Case STudy 2025

CASE STUDY- TYPE 2 DIABETES INITIAL HISTORY • 52-year old black female. • Diagnosed with type 2 diabetes 6 years ago but did to follow up with recommendations for care. • Now complaining of weakness in her right foot and itching rash in her groin area. Question 1: What questions would you like to ask her about her symptoms? ADDITIONAL HISTORY • Patient says her foot has been weak for about a month and is difficult to dorsiflex; feels numb. • Denies any other weakness, numbness, difficulty speaking or walking, syncope, or seizures. She finds that watching television particularly in the evening, is becoming a problem because her eyes “are tired” more. • Has had some increased thirst and gets up more often at night to urinate, sometimes excessively. • Says she has a rash on and off for many years. It is worse when the weather is warm. It also occurs in her armpits. She gets some relief from salt baths. She occasionally gets a boil in these areas. • Denies any chest pain, shortness of breath, edema, change in bowel habits, or skin ulcers. Question 2: What other personal and family-related questions would you like to ask her about her diabetes? DIABETES HISTORY • Patient remembers being told her blood sugar was “around 200” when she was first diagnosed. She had gone for a work physical and felt fine at the time and saw no need for expensive drugs. • Her mother and sister have diabetes. Both of them were diagnosed in their 40’s and are on pills and injections. • Has been completely asymptomatic, except for rash, until the foot weakness. • Has gained 18 pounds over the past year and eats a diet high in fats and refined sugars. • Employed as banking executive and gets little exercise. Question 3: What would you like to ask about her about her medical history? PHYSICAL EXAMINATION • Obese female in no acute distress. • T= 37 C orally; P=80 and regular; RR=15 and unlabored; BP= 162/98 right arm (sitting); weight 84 kg. Skin • Erythematous moist rash in both inguinal areas, beneath both breasts, and in the axillae. • No petechiae or eccymoses. • Many dime-sized hyper pigmented spots located on the anterior shins HEENT, Neck • Pupils equal and round, fundi with mild arteriolar narrowing. • Nares and tympanic membranes clear. • Pharynx clear. • Neck without bruits or thyromegaly. Lungs, Cardiac • Lungs clear to auscultation and percussion. • Cardiac examination with distant heart tones, a regular rate and rhythm without murmurs or gallops. Abdomen, Extremities • Abdomen moderately obese with bowel sounds heard in all four quadrants; no abdominal bruits, tenderness, masses or organomegaly. • Extremities without edema; arterial pulses are diminished in volume but palpable in both feet. Neurologic • Alert and oriented. • Cranial nerves II through XII intact (including normal vision acuity with glasses). • Limb strength 5/5 throughout except 2/5 on dorsiflexion of the right foot. • Sensory perception to light touch diminished on the soles of both feet along the metatarsal bar • Deep tendon reflexes 1+ and symmetric throughout. • Gait normal except for accommodation to a right foot drop; negative Romberg test. Question 4. What are the pertinent positives and negatives on the physical examination? Question 5. What laboratory tests would you order now? INITIAL LABORATORY RESULTS • Serum electrolytes, including BUN and creatinine, calcium, and magnesium all within normal limits. • Random glucose=253mg/dL (taken at 11 am). • HgbA1c=9.1% • Urine dipstick positive for glucose, negative for protein; microscopic without significant cellular or infectious findings. • Wet prep of smear from skin rash consistent with fungal spores and mycelia. • Electrocardiogram with evidence of early left ventricular hypertrophy (LVH) by voltage. Please answer the case study questions.

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3 Pages MAJOR REPORT 2025

MAJOR REPORT/CLASS PRESENTATION: The student will select a paper offering an in-depth investigation of current journal research on one health topic featured in the text. The paper must include ; 3 professional journal sources of data comparison presented in APA format. The student must list , within their report: the evaluation methods utilized in each study briefly outline the construct of each study, report the results of each study and overall conclusions. Points will be awarded for appropriate selection of professional journal articles, points will be awarded for a presentation of evaluation methods reflected in the articles, points will be awarded for the outline of the study or studies reported in the three articles, points will be awarded for the student’s evaluation of the study or studies presented and overall conclusions reported.

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Do Not Send Me A Request Unless YouI Are Very Knowledgeable. Tell Me What Your Experience Is With Nursing And Policy Making. 2025

