Students much review the case study and answer all questions with a scholarly response using APA and include 2 scholarly references. Answer both case studies on the same document and upload 1 document to Moodle.

Case Studies will be uploaded to Moodle and put through TURN-It-In (anti-Plagiarism program)

Turn it in Score must be less than 50% or will not be accepted for credit, must be your own work and in your own words. You can resubmit, Final submission will be accepted if less than 50%. Copy paste from websites or textbooks will not be accepted or tolerated. Please see College Handbook with reference to Academic Misconduct Statement.

..heart disease remains the No. 1 killer in America; nearly half of all Americans have high blood pressure, high cholesterol, or smoke—some of the leading risk factors for heart disease…

—Murphy et al., 2018

Despite the high mortality rates associated with cardiovascular disorders, improved treatment options do exist that can help address those risk factors that afflict the majority of the population today. 

As an advanced practice nurse, it is your responsibility to recommend appropriate treatment options for patients with cardiovascular disorders. To ensure the safety and effectiveness of drug therapy, advanced practice nurses must consider aspects that might influence pharmacokinetic and pharmacodynamic processes such as medical history, other drugs currently prescribed, and individual patient factors.

Reference: Murphy, S. L., Xu, J., Kochanek, K. D., & Arias, E. (2018). Mortality in the United States, 2017. Retrieved from https://www.cdc.gov/nchs/products/databriefs/db328.htm

To Prepare

• Review the Resources for this module and consider the impact of potential pharmacotherapeutics for cardiovascular disorders introduced in the media piece.
• Review the case study assigned by your Instructor for this Assignment.
• Select one the following factors: genetics, gender, ethnicity, age, or behavior factors.
• Reflect on how the factor you selected might influence the patient’s pharmacokinetic and pharmacodynamic processes.
• Consider how changes in the pharmacokinetic and pharmacodynamic processes might impact the patient’s recommended drug therapy.
• Think about how you might improve the patient’s drug therapy plan based on the pharmacokinetic and pharmacodynamic changes. Reflect on whether you would modify the current drug treatment or provide an alternative treatment option for the patient.

case study:

CASE STUDY 2: Patient HM has a history of atrial fibrillation and a transient ischemic attack (TIA). The patient has been diagnosed with type 2 diabetes, hypertension, hyperlipidemia and ischemic heart disease.

Drugs currently prescribed include the following:

• Warfarin 5 mg po daily MWF and 2.5 mg daily T, TH, Sat, Sun 

• Aspirin 81 mg po daily 

• Metformin 1000 mg po bid 

• Glyburide 10 mg po bid 

• Atenolol 100 mg po daily 

• Motrin 200 mg 1–3 tablets every 6 hours as needed for pain

Write a 2- to 3-page paper that addresses the following:

• Explain how the factor you selected might influence the pharmacokinetic and pharmacodynamic processes in the patient from the case study you were assigned.
• Describe how changes in the processes might impact the patient’s recommended drug therapy. Be specific and provide examples.
• Explain how you might improve the patient’s drug therapy plan and explain why you would make these recommended improvements.

Rubrics:

Explain how the factor you selected might influence the pharmacokinetic and pharmacodynamic processes in the patient from the case study you were assigned.–

Describe how changes in the processes might impact the patient’s recommended drug therapy. Be specific and provide examples.–

Explain how you might improve the patient’s drug therapy plan, and explain why you would make these recommended improvements.

Written Expression and Formatting – Paragraph Development and Organization:
Paragraphs make clear points that support well developed ideas, flow logically, and demonstrate continuity of ideas. Sentences are carefully focused–neither long and rambling nor short and lacking substance.

Written Expression and Formatting – English writing standards:
Correct grammar, mechanics, and proper punctuation

Written Expression and Formatting – The paper follows correct APA format for title page, headings, font, spacing, margins, indentations, page numbers, running head, parenthetical/in-text citations, and reference list.–

References:

Rosenthal, L. D., & Burchum, J. R. (2018). Lehne’s pharmacotherapeutics for advanced practice providers. St. Louis, MO: Elsevier.

