Respond one of your colleagues’ posts by offering a possible resolution to their  questions/concerns with supporting documentation.

at least 2 references in each peer responses! 

  

Nursing boards were created to establish guidelines for the scope of nursing practice. Each state has established its own board; thus regulations can vary by state. Advanced practice registered nurses must be familiar with their own state board’s regulations as it pertains to their practice, and advocate for the expansion of the nurse practitioner’s ability to practice and provide best care. 

Regulation 1

A main topic of conversation among nursing boards is the ability of advanced practice registered nurses (APRN’s) to practice independently of a collaborating physician. As discussed by Bosse et al., (2017), the ability of APRN’s to practice independently would help fill the gap in access to care associated with physician shortages and remote locations. Greater access to care has the potential to improve outcomes and reduce healthcare costs and complications. Currently, Missouri and Illinois both require APRN’s to maintain a collaborative practice agreement with a physician within a certain geographic range (Nurse Practice Act, 2018; Nursing & Collaborative Practice, 1996). The National Council of State Boards of Nursing (NCSBN) encourages APRN’s to advocate for independent practice in their states (Bosse et al., 2017). 

Regulation 2 

As technology plays an increasingly central role in the provision of healthcare, the use of technology must be addressed by regulatory boards. Telehealth is another solution to improving access to healthcare, especially in rural areas. Missouri permits APRN’s to practice virtually if the care is being provided to patients in remote areas (Utilization of telehealth, 2014). Illinois permits APRN’s to treat residents of the state via telehealth without geographical stipulations (Telehealth Act, 2018). 

Conclusion

As nurse practitioners, we can adhere to these regulations while also advocating for the advancement of the advanced practice registered nurse’s role in healthcare. Another opportunity for advocacy lies in the use of telehealth to improve access to care in rural areas. By providing exceptional care and demonstrating the knowledge and skills needed to practice independently, we can emulate the need to expand the scope of practice for nurse practitioners.  

 

Resources: Internet, University Library, and Human Diseases (4th ed.)

Imagine you are creating a community health promotion resource that addresses a cardiovascular subject of your choosing. You are creating this tool for a segmented population of health care consumers.

Create an informational tool (350 to 700 words) in the form of one of the following:

• Podcast
• Summary
• News transcript
• Brochure/pamphlet
• Video
• Interview
• Other option approved by your instructor

Include the following in your resource: 

• Identify the disease or subject of focus.
• Identify the population.
• Focus your information on the specific cultural beliefs of the population that you have chosen and how treatment and management of the disease might be affected by these aspects.
• Explain how this disease and the management of it affect resources in society.

 

Submit an evidence-based practice paper about cultural competency in mental health nursing. An evidence-based practice paper allows you to explore best practice and help improve client outcomes on a psychiatric unit. Your paper should describe how you, as a nurse, will include – or have included – cultural awareness in a client diagnosed with a mental illness. The person you describe could be someone in your clinical setting, someone you have worked with in the past, or a theoretical client.

Remember that culture can also include gender equality, sexual orientation, and other cultures besides race and religion – including cultures unique to one particular family. Your paper should be at least 3 pages (double-spaced, not including the title or reference pages) in APA Format and include:

• Assessment: Discuss what you would assess in regard to a client’s culture. For example, are there specific dietary requirements? Are schedule changes necessary to avoid conflicts with religious practices? Who is the spokesperson for the family? What would you assess?
• Diagnosis: List any mental health nursing diagnoses this person has or may be at risk for. Include at least one cultural diagnosis.
• Planning: What planning needs to be done to ensure the cultural and emotional safety of the client?
• Implementation: What are interventions that would ensure the safety of your client in regard to culture? Include at least two interventions. For example, if your client has religious beliefs that affect the ability to take medications, what interventions would you create to ensure the client’s safety? What can you do to make sure the client’s cultural needs are met?
• Evaluation: How will you evaluate whether your implementation was effective? Make sure the parameters are objective and measurable.
• In your summary, discuss whether any completed interventions were successful. What could be done differently in the future? If the interventions have not yet been carried out, you might discuss some institutional changes that could be made to ensure cultural safety for all clients in that setting.

Your paper should utilize proper APA guidelines and include at least three scholarly sources to support your paper. A scholarly source is a source that has been peer reviewed and has appropriate authors that are credentialed

..heart disease remains the No. 1 killer in America; nearly half of all Americans have high blood pressure, high cholesterol, or smoke—some of the leading risk factors for heart disease…

—Murphy et al., 2018

Despite the high mortality rates associated with cardiovascular disorders, improved treatment options do exist that can help address those risk factors that afflict the majority of the population today. 

As an advanced practice nurse, it is your responsibility to recommend appropriate treatment options for patients with cardiovascular disorders. To ensure the safety and effectiveness of drug therapy, advanced practice nurses must consider aspects that might influence pharmacokinetic and pharmacodynamic processes such as medical history, other drugs currently prescribed, and individual patient factors.

