2023 1 Review the Sample Size Topic Material Assume you want to do a project that compares the survey results before

Nursing 2023 sample size

1 Review the Sample Size Topic Material Assume you want to do a project that compares the survey results before 2023 Assignment

1. Review the “Sample Size” Topic Material. Assume you want to do a project that compares the survey results before an intervention to those after an intervention in the same sample (the same people will take both surveys). You plan to use a paired t-test to analyze your results. Identify and select a tool of your choice to conduct the sample size calculation. Perform a sample size calculation to determine how large your sample should be. Justify your sample size calculation with citations. Discuss how your sample size may affect the validity of your project. (reference) 60-80 words

2. Describe the process of a retrospective chart review. How are these data collected? How would you access the data? What is the validity and reliability of these data? What steps would you need to take to ensure these data were accurately pulled from the database? (reference ) 50 -80 words

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2023 Respond to this post with a positive response Ask a probing question

Nursing 2023 post abby-HP

Respond to this post with a positive response Ask a probing question 2023 Assignment

Respond to this post with a positive response :

Ask a probing question, substantiated with additional background information, evidence or research.

Share an insight from having read your colleagues’ postings, synthesizing the information to provide new perspectives.

Offer and support an alternative perspective using readings from the classroom or from your own research in the Walden Library.

Validate an idea with your own experience and additional research.

Make a suggestion based on additional evidence drawn from readings or after synthesizing multiple postings.

Expand on your colleagues’ postings by providing additional insights or contrasting perspectives based on readings and evidence.

Use  references

EXAMPLE OF A REFERENCE:

If you cannot locate a doi number, this is how the reference should look: 

Quelly, S. B. (2017). Characteristics Associated with School Nurse Childhood Obesity Prevention Practices. Pediatric Nursing, 43(4). Retrieved from https://www.pediatricnursing.net/issues/17julaug/abstr5.html

                                                   MAIN POST

Ethical and Economic Policy Challenges in Healthcare

            There is much tension today about policy decisions regarding healthcare due to economic and ethical challenges.  Economically, our nation struggles due to the rising demands of healthcare.  Demands have increased due to the changes in our nation’s demographics as the baby boomers have aged and required more healthcare services (Laureate Education, 2012).  In the article “For Baby Boomers, Health Care Where and When They Want It,” Barr (2014) describes how the baby boomers have much higher expectations than generations before them.  The number of senior citizens, along with the demands of this generation, increases the cost of healthcare.  Also, our requirements as a nation have increased due to significant new technologies (Laureate Education, 2012).  These technologies are welcomed by baby boomers who demand to have vast amounts of information regarding their healthcare (Barr, 2014).

Ethically, the struggle is determining how to supply the care, including new technologies and new treatments, even though it is expensive.  Of course, everyone would agree that we want those who are sick to get the care needed to live a longer, healthier life.  However, with the cost of healthcare, is this feasible?  For example, the Washington Post discusses a new drug, Provenge that costs $93,000 per patient (Stein, 2010, November 8).  Studies show it could extend a prostate cancer patient’s life by about four months (Stein, 2010, November 8).  Some may say this is a lot of money for only four more months of life.  Others may feel a day of life cannot have a price tag.  In the Washington Post, Stein (2010, November 8) mentions that government agencies such as Medicare spending a significant amount of money on a medication that will extend life by four months may prevent our nation from affording other treatments.  In the article, “As Healthcare Costs Continue to Rise, Providers Weigh Care’s Expense and Effect,” Walker (2015) discusses how considering the cost against the benefit of technology would help reduce cost.  Does someone really need to continue getting these expensive serial tests if they remain asymptomatic?  Limiting diagnostic testing to only when it is essential leads to more debate.  The baby boomers and other Americans feel the need to have all information possible (Barr, 2014).  Policymaking to ensure all citizens receive what they believe to be essential healthcare required to live a longer and healthier life remains an ethical and economic challenge.