• Chapter 34, “Review of Hemodynamics” (pp. 335–340)
• Chapter 35, “Diuretics” (pp. 341–349)
• Chapter 36, “Drugs Acting on the Renin-Angiotensin-Aldosterone System” (pp. 351–362)
• Chapter 37, “Calcium Channel Blockers” (pp. 363–369)
• Chapter 38, “Vasodilators” (pp. 371–373)
• Chapter 39, “Drugs for Hypertension” (pp. 375–388)
• Chapter 40, “Drugs for Heart Failure” (pp. 389–402)
• Chapter 41, “Antidysrhythmic Drugs” (pp. 403–418)
• Chapter 42, “Prophylaxis of Atherosclerotic Cardiovascular Disease: Drugs That Help Normalize Cholesterol and Triglyceride Levels” (pp. 419–439)
• Chapter 43, “Drugs for Angina Pectoris” (pp. 441–450)
• Chapter 44, “Anticoagulant and Antiplatelet Drugs” (pp. 451–472)

15% turnitin pls

I need these questions answered in 150 words each with individual references

UNIT 3

DQ1

Differentiate between bias and confounding. Discuss the criteria necessary to establish a factor as a confounder and provide an example applying these criteria. What is one way to adjust for a confounding relationship in the study design or the analysis?

DQ2

Explain the two major types of bias. Identify a peer-reviewed epidemiology article that discusses potential issues with bias as a limitation and discuss what could have been done to minimize the bias (exclude articles that combine multiple studies such as meta-analysis and systemic review articles). What are the implications of making inferences based on data with bias? Include a link to the article in your reference.

STUDY MATERIALS

Read Chapters 14 and 15 in Gordis Epidemiology.

Read “Association or Causation: Evaluating Links Between ‘Environment and Disease,'” by Lucas and McMichael (2005), located on the World Health Organization website. URL: https://www-ncbi-nlm-nih-gov.lopes.idm.oclc.org/pmc/articles/PMC2626424/pdf/16283057.pdf

Read “Weak Associations in Epidemiology: Importance, Detection, and Interpretation,” by Doll, from Journal of Epidemiology (1996). URL: https://www.jstage.jst.go.jp/article/jea1991/6/4sup/6_4sup_11/_pdf

Read “Causal Inference Based on Counterfactuals,” by Hofler (2005), located on the BioMed Central website. URL: https://bmcmedresmethodol.biomedcentral.com/articles/10.1186/1471-2288-5-28

Read “Multicausality: Confounding,” by Schoenbach (2004), located on the Epidemilog.net website. URL: http://www.epidemiolog.net/evolving/Multicausality-Confounding.pdf

View “Sensitivity and Specificity – Explained in 3 Minutes,” by Martin (2014), located on the YouTube website. URL: https://www.youtube.com/watch?v=FnJ3L-63Cf8

View “The Relationship Between Incidence and Prevalence,” by Patwari (2013), located on the YouTube website. URL: https://www.youtube.com/watch?v=1jzZe3ORdd8

Use the “Creating a 2×2 Contingency Table” resource to assist with the completion of the Measuring Morbidity: Prevalence and Incidence assignment, as needed.

UNIT 4

DQ1

Based on the “Multicausality: Confounding – Assignment,” by Schoenbach, discuss two significant insights you learned about confounding. Use specific examples from the assignment to support your answer.

DQ2

Describe the characteristics and design of a cohort study. Based on a disease or health condition identified from the “2020 LHI Topics” on the Healthy People 2020 website, or an article from the GCU library, discuss a real example of a cohort study (include the link to the article in your post to the forum). Include the participants, exposures or treatment groups, timeframe, and outcomes that were measured. Why is a cohort study described as an “observational” study rather than an “experimental” study design?

STUDY MATERIALS

Read Chapters 7-9 in Gordis Epidemiology.

View “Randomized Control Trials and Confounding,” by Martin (2013), located on the YouTube website. URL: https://www.youtube.com/watch?v=7ybuE39BpQ8

Read “2020 LHI Topics,” located on the Healthy People 2020 website. URL: https://www.healthypeople.gov/2020/leading-health-indicators/2020-LHI-Topics

Complete the “Multicausality: Confounding – Assignment,” by Schoenbach (2001), located on the Epidemilog.netwebsite. URL: http://www.epidemiolog.net/evolving/ConfoundingAssgt.pdf

Refer to the “Multicausality: Confounding – Assignment Solutions,” by Schoenbach (2001), located on the Epidemilog.netwebsite, to check your answers to the assignment. URL: http://www.epidemiolog.net/evolving/ConfoundingSolns.pdf

Read “Understanding Controlled Trials: Why Are Randomized Controlled Trials Important?” by Sibbald and Roland, from British Medical Journal (1998). URL:http://search.proquest.com.lopes.idm.oclc.org/docview/1777585669/fulltextPDF/2BDCED02960C4E6APQ/1?accountid=7374

UNIT 5

DQ1

Describe the common characteristics and design of a case-control study. Discuss the three important features when it comes to selecting cases and controls, and identify a situation when one of these might be violated. Discuss the limitations of using questionnaires for determining exposure status and provide examples of alternative strategies for collecting this information in a case-control study.

