, wheezing, disturbed sleep due to changes in breathing patterns, and fatigue associated with labored breathing (Stern et al., 2020).
Asthma is a chronic illness without a definitive cure. Although individuals, especially children, exhibit symptoms, the disease often relapses later in life. The nursing and medical management of asthma are symptomatic. Eliminating the causative agents can also help in managing asthma. The Global Initiative for Asthma (GINA) is the global strategy responsible for preventing and managing asthma. GINA works with public health officers and other professionals to reduce the global prevalence, morbidity, and mortality. It states that asthma management strategies aim at symptom control and risk reduction in asthma. These strategies also help prevent asthma exacerbation, mortality, and medication side effects (GINA, 2019). Asthma management also entails patient goals and initiatives. Management in pregnancy also entails cushioning the baby against asthma and its medications side effects. Asthma management entails pharmacologic and non-pharmacologic interventions.
Pharmacological treatment is low-dose regular ICS-Formoterol (maintenance and reliever). ICS-budesonide formoterol, SABA, or an inhaler with both ICS and SABA are optional asthma management therapies (GINA, 2019). According to Robijn et al. (2019), ICS-containing drugs have low risks for severe exacerbations such as status asthmaticus. GINA 2019 strategy changes remove SABA as a daily treatment because the drug has a high relapse rate. It will also help reduce reliance that develops when patients take SABA from the early development of the disease. Treatment in pregnancy increases intensity and aggressiveness, and asthma control surpasses any potential drug risk (Robijn et al., 2019). The absence of an ICS-formoterol calls for a SABA inhaler to prevent worsening of the symptoms. According to GINA, a low-dose maintenance therapy (200-500mcg) is integral.
There are various non-pharmacologic modalities for managing asthma. These methods are often underappreciated and include pulmonary rehabilitation, and focused breathing techniques (yoga and breath retraining) are the choice of non-pharmacologic interventions for this patient (Tan et al., 2020). Other interventions include vitamin B and C supplements, determining and avoiding allergens/ asthma triggers, and keeping warm. Pulmonary rehabilitation entails an exercise program that focuses on exercising to train the lung alveoli to open up adequately to support breathing. Exercises force open closed alveoli and promote bronchodilation, improving the integrity of the respiratory effort. It also reduces respiratory effort. It is also important to assess for occupation-related asthma exacerbation and advise on risk reduction.
Therapeutic patient communication is integral when handling the patient. It begins with understanding relevant patient data and creating a rapport and ends with making mutual goals and objectives. The communication plan will also include retraining in inhaler use. Establishing adherence is integral and entails pointing out the importance of adherence and the consequences of non-adherence to the drugs (GINA, 2019). Teaching about the side effects that are mild and self-limiting such as agitation and muscle and leg cramps, is equally crucial. Keeping warm is integral because cold exposure is a leading cause of asthma attacks. Wearing warm clothes and dressing according to the weather will help reduce exacerbations. GINA requires pregnant women with asthma exacerbation to attend a follow-up clinic after one week; hence booking a clinic after one week with the patient will be integral (GINA, 2019). A review every 3-4 weeks will also be necessary for this pregnant woman. It is vital to make the woman understand that she can come back to the clinic at any time if the symptoms persist.
The Asthma and Allergy Foundation of America (AAFA) Support Community connects patients, families, and caregivers (Cassalia, 2018). The community is an excellent online resource that allows families to interact with their care providers, discuss and consult on asthma problems, and garner support for all individuals. The community resource is available in all states because it is an online platform. The organization also works with local support groups in managing asthma. The community resource majorly works to identify gaps in asthma management and support the passage of laws that positively impact asthma patients and their families. It also focuses on drug availability and costs and new research on better patient management. The resource will help patients access other support groups that meet their specific needs depending on their differences. Other community resources include the asthma community network, online asthma community, Airnow, and Burnwise organizations, which are resources that target asthma risks and help individuals avoid them hence managing asthma.
Patient management requires proper physical assessment and history taking. Asthma is a chronic illness that causes narrowing of the upper airway hence wheezing, fatigue, and disturbed sleep patterns. Asthma is common in childhood, and individuals can acquire remission, but relapse is common, especially with SABA use. The global initiative for asthma is responsible for asthma management and recommends ICS-containing medications as a reliever and maintenance therapy. SABA is avoided due to its risk for relapse. Non-pharmacologic management interventions such as pulmonary rehabilitation are also integral in managing asthma symptoms. Healthcare providers can refer patients to community resources such as AAFA for further management and social support.
