In a well-developed paragraph (300–350 words) to each peer integrating atleast 2 an evidence-based resource, APA format. Respectfully agree and disagree with the responses and explain your reasoning by including your rationales in your explanation.

Response 1

 The purpose of this post is to discuss diagnosis of RR case study. After reviewing the present complaint and past medical history of RR, this writer suspects that the patient has pneumonia. This writer suspects that either of the following S. pneumoniae, H. influenzae, S. aureus, or gram-negative bacteria was the cause of the infection (Woo, Terri Moser, Robinson & Marylou. 2020). This is because RR has symptoms of fever, chills, green sputum (Woo, Terri Moser, Robinson & Marylou. 2020). Additionally, RR has complaints of pain in the right mid-back with deep breathing and coughing (Woo, Terri Moser, Robinson & Marylou. 2020). Additionally, RR had rales during the auscultation of the lungs in the right lower-posterior lung field (Woo, Terri Moser, Robinson & Marylou. 2020). As a result, ordering a lung ultrasound is beneficial to solidify the diagnosis of pneumonia (Long et al., 2017).

Pneumonia is an infection of one or both lungs (Zambare & Thalkari. 2019). The cause of pneumonia is from either bacteria, viruses, or fungi (Zambare & Thalkari. 2019). As a healthcare provider assessing for the cause of pneumonia in patient RR is crucial because pneumonia can be life-threatening (Zambare & Thalkari. 2019). The goal of treatment is to return to the respiratory status before having pneumonia (Woo, Terri Moser, Robinson & Marylou. 2020). This writer would assess the last use of antibiotics to ensure no antibiotics in the past 3 months, and the patient was previously healthly with no cardiopulmonary disease (Woo, Terri Moser, Robinson & Marylou. 2020).The first choice antibiotic this writer would recommend to treat RR with is an advanced-generation macrolide, such as azithromycin or clarithromycin (Woo, Terri Moser, Robinson & Marylou. 2020). Erythromycin would mostly likely be used to treat RR pneumonia because it is the least expensive of the macrolides (Woo, Terri Moser, Robinson & Marylou. 2020). If RR is allergic to macrolide, then this writer would use doxycycline for treatment (Woo, Terri Moser, Robinson & Marylou. 2020). The patient should respond to treatment within 48 to 72 hours, unless the patient illness is not improving (Woo, Terri Moser, Robinson & Marylou. 2020). Due to RR not having any comorbidities fluoroquinolone ushc as moxifloxacin, gemifloxacin, or levofloxacin is not needed for treating pneumonia (Woo, Terri Moser, Robinson & Marylou. 2020).

Erythromycin is the medication used to treatment RR pneumonia. The mechanism of action for macrolide such as erythromycin is to suppresses protein synthesis at the level of the 50S bacterial ribosome (Vallerand & Sanoski. 2016). The therapeutic effect of erythromycin is bacteriostatic action against susceptible bacteria  (Vallerand & Sanoski. 2016). Educating and counseling the patient about the medication is essential for the patient to understand the treatment, expected adverse effects, drug interactions, and length of treatment (Woo, Terri Moser, Robinson & Marylou. 2020). Some of the adverse effects of erythromycin are nausea, vomiting, abdominal pain, and cramping  (Vallerand & Sanoski. 2016). Moreover, RR should be informed to take the medication as prescribed and until finished even if feeling better  (Vallerand & Sanoski. 2016). Patient will be educated that the response to treatment will assist in determining the pathogen (Woo, Terri Moser, Robinson & Marylou. 2020). This writer will discuss lifestyle modifications such as hydration, smoking cessation and rest (Woo, Terri Moser, Robinson & Marylou. 2020). A discussion of worsening symptoms of pneumonia with RR will occur (Woo, Terri Moser, Robinson & Marylou. 2020). Lastly, this writer will inform RR to contact this writer or seek urgent medical care for worsening symptoms (Woo, Terri Moser, Robinson & Marylou. 2020).

