In the Module 4 Discussion, you considered how professional nurses can become involved in policy-making. A critical component of any policy design is evaluation of the results. How comfortable are you with the thought of becoming involved with such matters?

Some nurses may be hesitant to get involved with policy evaluation. The preference may be to focus on the care and well-being of their patients; some nurses may feel ill-equipped to enter the realm of policy and political activities. However, as you have examined previously, who better to advocate for patients and effective programs and polices than nurses? Already patient advocates in interactions with doctors and leadership, why not with government and regulatory agencies?

In this Discussion, you will reflect on the role of professional nurses in policy evaluation.

To Prepare:

• In the Module 4 Discussion, you considered how professional nurses can become involved in policy-making.
• Review the Resources and reflect on the role of professional nurses in policy evaluation.

By Day 3 of Week 9

Post an explanation of at least two opportunities that currently exist for RNs and APRNs to actively participate in policy review. Explain some of the challenges that these opportunities may present and describe how you might overcome these challenges. Finally, recommend two strategies you might make to better advocate for or communicate the existence of these opportunities. Be specific and provide examples.

By Day 6 of Week 9

Respond to at least two of your colleagues* on two different days by suggesting additional opportunities or recommendations for overcoming the challenges described by your colleagues.

Question 1

In 200-250 words,  Discuss what resources are often necessary for nonacute care for cardiorespiratory issues. Explain how they support patient independence and decrease readmission. 

Question 2  

It is necessary for an RN-BSN-prepared nurse to demonstrate an enhanced understanding of the pathophysiological processes of disease, the clinical manifestations and treatment protocols, and how they affect clients across the life span.

Evaluate the Health History and Medical Information for Mrs. J., presented below.

Based on this information, formulate a conclusion based on your evaluation, and complete the Critical Thinking Essay assignment, as instructed below.

Health History and Medical Information

Health History

Mrs. J. is a 63-year-old married woman who has a history of hypertension, chronic heart failure, and chronic obstructive pulmonary disease (COPD). Despite requiring 2L of oxygen/nasal cannula at home during activity, she continues to smoke two packs of cigarettes a day and has done so for 40 years. Three days ago, she had sudden onset of flu-like symptoms including fever, productive cough, nausea, and malaise. Over the past 3 days, she has been unable to perform ADLs and has required assistance in walking short distances. She has not taken her antihypertensive medications or medications to control her heart failure for 3 days. Today, she has been admitted to the hospital ICU with acute decompensated heart failure and acute exacerbation of COPD.

Subjective Data

1. Is very anxious and asks whether she is going to die.

2. Denies pain but says she feels like she cannot get enough air.

3. Says her heart feels like it is “running away.”

4. Reports that she is exhausted and cannot eat or drink by herself.

Objective Data

1. Height 175 cm; Weight 95.5kg.

2. Vital signs: T 37.6C, HR 118 and irregular, RR 34, BP 90/58.

3. Cardiovascular: Distant S1, S2, S3 present; PMI at sixth ICS and faint: all peripheral pulses are 1+; bilateral jugular vein distention; initial cardiac monitoring indicates a ventricular rate of 132 and atrial fibrillation.

4. Respiratory: Pulmonary crackles; decreased breath sounds right lower lobe; coughing frothy blood-tinged sputum; SpO2 82%.

5. Gastrointestinal: BS present: hepatomegaly 4cm below costal margin.

Intervention

The following medications administered through drug therapy control her symptoms:

1. IV furosemide (Lasix)

2. Enalapril (Vasotec)

3. Metoprolol (Lopressor)

4. IV morphine sulphate (Morphine)

5. Inhaled short-acting bronchodilator (ProAir HFA)

6. Inhaled corticosteroid (Flovent HFA)

7. Oxygen delivered at 2L/ NC

Critical Thinking Essay

In 750-1,000 words, critically evaluate Mrs. J.’s situation. Include the following:

1. Describe the clinical manifestations present in Mrs. J.

2. Discuss whether the nursing interventions at the time of her admissions were appropriate for Mrs. J. and explain the rationale for each of the medications listed.

3. Describe four cardiovascular conditions that may lead to heart failure and what can be done in the form of medical/nursing interventions to prevent the development of heart failure in each condition.

4. Taking into consideration the fact that most mature adults take at least six prescription medications, discuss four nursing interventions that can help prevent problems caused by multiple drug interactions in older patients. Provide a rationale for each of the interventions you recommend.

5. Provide a health promotion and restoration teaching plan for Mrs. J., including multidisciplinary resources for rehabilitation and any modifications that may be needed. Explain how the rehabilitation resources and modifications will assist the patients’ transition to independence.

6. Describe a method for providing education for Mrs. J. regarding medications that need to be maintained to prevent future hospital admission. Provide rationale.

7. Outline COPD triggers that can increase exacerbation frequency, resulting in return visits. Considering Mrs. J.’s current and long-term tobacco use, discuss what options for smoking cessation should be offered.

You are required to cite to a minimum of TWO sources to complete this assignment. Sources must be published within the last 5 years and appropriate for the assignment criteria and relevant to nursing practice.

Prepare this assignment according to the guidelines found in the APA Style Guide.

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

You are required to submit this assignment to LopesWrite. 

Purpose

The purpose of this activity is to deepen learning through reflective inquiry. This activity will allow for expansion in self-awareness, identification of knowledge gaps, and assessment of learning goals.

Preparing the Assignment

Follow these guidelines when completing each component of this assignment. Contact your course faculty if you have questions. It is each student’s responsibility to save and maintain all artifacts required in the e-Portfolio (Links to an external site.).

1-Write a brief 1-2 paragraph weekly reflection addressing the questions posed in the Reflect section of each weekly module. 