References

Barr, P. (2014). For Baby Boomers, health care where and when they want it. H&HN: Hospitals & Health Networks, 88(12), 36–40. Retrieved from https://ezp.waldenulibrary.org/login?url=https://search.ebscohost.com/login.aspx?direct=true&db=rzh&AN=107841386&site=ehost-live&scope=site

Laureate Education (Producer). (2012). Healthcare economics and financing. Baltimore, MD: Author.

Stein, R. (2010, November 8). Review of prostate cancer drug Provenge renews medical cost-benefit debate. The Washington Post. Retrieved from http://www.washintonpost.com/wp-dyyn/content/article/2010/11/07/AR2010110705205.html

Walker, S. (2015). As healthcare costs continue to rise, providers weigh care’s expense and effect. ONS Connect, 30(4), 57. Retrieved from https://ezp.waldenulibrary.org/login?url=https://search.ebscohost.com/login.aspx?direct=true&db=rzh&AN=111511288&site=ehost-live&scope=site

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2023 You are working in a rural Family Planning Health clinic and a 16 y o presents with complaints

Nursing 2023 For Essays Guru – Week 10 Maternal Initial DQ

You are working in a rural Family Planning Health clinic and a 16 y o presents with complaints 2023 Assignment

You are working in a rural Family Planning Health clinic and a 16 y/o presents with complaints of vaginal pain, discharge, odor x 4 days. Pain is getting worse. Her mother relates she has a cognitive learning delay and has tried to talk to her about her consensual sexual behavior with multiple partners. She tells you she has “felt some ‘bumps’ down there.” She relates multiple sexual partners because she is now popular and it is part of the ‘game’ to stay popular with her new friends. Diagnosis: HPV with several condyloma lesions, a vaginal yeast infection, and chlamydia.

She is given a prescription for Chlamydia, and the vulvar lesions, told to follow up in 2 weeks.

How do you approach her and begin the conversation regarding safe sexual practices? What are your thoughts about this young lady? How do you feel about her game? How would you proceed to give her education? 300 words

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2023 Throughout history technological advancements have appeared for one purpose before finding applications elsewhere that lead to

Nursing 2023 Discussion: Healthcare Information Technology Trends

Throughout history technological advancements have appeared for one purpose before finding applications elsewhere that lead to 2023 Assignment

Throughout history, technological advancements have appeared for one purpose before finding applications elsewhere that lead to spikes in its usage and development. The internet, for example, was originally developed to share research before becoming a staple of work and entertainment. But technology—new and repurposed—will undoubtedly continue to be a driver of healthcare information. Informaticists often stay tuned to trends to monitor what the next new technology will be or how the next new idea for applying existing technology can benefit outcomes.

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2023 To help you to better understand why case mix is important to managed care and reimbursement methods here are

Nursing 2023 Case Mix Crisis

To help you to better understand why case mix is important to managed care and reimbursement methods here are 2023 Assignment

To help you to better understand why case mix is important to managed care and reimbursement methods; here are some fictional heart attack mortality rates for three different hospitals. Consider the national average for heart attack death rates to be 16%.

  

Hospital

Mortality Rate

National Mortality Rate 

Hospital A

16.1%

16%

Hospital B

18.6%

Hospital C

15.7%

Part I

Write a brief report in which you answer the following questions:

  1. Explain case mix and why it is important in evaluating different health care providers.
  2. Refer to the table of heart attack mortality rates for Hospitals A, B, and C. From your reading this week, what variables might be impacting the rates in the table? Please explain and discuss the use of data analysis for evaluating this kind of information.

Part II

You are a staff member at Hospital B, which has the worst mortality rate from heart attacks as seen in the table. Imagine that the administrator for Hospital B has asked you to appear at a Press Conference to share your knowledge about case mix.

  

Hospital

Mortality Rate

National Mortality Rate 

Hospital A

16.1%

16%

Hospital B

18.6%

Hospital C

15.7%

After participating in the Press Conference, write a 1-page summary to explain the use of date for decision-making purposes, and how the technology department performs critical core business processes essential to the managed care organization.

