“Professional Roles and Responsibilities”

Family nurse practitioners (FNPs) are graduate-educated, nationally-certified and state licensed advanced practice registered nurses (APRNs) who care for medically stable patients across the lifespan, from infants to geriatric patients. 

Share your thoughts

1. What are the educational requirements to practice as a FNP?
2. According to the American Association of Colleges of Nursing (AACN), what is the recommended terminal degree to prepare nurse practitioners. 
3. Who determines the scope of practice for FNPs?
4. Who defines it? Who Credentials and what is the role of a Professional and Political Organization in defining the role? 
5. See rubric

Discussion 3

Much of the ongoing debate over scope-of-practice (SoP) laws that govern the practice of nurse practitioners (NPs) across the country focuses on the cost of and access to health care and on whether these laws legitimately promote patient safety or are simply anticompetitive restrictions on NPs’ ability to compete with physicians. After completing the following CE activity at Medscape https://www.medscape.org/viewarticle/506277_1 ( sign for the free account), please answer the following questions:

Should an NP who is educationally prepared as an acute care NP work in an adult primary care setting? 

Is it within the scope for an FNP to diagnose and treat uncomplicated mental health conditions like depression, anxiety, and ADHD?

Are there any restrictions for the FNP to treat patients with mood disorders and to prescribe them antipsychotics or SSRIs ?

Discussion 4:

CS/SB 614 authorizes  an ARNP to prescribe, dispense, administer, or order any drug, which would include controlled substances.

ARNP disciplinary sanctions are added to the bill in s. 456.072, F.S., (Section 5) to mirror a physician’s sanctions for prescribing or dispensing a controlled substance other in the course of professional practice or failing to meet practice standards. Additional acts for which discipline may be taken against an ARNP relating to practicing with controlled substances that are added to the Nurse Practice Act (Section 10) include:

 Presigning blank prescription forms.

 Prescribing a Schedule II for office use.

 Prescribing, dispensing, or administering an amphetamine or sympathomimetic amine drug, except for specified conditions.

 Prescribing, dispensing, or administering certain hormones for muscle-building or athletic performance.

 Promoting or advertising a pharmacy on a prescription form unless the form also states that the prescription may be filled at the pharmacy of your choice.

 Prescribing, dispensing, or administering drugs, including controlled substances, other than in the course of his or her professional practice.

 Prescribing, dispensing, or administering a controlled substance to himself or herself.

 Prescribing, dispensing, or administering laetrile.

 Dispensing a controlled substance listed in Schedule II or Schedule III in violation of the requirements for dispensing practitioners in the Pharmacy Practice Act.

 Promoting or advertising controlled substances.

After reading the following news article http://c-hit.org/2015/04/06/high-prescribing-nurse-surrenders-drug-licenses/

Identify what issues may arise with prescriptive authority of controlled substances and how you may avoid these situations? 

“Professional Roles and Responsibilities”

Family nurse practitioners (FNPs) are graduate-educated, nationally-certified and state licensed advanced practice registered nurses (APRNs) who care for medically stable patients across the lifespan, from infants to geriatric patients. 

Share your thoughts

1. What are the educational requirements to practice as a FNP?
2. According to the American Association of Colleges of Nursing (AACN), what is the recommended terminal degree to prepare nurse practitioners. 
3. Who determines the scope of practice for FNPs?
4. Who defines it? Who Credentials and what is the role of a Professional and Political Organization in defining the role? 
5. See rubric

Discussion 3

Much of the ongoing debate over scope-of-practice (SoP) laws that govern the practice of nurse practitioners (NPs) across the country focuses on the cost of and access to health care and on whether these laws legitimately promote patient safety or are simply anticompetitive restrictions on NPs’ ability to compete with physicians. After completing the following CE activity at Medscape https://www.medscape.org/viewarticle/506277_1 ( sign for the free account), please answer the following questions:

Should an NP who is educationally prepared as an acute care NP work in an adult primary care setting? 

Is it within the scope for an FNP to diagnose and treat uncomplicated mental health conditions like depression, anxiety, and ADHD?

Are there any restrictions for the FNP to treat patients with mood disorders and to prescribe them antipsychotics or SSRIs ?

Discussion 4:

CS/SB 614 authorizes  an ARNP to prescribe, dispense, administer, or order any drug, which would include controlled substances.

ARNP disciplinary sanctions are added to the bill in s. 456.072, F.S., (Section 5) to mirror a physician’s sanctions for prescribing or dispensing a controlled substance other in the course of professional practice or failing to meet practice standards. Additional acts for which discipline may be taken against an ARNP relating to practicing with controlled substances that are added to the Nurse Practice Act (Section 10) include:

 Presigning blank prescription forms.

 Prescribing a Schedule II for office use.

 Prescribing, dispensing, or administering an amphetamine or sympathomimetic amine drug, except for specified conditions.

 Prescribing, dispensing, or administering certain hormones for muscle-building or athletic performance.

 Promoting or advertising a pharmacy on a prescription form unless the form also states that the prescription may be filled at the pharmacy of your choice.

 Prescribing, dispensing, or administering drugs, including controlled substances, other than in the course of his or her professional practice.