Barnes, P. J. (2018). Targeting cytokines to treat asthma and chronic obstructive pulmonary disease. Nature Reviews Immunology, 18(7), 454-466. https://doi.org/10.1038/s41577-018-0006-6
Beasley, R., Braithwaite, I., Semprini, A., Kearns, C., Weatherall, M., Harrison, T. W., … & Pavord, I. D. (2020). ICS-formoterol reliever therapy stepwise treatment algorithm for adult asthma. European Respiratory Journal, 55(1). https://doi.org/10.1183/13993003.01407-2019
Cassalia, M. (2018). AAFA and Allergy Standards Host Allergy Summit to Elevate Industry and Consumer Perspectives to Improve Products for Allergy Aware. Retrieved from https://www.globenewswire.com/news-release/2018/11/01/1640881/0/en/AAFA-and-Allergy-Standards-Host-Allergy-Summit-to-Elevate-Industry-and-Consumer-Perspectives-to-Improve-Products-for-Allergy-Aware-Consumers.html
Global Initiative for Asthma (GINA), (2019). A Pocket Guide for Asthma Management and Prevention (for adults and children above five years). Retrieved from https://ginasthma.org/wp-content/uploads/2019/04/GINA-2019-main-Pocket-Guide-wms.pdf
Robijn, A. L., Murphy, V. E., & Gibson, P. G. (2019). Recent developments in asthma in pregnancy. Current Opinion In Pulmonary Medicine, 25(1), 11-17. https://doi.org/10.1097/MCP.0000000000000538
Stern, J., Pier, J., & Litonjua, A. A. (2020, February). Asthma epidemiology and risk factors. In Seminars in Immunopathology (Vol. 42, No. 1, pp. 5-15). Springer Berlin Heidelberg. https://doi.org/10.1007/s00281-020-00785-1
Tan, D. J., Burgess, J. A., Perret, J. L., Bui, D. S., Abramson, M. J., Dharmage, S. C., & Walters, E. H. (2020). Non-pharmacological management of adult asthma in Australia: a cross-sectional analysis of a population-based cohort study. Journal of Asthma, 57(1), 105-112. https://doi.org/10.1080/02770903.2018.1545030
Trivedi, M., & Denton, E. (2019). Asthma in children and adults—what are the differences, and what can they tell us about asthma?. Frontiers in Pediatrics, 7, 256. https://doi.org/10.3389/fped.2019.00256
Part 1
Choose a drug that is used for the GI system. Write a legal prescription for the drug for a fictitious patient. You are the provider. Be sure your prescription includes all legally correct patient information, provider information, medication information as well as any special instructions to the pharmacist. Your writing Assignment should include all the legal elements of a prescription.
Part 2
Write a 250-300 word paper to describe the pharmacokinetics and pharmacodynamics of the drug as well as specific patient education about the chosen drug. Reference your work using correct APA formatting. Utilize correct professional writing including grammar, punctuation, and mechanics. Directions
Mr. Smith brings his 4-year-old son to your primary care office. He states the boy has been ill for three days. Mr. Smith indicates that he would like antibiotics so he can send his son back to pre-school the next day.
History – Child began with sneezing, mild cough, and low grade fever of 100 degrees three days ago. All immunizations UTD. Father reports that the child has had only two incidents of URI and no other illnesses.
Social – non-smoking household. Child attends preschool four mornings a week and is insured through his father’s employment. No other siblings in the household.
PE/ROS -T 99, R 20, P 100. Alert, cooperative, in good spirits, well-hydrated. Mildly erythemic throat, no exudate, tonsils +2. Both ears mild pink tympanic membrane with good movement. Lungs clear bilaterally. All other systems WNL.
Do not consider COVID-19 for this patient diagnosis.
