New technology—and the application of existing technology—only appears in healthcare settings after careful and significant research. The stakes are high, and new clinical systems need to offer evidence of positive impact on outcomes or efficiencies.

Nurse informaticists and healthcare leaders formulate clinical system strategies. As these strategies are often based on technology trends, informaticists and others have then benefited from consulting existing research to inform their thinking.

In this Assignment, you will review existing research focused on the application of clinical systems. After reviewing, you will summarize your findings.

To Prepare:

• Review the Resources and reflect on the impact of clinical systems on outcomes and efficiencies within the context of nursing practice and healthcare delivery.
• Conduct a search for recent (within the last 5 years) research focused on the application of clinical systems. The research should provide evidence to support the use of one type of clinical system to improve outcomes and/or efficiencies, such as “the use of personal health records or portals to support patients newly diagnosed with diabetes.”
• Identify and select 4 peer-reviewed research articles from your research.
• For information about annotated bibliographies, visit https://academicguides.waldenu.edu/writingcenter/assignments/annotatedbibliographies

The Assignment: (4-5 pages not including the title and reference page)

In a 4- to 5-page paper, synthesize the peer-reviewed research you reviewed. Format your Assignment as an Annotated Bibliography. Be sure to address the following:

• Identify the 4 peer-reviewed research articles you reviewed, citing each in APA format.
• Include an introduction explaining the purpose of the paper.
• Summarize each study, explaining the improvement to outcomes, efficiencies, and lessons learned from the application of the clinical system each peer-reviewed article described. Be specific and provide examples.
• In your conclusion, synthesize the findings from the 4 peer-reviewed research articles.
• Use APA format and include a title page.

Instructions:

With a well thought out plan, you can achieve virtually any goal you set for yourself. And making a plan is crucial for continuing your education to build further skills and knowledge that can be applied to your work.

For this assignment, you are going to develop a plan for continuing education in psychopharmacology. The purpose of this assignment is to familiarize you with continuing education materials and to begin developing habits that will keep your psychopharmacology skills and knowledge up to date.

Familiarize yourself with various learning resources and continuing education opportunities including but not limited to reference books, clinical journals, newsletters, professional organizations, conferences, CME events, local psychiatry grand rounds, psychiatry podcasts (several universities podcast their grand rounds). 

• Identify the resources that you find most useful. What do you like about them?
• Which resources are appropriate for use on a routine basis for point of care clinical information?
• Which resources are helpful for staying current with emerging information in psychopharmacology?
• Which resources are useful for in depth learning on topics of interest?
• What is the feasibility of these resources in terms of cost, time and travel?
• Develop a continuing education plan. This is your commitment to independent learning. Identify the actions that you plan to take:
  • On a routine basis, when questions arise at point of care.
  • On a weekly or monthly basis – subscriptions, online readings, etc.
  • On an annual basis, such as conferences or symposiums.
  • Include resources that will provide a meet a variety of learning needs – guide clinical decision making at point of care, provide current information on new drugs or new safety information and deepen your understanding of particular topics.
  • Write a summary of your plan. How do your chosen resources support your learning goals? Why did you choose them?
  • Please provide references and links to your educational resources.
  • Submit your plan to Moodle.

The main ideas are to:

1. Identify your psychopharmacology learning goals. Research available resources including journals, newsletters, lecture series (such as grand rounds), conferences. Then, create a learning plan to meet your learning goals. 
2. Note when you would like to complete each goal and the feasibility of the time range.
3. Note future plans for your continuing education that would allow to reach your goals.Appropriate spelling and grammar are required. Turnitin assignment. 

NOTE: Attached, you will find a copy of a classmate assignment example, and you may use some of its data as a reference to complete my assignment. TURNITIN Assignment (No plagiarism)

Background: I live in South Florida, I am currently enrolled in the Psych Mental Health Nurse Practitioner Program, I am a Registered Nurse, I work in a Psychiatric Hospital. 

 

Throughout the RN-to-BSN program, students are required to  participate in scholarly activities outside of clinical practice or  professional practice. Examples of scholarly activities include  attending conferences, seminars, journal club, grand rounds, morbidity  and mortality meetings, interdisciplinary committees, quality  improvement committees, and any other opportunities available at your  site, within your community, or nationally.

You are required to  post at least one documented scholarly activity by the end of this  course. In addition to this submission, you are required to be involved  and contribute to interdisciplinary initiatives on a regular basis.

Submit,  by way of this assignment, a summary report of the scholarly activity,  including who, what, where, when, and any relevant take-home points.  Include the appropriate program competencies associated with the  scholarly activity as well as future professional goals related to this  activity. You may use the “Scholarly Activity Summary” resource to help  guide this assignment.

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

APA style is not required, but solid academic writing is expected.

Nurses are often portrayed in films and television. From Nurse Ratched in One Flew over the Cuckoo’s Nest, to Julia Baker in Julia, and Gaylord “Greg” Focker in Meet the Parents, nurses have been portrayed showing various traits. Some are positive, while others are less than caring. For each, the five elements of emotional intelligence, 1) self-awareness, 2) self-regulation, 3) motivation, 4) empathy, and 5) social skills, are expressed at different levels. Select a nurse archetype portrayed in films or on television and consider the following.