DQ2 

Discuss the strengths and weaknesses of cross-sectional studies and examples of how they can be “descriptive” or “analytic” study designs. Discuss an example of a disease where survival could influence the association between a possible exposure and the disease when measured with a cross-sectional study. Do not discuss examples used in the textbook.

STUDY MATERIALS

Read Chapter 10 in Gordis Epidemiology.

View “Cohort and Case Control Studies,” by Martin (2013), located on the YouTube website. URL: https://www.youtube.com/watch?v=J3GHTYa-gZg

Read “Introduction to Study Designs – Cross-Sectional Studies,” located on the Health Knowledge website. URL: https://www.healthknowledge.org.uk/e-learning/epidemiology/practitioners/introduction-study-design-css

Read “Cross-Sectional Studies,” from ERIC Notebook (2012), located on the Gillings School of Global Public Health -University of North Carolina website. URL: https://sph.unc.edu/files/2015/07/nciph_ERIC8.pdf

Read “Section 7: Analytic Epidemiology,” from Lesson 1 of the Centers for Disease Control and Prevention (CDC) self-study course, Principles of Epidemiology in Public Health Practice: An Introduction to Applied Epidemiology and Biostatistics (2012), located on the CDC website. URL: https://www.cdc.gov/csels/dsepd/ss1978/lesson1/section7.html

UNIT 6

DQ1

Differentiate between association and causation using the causal guidelines. Discuss which of the guidelines you think is the most difficult to establish. Discuss the four types of causal relationships and use an example not listed in the textbook to describe each relationship.

DQ2

Explain the difference between relative risk, attributable risk, and population attributable risk. Provide an example (not from the textbook) of how each type of risk is used in epidemiology. How would you propose using population attributable risk to advocate for a health policy or intervention relative to your health interest?

STUDY MATERIALS

Review Chapter 14, and read Chapters 11-13 in Gordis Epidemiology.

Read “Causation in Epidemiology: Association and Causation,” located on the Health Knowledge website. URL: https://www.healthknowledge.org.uk/e-learning/epidemiology/practitioners/causation-epidemiology-association-causation

Read “Section 5: Measures of Association,” from Lesson 3 of the Centers for Disease Control and Prevention (CDC) self-study course, Principles of Epidemiology in Public Health Practice: An Introduction to Applied Epidemiology and Biostatistics (2012), located on the CDC website. URL: https://www.cdc.gov/csels/dsepd/ss1978/lesson3/section5.html

Use the “BRFSS Web Enabled Analysis Tool,” located on the Centers for Disease Control and Prevention (CDC) website, to complete the topic assignment. URL: https://nccd.cdc.gov/weat/#/

Review “Multicausality: Confounding,” by Schoenbach (2004), located on the Epidemilog.net website. URL: http://www.epidemiolog.net/evolving/Multicausality-Confounding.pdf

View “How to Calculate Relative Risk,” by Shaneyfelt (2012), located on the YouTube website. URL: https://www.youtube.com/watch?v=xk2uK14eHNs

View “How to Calculate an Odds Ratio,” by Shaneyfelt (2012), located on the YouTube website. URL: https://www.youtube.com/watch?v=ITi0SxmQTO8

UNIT 7

DQ1

Epidemiological methods are used in a variety of public health areas (including infectious disease, chronic disease, and social health) and settings (including the community, schools, and the workplace). Epidemiological methods are used to assess, describe, analyze, and make comparisons of populations to inform evidence-based practices, policies, and interventions. Propose a study based on the methods you have learned thus far designed to investigate an association within one of the public health areas listed (infectious disease, chronic disease, or social health) and the methods you would apply. Discuss and define the risk factor or exposure that is being assessed, the method of comparison that is used, and the setting or situation (community, school, workplace, etc.) your study would look to address. Consider the concepts of causal inference, measures of association, and study design.

DQ2

Race is often used as a descriptor of disease burden and helps us to determine where health disparities exist in order to address them, which is important. It is helpful to differentiate between race as a descriptor and race as a risk factor. Think about institutional racism and its influence on health. Consider the factors related to race and ethnicity that might be influencing disease status more than the genetics of race when answering this discussion question.