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2023 Health Systems Daniel a DNP prepared ED NP identified that patients

Nursing 2023 Week 2

Health Systems Daniel a DNP prepared ED NP identified that patients 2023 Assignment

  

Health Systems: Daniel, a DNP prepared ED NP identified that patients seen in the ED for various reasons had undiagnosed HTN. He observed that the patient’s chief compliant was well addressed but the HTN was not. He has approached the hospital system about the problem and suggested an outpatient clinic adjacent to the ED to address the HTN and other coincidentally found problems. What AP roles, core competencies and support are needed to make this happen?

I am a nurse manager and discuss what roles are needed to make this outpatient clinic happen.

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2023 Purpose To provide students with the opportunity to understand the role FLORIDA s state Board of Nursing

Nursing 2023 discussion 8

Purpose To provide students with the opportunity to understand the role FLORIDA s state Board of Nursing 2023 Assignment

Purpose: To provide students with the opportunity to understand the role FLORIDA’s state Board of Nursing (BON) and explore how it protects the welfare and safety of citizens and regulates the practice of nursing. For this week’s discussion read chapters 70, 72, and 74, then provide simple and short answers to the following questions:

  1. What is the structure and authority of the BON?
  2. What is the code of conduct as described in the Nurse Practice Act?
  3. How is professional misconduct defined?
  4. What are the sanctions for misconduct?
  5. How do nurses remain in good standing?
  6. Name three (3) OTHER nursing organizations (include at least one APRN organization)

 https://floridasnursing.gov/  Board Seal

Reminder: 1)  250 words post. 2) All questions must be answered to receive full grade.  DO NOT forget your references.

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2023 write a paper using journals and research articles explore the following Nursing influence on patient outcomes registered

Nursing 2023 The future of nursing

write a paper using journals and research articles explore the following Nursing influence on patient outcomes registered 2023 Assignment

write a paper using journals and research articles, explore the following; Nursing influence on patient outcomes, registered nurse role and responsibility, adapting to health changes and meeting the needs of the patients, burnout, lateral violence, continuing education, feel free to add in any other points beyond this list if applicable..

*A well-written paper; 1,000 words, APA format, minimum 6-10 cited references (the only acceptable web-based sources are .edu or .org), 

proper grammar and professional writing style..

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2023 Week 5 Anxiolytic Therapy PTSD Treatment I m no longer at the mercy of my PTSD and

Nursing 2023 Psychiatric Nursing

Week 5 Anxiolytic Therapy PTSD Treatment I m no longer at the mercy of my PTSD and 2023 Assignment

 

Week 5: Anxiolytic Therapy & PTSD Treatment

“I’m no longer at the mercy of my PTSD, and I would not be here today had I not had the proper diagnosis and treatment. It’s never too late to seek help.”
—P.K. Philips, PTSD patient

For individuals suffering from posttraumatic stress disorder (PTSD) and other anxiety disorders, everyday life can be a constant challenge. Clients requiring anxiolytic therapy may present with anxiousness, depression, substance abuse issues, and even physical symptoms related to cardiovascular, respiratory, and gastrointestinal ailments. As a psychiatric mental health nurse practitioner, you must be prepared to address the many needs of individuals seeking treatment for PTSD and other anxiety disorders.

This week, as you study anxiolytic therapies and PTSD treatments, you examine the assessment and treatment of clients with PTSD and other anxiety disorders. You also explore ethical and legal implications of these therapies.

Photo Credit: [shironosov]/[iStock / Getty Images Plus]/Getty Images

Assignment: Assessing and Treating Clients With Anxiety Disorders

    Common symptoms of anxiety disorders include chest pains, shortness of breath, and other physical symptoms that may be mistaken for a heart attack or other physical ailment. These manifestations often prompt clients to seek care from their primary care providers or emergency departments. Once it is determined that there is no organic basis for these symptoms, clients are typically referred to a psychiatric mental health practitioner for anxiolytic therapy. For this Assignment, as you examine the client case study in this week’s Learning Resources, consider how you might assess and treat clients presenting with anxiety disorders.

Learning Objectives

Students will:
  • –Assess client factors and history to develop personalized plans of anxiolytic therapy for clients
  • –Analyze factors that influence pharmacokinetic and pharmacodynamic processes in clients requiring anxiolytic therapy
  • –Evaluate efficacy of treatment plans
  • –Analyze ethical and legal implications related to prescribing anxiolytic therapy to clients across the lifespan.

sample that can be audit and submit with plagiarism less than 15% 

  

Assessing and Treating Clients with Anxiety Disorder 

  Assessing and Treating Clients with Anxiety Disorders.