Response 2

 The purpose of this discussion is to assess and treat patient RR from the case study provided. RR could have several causes of these symptoms. The test I would focus on due to her health history and symptoms would be for pneumonia, however I would like to rule out Tuberculosis (TB)as well. Mycobacteria is responsible for TB and is defined as an atypical bacterium and are more difficult to treat than other forms of bacteria (Woo & Robinson, 2020). The most common bacteria that causes bacterial pneumonia in America is called Streptococcus pneumoniae (CDC, 2020). Bacterial pneumonia presents with all the symptoms RR lists: fever, productive green sputum, cough that causes pain, difficulty breathing, and rales. Smoking will exacerbate these symptoms. The rule out on TB would be because of her living conditions, patients who are in homeless shelters are at higher risks for being susceptible to TB (Brown, 2019).
The antibiotic used for bacterial community acquired pneumonia is most commonly a combination of azithromycin and ceftriaxone (Woo & Robinson, 2020). Because this condition has not yet been treated starting with the most generally used antibiotics would be recommended. If these medications do not work and the bacteria appears to be resistant other antibiotics can be initiated.
Azithromycin is known as a bacteriostatic or bactericidal antibiotic when given in higher doses (Woo & Robinson, 2020). This is a broad spectrum antibiotic that gram-negative and gram-negative bacteria are susceptible to. Ceftriaxone is a third generation cephalosporin medication that is recommended for broader indications and is more effective against gram-negative bacteria (Woo & Robinson, 2020).
The mechanism of action for azithromycin is that it binds to 50S ribosomal subunit of the causative bacteria and intercepts the detachment of peptidyl tRNA from the ribosomes. The bacteria are dependent on the RNA for protein synthesis therefore, without it the bacteria cannot synthesize (Medscape, 2020). Ceftriaxone works less successfully against gram-positive microorganisms, however, is a better choice for a cephalosporin for resistant organisms. This antibiotic inhibits the production of peptidoglycan which is the bacteria’s enzyme that builds its cell wall. This creates the bacteria lyse (Medscape, 2020).
Studies have concluded that the use of these two medications in a combination therapy has resulted in quicker recovery, less residual symptoms, and a decrease in sepsis occurrence and should be given to high risk patients (Caballero et al., 2011). Given RR’s health history and current living conditions I would conclude that she falls into the high risk population for pneumonia complications. I would also recommend that RR gets plenty of rest and fluid, educate on the benefits of smoking cessation (and offer a nicotine gum prescription), to take the full course of medication even if symptoms resolve, and to come back if any symptoms persist or worsen.

RUBRIC

 Peer Response Post. Offers both supportive and alternative viewpoints to the discussion, using two or more scholarly references per peer post. Post provides additional value to the conversation.

All instruction requirements noted.

40 pointsEvidence of further synthesis of course content. Provides clarification and new information or insight related to the content of the peer’s post.

Response is supported by course content and a minimum of one scholarly reference per each peer post.

All instruction requirements noted.

35 pointsLacks clarification or new information. Scholarly reference supports the content in the peer post without adding new information or insight.

Missing reference from one peer post.

Partially followed instructions regarding number of reply posts.

Most instruction requirements are noted.

31 pointsPost is primarily a summation of peer’s post without further synthesis of course content.

Demonstrates incomplete understanding of content and/or inadequate preparation.

Did not follow instructions regarding number of reply posts.

Missing reference from peer posts.

Missing several instruction requirements.

Submits post late.

27 points40Frequency of DistributionInitial post and peer post(s) made on multiple separate days.

All instruction requirements noted.

10 pointsInitial post and peer post(s) made on multiple separate days.

8 pointsMinimum of two post options (initial and/or peer) made on separate days.

7 pointsAll posts made on same day.

Submission demonstrates inadequate preparation.

No post submitted.

6 points10OrganizationWell-organized content with a clear and complex purpose statement and content argument. Writing is concise with a logical flow of ideas.

5 pointsOrganized content with an informative purpose statement, supportive content, and summary statement. Argument content is developed with minimal issues in content flow.

4 pointsPoor organization and flow of ideas distract from content. Narrative is difficult to follow and frequently causes reader to reread work.

Purpose statement is noted.

3 pointsIllogical flow of ideas. Prose rambles. Purpose statement is unclear or missing.

Demonstrates incomplete understanding of content and/or inadequate preparation.

No purpose statement.

