The neurological system affects all parts and functions of the body through nerve stimulation. Nerves also control the sensation and perception of pain. While pain can be described in a variety of ways, it is essentially labeled according to its duration and source. As an advanced practice nurse evaluating a patient, you need to consider the following questions: Does the pain quickly come and go, or is it persistent and ongoing? Does the pain arise at the source of injury or in another location? In this Discussion, you compare three common types of pain—acute, chronic, and referred.

To Prepare

· Review this week’s media presentation on the neurological system, as well as Chapter 14 in the Huether and McCance text.

· Identify the pathophysiology of acute, chronic, and referred pain. Consider the similarities and differences between these three types of pain.

· Select two of the following patient factors: genetics, gender, ethnicity, age, or behavior. Reflect on how the factors you selected might impact the pathophysiology, diagnosis, and prescription of treatment for acute, chronic, and referred pain.

Discussion Post: 

Post a description of the pathophysiology of acute, chronic, and referred pain, including similarities and differences between them. Then, explain how the factors you selected might impact the pathophysiology, diagnosis, and prescription of treatment for acute, chronic, and referred pain.

Required Readings

Huether, S. E., & McCance, K. L. (2017). Understanding pathophysiology (6th ed.). St. Louis, MO: Mosby.

• Chapter 13, “Structure and      Function of the Neurologic System”

This chapter begins with an overview of the structure and function of the nervous system. It also explains the importance of the central, peripheral, and autonomic nervous systems.

• Chapter 14, “Pain,      Temperature, Sleep, and Sensory Function”

This chapter covers the role of pain, sleep, stress, and the senses on body functions. It also explores alterations involving pain, sleep, stress, and the senses.

• Chapter 15, “Alterations in      Cognitive Systems, Cerebral Hemodynamics, and Motor Function”

This chapter explores disorders of cognitive systems, neuromotor function, tone, movement, and motor performance. It also examines factors that impact these disorders as well as clinical manifestations.

• Chapter 16, “Disorders of      the Central and Peripheral Nervous Systems and Neuromuscular Junction”

This chapter examines the pathophysiology, clinical manifestations, and evaluation and treatment of central and peripheral nervous system disorders. Tumors of the central nervous system are also covered.

• Chapter 17, “Alterations of      Neurologic Function in Children”

This chapter focuses on the pathophysiology, clinical manifestations, evaluation, and treatment of neurologic disorders and brain tumors in children. Normal growth and development is also examined.

Hammer, G. D., & McPhee, S. J. (2019). Pathophysiology of disease: An introduction to clinical medicine (8th ed.). New York, NY: McGraw-Hill Education.

• Chapter 7, “Nervous System      Disorders”

This chapter begins with an overview of the structure and function of the nervous system to lay a foundation for exploring nervous system disorders. It then examines several nervous system disorders such as Parkinson’s disease, epilepsy, dementia, Alzheimer’s disease, and stroke.

• Chapter 12, “Disorders of      the Adrenal Medulla”

This chapter examines disorders relating to alterations of the adrenal medulla. It classifies disorders by the organ or tissue that is most impacted by the disorder. The pathophysiology, clinical manifestations, symptoms, and signs of the disorders are also covered.

• Chapter 19, “Disorders of      the Hypothalamus & Pituitary Gland”

This chapter covers the structure and function of the hypothalamus and pituitary glands. It also explores disorders of the hypothalamus and pituitary glands.

• Chapter 21, “Disorders of      the Adrenal Cortex”

This chapter begins by exploring the structure and function of the adrenal cortex. It then explores disorders relating to alterations of the adrenal cortex.

Hi, i need the table i uploaded to be filled

Health Promotion Program, Part B2: Evidence-based Literature SearchYou will be expected to search for the highest level of evidence for your health promotion project. Please listen to the lecture on searching the evidence, use the services of the research librarian, and pull from the knowledge gained in NUR 39000 Nursing Research to complete this assignment. The Purdue Owl website is a great resource for you when citing your references in APA style.  

Self- Assessment of Learning Styles.pdf          .
JBI-Levels-of-Evidence(1).pdf

Library Resources: The reference librarian for the School of Nursing has created a very helpful website of library resources for this course. Click on the link below to accept this website:NUR 39400 Library Resource Guide

 https://mycourses.purdue.edu/bbcswebdav/pid-12421733-dt-content-rid-93949047_1/courses/pnw_45033.201920/JBI-Levels-of-Evidence%281%29.pdf

New JBI Levels of Evidence

Developed by the Joanna Briggs Institute Levels of Evidence and Grades of Recommendation Working Party October 2013

PLEASE NOTE: These levels are intended to be used alongside the supporting document outlining their use. Using Levels of Evidence does not preclude the need for careful reading, critical appraisal and clinical reasoning when applying evidence.