Reference: Murphy, S. L., Xu, J., Kochanek, K. D., & Arias, E. (2018). Mortality in the United States, 2017. Retrieved from https://www.cdc.gov/nchs/products/databriefs/db328.htm

To Prepare

• Review the Resources for this module and consider the impact of potential pharmacotherapeutics for cardiovascular disorders introduced in the media piece.
• Review the case study assigned by your Instructor for this Assignment.
• Select one the following factors: genetics, gender, ethnicity, age, or behavior factors.
• Reflect on how the factor you selected might influence the patient’s pharmacokinetic and pharmacodynamic processes.
• Consider how changes in the pharmacokinetic and pharmacodynamic processes might impact the patient’s recommended drug therapy.
• Think about how you might improve the patient’s drug therapy plan based on the pharmacokinetic and pharmacodynamic changes. Reflect on whether you would modify the current drug treatment or provide an alternative treatment option for the patient.

case study:

CASE STUDY 2: Patient HM has a history of atrial fibrillation and a transient ischemic attack (TIA). The patient has been diagnosed with type 2 diabetes, hypertension, hyperlipidemia and ischemic heart disease.

Drugs currently prescribed include the following:

• Warfarin 5 mg po daily MWF and 2.5 mg daily T, TH, Sat, Sun 

• Aspirin 81 mg po daily 

• Metformin 1000 mg po bid 

• Glyburide 10 mg po bid 

• Atenolol 100 mg po daily 

• Motrin 200 mg 1–3 tablets every 6 hours as needed for pain

Write a 2- to 3-page paper that addresses the following:

• Explain how the factor you selected might influence the pharmacokinetic and pharmacodynamic processes in the patient from the case study you were assigned.
• Describe how changes in the processes might impact the patient’s recommended drug therapy. Be specific and provide examples.
• Explain how you might improve the patient’s drug therapy plan and explain why you would make these recommended improvements.

Rubrics:

Explain how the factor you selected might influence the pharmacokinetic and pharmacodynamic processes in the patient from the case study you were assigned.–

Describe how changes in the processes might impact the patient’s recommended drug therapy. Be specific and provide examples.–

Explain how you might improve the patient’s drug therapy plan, and explain why you would make these recommended improvements.

Written Expression and Formatting – Paragraph Development and Organization:
Paragraphs make clear points that support well developed ideas, flow logically, and demonstrate continuity of ideas. Sentences are carefully focused–neither long and rambling nor short and lacking substance.

Written Expression and Formatting – English writing standards:
Correct grammar, mechanics, and proper punctuation

Written Expression and Formatting – The paper follows correct APA format for title page, headings, font, spacing, margins, indentations, page numbers, running head, parenthetical/in-text citations, and reference list.–

References:

Rosenthal, L. D., & Burchum, J. R. (2018). Lehne’s pharmacotherapeutics for advanced practice providers. St. Louis, MO: Elsevier.

• Chapter 34, “Review of Hemodynamics” (pp. 335–340)
• Chapter 35, “Diuretics” (pp. 341–349)
• Chapter 36, “Drugs Acting on the Renin-Angiotensin-Aldosterone System” (pp. 351–362)
• Chapter 37, “Calcium Channel Blockers” (pp. 363–369)
• Chapter 38, “Vasodilators” (pp. 371–373)
• Chapter 39, “Drugs for Hypertension” (pp. 375–388)
• Chapter 40, “Drugs for Heart Failure” (pp. 389–402)
• Chapter 41, “Antidysrhythmic Drugs” (pp. 403–418)
• Chapter 42, “Prophylaxis of Atherosclerotic Cardiovascular Disease: Drugs That Help Normalize Cholesterol and Triglyceride Levels” (pp. 419–439)
• Chapter 43, “Drugs for Angina Pectoris” (pp. 441–450)
• Chapter 44, “Anticoagulant and Antiplatelet Drugs” (pp. 451–472)

15% turnitin pls

Comment 1

Z-tests are used to compare the collected data of a defined population and the sample.  The z-score tells you how far, in standard deviation, a data point is from the mean or average of a data set. A z-test compares a sample to a defined population. Normally, a z-test identifies issues with larger samples that are being studied (n > 30). Z-tests are also useful when testing out a hypothesis. Generally, they are most useful when the standard deviation is known.

T-tests are calculations used to test a hypothesis. However, t-tests are used to determine the statistical difference between two independent sample groups. In other words, a t-test analyzes how likely the difference between two samples occurs due to random chance. Usually, t-tests are most appropriate to use when dealing with problems with a limited or small sample size (n < 30).

One-sample T-tests are used to compare the mean average between the sample and the population studied. The test is also applied compare the difference between the mean of the sample and the mean of the population. Z-tests always use normal distribution and should be used when the standard deviation is known after the data is collected.

Comment 2.

A z-score and a t- score are both used in hypothesis testing. Generally, in elementary stats and AP stats, you’ll use a z-score in testing more often than a t score.

Z-scores are a conversion of individual scores into a standard form. The conversion is based on your knowledge about the population’s standard deviation and mean. A z-score tells you how many standard deviations from the mean your result is. You can use your knowledge of normal distributions (like the 68 95 and 99.7 rule) or the z-table to determine what percentage of the population will fall below or above your result.  Like z-scores, t-scores are also a conversion of individual scores into a standard form. However, t-scores are used when you don’t know the population standard deviation.

You use the z-score test if:
Population normal and variance known (for any sample size)

1. Population normal, variance unknown and   n > 30 n>30 (due to CLT)

2. Population binomial,  n p > 10 np>10,   n q >10 nq>10

You use the   t- score test if:
1. Population normal, variance unknown and   n < 30 n<30

2. No knowledge about population or variance and   n < 30 n<30, but sample data looks normal / passes tests etc. so population can be assumed normal.