Due 7/1/18 7 p.m EST

4 slide PPT not including title and Reference Page  APA

  

Scholar-Practitioner Project: Create a Digital Dashboard

Without the usability features inherent in effective design, informatics systems may overwhelm a user with data. This portion of your Scholar-Practitioner Project requires that you put to use the informatics display techniques that are covered in this week’s Learning Resources.

To complete this week’s portion of your Scholar-Practitioner Project, create a mock-up screen of a “digital dashboard” for your disease surveillance system. Your text includes examples and ideas for such digital dashboards. Include a framework for the display of data based on the algorithm you designed previously (see note from professor on algorithm below), using appropriate graphics, symbols, and words. Use PowerPoint when choosing to create the screen. Additionally, you may choose to annotate the mock-up as appropriate.

Please save the mock-up in the following formats:

· PowerPoint file: Use “.ppt” extension

(NOTE FROMPROFESSOR ON LAST WEEK PAPER ON SURVEILLANCE ALGORITHM)This is a good start; you have provided a good description of your pathology of interest and the diagnostic algorithm used by the clinicians.  Remember, the idea of this SPP is to develop (try to) a biosurveillance system for your disease/condition of interest.  You have mentioned the algorithm and some covariates; however, you did not address the surveillance algorithm.  Algorithms used in surveillance usually involve decisions based on statistical analyses of data provided (not usually intended for a diagnosis).  Remember, that you do not want to evaluate a clinical intervention or the burden of a disease, the intention of your system is surveillance. Please address the issues marked on your paper.  I am looking forward to reading the next steps of your project 

  

The unapproved use of approved drugs, also called off-label use, with children is quite common. This is because pediatric dosage guidelines are typically unavailable since very few drugs have been specifically researched and tested with children.

When treating children, prescribers often adjust dosages approved for adults to accommodate a child’s weight. However, children are not just “smaller” adults. Adults and children process and respond to drugs differently in their absorption, distribution, metabolism, and excretion. Children even respond differently during stages from infancy to adolescence. This poses potential safety concerns when prescribing drugs to pediatric patients. As an advanced practice nurse, you have to be aware of safety implications of the off-label use of drugs with this patient group.

To prepare:

· Review the Bazzano et al. and Mayhew articles in the Learning Resources. Reflect on situations in which children should be prescribed drugs for off-label use.

· Think about strategies to make the off-label use and dosage of drugs safer for children from infancy to adolescence. Consider specific off-label drugs that you think require extra care and attention when used in pediatrics.

With these thoughts in mind:

Post an explanation of circumstances under which children should be prescribed drugs for off-label use. Then, describe strategies to make the off-label use and dosage of drugs safer for children from infancy to adolescence. Include descriptions and names of off-label drugs that require extra care and attention when used in pediatrics.

This work should have Introduction and conclusion

– This work should have at 3 to 5current references (Year 2012 and up)

– Use at least 2 references from class Learning Resources

The following Resources are not acceptable:

1. Wikipedia

2. Cdc.gov- nonhealthcare professionals section

3. Webmd.com

4. Mayoclinic.com

Required Readings

Arcangelo, V. P., Peterson, A. M., Wilbur, V., & Reinhold, J. A. (Eds.). (2017). Pharmacotherapeutics for advanced practice: A practical approach (4th ed.). Ambler, PA: Lippincott Williams & Wilkins.