1- What features of emotional intelligence does your selected nurse portray? What features are they lacking? Provide an example to support your rationale.

2- If you were the nurse’s leader, how would use your change agent characteristics to support that individual’s growth? Provide specific examples using scenarios from the setting from which the nurse is portrayed.

3- How does complexity theory or chaos theory influence the organization in which the nurse is portrayed? Provide specific examples to support your rationale.

At its core, pathology is the study of disease. Diseases occur for many reasons. But some, such as cystic fibrosis and Parkinson’s Disease, occur because of alterations that prevent cells from functioning normally.

Understanding of signals and symptoms of alterations in cellular processes is a critical step in diagnosis and treatment of many diseases. For the Advanced Practice Registered Nurse (APRN), this understanding can also help educate patients and guide them through their treatment plans.

For this Discussion, you examine a case study and explain the disease that is suggested. You examine the symptoms reported and explain the cells that are involved and potential alterations and impacts. 

To prepare:

• By Day 1 of this week, you will be assigned to a specific scenario for this Discussion. Please see the “Course Announcements” section of the classroom for your assignment from your Instructor.

By Day 3 of Week 1

Post an explanation of the disease highlighted in the scenario you were provided. Include the following in your explanation:

• The role genetics plays in the disease.
• Why the patient is presenting with the specific symptoms described.
• The physiologic response to the stimulus presented in the scenario and why you think this response occurred.
• The cells that are involved in this process.
• How another characteristic (e.g., gender, genetics) would change your response.

I will be adding a discussion that will need a reply after. I will add 2 of them but at a different time depending on when they are availabe.

Julia’s discussion

In this scenario, it appears that a 16-year-old boy had an allergic reaction to amoxicillin. While this is unfortunate and was probably unavoidable, the provider could have reduced the risk of a medical emergency by asking a few questions. Genetics is important as familial tendency to develop allergic conditions is thought to have a genetic link. In an article published in PubMed, the authors wrote “The allergic diseases are complex phenotypes for which a strong genetic basis has been firmly established.” (Ortiz & Barnes, 2014). It does not say in the scenario, but family medical history could have identified an increased risk for this child, but the order was most appropriate given the diagnosis of Strep throat and the available history.

According to the required reading this week, the clinical manifestations of an allergic reaction are related to histamine being released into the body McCance, K. & Huether, S., 2019) . Acute allergic reactions are mediated by IgE antibodies and arises rapidly after exposure. Symptoms include hypotension, bronchospasm, angioedema (swelling), and urticaria (itching), all reported reactions in this scenario. Acute allergic reactions result from the immune system identifying a substance, in this case, amoxicillin as dangerous as a result of previous exposure (Bhattacharya, 2010). After exposure, there are antibody receptors for that substance in the body, another exposure results in the rapid release of histamine and other mediators from basophils and mast cells. Basophils and mast cells both look granulated. The granules are tiny packets of chemicals: histamine, leukotrienes, and cytokines, and other mediators. When the IgE antibodies on the surface of the basophils and the mast cells encounter an identified allergen, it triggers the cells to degranulate, releasing the contents of the granules out of the cell, where they can act in the body. The release of these vasoactive mediators results in a sudden drop in blood pressure and blood volume, flushing, itching, and bronchospasm, and potential death due to shock.

In the case that his boy had other factors such as he was female, had a family history of sensitivities or autoimmune disorders would have increased his risk of having an allergic reaction. The article “Genetics of allergic disease” went on to say, “Several reports have found that allergic diseases such as asthma, rhinitis, conjunctivitis, and dermatitis as well as allergic reactions to drugs and foods, are more common in patients with the autoimmune disease systemic lupus erythematosus.” (Ortiz & Barnes, 2014). It is important to get a full medical history and family history to avoid potential drug reactions like what was described in this scenario. While genetics alone does not guarantee a reaction, it does increase the risks and should be considered when implementing medications in a patient’s care.

References

Bhattacharya, S. (2010, January). The facts about penicillin allergy: A review. PubMed Central (PMC). Retrieved March 1, 2021, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3255391/

McCance, K. L. & Huether, S. E. (2019). Pathophysiology: The biologic basis for disease in adults and children (8th ed.). St. Louis, MO: Mosby/Elsevier

Ortiz, R., & Barnes, K. (2014, November 21). Genetics of allergic diseases. PubMed Central (PMC). Retrieved February 28, 2021, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4415518/

Jens Discussion

Discussion Response

The scenario displays a patient that has strep throat. Strep throat is caused by group A streptococci or streptococcus pyogenes (Krishnan et al., 2016). There are many factors that can play a role in regard to how severe the disease can be for the compromised individual. Genetic context is one of those factors. Many people wonder why some children are more prone to getting strep throat over others. Research has shown that a combination of genetic and immunological factors makes some individuals more suspectable (Dan et al., 2019). Kids with recurrent episodes of strep throat have a decrease of both B and follicular helper T cells, and have smaller geminal center areas (Dan et al., 2019). Thus, a poor immune response is associated with these kids. Genetic testing suggests that group A streptococci tonsillitis is more prevalent in people who have two specific gene variants in the HLA region (Dan et al., 2019). 