I am looking for someone who is experienced in nursing and implementing a policy. PLEASE read the assignment before you ask for this job. Must be proficient in APA and English expert. 8-10 pages. thanks Application Assignment 3: Policy Analysis Paper [Major Assessment 2] In previous Discussions and Application Assignments, you have examined various aspects of the policy process: exploring the unintended consequences of policies, agenda setting, and analyzing policy recommendations. In this Application Assignment, you will have the opportunity to further develop your analysis skills by working through the policy analysis process. To be an effective agent for social change, you must be able to logically and critically analyze policy from multiple perspectives and contexts and then present your insights in a succinct and professional manner. This exercise will afford such an experience. For this Application Assignment, you will examine a particular policy of interest to you (perhaps the one you selected for this week’s Discussion), and apply a policy analysis framework to understand the impact associated with the implementation of the policy. You will then develop a policy analysis paper, which is due the end of Week 11. This paper will also serve as your Major Assessment for this course. To prepare: Select a health care policy and a policy analysis framework to utilize for this Application. You may use the policy and framework you identified in this week’s Discussion or change your selection. I introduced a policy that would include breastfeeding and breast milk as a “point” in patient acuity in the neonatal intensive care. Nurses are assigned to patients according to their acuity score. Breastfeeding mothers or breast milk for feeding are not considered and yet it takes a lot of time, more than giving blood yet blood is accounted for in the acuity and not breast milk or breastfeeding. You get the picture. To complete: Write an 8- to 10-page analysis paper (including references) in which you succinctly address the following: · Part 1: · Define the policy issue. · How is the issue affecting the policy arena? · What are the current politics of the issue? · At what level in the policy making process is the issue? · Part 2: Apply a policy analysis framework to explore the issue using the following contexts: · Social Ethical · Legal · Historical · Financial / economic Theoretical underpinnings of the policy Include in this section: · Who are the stakeholders of interest? · Is there a nursing policy/position statement on this health care issue? If so, who developed it? Part 3: Policy options/solutions · What are the policy options/solutions for addressing the issue? Include at least three levels of options/solutions: no change; partial change; radical change or maximum change. · What are the theoretical underpinnings of the policy options/solutions? · What are the health advocacy aspects and leadership requirements of each option? · How does each option/solution provide an opportunity or need for inter-professional collaboration? · What are the pros and cons of each suggested change? Include the cost benefits, effectiveness, and efficiency of each option along with the utility and feasibility of each option. · Part 4 : Building Consensus · Outline a plan for building consensus around your recommended option/solution for solving the policy issue. · · Part 5: References · Limit your references so this section is no more than 2 pages . Your written assignments must follow APA guidelines. Be sure to support your work with specific citations from appropriate Learning Resources and additional scholarly sources as appropriate. Refer to the Publication Manual of the American Psychological Association to ensure that your in- text citations and reference list are correct.

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Translating Evidence Into Practice 2025