Anxiety disorders are the most prevalent category of mental illness and are characterized by chronic anxiety causing distress and interference in the individual’s life. According to DSM-5, excessive anxiety and worry must cause significant distress or impairment and occurs on more days than not for at least six months for diagnostic criteria (Stein et al., 2015) The disorder can be effectively treated with medication, psychotherapy, or a combination of the two modalities. 

This paper addresses the pharmacology approach in treating a 46 year- old white male who is experiencing anxiety, and the impact pharmacokinetic and pharmadynamic processes will be explored to guide for the appropriate treatment. 

Case Scenario

A 46-year-old white male who initially presented to ER with a complaint of chest pain and cardiac work- up was negative, and a PMHNP consult was sought for psychiatric evaluation. The client ‘s Hamilton Anxiety Rating Scale( HAM-A) was 26 indicating moderate to severe anxiety phase. The PMHNP decides to start the client on medications. 

 Options: Zoloft 50 mg Po Daily, imipramine 25 mg po BID, buspirone 10 mg BID. 

 Decision: Zoloft 50 mg PO daily.

Rationale: Selective serotonin reuptake inhibitors (SSRIs) and serotonin norepinephrine reuptake inhibitors (SNRIs ) benzodiazepines, buspirone, and α2δ ligands such as pregabalin and gabapentin are recommended as first line treatments for anxiety disorders spectrum (Stahl, 2017) However,  SSRI and SNRIs are efficacious in the treatment of generalized anxiety disorder (GAD) and panic attack as in the case of our patient in the scenario. Additionally, in cases of co-occurring GAD and depression, a common comorbidity, SSRIs can provide effective treatment for both GAD and major depression ( Johnson & Coles, 2014) .

Selecting sertraline (Zoloft) was based on the fact it belongs to the family of SSRI, and well recognized in the treatment of GAD and panic attack. Secondly, possible side effects of Zoloft which include sexual dysfunction, gastrointestinal abnormalities (nausea and diarrhea), insomnia, weight gain, and agitation and/or hyperactivation (Kamo et al.,2016) were explored prior selecting Zoloft. The patient was overweight (15 lb), hence a healthy lifestyle will be important for education, and the rest of side effects can be monitored and managed early in treatment.   

Sertraline affects the serotonin neurotransmitter in the synaptic cleft by blocking the serotonin transporter from returning the remaining serotonin to the presynaptic cell. Sertraline is well absorbed in gastrointestinal tract, highly protein bound, predominantly metabolized by CYP 450 system  with half-life of 24- 26 hrs and removed primarily  by kidneys ( Woo & Wayne, 2013).  

Imipramine, a tricyclic antidepressant was not my first choice because its possible side effects: blurred vision, dry mouth, urinary retention, drowsiness, weight gain, hypotension, and seizures (Stahl,2017)

Buspirone (Buspar), a serotonin receptor partial agonist can be appropriate for augmentation but not as first line treatment of GAD. Additionally, Buspirone takes longer (2 – 4 weeks) to have a full effect, and due to its sedation side effect, it would not be appropriate in our patient who has history of increased alcohol intake.

 The goals of treatment of anxiety disorders are resolution of symptoms and prevention of relapse. 

The client returns in four weeks, responding well to medication, anxiety decreased HAM A 18 from 26. 

Options : Increase dose to 75 mg daily, increase dose to 100 mg daily, no change in drug/ dosage

Decision # 2 Increase dose to 75 mg daily. 

Rationale: Sertraline dosing in panic, PTSD, and social anxiety begin with 25 mg/day; increase to 50 mg/day after 1 week thereafter, usually wait a few weeks to assess drug effects before increasing dose; maximum generally 200 mg/day; single dose (Stahl,2017).

 Moreover, increasing dosage slowly will reduce the possibility of acquiring side effects from the medication (Stein et al., 2014)

The client returns in four weeks, reports further reduction in anxiety symptoms HAM- A 10 (mild anxiety) 

Options: Maintain current dose, increase to 100 mg daily, add Buspirone. 