• Review Chapter 4, “Principles      of Pharmacotherapy in Pediatrics” (pp. 53-63)
       This chapter explores concepts relating to drug selection, administration,      and interaction for pediatric patients. It also compares age-related      pharmacokinetic differences in children and adults.
• Chapter 17, “Ophthalmic      Disorders” (pp. 221-243)
       This chapter examines the causes, pathophysiology, diagnostic criteria,      and drug treatment for four ophthalmic disorders: blepharitis,      conjunctivitis, keratoconjunctivitis sicca, and glaucoma. It also explores      methods of monitoring patient response to treatment.
• Chapter 43,      “Attention-Deficit/Hyperactivity Disorder” (pp. 743-756)
       This chapter explains the process of diagnosing      Attention-Deficit/Hyperactivity Disorder (ADHD). It also identifies drugs      for treating patients with ADHD, including proper dosages, selected      adverse events, and special considerations for each drug.
• Chapter 51, “Immunizations”      (pp. 906-926)
       This chapter explores vaccines that are licensed for use in the United      States and provides a recommended vaccination schedule for pediatric      patients and adults.
• Chapter 52, “Smoking Cessation”      (pp. 927-943)
       This chapter examines clinical implications of smoking. It also covers      various approaches for aiding patients who are dependent on nicotine but      want to stop smoking.
• Chapter 54, “Weight Loss” (pp. 945-956)
       This chapter begins by reviewing patient factors that contribute to      obesity. It also examines drug therapy for initiating weight loss in      patients, as well as alternative non-drug treatments.

Bazzano, A. T, Mangione-Smith, R., Schonlau, M., Suttorp, M. J., & Brook, R. H. (2009). Off-label prescribing to children in the United States outpatient setting. Academic Pediatrics, 9(2), 81–88. 

This study examines the frequency of off-label prescribing to children and explores factors that impact off-label prescribing.

Mayhew, M. (2009). Off-label prescribing. The Journal for Nurse Practitioners, 5(2), 122–123. 

This article reviews the prevalence of off-label prescribing, including its benefits and risks. It also explores issues regarding the safety of off-label prescribing and when it is unavoidable.

Drugs.com. (2012). Retrieved from http://www.drugs.com/

This website presents a comprehensive review of prescription and over-the-counter drugs including information on common uses and potential side effects. It also provides updates relating to new drugs on the market, support from health professionals, and a drug-drug interactions checker.

Required Media

Laureate Education, Inc. (Executive Producer). (2012). Advanced pharmacology – Final course review. Baltimore, MD: Author. 

This media is an interactive final review covering course content.

Innate and Adaptive Immunity

Melissa is a 15-year-old high school student. Over the last week, she had been feeling tired and found it difficult to stay awake in class. By the time the weekend had arrived, she developed a sore throat that made it difficult to eat and even drink. Melissa was too tired to get out of bed, and she said her head ached. On Monday morning, her mother took her to her doctor. Upon completing the physical exam, he told Melissa the lymph nodes were enlarged in her neck and she had a fever. He ordered blood tests and told Melissa he thought she had mononucleosis, a viral infection requiring much bed rest.

1. Innate and adaptive immune defenses work collectively in destroying invasive microorganisms. What is the interaction between macrophages and T lymphocytes during the presentation of antigen?
2. Melissa’s illness is caused by a virus. Where are type I interferons produced, and why are they important in combating viral infections?

 

1. Humoral immunity involves the activation of B lymphocytes and production of antibodies. What are the general mechanisms of action that make antibodies a key component of an immune response?

4 pages APA not including title page and reference page

The Case of the Missionary Health Care Worker in Africa

Jenny, a twenty-two year old college graduate, has recently decided to spend two years as a missionary in a coastal African village. As part of her duties, she will work in the missionary clinic that has recently been established in the village. This clinic will provide routine medical care and a traveling physician and nurse will visit once each week. Jenny feels fortunate to have the opportunity to use the information that was presented to her in various classes she completed while in college. After completing a 4-month intensive training period (language classes, medical preparation for work in the clinic, and cultural enrichment), she departed for Africa.

Upon her arrival, Jenny found that she would be spending most of her time in the clinic since the village had been without routine medical care for the past 2 years. The previous clinic was closed due to flooding and insufficient funds to rebuild. Initially, Jenny found that she was very dependent upon the physician’s weekly visits since her training was limited. Gradually, she found that she was beginning to call upon her training (both clinical and classroom) and she felt comfortable diagnosing and treating some of the more routine cases. One morning, a mother came in with her five-year-old child. The mother reported that the child had been unable to eat or drink anything for the past day because of vomiting. In addition, her child was experiencing severe diarrhea. Jenny asked the mother if any other family members were exhibiting similar symptoms, to which the mother replied that a few other members of the family had similar symptoms, however, not as severe. Jenny’s first thought was that the symptoms were very similar to those she had exhibited following a bout of food poisoning while in college. Since the villagers had no refrigeration and poor sanitation, Jenny gave the mother an electrolyte solution containing glucose similar to Gatorade® and told the mother to have the affected children consume this solution and nothing else for the next 24 hours. After that time, if the children were no longer vomiting, she could start feeding them tea and broth. Jenny also cautioned the mother that if the children did not seem to be getting better after 24 hours to bring the children back to the clinic.

