An elderly widow who just lost her spouse. 

Subjective: A patient presents to your primary care office today with chief complaint of insomnia. Patient is 75 YO with PMH of DM, HTN, and MDD. Her husband of 41 years passed away 10 months ago. Since then, she states her depression has gotten worse as well as her sleep habits. The patient has no previous history of depression prior to her husband’s death. She is awake, alert, and oriented x3. Patient normally sees PCP once or twice a year. Patient denies any suicidal ideations. Patient arrived at the office today by private vehicle. Patient currently takes the following medications: 

• Metformin 500mg BID 
• Januvia 100mg daily 
• Losartan 100mg daily 
• HCTZ 25mg daily 
• Sertraline 100mg daily 

Current weight: 88 kg

Current height: 64 inches

Temp: 98.6 degrees F

BP: 132/86 

By Day 3 of Week 7

Post a response to each of the following:

• List three questions you might ask the patient if she were in your office. Provide a rationale for why you might ask these questions. 
• Identify people in the patient’s life you would need to speak to or get feedback from to further assess the patient’s situation. Include specific questions you might ask these people and why. 
• Explain what, if any, physical exams, and diagnostic tests would be appropriate for the patient and how the results would be used. 
• List a differential diagnosis for the patient. Identify the one that you think is most likely and explain why. 
• List two pharmacologic agents and their dosing that would be appropriate for the patient’s antidepressant therapy based on pharmacokinetics and pharmacodynamics. From a mechanism of action perspective, provide a rationale for why you might choose one agent over the other. 
• For the drug therapy you select, identify any contraindications to use or alterations in dosing that may need to be considered based on the client’s ethnicity. Discuss why the contraindication/alteration you identify exists. That is, what would be problematic with the use of this drug in individuals of other ethnicities?
•  indicate any therapeutic changes that you might make based on possible outcomes that may happen given your treatment options chosen. 

Architect Daniel Libeskind is credited with saying “To provide meaningful architecture is not to parody history, but to articulate it.” The suggestion is that his work does not copy the efforts of others but relies on it.

Understanding the work of others is critically important to new work. Contributions to the nursing body of knowledge can happen when you are able to analyze and articulate the efforts of previous research. Research analysis skills are therefore critical tools for your toolbox.

In this Assignment, you will select one of the three listed existing research articles below;

1. The expression and receipt of compassion through touch in a health setting; a qualitative study.

2. The language of behavior changes in dementia: A mixed methods survey exploring the perspectives of people with dementia.

3. Mental workload of frontline nurses aiding in the COVID‐19 pandemic: A latent profile analysis.

You also will analyze the selected research article using a tool helpful for analysis.

To Prepare:

• Reflect on the strategies presented in the Resources this Module’s Learning Resources in support of locating and analyzing research.
• Use the School Library to identify and read the selected peer-reviewed research article.
• Review the article you selected and reflect on the professional practice use of theories/concepts described by the article.

The Assignment:

Using the “Module 4 | Part 4” section of your Academic Success and Professional Development Plan Template presented in the Resources, conduct an analysis of the elements of the research article you identified. Be sure to include the following:

• Your topic of interest.
• A correctly formatted APA citation of the article you selected, along with link or search details.
• Identify a professional practice use of the theories/concepts presented in the article.
• Analysis of the article using the “Research Analysis Matrix” section of the template
• Write a 1-paragraph justification stating whether you would recommend this article to inform professional practice.
• Write a 2- to 3-paragraph summary that you will add to your Academic Success and Professional Development Plan that includes the following:
  • Describe your approach to identifying and analyzing peer-reviewed research.
  • Identify at least two strategies that you would use that you found to be effective in finding       peer-reviewed research.
  • Identify at least one resource you intend to use in the future to find peer-reviewed research.

A nurse is caring for a 48-year-old man diagnosed with meningitis after a head injury. The client was driving a motorcycle while on vacation and was not wearing a helmet. It had started to rain, and the client’s motorcycle swirled onto a grassy area. He fell off the motorcycle and landed on the ground. The client hit his head and suffered cuts and abrasions to his face, arms, and legs from the fall. He was taken to the emergency department of the local hospital by paramedics. Upon examination, the physician ordered a head CT scan and a brain MRI to determine if any head trauma had occurred. Both exams revealed negative findings, and the client was sent home after a 24-hour stay at the hospital for observation. The client was to return in 1 week for follow-up unless symptoms developed. Three days after the accident, the client began to have severe headaches, nausea and vomiting, blurred vision, and an oral temperature of 103°F (39.4°C). The client returned to the emergency department, and a diagnosis of meningitis was confirmed. The client was admitted and started on IV antibiotics. The next morning, the client asks the nurse “What is going on? I left the hospital 3 days ago and I felt fine.” (Learning Objectives: 1, 3)

Questions:

a. How should the nurse respond to the client’s question?

b. The nurse needs to complete the admission forms. When collecting subjective data, on what present or past health concerns should the nurse focus? 

Using Kotter’s tables comparing the 20th and 21st century organizations and his tables on lifelong learning, in Leading Change, write a 6-8 page paper discussing the following.

• To what extent has your practice setting in your workplace moved into the 21st century model? Give specific examples.
• Briefly describe yourself in terms of the characteristics of lifelong learning depicted in the table and analyze your competitive capacity.
• Discuss the extent to which you have the mental habits that support lifelong learning as outlined in the Table on mental habits in lifelong learning. Give specific examples.

Please use peer reviewed articles.

Apply a model of cultural competence to personal practice beliefs. For this assignment:

1. Reflect on the 5 constructs of Campinha-Bacote’s model of The Process of Cultural Competence in the Delivery of Healthcare Services: Cultural desire, Cultural Awareness, Cultural Knowledge, Cultural Skill, and Cultural Encounters. (See Chapter 2)
2. Review the Mission statements and values of St. Thomas University and its Nursing programs.
3. Reflect on your learning during this course.
4. Evidence of reflection on Campinha-Bacote’s cultural competency model and/or STU mission and values.
5. Your personal beliefs.
6. Your philosophy statement(s) related to culturally competent nursing care.
7. Implementing your beliefs.
8. Continuing your journey towards cultural competence.

Submission Instructions:

  Your paper should be formatted per current APA and references should be current 

• The paper is to be no shorter than 1 pages; nor longer than 2 pages in length, excluding the title, abstract and references page.
• Incorporate a minimum of 2 current (published within last five years) scholarly journal articles or primary legal sources