 Prescribing, dispensing, or administering a controlled substance to himself or herself.

 Prescribing, dispensing, or administering laetrile.

 Dispensing a controlled substance listed in Schedule II or Schedule III in violation of the requirements for dispensing practitioners in the Pharmacy Practice Act.

 Promoting or advertising controlled substances.

After reading the following news article http://c-hit.org/2015/04/06/high-prescribing-nurse-surrenders-drug-licenses/

Identify what issues may arise with prescriptive authority of controlled substances and how you may avoid these situations? 

 

Mr. C., a 32-year-old single man, is seeking information at the outpatient center regarding possible bariatric surgery for his obesity. He reports that he has always been heavy, even as a small child, but he has gained about 100 pounds in the last 2–3 years. Previous medical evaluations have not indicated any metabolic diseases, but he says he has sleep apnea and high blood pressure, which he tries to control with sodium restriction. He current works at a catalog telephone center.

Objective Data

1. Height: 68 inches; Weight 134.5 kg
2. BP: 172/96, HR 88, RR 26
3. Fasting Blood Glucose: 146/mg/dL
4. Total Cholesterol: 250mg/dL
5. Triglycerides: 312 mg/dL
6. HDL: 30 mg/dL

Critical Thinking Questions

What health risks associated with obesity does Mr. C. have? Is bariatric surgery an appropriate intervention? Why or why not?

Mr. C. has been diagnosed with peptic ulcer disease and the following medications have been ordered:

1. Magnesium hydroxide/aluminum hydroxide (Mylanta) 15 mL PO 1 hour before bedtime and 3 hours after mealtime and at bedtime.
2. Ranitidine (Zantac) 300 mg PO at bedtime.
3. Sucralfate/Carafate 1 g or 10ml suspension (500mg / 5mL) 1 hour before meals and at bedtime.

The patient reports eating meals at 7 a.m., noon, and 6 p.m., and a bedtime snack at 10 p.m. Plan an administration schedule that will be most therapeutic and acceptable to the patient.

1. Assess each of Mr. C.’s functional health patterns using the information given. (Hint: Functional health patterns include health-perception – health management, nutritional – metabolic, elimination, activity-exercise, sleep-rest, cognitive-perceptual, self-perception – self-concept, role-relationship, sexuality – reproductive, coping – stress tolerance.)
2. What actual or potential problems can you identify? Describe at least five problems and provide the rationale for each.

Due 6/8 6 p.m est

500 words not including min 4 references APA format

  

Public health officials use myriad data sources to collect information for disease surveillance. Because of the ease of access, the majority of this information comes from electronic data sources such as daily physician visits, frequency of ambulance use, and filling of pharmacy prescriptions. Because every piece of information a public health official receives is not an indicator of disease, it is critical to find the right data sources to detect events and trends.

Often, creative thinking is required to identify potentially useful data sources and the combination of variables that may be revealing. Of course, identifying the data sources is only half the battle. It is also critical to determine how reliable the data are and how they will be obtained

Select a chronic disease or condition. Analyze data sources that are or might be used to monitor the disease or condition. Then identify three data sources that you think are useful indicators of an event or trend related to the disease or condition you have selected. Justify your selection of each of the data sources you identified. Briefly address the case protocol (if appropriate) for the data sources and describe how the accuracy of that data might influence the disease surveillance 

  

4-The mode, median and mean tell us something about a set of observations. The mode is the only measure of center appropriate for nominal data. For example, if we were looking at the most frequently purchased food item in a certain snack bar in 1999, it make sense to say that the most frequent (modal) food purchased was mini chocolate.  The median is at the middle of an ordered data set and is a useful measure for ordinal variables, while the mean only makes sense for interval and ratio scales of measurement

  

5-A populationis is a set of persons or objects that has a common observable characteristics and a complete set of items that share at least one property in common that is the subject of a statistical analysis. An example is the people in certain locality that share a common geographic origin, language, literature, and genetic heritage, among other traits, that distinguish them from people of different nationalities.

  

6-The mean is the summary of an entire population.  Sometimes it is called the average.  It isn’t a particular individual, but rather the entire population (University, 2013).  The mean could be used to determine the average age of a population.  If you add all the ages of all the people in the population and divide by the number of individuals, it would give you the mean.  This is the “summary” of the population. The median is more centralized and would be used to explain what a “typical, normal, or average” member of the population is (University, 2013).  You could use the median to again find the median age.  This is slightly different than the mean in the way that there is only 1 answer.  The median is the middle of the data set (University, 2013), meaning it may be slightly higher or lower than the mean.  Sometimes outliers will skew the numbers, but it isn’t affected as much as the mean would be. The mode is used to calculate the number that appears the most in a set of numbers.  Going along with the ages of the individuals, we would write out all ages of the individuals in the community.  If the age of 60 showed up 18 times and was the highest amount of all the numbers, the mode would be 60.  The mode is not used very often because it is not a measure of the centre of the data in the same way that the median and mean can be.

Reference

University of Wollongong. (2013, August 12). Appropriate use of mean, median and mode.  Retrieved from http://www.uow.edu.au/student/qualities/statlit/module2/3.2mmm/UOW153116.html