Week 1

o  What were the most important concepts you learned in week 1?

o  Why are these concepts important?

o  How will they prepare you for your future role as a DNP-prepared nurse?

o  In what ways do you feel prepared for your new role? In what ways do you feel unprepared?

Week 2

o  Provide one specific example of how you achieved the weekly objectives.

o  What do you value most about your learning this week?

o  What else do you need to explore to further grow as a DNP practice scholar?

Week 3

o  Provide one specific example of how you achieved the weekly objectives.

o  What personal values, if any, were challenged this week?

o  What values can you reaffirm or want to reconsider after this learning?

Week 4

o  Provide one specific example of how you achieved the weekly objectives.

o  What concepts, theories, models, tools, techniques, and resources in this week did you find most valuable?

o  What issues had you not considered before?

Week 5

o  Provide one specific example of how you achieved the weekly objectives.

o  How might you use this information in your future role as a DNP practice scholar?

o  What topics, if any, had you not considered before?

Week 6

o  Provide one specific example of how you achieved the weekly objectives.

o  What knowledge do you still need to demonstrate competency in the weekly concepts?

o  What skills do you need to continue developing to apply these concepts?

Week 7

o  Provide one specific example of how you achieved the weekly objectives.

o  What are the core values and best practices that define the roles of the DNP practice scholar?

o  How will this knowledge improve your effectiveness as a DNP practice scholar?

o  What skills do you need to implement these best practices and how will you develop them?

Reflection on Learning

Requirements:
1. Addresses all aspects of the weekly reflection
2. Assesses own learning
3. Assesses value of the learning experience

Includes no fewer than 3 requirements for weekly reflection.

Writing Organization and Mechanics

Requirements:

-Grammar and mechanics are free of errors.

-Presents information using clear and concise language in an organized manner (0-1 errors in English grammar, spelling, syntax, and punctuation).

Please answer each week separated 2

You are required to submit this assignment to LopesWrite. Refer to the LopesWrite Technical Support articles for assistance.

The growth, development, and learned behaviors that occur during the first year of infancy have a direct effect on the individual throughout a lifetime. For this assignment, research an environmental factor that poses a threat to the health or safety of infants and develop a health promotion that can be presented to caregivers.

Create a 10-12 slide PowerPoint health promotion, with speaker notes, that outlines a teaching plan. For the presentation of your PowerPoint, use Loom to create a voice over or a video. Include an additional slide for the Loom link at the beginning, and an additional slide for references at the end.

In developing your PowerPoint, take into consideration the health care literacy level of your target audience, as well as the demographic of the caregiver/patient (socioeconomic level, language, culture, and any other relevant characteristic of the caregiver) for which the presentation is tailored.

Include the following in your presentation:

1. Describe the selected environmental factor. Explain how the environmental factor you selected can potentially affect the health or safety of infants.
2. Create a health promotion plan that can be presented to caregivers to address the environmental factor and improve the overall health and well-being of infants.
3. Offer recommendations on accident prevention and safety promotion as they relate to the selected environmental factor and the health or safety of infants.
4. Offer examples, interventions, and suggestions from evidence-based research. At least three scholarly resources are required. Two of the three resources must be peer-reviewed and no more than 6 years old.
5. Provide readers with two community resources, a national resource, and a Web-based resource. Include a brief description and contact information for each resource.

Refer to the resource, “Creating Effective PowerPoint Presentations,” located in the Student Success Center, for additional guidance on completing this assignment in the appropriate style.

Refer to the resource, “Loom,” located in the Student Success Center, for additional guidance on recording your presentation.

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.

You are required to submit this assignment to LopesWrite. Refer to the LopesWrite Technical Support articles for assistance.

RUBRICDue Date: 16-Oct-2020 at 11:59:59 PM

Maximum Points: 80.0

This assessment has been reassigned to you.

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Purpose: PICO questions are used by practicing nurses and researchers to focus research questions and develop an efficient literature search strategy.  It is essential that future nurses learn how to do this to develop evidenced-based solutions to patient care problems in a healthcare organization. 

 

1. Write a PICO question based on a scenario you choose from the list of scenarios attached below.  Use the templates in the EBP Step by Step 3 article to help create your questions. You may need to do a pre-search to finding an intervention (the “I”) that has been studied and published to solve the problem.
2. Identify the PICO elements for each question. 
3. Develop a search strategy using at least 3 keywords from the P, I, and O parts of your PICO, 1 synonym for one of the keywords, and 1 MeSH term for one of your keywords. 
4. Locate 4 articles that help answer your PICO question.  The articles must meet the following requirements: 
   • must be primary source quantitative research articles.  
   • No article can be older than 2016. 
5. Obtain pdfs of the four articles you selected from the ResU database.  If not available for the ResU database, you may request access from the ResU Library, or you can email me the citation for the article, and I will attempt to locate a pdf of it. 
6. On a Word document, include your scenario; write your PICO question as a sentence; identify the P, I, C, and O for each question; and list the search terms (3 keywords, 1 synonym, 1 MeSH term) for each. You may use the template attached here. See also the link to the MeSH terms website below.
7. Provide a properly formatted APA reference page for your selected articles from Step 4 of these instructions. See the link to the APA and Writing LibGuide below.
8. Name each document (one Word doc and 4 article pdfs) as follows and upload to the appropriate submission folder in Brightspace:  
   • Lastname PICO, 
   • Lastname article 1,
   • Lastname article 2,
   • Lastname article 3,
   • Lastname article 4

https://libguides.resu.edu/c.php?g=755071&p=5411646  (library) 

https://www.ncbi.nlm.nih.gov/mesh/