-PLEASE refer to attachment(Case Scenario Questions)

-APA Format.

– Introduction or Abstract page

– summary or Conclusion page.

– Four pages minimum, no including: Introduction or Abstract , summary or conclusion, and Bibliography pages

– It is completely unacceptable to Copy and Paste from the Internet, or other resources

– Bibliography has to be in APA Format, minimum 3, no more than 3 years old.

Similarities less Than 10%

Reflect on the current roles of advanced practice nurses in healthcare as the care providers at the front line of disease management and health promotion in primary care and many other specialty settings. What do you think are some effective tactics for APN strategic positioning regarding pay equality? Should APNs position themselves as lower-cost providers who provide better care or push for comparable worth, same service and same pay?

Below is an article that provides great practical information that highlights how provider productivity is calculated in the clinical setting, which is important to know as future nurse practitioners.

Calculating Your Worth: Understanding Productivity and Value- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4093517/ 

Assignment Content

1. Log in to the University Library.

   Identify and read two to three articles that discuss the cost and benefits associated with the initiative you have selected. (Energy Efficiency is my topic)

   Note: If relevant articles are not found in the University Library, expand your search to outside sources and materials.

   Identify best practices you can use in your sustainability initiative.

   Write a 90- to 175-word summary for each citation that explains how the article supports the sustainability initiative you are developing in this course.

   Format your assignment according to APA guidelines.

   Submit your assignment. For additional help, check out the ULTRA: Access your assignments page.

   Copyright 2018 by University of Phoenix. All rights reserved.

 Week 1

 For 6 years I worked with whom I consider the best nurse leader I could ever had. Participative (Democratic) style describes exactly how she was. She always took into consideration the staff’s opinions before making any decision, she was humble enough to tell us “hey, great idea! thanks for helping me with your opinion to get to a final determination”. On this theory, everyone is given the opportunity to participate, ideas are exchanged freely, and discussion is encouraged. While the democratic process tends to focus on group equality and the free flow of ideas, the leader of the group is still there to offer guidance and control. The democratic leader is charged with deciding who is in the group and who gets to contribute to the decisions that are made (Kendra Cherry, 2014)

How has your experience been with the nurse leader? Provide a description of your interactions with him or her?

As I mention in the question above, I consider this nurse the best nurse leader I could ever had, besides being an excellent leader she was a great mentor for my professional growth, when I moved from Colombia as a Paramedic to Miami I met her at the first job I had for 6 years, it was a clinical research company and I had no idea this even existed, I just wanted a job, I was recently married and this job was looking for people with experience in the medical field to draw blood, admit patients, etc. I got my EMT but I wanted more, I wanted to go to school for something else, but I was kind of lost in regards to which school should I go? can I rollover some classes from Paramedic school? how can I start?  and this great nurse leader had faith on me, she DROVE me to Miami Dade College, she stayed there for almost 3 hours with me waiting for an advisor to help me get the information needed and during the entire program she never let me drop out even though sometimes that’s all I wanted to do, I started nursing school with a 3 month old and it was extremely hard to keep up with home, baby, full time job and school; but this leader was always there. She thought me throughout those years that being a great leader is not synonym of being a selfish leader, work wise she always had the best from me, and research have found that the democratic leadership style is one of the most effective types and leads to higher productivity, better contributions from group members, and increased group morale and this is EXACTLY what she obtained from me. Now, I’m the charge nurse at the GI center where I work and I consider myself to be a democratic leader as well since I totally understood this was the best way to get the whole team involved and to receive their best production. 

Discussion Question #1 

For this questions, please read the following case stud and then respond to the questions noted below. 

Mr. EBR is a 74-year-old retired Hispanic gentleman with known coronary artery disease (CAD), who presents to your clinic with substernal chest pain for the past 3 months. It is not positional; it reliably occurs with exertion, approximately one to two times daily, and is relieved with rest, or one or two sublingual nitroglycerin (NTG) tabs. It is similar in quality, but is much less severe, than the chest pain that occurred with his previous inferior myocardial infarction (MI) 3 years ago. Until the past 3 months, he has felt well.

The chest pain is accompanied by diaphoresis and nausea, but no shortness of breath (SOB) or palpitations. He does not vomit. He denies orthopnea, paroxysmal nocturnal dyspnea (PND), syncope, presyncope, dizziness, lightheadedness, and symptoms of stroke or transient ischemic attack (TIA). An echocardiogram done after his MI demonstrated a preserved left ventricular ejection fraction (LVEF). Other medical problems include well-controlled type 2 diabetes mellitus (DM), well-controlled hypertension (HTN), and hyperlipidemia, with low-density lipoprotein (LDL) at goal. He also has stage 3 chronic kidney disease (CKD) and diabetic neuropathy. He no longer smokes and does not use alcohol or recreational drugs. His daily medications include: Atenolol 25 mg PO bid, Lisinopril 20 mg PO bid, aspirin 81 mg PO daily, Simvastatin 80 mg PO each evening, and metformin 500 mg PO bid.

Mr. EBR’s physical assessment includes the following: height 68 inches, weight 185 lb, Blood pressure (BP) 126/78, heart rate (HR) 64, Respiratory rate (RR) 16, and temperature 98.6°F orally. He is alert and oriented, and in no apparent distress (NAD). His neck is without jugular venous distention (JVD) or carotid bruits. Lungs are clear to auscultation bilaterally. Cardiovascular: normal S1 & S2, RRR, without rubs, murmurs or gallops. Abdomen has active bowel tones and is soft, nontender, and nondistended (NTND). Extremities are without clubbing, cyanosis, or edema. Distal pedal pulses are 2+ bilaterally

1. What would you add to the current treatment plan? Why?
2. Would you discontinue any of the currently prescribed medication? Why or why not?
3. How does the diagnosis stage 3 chronic kidney disease affect your choices?
4. Why is the patient prescribed more than one antihypertensive?
5. What is the benefit of the aspirin therapy in this patient?

Discussion Question #2

List three classes of drugs affecting the Hematopoietic System. List the mechanism of action for each class of drug. Choose one medication from the three classes and discuss what disorder the drug is used to treat? How often the medication is given? What labs should get monitored while the patient is taking this medication? Your response should be at least 350 words.