Consider the following statement: “Race is not a risk factor and should not be used in public health data collection.” Discuss the ethical and public health implications of this statement. When might collecting data on race perpetuate institutional racism leading to health disparities and when is it necessary to improve public health? Provide support and examples for your answer. Consider ethical issues related to respect for persons, beneficence, and justice as described in “The Belmont Report.”

STUDY MATERIALS

Read Chapters 17, 19, and 20 in Gordis Epidemiology.

Read “Health Inequalities Among British Civil Servants: The Whitehall II Study,” by Marmot and Smith, from The Lancet (1991). URL:https://lopes.idm.oclc.org/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=hch&AN=9107080526&site=ehost-live&scope=site

Read “The Role of Epidemiology in Disaster Response Policy Development,” by Thorpe et al., from Science Direct (2015). URL:http://www.sciencedirect.com.lopes.idm.oclc.org/science/article/pii/S1047279714003184?_rdoc=1&_fmt=high&_origin=gateway&_docanchor=&md5=b8429449ccfc9c30159a5f9aeaa92ffb

Read “Prescription Drug Abuse: From Epidemiology to Public Policy,” by McHugh, Nielsen, and Weiss, from Journal of Substance Abuse Treatment (2015). URL:http://www.sciencedirect.com.lopes.idm.oclc.org/science/article/pii/S0740547214001871?_rdoc=1&_fmt=high&_origin=gateway&_docanchor=&md5=b8429449ccfc9c30159a5f9aeaa92ffb&ccp=y

Read “The Role Epidemiology in Evidence-Based Policy Making: A Case Study of Tobacco Use in Youth,” by Aldrich et al., from Annals of Epidemiology (2015). URL:http://www.sciencedirect.com.lopes.idm.oclc.org/science/article/pii/S1047279714001495?_rdoc=1&_fmt=high&_origin=gateway&_docanchor=&md5=b8429449ccfc9c30159a5f9aeaa92ffb

Read “Epidemiology, Policy, and Racial/Ethnic Minority Health Disparities,” by Carter-Pokras et al., from Annals of Epidemiology (2012). URL: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3724931/

Read “Epidemiology and Public Policies,” by Barata, from Revista Brasileira de Epidemiologia (2013). URL: http://www.scielo.br/scielo.php?pid=S1415-790X2013000100003&script=sci_arttext&tlng=en

Read “Ethical Issues in Epidemiologic Research and Public Health Practice,” by Coughlin, from Emerging Themes Epidemiology (2006). URL: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1594564/

Explore the “Viral Hepatitis Epidemiologic Profiles” map, located on the Association of State and Territorial Health Officials (ASTHO) website, to assist with topic assignment.URL: https://www.astho.org/Viral-Hepatitis-Epi-Profiles/Map/

Use the “BRFSS Web Enabled Analysis Tool,” located on the Centers for Disease Control and Prevention (CDC) website, to complete the topic assignment. URL: https://nccd.cdc.gov/weat/#/

Review the “Belmont Report,” by the National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research (1979), located on the U.S. Department of Health and Human Services – Office for Human Research Protections website. URL: https://www.hhs.gov/ohrp/regulations-and-policy/belmont-report/index.html

Explore the resources on “Health Data Tools and Statistics,” located on the PHPartners website. URL: https://phpartners.org/health_stats.html

Explore “Surveillance, Epidemiology and the End Results Program,” from the National Cancer Institute.URL: https://seer.cancer.gov/

Explore the STEPwise Approach to Surveillance (STEPS) page of the World Health Organization (WHO) website. URL: http://www.who.int/chp/steps/en/

UNIT 8

DQ1

One method to investigate gene-environment interactions is to study monozygotic twins. Identify an example of a twin study not listed in the textbook used to examine the gene-environment interaction of a specific disease or condition. Briefly summarize the gene-environment interaction investigated, the methods, and the results. What are other possible methods for studying gene-environment interactions as they relate to improving population health?

DQ2

Using the CDC Wonder website, set the query criteria for pancreatic cancer for the United States as illustrated below. Compare the rates by race for Wisconsin and Colorado. Discuss possible biological, genetic, and environmental reasons for differences. What are potential social determinants that contribute to the disparity presented between the two states?

Use this query upon entering the CDC Wonder website:

Select “Cancer Statistics” under the Wonder Systems tab

Select “Cancer Incidence 1999 – 2013” and click “Data Request”

Organize table layout:

1. Group      results by 1. States and 2. Race (leave the rest of the group options as      “None”)
2. Measures      – click “Count” (default) and “Age Adjusted Rates”

Select location – select “States” and “The United States”

Select year and demographics

1. Year      – 2014
2. Sex      – All genders
3. Age      groups – All ages
4. Ethnicity      – All ethnicities
5. Race      – All races

Select cancers of interest – select “Pancreas”

Other options – keep default settings

STUDY MATERIALS

Read Chapter 16 in Gordis Epidemiology.