LEVELS OF EVIDENCE FOR EFFECTIVENESS

Level 1 – Experimental Designs

Level 1.a – Systematic review of Randomized Controlled Trials (RCTs)

Level 1.b – Systematic review of RCTs and other study designs

Level 1.c – RCT

Level 1.d – Pseudo-RCTs

Level 2 – Quasi-experimental Designs

Level 2.a – Systematic review of quasi-experimental studies

Level 2.b – Systematic review of quasi-experimental and other lower study designs

Level 2.c – Quasi-experimental prospectively controlled study

Level 2.d – Pre-test – post-test or historic/retrospective control group study

Level 3 – Observational – Analytic Designs

Level 3.a – Systematic review of comparable cohort studies

Level 3.b – Systematic review of comparable cohort and other lower study designs

Level 3.c – Cohort study with control group

Level 3.d – Case – controlled study

Level 3.e – Observational study without a control group

Page | 2

Level 4 – Observational –Descriptive Studies

Level 4.a – Systematic review of descriptive studies

Level 4.b – Cross-sectional study

Level 4.c – Case series

Level 4.d – Case study

Level 5 – Expert Opinion and Bench Research

Level 5.a – Systematic review of expert opinion

Level 5.b – Expert consensus

Level 5.c – Bench research/ single expert opinion

Page | 3

LEVELS OF EVIDENCE FOR DIAGNOSIS

Level 1 – Studies of Test Accuracy among consecutive patients

Level 1.a – Systematic review of studies of test accuracy among consecutive patients

Level 1.b – Study of test accuracy among consecutive patients

Level 2 – Studies of Test Accuracy among non-consecutive patients

Level 2.a – Systematic review of studies of test accuracy among non-consecutive patients

Level 2.b – Study of test accuracy among non-consecutive patients

Level 3 – Diagnostic Case control studies

Level 3.a – Systematic review of diagnostic case control studies

Level 3.b – Diagnostic case-control study

Level 4 – Diagnostic yield studies

Level 4.a – Systematic review of diagnostic yield studies

Level 4.b – Individual diagnostic yield study

Level 5 – Expert Opinion and Bench Research

Level 5.a – Systematic review of expert opinion

Level 5.b – Expert consensus

Level 5.c – Bench research/ single expert opinion

Page | 4

LEVELS OF EVIDENCE FOR PROGNOSIS

Level 1 – Inception Cohort Studies

Level 1.a – Systematic review of inception cohort studies

Level 1.b – Inception cohort study

Level 2 – Studies of All or none

Level 2.a – Systematic review of all or none studies

Level 2.b – All or none studies

Level 3 – Cohort studies

Level 3.a – Systematic review of cohort studies (or control arm of RCT)

Level 3.b – Cohort study (or control arm of RCT)

Level 4 – Case series/Case Controlled/ Historically Controlled studies

Level 4.a – Systematic review of Case series/Case Controlled/ Historically Controlled studies

Level 4.b – Individual Case series/Case Controlled/ Historically Controlled study

Level 5 – Expert Opinion and Bench Research

Level 5.a – Systematic review of expert opinion

Level 5.b – Expert consensus

Level 5.c – Bench research/ single expert opinion

Page | 5

LEVELS OF EVIDENCE FOR ECONOMIC EVALUATIONS

Levels

1. Decision model with assumptions and variables informed by systematic review and tailored to fit the decision making context.

2. Systematic review of economic evaluations conducted in a setting similar to the decision makers.

3. Synthesis/review of economic evaluations undertaken in a setting similar to that in which the decision is to be made and which are of high quality (comprehensive and credible measurement of costs and health outcomes, sufficient time period covered, discounting, and sensitivity testing).

4. Economic evaluation of high quality (comprehensive and credible measurement of costs and health outcomes, sufficient time period covered, discounting and sensitivity testing) and conducted in setting similar to the decision making context.

5. Synthesis / review of economic evaluations of moderate and/or poor quality (insufficient coverage of costs and health effects, no discounting, no sensitivity testing, time period covered insufficient).

6. Single economic evaluation of moderate or poor quality (see directly above level 5 description of studies). 7. Expert opinion on incremental cost effectives of intervention and comparator.

Page | 6

LEVELS OF EVIDENCE FOR MEANINGFULNESS

1. Qualitative or mixed-methods systematic review

2. Qualitative or mixed-methods synthesis

3. Single qualitative study

4. Systematic review of expert opinion

5. Expert opinion

 Required TASK 

100 word positive response to the statement below. With 3 references.  

Psychiatric Nurse Practitioners, have successfully increased access to care in underserved rural communities by practicing at the fullest extent of their scope without mandated supervision, utilizing telepsychiatry practice, while expanding PMHNP rural mental health education and research to meet and absolve pressing rural mental health challenges (Finley,2020).