Course Project: Part 3—Translating Evidence Into Practice In Part 3 of the Course Project, you consider how the evidence you gathered during Part 2 can be translated into nursing practice. Now that you have located available research on your PICOT question, you will examine what the research indicates about nursing practices. Connecting research evidence and findings to actual decisions and tasks that nurses complete in their daily practice is essentially what evidence-based practice is all about. This final component of the Course Project asks you to translate the evidence and data from your literature review into authentic practices that can be adopted to improve health care outcomes. In addition, you will also consider possible methods and strategies for disseminating evidence-based practices to your colleagues and to the broader health care field. To prepare: Consider Parts 1 and 2 of your Course Project. How does the research address your PICOT question? With your PICOT question in mind, identify at least one nursing practice that is supported by the evidence in two or more of the articles from your literature review. Consider what the evidence indicates about how this practice contributes to better outcomes. Explore possible consequences of failing to adopt the evidence-based practice that you identified. Consider how you would disseminate information about this evidence-based practice throughout your organization or practice setting. How would you communicate the importance of the practice? To complete: In a 3- to 4-page paper: 1) Restate your PICOT question and its significance to nursing practice. My PICOT question is: does hand washing and appropriate staff dressing among the surgical ward nurses reduce cross infection during patient management? 2) Summarize the findings from the articles you selected for your literature review. Describe at least one nursing practice that is supported by the evidence in the articles. Justify your response with specific references to at least 2 of the articles. Please refer to the articles below: Aiken, A. M., Karuri, D. M., Wanyoro, A. K., & Macleod, J. (2012). Interventional studies for preventing surgical site infections in sub-Saharan Africa. International Journal of Surgery , 242-249. Doi: 10.1016/ j .ijsu.2012.04.004 Al-Khawaldeh, O., Al-Hussami, M., & Darawad, M. (2015). Influence of Nursing Students Handwashing Knowledge, Beliefs, and Attitudes on Their Handwashing Compliance . Scientific Research Publishing . Doi: http://dx.doi.org.ezp.waldenulibrary.org/10.4236/health.2015.75068 Bukhari, S., Hussain, W., Banjar, A., Almaimani, W., Karima, T., & Fatani, M. (2011). Hand hygiene compliance rate among healthcare professionals. PubMed – NCBI . Ncbi.nlm.nih.gov . Retrieved 1 April 2016, from http://www.ncbi.nlm.nih.gov/pubmed/21556474 3) Explain how the evidence-based practice that you identified contributes to better outcomes. In addition, identify potential negative outcomes that could result from failing to use the evidence-based practice. 4) Outline the strategy for disseminating the evidence-based practice that you identified throughout your practice setting. Explain how you would communicate the importance of the practice to your colleagues. Describe how you would move from disseminating the information to implementing the evidence-based practice within your organization. How would you address concerns and opposition to the change in practice? This part of the Course Project should be combined with the other two components of the Course Project and turned in as your Portfolio Assignment for this course. Note: In addition, include a 1-page summary of your project COURSE REQUIRED RESOURCES Readings Polit, D. F., & Beck, C. T. (2012). Nursing research: Generating and assessing evidence for nursing practice (Laureate Education, Inc., custom ed.).Philadelphia, PA: Lippincott Williams & Wilkins. Chapter 12, “Sampling in Quantitative Research” This chapter introduces key concepts concerning sampling in quantitative research. This includes such concepts as a description of populations, different types of sampling and their uses, and how to determine a manageable, yet sufficient number to be included in a sample. The chapter also includes suggestions for implementing a sampling plan. Chapter 13, “Data Collection in Quantitative Research” Once a sampling design is complete, the next step is to collect the data, and this is the focus of Chapter 13. The chapter describes how to develop a data collection plan, and provides information about the different types of instruments that can be used, such as structured observation and biophysiologic measures. Chapter 21, “Sampling in Qualitative Research” The focus of this chapter is on the sampling process in qualitative research. The chapter describes the different types of sampling and when they are commonly used. Sampling techniques in the three main qualitative traditions (ethnography, phenomenological studies and grounded theory studies) are highlighted. Chapter 22, “Data Collection in Qualitative Research” This chapter examines the process of data collection in qualitative research as well as key issues surrounding data collection. This includes such methods as self-reporting, surveys, interviews, and personal journal keeping. The chapter also highlights important considerations when utilizing unstructured observations to gather data and how to record field notes. Keough, V. A., & Tanabe, P. (2011). Survey research: An effective design for conducting nursing research. Journal of Nursing Regulation, 1 (4), 37–44. Retrieved from the Walden Library databases. This text emphasizes the advantages of survey research. The authors describe the nuances of survey research projects, including their design, methods, analysis, and limitations. Media Laureate Education, Inc. (Executive Producer). (2012b). Data collection. Baltimore, MD: Author. Note: The approximate length of this media piece is 4 minutes. Dr. Kristen Mauk discusses how she collected data for her DNP project in this video. She describes the details of her pre- and post-tests used to track nurses’ knowledge in a rehabilitation unit. Polit, D. F., & Beck, C. T. (2012). Nursing research: Generating and assessing evidence for nursing practice (Laureate Education, Inc., custom ed.).Philadelphia, PA: Lippincott Williams & Wilkins. Review Chapter 2, Fig. 2.1 Chapter 27, “Systematic Reviews of Research Evidence: Meta-analysis, Metasynthesis, and Mixed Studies Review” This chapter focuses on the different types of systematic reviews. The chapter discusses the advantages of this type of analysis and the steps for conducting a meta-analysis or metasynthesis. Dingle, P. (2011). Statin statistics: Lies and deception. Positive Health , 180 , 1. Retrieved from the Walden Library databases. In this article, the author outlines how misleading statistics are used to make false claims about the positive use of statin drugs in order to retain a market share of sales for pharmaceutical firms. Katapodi, M. C., & Northouse, L. L. (2011). Comparative effectiveness research: Using systematic reviews and meta-analyses to synthesize empirical evidence. Research & Theory for Nursing Practice, 25 (3), 191–209. Retrieved from the Walden Library databases. The authors of this article assert that more comparative effectiveness research (CER) is necessary to accommodate the elevated demand for evidence-based health care practices. The article supplies a summary of methodological issues relevant to systematic reviews and meta-analyses used in the process of CER. Stichler, J. F. (2010). Evaluating the evidence in evidence-based design. Journal of Nursing Administration, 40 (9), 348–351. Retrieved from the Walden Library databases. The quality of evidence used in EBP can vary considerably. This article highlights the necessity of critically appraising facility design research articles and using a hierarchical model to rate the strength of evidence. Bernd, R., du Prel, J.-B., & Blettner, M. (2009). Study design in medical research: Part 2 of a series on the evaluation of scientific publications. Deutsches Aerzteblatt International , 106 (11), 184–189. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2695375/pdf/Dtsch_Arztebl_Int-106-0184.pdf This article provides guidance in evaluating the study design of scientific publications for reliability and credibility. The authors suggest that the most important elements to consider are the question to be answered, the study population, the unit of analysis, the type of study, the measuring technique, and the calculation of sample size. Walden University. (n.d.a). Paper templates. Retrieved July 23, 2012, from http://writingcenter.waldenu.edu/57.htm (for review) This website provides you access to the School of Nursing Sample Paper , which will serve as a template for formatting your papers. Media Laureate Education, Inc. (Executive Producer). (2012g). Hierarchy of evidence pyramid . Baltimore, MD: Author. (for review) This multimedia piece explains the hierarchy of evidence pyramid. The piece offers definitions and key information for each level of the pyramid. Laureate Education, Inc. (Executive Producer). (2012n). Weighing the evidence. Baltimore, MD: Author. Note: The approximate length of this media piece is 6 minutes. In this video, Dr. Kristen Mauk provides insight about how she analyzed her data and interpreted meanings of what the data showed. She describes how she drew conclusions based on the results and how she explained unexpected findings that were contrary to her initial hypotheses.

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