The next morning Jenny opened the clinic to find the mother, and not just the child she had seen the previous day, but three more of the woman’s children. All of the children were exhibiting similar symptoms that now included muscle cramping and excessive thirst in addition to diarrhea and vomiting. When checking the vital signs of the children, Jenny noticed increases in both the pulse and respiratory rates accompanied by decreased blood pressures. Uncertain as to the appropriate course of action, Jenny contacted the physician by radio. Upon conveying the histories and information to the physician, Jenny received instructions to keep the children at the clinic, start intravenous (IV) infusion with lactated Ringer’s solution, and allow the children to drink as much of the electrolyte solution with glucose as they would like. The physician also gave Jenny a list of laboratory tests to run on the blood, urine and stool samples that she should collect. Jenny started the IV infusions and gave each child some of the electrolyte solution. After this, she obtained stool, blood and urine samples from each child and asked the mother to leave the children with her for care and observation. The mother agreed and said she would return later that night to help with the children.

The results of the tests run indicated severe metabolic acidosis, an increased hematocrit, hypokalemia, and the presence of Vibrio cholerae bacteria in the stool samples. Based on the results of these tests, the physician and Jenny diagnosed the children with cholera and obtained a more detailed history in an attempt to determine whether these individuals were the only ones exposed or whether these cases were the first of a possible epidemic. Jenny and the physician found that the family had recently visited relatives in a distant village where similar symptoms had been present in a number of families that had all celebrated a recent shellfish harvest.

The physician prescribed continued IV infusions with lactated Ringer’s solution and electrolyte fluid replacement by mouth. The children were not allowed to consume other foods or drinks, especially coffee or any other beverages containing caffeine. The children were also told that once the vomiting stopped they could start consuming solid foods. The children were all treated with antibiotics and stool samples were taken from other family members to determine whether or not they were infected with Vibrio cholerae. Infected, asymptomatic individuals were treated with antibiotics. The physician later explained to Jenny that caffeine was prohibited because the toxin produced by the bacteria (termed choleragen) binds to the surface of the epithelial cells of the small intestine and activates adenylate cyclase. In addition, the toxin interferes with the active transport of sodium ions in the intestinal lumen.

Why did Jenny initially suspect that the child and other family members were experiencing food poisoning? Upon further evaluation on the second day why would the child present an increased pulse and respiratory rate but decreased blood pressure?

Here are the discussion board requirements.

• The initial discussion post must be at least 250 words of content, referencing the reading of the week, and include a scholarly source.
• Plagiarism of any kind will result in a “0”.

The “Pulse” Check.  Where are you in your journey and how are you doing?

DQ2 of Week 5 is an opportunity for you to self-assess and reflect on your journey. You can write about it or you can share a created video (you-tube) expressing your navigation through the Role course. Model from the scripts in this week, but be specific to your experience.

Evaluate how you have achieved course competencies and your plans to develop further in these areas. The course competencies for this course are as follows:

1. Explore the historical evolution of the advance practice nurse.
2. Differentiate the roles and scope of practice for nurses working in advanced clinical, education, administration, informatics, research, and health policy arenas.
3. Analyze attributes of the practice arena such as access and availability, degree of consumer choice, competition, and financing that impact advanced practice nurses and their ability to effectively collaborate with other health professionals.
4. Integrate evidence from research and theory into discussions of practice competencies, health promotion and disease prevention strategies, quality improvement, and safety standards.
5. Identify collaborative, organizational, communication, and leadership skills in working with other professionals in healthcare facilities and/or academic institutions.
6. Synthesize knowledge from values theory, ethics, and legal/regulatory statutes in the development of a personal philosophy for a career as an advanced practice nurse.