Discussion Question #1 

For this questions, please read the following case stud and then respond to the questions noted below. 

Mr. EBR is a 74-year-old retired Hispanic gentleman with known coronary artery disease (CAD), who presents to your clinic with substernal chest pain for the past 3 months. It is not positional; it reliably occurs with exertion, approximately one to two times daily, and is relieved with rest, or one or two sublingual nitroglycerin (NTG) tabs. It is similar in quality, but is much less severe, than the chest pain that occurred with his previous inferior myocardial infarction (MI) 3 years ago. Until the past 3 months, he has felt well.

The chest pain is accompanied by diaphoresis and nausea, but no shortness of breath (SOB) or palpitations. He does not vomit. He denies orthopnea, paroxysmal nocturnal dyspnea (PND), syncope, presyncope, dizziness, lightheadedness, and symptoms of stroke or transient ischemic attack (TIA). An echocardiogram done after his MI demonstrated a preserved left ventricular ejection fraction (LVEF). Other medical problems include well-controlled type 2 diabetes mellitus (DM), well-controlled hypertension (HTN), and hyperlipidemia, with low-density lipoprotein (LDL) at goal. He also has stage 3 chronic kidney disease (CKD) and diabetic neuropathy. He no longer smokes and does not use alcohol or recreational drugs. His daily medications include: Atenolol 25 mg PO bid, Lisinopril 20 mg PO bid, aspirin 81 mg PO daily, Simvastatin 80 mg PO each evening, and metformin 500 mg PO bid.

Mr. EBR’s physical assessment includes the following: height 68 inches, weight 185 lb, Blood pressure (BP) 126/78, heart rate (HR) 64, Respiratory rate (RR) 16, and temperature 98.6°F orally. He is alert and oriented, and in no apparent distress (NAD). His neck is without jugular venous distention (JVD) or carotid bruits. Lungs are clear to auscultation bilaterally. Cardiovascular: normal S1 & S2, RRR, without rubs, murmurs or gallops. Abdomen has active bowel tones and is soft, nontender, and nondistended (NTND). Extremities are without clubbing, cyanosis, or edema. Distal pedal pulses are 2+ bilaterally

1. What would you add to the current treatment plan? Why?
2. Would you discontinue any of the currently prescribed medication? Why or why not?
3. How does the diagnosis stage 3 chronic kidney disease affect your choices?
4. Why is the patient prescribed more than one antihypertensive?
5. What is the benefit of the aspirin therapy in this patient?

Discussion Question #2

List three classes of drugs affecting the Hematopoietic System. List the mechanism of action for each class of drug. Choose one medication from the three classes and discuss what disorder the drug is used to treat? How often the medication is given? What labs should get monitored while the patient is taking this medication? Your response should be at least 350 words.

Assignment: Academic Success and Professional Development Plan Part 6: Finalizing the Plan

At some point in every construction project, efforts turn from design and the focus moves to actual construction. With the vision in place and the tools secured, the blueprint can be finalized and approved. Then it is time to put on hardhats and begin work.

Throughout the course you have developed aspects of your Academic and Professional Development Plan. You have thought a great deal about your vision and goals, your academic and professional network of support, research strategies and other tools you will need, the integrity of your work, and the value of consulting the work of others. With your portfolio in place, it is now time to finalize your blueprint for success.

Much as builders remain cognizant of the building standards as they plan and begin construction, nurses must remain mindful of the formal standards of practice that govern their specialties. A good understanding of these standards can help ensure that your success plan includes any steps necessary to excel within your chosen specialty.

In this Assignment you will continue developing your Academic Success and Professional Development Plan by developing the final component–a review of your specialty standards of practice. You will also submit your final version of the document, including Parts 1–5.

The Assignment:
Complete the following items and incorporate them into the final version of your Academic Success and Professional Development Plan.

• With the resources specific to the MSN specialization and the, Walden University. (n.d.). Master of Science in Nursing (MSN), shared in this module, write a paragraph or make a Nursing Specialty Comparison table, comparing at least two nursing specialties that include your selected specialization and second-preferred specialization.
• Write a 2- to 3-paragraph justification statement identifying your reasons for choosing your MSN specialization. Incorporate feedback you received from colleagues in this Module’s Discussion forum.
• Identify the professional organization related to your chosen specialization for this Assignment, and explain how you can become an active member of this organization.

Note: Your final version of the Academic Success and Professional Development Plan should include all components as presented the Academic Success and Professional Development Plan template.

 Using the Reflective Conflict Guide for the APN (Word), think back to a clinical or practice situation in which a conflict arose. This can be an event that was recent or many months ago. After reading the required readings, including the conflict resolutions steps article, begin to apply what you have learned to that situation, by following the prompts in the conflict guide. This will not be shared with your classmates, as the goal of this exercise is to have you truly reflect on a situation that was unethical, immoral, negligent, etc., so that you can identify appropriate actions if put in the same position in the future. 

Search the GCU Library and find two new health care articles that use quantitative research. Do not use articles from a previous assignment, or articles that appear in the Topic Materials or textbook.

Complete an article analysis for each using the “Article Analysis: Part 2” template.

Refer to the “Patient Preference and Satisfaction in Hospital-at-Home and Usual Hospital Care for COPD Exacerbations: Results of a Randomised Controlled Trial,” in conjunction with the “Article Analysis Example 2,” for an example of an article analysis.

While APA style is not required for the body of this assignment, solid academic writing is expected, and documentation of sources should be presented using APA formatting guidelines, which can be found in the APA Style Guide, located in the Student Success Center.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

At some point in every construction project, efforts turn from design, and the focus moves to actual construction. With the vision in place and the tools secured, the blueprint can be finalized and approved. Then it is time to put on hard hats and begin work.

Throughout the course, you have developed aspects of your Academic and Professional Development Plan. You have thought a great deal about your vision and goals, your academic and professional network of support, research strategies and other tools you will need, the integrity of your work, and the value of consulting the work of others. With your portfolio in place, it is now time to finalize your blueprint for success.

Much as builders remain cognizant of the building standards as they plan and begin construction, nurses must remain mindful of the formal standards of practice that govern their specialties. A good understanding of these standards can help ensure that your success plan includes any steps necessary to excel within your chosen specialty.

In this Assignment, you will continue developing your Academic Success and Professional Development Plan by developing the final component–a review of your specialty standards of practice. You will also submit your final version of the document, including Parts 1–5.

To Prepare:

• Review the scope and standards of practice or competencies related to your chosen specialty in the resources for this module.
• Review the MSN specializations offered at the school website by viewing the module resource, Master of Science in Nursing (MSN)      
• Examine professional organizations related to the specialization you have chosen and identify at least one to focus on for this Assignment.
• Reflect on the thoughts you shared in the Discussion forum regarding your choice of a specialty, any challenges you have encountered in making this choice, and any feedback you have received from colleagues in the Discussion.

The Assignment:

Complete the following items and incorporate them into the final version of your Academic Success and Professional Development Plan.

• With the resources specific to your MSN specialization (Psychiatric Mental Health Nurse Practitioner) and other Master of Science in Nursing (MSN) specializations shared in this module, write a paragraph or make a Nursing Specialty Comparison table, comparing at least two nursing specialties that include your selected specialization and second-preferred specialization.
• Write a 2- to 3-paragraph justification statement identifying your reasons for choosing your MSN specialization. Incorporate feedback you received from colleagues in this Module’s Discussion forum.

Identify the professional organization related to your chosen specialization for this Assignment and explain how you can become an active member of this organization.