Submits assignment late.

2 points5APA, Grammar, and SpellingCorrect APA formatting with no errors.

The writer correctly identifies reading audience, as demonstrated by appropriate language (avoids jargon and simplifies complex concepts appropriately).

Writing is concise, in active voice, and avoids awkward transitions and overuse of conjunctions.

There are no spelling, punctuation, or word-usage errors.

5 pointsCorrect and consistent APA formatting of references and cites all references used. No more than two unique APA errors.

The writer demonstrates correct usage of formal English language in sentence construction. Variation in sentence structure and word usage promotes readability.

There are minimal to no grammar, punctuation, or word-usage errors.

4 pointsThree to four unique APA formatting errors.

The writer occasionally uses awkward sentence construction or overuses/inappropriately uses complex sentence structure. Problems with word usage (evidence of incorrect use of thesaurus) and punctuation persist, often causing some difficulties with grammar. Some words, transitional phrases, and conjunctions are overused.

Multiple grammar, punctuation, or word usage errors.

3 pointsFive or more unique formatting errors or no attempt to format in APA.

The writer demonstrates limited understanding of formal written language use; writing is colloquial (conforms to spoken language).

The writer struggles with limited vocabulary and has difficulty conveying meaning such that only the broadest, most general messages are presented.

Grammar and punctuation are consistently incorrect. Spelling errors are numerous.

 Nursing is a very highly regulated profession. There are over 100 boards of nursing and national nursing associations throughout the United States and its territories. Their existence helps regulate, inform, and promote the nursing profession. With such numbers, it can be difficult to distinguish between BONs and nursing associations, and overwhelming to consider various benefits and options offered by each.

Both boards of nursing and national nursing associations have significant impacts on the nurse practitioner profession and scope of practice. Understanding these differences helps lend credence to your expertise as a professional. In this Assignment, you will practice the application of such expertise by communicating a comparison of boards of nursing and professional nurse associations. You will also share an analysis of your state board of nursing.

To Prepare:

· Assume that you are leading a staff development meeting on regulation for nursing practice at your healthcare organization or agency.

· Review the NCSBN and ANA websites to prepare for your presentation.

The Assignment: (10 slide PowerPoint presentation)

Develop a  10-slide PowerPoint Presentation that addresses the following:

· Describe the differences between a board of nursing and a professional nurse association.

· Describe the board for your specific region/area.

o Who is on the board?

o How does one become a member of the board?

· Describe at least one state regulation related to general nurse scope of practice.

o How does this regulation influence the nurse’s role?

o How does this regulation influence delivery, cost, and access to healthcare?

· Describe at least one state regulation related to Advanced Practice Registered Nurses (APRNs).

o How does this regulation influence the nurse’s role?

o How does this regulation influence delivery, cost, and access to healthcare?

· Include Speaker Notes on Each Slide (except on the title page and reference page)

Milstead, J. A., & Short, N. M. (2019). Health policy and politics: A nurse’s guide (6th ed.). Burlington, MA: Jones & Bartlett Learning.

• Chapter 4, “Government Response: Regulation” (pp.      57–84)

American Nurses Association. (n.d.). ANA enterprise. Retrieved September 20, 2018, from http://www.nursingworld.org

Bosse, J., Simmonds, K., Hanson, C., Pulcini, J., Dunphy, L., Vanhook, P., & Poghosyan, L. (2017). Position statement: Full practice authority for advanced practice registered nurses is necessary to transform primary care. Nursing Outlook, 65(6), 761–765. doi:10.1016/j.outlook.2017.10.002

Note: You will access this article from the Walden Library databases.

Halm, M. A. (2018). Evaluating the impact of EBP education: Development of a modified Fresno test for acute care nursing. Worldviews on Evidence-Based Nursing, 15(4), 272–280. doi:10.1111/wvn.12291

National Council of State Boards of Nursing (NCSBN). (n.d.). Retrieved September 20, 2018, from https://www.ncsbn.org/index.htm

Neff, D. F., Yoon, S. H., Steiner, R. L., Bumbach, M. D., Everhart, D., & Harman J. S. (2018). The impact of nurse practitioner regulations on population access to care. Nursing Outlook, 66(4), 379–385. doi:10.1016/j.outlook.2018.03.001

Note: You will access this article from the Walden Library databases.