The patient presented with enlarged tonsils, sore throat and cervical adenopathy. These symptoms occurred from the invasion of streptococcus pyogens. The body tries to fight the illness by sending white blood cells to kill the bacteria, which causes an inflammatory response. When foreign bodies are presented to the lymphoid cells, cellular proliferation and enlargement occurs (Maini & Nagalli, 2021). Hyperemia and oedema cause the tonsils to enlarge and convert the lymphoid follicles into abscesses that then become crypts (McCance & Huether, 2019). These crypts produce exudate. A temperature of 99.6 may or may not be an immune response. If the low-grade temp is in correlation with the infection, it is the bodies way to kill the bacteria and make it harder for the pathogen to survive. 

Anaphylaxis is a severe reaction with rapid onset and is characterized by breathing or circulatory problems and is usually connected with skin and mucosal changes (Reber et al., 2017). This allergic reaction occurred when the boy took amoxicillin. This response occurred because the body failed to protect itself from the foreign body or antigen (Reber et al., 2017). The exposure to the allergen caused large quantities of Immunoglobin E (IgE) to be released. The antigen binds to IgE which causes chemicals to be released. One of these chemicals that is released from the basophils and mast cells is histamine (Reber et al., 2017). Histamine causes bronchoconstriction, increased gastric motility, vasodilation, and increased vascular permeability (Reber et al., 2017). Histamine is a defense mechanism used to try to destroy the antigen (Reber et al., 2017). Histamine is what caused the boy to have swelling of the tongue and lips, difficulty breathing and audible wheezing. 

The effector cells involved in the allergic reaction are mast cells, basophils, macrocytes/macrophages and neutrophils (Reber et al., 2017). Mast cells are key players in anaphylaxis and IgE dependent allergies (Reber et al., 2017). Mast cells emit large numbers of FcεRI, the IgE receptor, during an immune response to an allergen (Reber et al., 2017). These receptors activate the secretion of chemicals such as histamine and cysteinyl leukotrienes (Reber et al., 2017). 

Basophils can also express high levels of FcεRI (Reber et al., 2017). There is not enough evidence to show how important basophils are in the pathology of anaphylaxis, however, basophils can help diagnose or determine allergens during an allergen sensitivity test (Reber et al., 2017). IgE dependent activation of human basophils is correlated with higher basophil cell surface makers and forms the basis of “basophil activation tests” or allergen tests (Reber et al., 2017). 

Monocytes/macrophages respond to anaphylatoxins and express high levels of FcγRs (Reber et al., 2017). However, there is not enough research to show how much monocytes/macrophages are involved in the anaphylaxis process (Reber et al., 2017). Along with monocytes/macrophages, neutrophils are also an area of continuing studies. Research has recently shown that neutrophils have a T cell priming ability which enhances eosinophil migration (Reber et al., 2017). 

Perhaps if the individual in the scenario was a female, the symptoms wouldn’t have been as severe. A study was conducted on mice that showed female mice were more resistant to the group A Steptococcus bacteria (Krishnan et al., 2016). The male mice had greater concentrations of inflammatory cytokines and chemokines, and greater bacterial dissemination (Krishnan et al., 2016). 

References

Dan, J. M., Havenar-Daughton, C., Kendric, K., Al-kolla, R., Kaushik, K., Rosales, S. L., Anderson, E. L., LaRock, C. N., Vijayanand, P., Seumois, G., Layfield, D., Cutress, R. I., Ottensmeier, C. H., Linestam Arlehamn, C. S., Sette, A., Nizet, V., Bothwell, M., Brigger, M., & Crotty, S. (2019). Recurrent Group A streptococcus tonsillitis is an immune susceptibility disease involving antibody deficiency and aberrant T follicular helper cells. Science Translational Medicine. https://doi.org/10.1126/scitranslmed.eaau3776

Krishnan, K. C., Mukundan, S., Alagarsamy, J., Laturnus, D., & Kotb, M. (2016). Host genetic variation and sex differences potentiate predisposition, severity, and outcomes of Group A Streptococcus mediated necrotizing soft tissue infections. Infection and Immunity, 84(2), 416–424. https://doi.org/10.1128/IAI.01191-15

Maini, R., & Nagalli, S. (2021). Lymphadenopathy. Treasure Island, FL: StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK558918/

McCance, K. L., & Huether, S. E. (2019). Pathophysiology: The biologic basis for disease in adults and children (8th ed.). St. Louis, MO: Mosby/Elsevier.

Reber, L. L., Hernandez, J. D., & Galli, S. J. (2017). The pathophysiology of anaphylaxis. Journal of Allergy and Clinical Immunology, 140(2), 335–348. https://doi.org/10.1016/j.jaci.2017.06.003