Decision: Maintain current dose 

Rationale: Major errors in psychopharmacological treatment of anxiety disorders include not achieving full remission of symptoms but instead accepting partial response, and not providing an adequate trial of medications (8 to 12 weeks ) before switching, discontinuing, or augmenting ( Woo & Wayne, 2013) . The patient was responding pretty well to medication ( 50% reduction in symptoms) , and reported no side effects. Therefore, continuing the same dosage, providing regular follow up with the patient to ensure medication adherence would be appropriate to meet the goals of remission. 

References

Johnson, E. M., & Coles, M. E. (2014). Failure and Delay in Treatment-Seeking Across Anxiety Disorders. Community Mental Health Journal, 49(6), 668-674. Retrieved from https://web-a-ebscohost-com.ezp.waldenulibrary.org/ehost/pdfviewer/pdfviewer?vid=29&sid=7eabbc3a-b3a4-4cbf-b934-aa75c2e5b6fd%40sessionmgr4007

Kamo, T., Maeda, M., Oe, M., Kato, H., Shigemura, J., Kuribayashi, K., & Hoshino, Y. (2016). Dosage, effectiveness, and safety of sertraline treatment for posttraumatic stress disorder in a Japanese clinical setting: a retrospective study. BMC Psychiatry, 16(1). Retrieved from https://web-b-ebscohost-com.ezp.waldenulibrary.org/ehost/pdfviewer/pdfviewer?vid=6&sid=2ee0b7c6-b1c7-44e7-9b93-42c3b9a745c3%40sessionmgr102

Stein, D. J., Craske, M. A., Friedman, M. J., & Phillips, K. A. (2014). Anxiety Disorders, Obsessive-Compulsive and Related Disorders, Trauma- and Stressor-Related Disorders, and Dissociative Disorders in DSM-5. American Journal of Psychiatry, 171(6), 611-613. Retrieved from https://ajp.psychiatryonline.org/doi/full/10.1176/appi.ajp.2014.14010003

Woo, T. M., & Wynne, A. L. (2013). Pharmacotherapeutics for nurse practitioner prescribers(3rd ed.). Philadelphia, PA: F.A. Davis Co.

 

  • Decision #1
    • Which decision did you select?
    • Why did you select this decision? Support your response with evidence and references to the Learning Resources.
    • What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.
    • Explain any difference between what you expected to achieve with Decision #1 and the results of the decision. Why were they different?
  • Decision #2
    • Why did you select this decision? Support your response with evidence and references to the Learning Resources.
    • What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.
    • Explain any difference between what you expected to achieve with Decision #2 and the results of the decision. Why were they different?
  • Decision #3
    • Why did you select this decision? Support your response with evidence and references to the Learning Resources.
    • What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.
    • Explain any difference between what you expected to achieve with Decision #3 and the results of the decision. Why were they different?

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2023 250 words citation and references What spiritual considerations surrounding a disaster can arise for individuals communities and

Nursing 2023 T5 DQ1. BY3/25

250 words citation and references What spiritual considerations surrounding a disaster can arise for individuals communities and 2023 Assignment

250 words citation and references

What spiritual considerations surrounding a disaster can arise for individuals, communities, and health care providers? Explain your answer in the context of a natural or manmade disaster. How can a community health nurse assist in the spiritual care of the individual, community, self, and colleagues? 

Instructor post

It is imperative the community health nurse has a clear understanding of their own beliefs during a time of disaster, and to be aware of their feelings when someone may question their own beliefs.Having a clear understanding of the term spirituality will also help the nurse to provide this type of care, spiritual care does not mean religious or faith based care. Spirituality is the values, meaning and purpose of life to each individual.

During a time of disaster people have many mixed feelings spiritually, such as those who do not believe may find themselves praying for help, or those who have put their life in gods hands, questioning their faith that something like this could happen. Providing holistic care in these situations requires the nurse to have a firm understanding of their own beliefs and ensure caring for these patients is fully focused on their needs and not the nurses feelings.

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