For the assignment, do the following:
There are various upper respiratory tract infections. They include common cold, influenza, allergic and vasomotor rhinitis, intranasal foreign body, and sinus. Thomas & Bomar (2021) note that influenza is a more acute condition with more severe symptoms, occurring and worsening within twenty hours. The child has had the mild symptoms for three days, ruling out influenza. Allergic and vasomotor rhinitis primarily manifest with inflammation of the nasal mucosal hence nasal drainage, itching, and nasal congestion are absent in Mr. Smith’s son (Meng, Wang, $ Zang, 2019). Intranasal foreign bodies present with rhinorrhea, pain, swelling, and no fever except in severe cases. The child presents with different symptoms ruling out the foreign bodies. Sinusitis is the inflammation of the membrane of the sinuses, and the presentations depend on the affected sinuses. They include nasal congestion, facial pain (sinus inflammation), and nasal congestion absent in this child, ruling out the diagnosis (Leung et al., 2020). Common cold is prevalent in children and is caused by a viral infection of the upper respiratory tract. The symptoms have an acute onset (less critical than influenza), ranging from mild to severe (Thomas & Bomar, 2021). They include nasal congestion, stuffiness, sore throat, cough, and fever.
Common cold is a mild healthcare condition that requires only supportive management. Decongestants and antiviral therapies in children below four years lack clinical trials showing their efficacy, and the FDA advises against their use (Thomas & Bomar, 2021). Symptomatic management using antipyretics and supportive therapy is the mainstay of treatment for Mr. Smith’s son. Ibuprofen 20mg/kg/day oral dosage will help reduce the fever. Nasal irrigation using saline nasal drops is another mainstay management to help dry secretions and congestion. Throat saline spray/irrigation will also help with the sore throat. Zinc sulfate supplement will help reduce the cold’s duration and reduce the severity of the symptoms. Minimizing exposure to a cold environment using warm jackets, gloves, and socks will help prevent severe common cold symptoms (Susan et al., 2022). These interventions will help manage the symptoms and reduce the severity and duration of the cold.
The family’s involvement in managing this patent is vital. The parent must understand the medications, dosages, importance, routes, and precautions. Nasa drops are instilled twice daily, in the morning and evening, and nasal saline sprays are used similarly (Susaman et al., 2022). Ensure the baby’s nostrils are clear before instilling three drops in each nose. The father also educates on why his child will not receive antibiotics because it is the common cold. Education will also entail follow-up if the cold does not resolve after a week. Common cold resolves independently, and the parent also needs to understand that. Teaching the parent will ensure they participate in care delivery and promote better patient outcomes. Reminding the father to help monitor the child by frequent handwashing and avoiding touching eyes and face will be necessary (Thomas & Bomar, 2020).
Various resources provide information about common cold, its causes, management, and prevention. Some resources also provide information on the management of common cold. The CDC investigates and releases reports on conditions and their management (CDC, 2021). It provides updated information on current common cold treatments for a common cold. The organization will also give more information to support my choices in managing the child’s cold.
Common cold in adults and children is a mild healthcare cond
MN605 Transition to Practice Unit 6 Midterm
Question 1 Currently in the U.S., medical treatments that result in injury or death is a:
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Question 2
Risk management is about analyzing the act of the individual provider versus the system the provider works in.
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Question 3
Medication errors that occur during prescribing, administering, or dispensing are one of the leading causes of malpractice claims against Nurse Practitioners (NP).
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Question 4 Today, the trend of malpractice suits against NPs in the U.S. are (select all that apply)
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Question 5 When courts are determining reasonable practice of a prudent NP, they consider :
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Question 6 For the NP, scope of practice , as issued by state boards or national professional standards, serve to:
set limitations of what the NP can do and not do.
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Question 7
Under Tort law, causation refers to:
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Question 8
For someone to claim malpractice the following need to have occurred except:
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Question 9
When determining deviation from standard of care, all of the following is considered except:
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Question 10
A successful malpractice claim against an NP is highly unlikely if (check all that apply) the NP:
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Question 11
A major source of severe penalties of malpractice claims against NPs are all except:
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Question 12
Daily patient workload may increase the risk of a malpractice claim.
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Question 13
Following clinical practice guidelines is one of the best ways to avoid malpractice litigation.
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Question 14
When a plaintiff proves a malpractice claim in court, the penalties for the defendant are always:
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Question 15 Punitive damages are awarded when it is proven that the gross malpractice is caused by the defendant. The amount of punitive damages is based upon the jury recommendations and jurisdictional limits.
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