Current evidence supports that rural mental health care improves when PMHNPs have full scope of practice, utilize telepsychiatry, engage in related scholarly, and have formalized education and training for rural health care delivery, which collectively answer the professional and moral call serving the underserved rural population with mental illness (Finley,2020). I chose to become a Mental health Nurse Practitioner, because it’s a passion of mine. I live in a rural area and would like to create a program for this area and the inner city where I also work. As a nurse practitioner I feel I can teach, educate and help each area, even though the needs are different. My heart goes out for the mentally challenged.

Database

I recommend, Thoreau advanced search database in the Walden Library, so far, I have had a lot of luck with this database. I have used different search engines before however, Thoreau advanced search is a miracle worker for me. Thoreau, searches most of the library’s collection in one place. It includes articles, books, videos, peer reviewed journals and more. I could not name them all however, Thoreau search so many databases, I don’t have to scroll down and figure which to choose it does the work for me.

References

Finley, B. A. (2020). Psychiatric Mental Health Nurse Practitioners Meeting Rural Mental Health Challenges. Journal of the American Psychiatric Nurses Association, 26(1), 97.

Walden University Library. (n.d.). Database A-Z Nursing. Retrieved October 4, 2019 from https://academicguides,waldenu.edu/az.php?s=19981

Mary is a 35 years old electrical engineer who presents to the office for evaluation of a rash on her face that has been present for 1 week. She denies new soaps, detergents, lotions, environmental exposures, medications, and foods. The rash is across her face and the bridge of her nose. She states that she first noticed it after spending a week hiking and camping in the Appalachians. The lesions itch and are painful. She has not tried anything to make it better, but she has noticed that going outdoors makes it worse. She denies any spread of the rash to other areas. She has never had this rash before.

She has noticed some increased fatigue, fever, and weight loss. She denies headache, sore throat, ear pain, nasal or sinus congestion, chest pain, shortness of breath, cough, abdominal pain, and pain with urination, constipation, or diarrhea. She does have mouth soreness. She has noticed some increased muscle aches and pains, which are worse in the hand and wrist. She denies early morning joint stiffness or difficulty with being able to move in the morning. She denies temperature intolerance, polyuria, polydipsia, or polyphagia.

She had a tonsillectomy at age 9 for chronic strep throat infections. She has been healthy as an adult. She has never had children. She has never been hospitalized for any reason.

Her family history is significant for a mother with rheumatoid arthritis. Her father is healthy.

She does not smoke; she drinks a glass of wine nearly every night with her dinner; she denies illicit drug use. She completed a master’s degree in engineering. She has lived with her boyfriend for the past 5 years.

Patient is an alert young woman, sitting comfortably on the examination table. BP 112/66 mm Hg; HR 62 BPM and regular; respiratory rate 12 breaths/min; temperature 100.3°F. Several erythematous plaques scattered over the cheeks and the bridge of nose, sparing the nasolabial folds. Normocephalic, atraumatic. Sclera white, conjunctivae clear; pupils constrict from 4 mm to 2 mm and equal, round, and reactive to light and accommodation. Oropharynx moist with erythema in the posterior pharyngeal wall; no exudates; shallow ulcers in the buccal mucosa bilaterally. Neck supple without cervical lymphadenopathy or thyromegaly. Full range of motion; no swelling or deformity; muscles with normal bulk and tone.

Instructions:

Make a whole history and physical examination in a comprehensive manner with all its elements included: CC, HPI, PMH, FH, SH, MEDICATIONS, ALLERGIES, ROS PER APPARATUS OR SYSTEMNS, HEAD TO TOE PHYSIACL EXAMINATION PER SYSTEMS ( write your presentation in H&P format no paragraph format).

           Based on this information, what is your presumptive nursing diagnosis? All nursing diagnosis that apply to the case written in NANDA format related to … and evidence by…., NO MEDICAL DIAGNOSIS.

   Teaching plan and nursing care plan per each nursing diagnosis on this case.

 

Requirements.

           1- All written assignment and documentations must be  in APA 6th edition format.

           2- Double spaces, minimum 4 pages long , minimum 3 up to date bibliography. (UP to date means last 3 years.), Note: you can use your test book as bibliography too, bibliography have to be written in APA format.

The authors of the assigned article, “A Patient-Driven Adaptive Prediction Technique to Improve Personalized Risk Estimation for Clinical Decision Support (http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3392846/) have found that using patient-driven, adaptive technologies to guide clinical decision making are influencing the quality of patient care. How might these technologies minimize risk, promote health, and encourage patient engagement in their own care? one page. APA. NEED IT BY 8 AM FLORIDA TIME.