Read “Gene-Environment Interaction,” located on the National Institute of Environmental Health Sciences website. URL: https://www.niehs.nih.gov/health/topics/science/gene-env/index.cfm

Read “Defeating the ZIP Code Health Paradigm: Data, Technology, and Collaboration Are Key,” by Graham, Ostrowski, and Sabina, from the Health Affairs Blog (2015), located on the Health Affairs website. URL: http://healthaffairs.org/blog/2015/08/06/defeating-the-zip-code-health-paradigm-data-technology-and-collaboration-are-key/

Explore the CDC Wonder page of the Centers for Disease Control and Prevention (CDC) website.URL: https://wonder.cdc.gov/

Review the Mapping Life Expectancy page of the Robert Wood Johnson Foundation website. URL: http://www.rwjf.org/en/library/articles-and-news/2015/09/city-maps.html

 

Create 1 page outlines of your response plan for three intervention scenarios.

Nurse leaders need to quickly identify a strategy for evaluating a nursing leadership problem and the dynamics related to the problem, in order to orchestrate intervention efforts and put together a plan of action that leads to stakeholder cooperation.

By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and assessment criteria:

• Competency 1: Integrate key nursing leadership, management, and communication concepts into collaborative practice situations.
  • Explain concepts of change theory and how it can be used as a tool to manage situations.
  • Describe an effective leadership style to address a problem.
• Competency 2: Explain the accountability of the nurse leader for decisions that affect health care delivery and patient outcomes.
  • Describe how outcomes or success of the style selected for each situation could be measured.
• Competency 4: Apply professional standards of moral, ethical, and legal conduct in professional practice.
  • Explain how professional and legal standards guide the effective nurse leader when making decisions.
• Competency 5: Communicate in manner that is consistent with the expectations of a nursing professional.
  • Write content clearly and logically, with correct use of grammar, punctuation, mechanics, and current APA style.

 

Preparation

Use the Internet to research change theory, leadership, and communication strategies. Use the Suggested Resources to research leadership and communication concepts and change theory.

• The challenge in this assessment is to create a response plan for several intervention scenarios.
  • There are three deliverables required for this assessment.

Rationale for this assessment:

Nurse leaders solve problems or resolve conflict on a daily basis. Understanding how change theory can be applied to a situation and examining various types of interventions in advance can relieve pressure on the nurse leader and improve the workplace environment and outcomes. Rehearsing potential interventions provides a mental toolkit on which to rely during stressful times.

Your management training workshop continues:

The second day of HR’s Nursing Leadership Workshop is designed to help you identify and practice effective responses and interventions to common problems and situations. Participants are presented with three scenarios and must create a response plan for each scenario, in the form of a 1–2 page outline.

Deliverables: Submit three Response Plans to complete this assessment.

• Choose 3 of the 5 Intervention Scenarios linked in the Required Resources for this assessment.
• For each scenario you choose, develop a separate Response Plan in the form of a 1–2 page outline.
  • Label each outline using the example below:
    • Example: Response Plan for School Nurse.

Instructions

Analyze each Intervention Scenario and describe the leadership, communication, and management strategies you believe would be most effective for each situation.

Use the following subheadings to organize your Response Plan outline for each situation.

• Change Theory: Explain concepts of change theory and how it can be used as a tool to manage situations.
  • Identify elements of change theory that fit best with the scenario.
  • How can you use change theory to deal with conflict?
• Strategies and Rationale: Describe an effective leadership style you would employ to address a problem.
  • Explain the rationale for choosing a leadership strategy to solve a problem.
  • Identify interventions to address the problem.
• Expected Outcome: Describe how outcomes or success of the style selected for each situation could be measured.
  • Describe how you could determine improved outcomes or measure success of the leadership style selected for each situation.
    • What might go wrong and how would you deal with that?
• Professional Standards: Explain how professional and legal standards guide the effective nurse leader when making decisions.

Additional Requirements

• Written communication: Written communication should be free of errors that detract from the overall message.
• APA formatting: Resources and in-text citations should be formatted according to current APA style and formatting.
• Length: Each outline should be 1–2 pages double-spaced.
• Font and font size: Times New Roman, 12 point.
• Number of resources: Use a minimum of three peer-reviewed resources.