Peterson, C., Adams, S. A., & DeMuro, P. R. (2015). mHealth: Don’t forget all the stakeholders in the business case. Medicine 2.0, 4(2), e4. doi:10.2196/med20.4349

Note: You will access this article from the Walden Library databases.

Required Media

Laureate Education (Producer). (2018). The Regulatory Process [Video file]. Baltimore, MD: Author.

 APA style and less than 10 % similarity

Please answer the following Discussion Question. Please be certain to answer the four questions on this week DQ and to provide a well-developed and complete answer to receive credit. Also, please ensure to have read the assigned chapters for the current week. 

Case Study, Chapter 21, Health Care Reform: The Dismantling of the Affordable Care ActAs we entered 2018, millions of Americansstill relied onAffordable Care Act(ACA) subsidies, health premiums were soaring, and provider choice was more limited than ever.There was, however, momentum for reform. Health care was identified as the country’s leading priority for Democrats (54%) and the second highest priority for Republicans (42%) at the close of 2017. A group of registered nurses debate the issue of health care reform

.

1. The nurses debate whether the country feels that health care reform is really necessary. Discuss reasons why reform is needed and what that reform should address.

2. What were the 10 essential benefits guaranteed by insurance plans in the ACA Health Care Marketplace? 

3. What are the successes of the ACA?

4. What are the failures of the ACA?

 

Personal Leadership Philosophies

Many of us can think of leaders we have come to admire, be they historical figures, pillars of the industry we work in, or leaders we know personally. The leadership of individuals such as Abraham Lincoln and Margaret Thatcher has been studied and discussed repeatedly. However, you may have interacted with leaders you feel demonstrated equally competent leadership without ever having a book written about their approaches.

What makes great leaders great? Every leader is different, of course, but one area of commonality is the leadership philosophy that great leaders develop and practice. A leadership philosophy is basically an attitude held by leaders that acts as a guiding principle for their behavior. While formal theories on leadership continue to evolve over time, great leaders seem to adhere to an overarching philosophy that steers their actions.

What is your leadership philosophy? In this Assignment, you will explore what guides your own leadership.

To Prepare:

• Identify two to three scholarly resources, in addition to this Module’s readings, that evaluate the impact of leadership behaviors in creating healthy work environments.
• Reflect on the leadership behaviors presented in the three resources that you selected for review.
• Reflect on your results of the CliftonStrengths Assessment, and consider how the results relate to your leadership traits.

The Assignment (2-3 pages):

Personal Leadership Philosophies

Develop and submit a personal leadership philosophy that reflects what you think are characteristics of a good leader. Use the scholarly resources on leadership you selected to support your philosophy statement. Your personal leadership philosophy should include the following:

• A description of your core values
• A personal mission/vision statement
• An analysis of your CliftonStrengths Assessment summarizing the results of your profile
• A description of two key behaviors that you wish to strengthen
• A development plan that explains how you plan to improve upon the two key behaviors you selected and an explanation of how you plan to achieve your personal vision. Be specific and provide examples.
• Be sure to incorporate your colleagues’ feedback on your CliftonStrengths Assessment from this Module’s Discussion 2.

Read Chapter 8

1. Describe a situation in which the nurse manager would use problem resolution in the workplace. Describe a situation in which the nurse manager would use negotiation to resolve a conflict (or potential conflict) in the workplace. 

2. Compare and contrast strategies for resolving a conflict, using first the informal negotiation method and then the formal negotiation method. 

3. Explore the American Nurses Association website for information on collective bargaining for nurses. Which states have nursing unions? Debate the issue of joining a union with another group of students. 

4. PART 1: Log onto the website of your state nurses association and search for information on collective bargaining. Search for news articles, union websites, and other recent information on collective bargaining for nurses in your state. Is there a great deal of collective bargaining activity in your state? If not, why? If yes, what are the primary issues under discussion?

PART 2: Review the pros and cons of becoming part of a collective bargaining unit. If you were a full-time staff nurse, would you want to join a union? Why or why not?

250 words or more

APA citation 

3 references or more