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In your discussion question response, provide a substantive response that illustrates a well-reasoned and thoughtful response; is factually correct with relevant scholarly citations, references, and examples; demonstrates a clear connection to the readings
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Gami is a 48-year-old who you discover when completing a health history is taking cinnamon to treat Type II Diabetes. She is specifically using cassia Cinnamon. You also discover that she is taking Ginseng to assist with memory. Her prescribed medications are Aricept and Coumadin.

Ms. GM is a 48-year-old who presents to your clinic to establish care. During the health history, you learn that she has a history of Type II Diabetes. When asked about prescription and non-traditional medications, she reports being prescribed Aricept, Coumadin, Cassia cinnamon for Type II Diabetes and Ginseng for memory.

1. Is there any additional subjective or objective information you need for this client? Explain.
2. What would be your position on the Ms. GMs use of alternative supplements for her diabetes and memory? Explain and include contraindications, if any.
3. Are there any additional test/assessments you would complete for this patient given this list of medications? Explain.
4. How might your treatment plan, in terms of medications, differ for this patient? Include the class of the medication, mechanism of action, route, the half-life; how it is metabolized in and eliminated from the body; contraindications and black box warnings.
5. What health maintenance or preventive education is important for this client based on your choice medication/treatment?

A 47-year-old overweight male with a history of arthrosclerosis, diabetes mellitus type 2, and coronary artery disease (CAD) is found by a neighbor unconscious and not breathing in his front lawn where he appears to have been mowing his lawn. He is rushed to a local emergency room where it is determined that he has suffered a massive inferior myocardial infarction. He is sent to the intensive care unit in critical condition where he is placed on advanced life support equipment, and several days later, it is determined that he has minimal brain activity.

1. After hearing her husband’s condition, his tearful wife asks you how it is possible that her husband’s brain might not function if it was his heart that stopped beating. How would you answer?
2. As the next of kin, his wife has the right to make husband’s medical decisions when he is unable to. Because the length of time that this patient was in cardiac arrest appears to have been substantial, the patient’s recovery is highly unlikely. The medical staff gently informs the wife that she has to make a decision regarding his health care: she can withdraw care now or choose to do everything to keep him alive, even though he will most likely die. She asks you what you think she should do. With your knowledge of neurophysiology, how would you answer her?

APA STYLE

3 PARAGRAPHS 3 SENTENCES EACH

2 REFERENCES NOT OLDER THAN 2015

1. What competitor information categories are useful in competitor analysis? Are these categories appropriate for health care organizations? How can these information categories provide focus for information gathering and strategic decision making?
2. Why is it important to clearly define the service area? How does managed care penetration affect service area definition?

Professional Development: 

Conduct a service area competitor analysis within your community. Keep it fairly small in scope (i.e. laser hair removal business, extended care facility for ventilator-dependant patients, etc.) so that it is manageable. Begin by introducing the macro issues (general and health care) and then use this outline as an initial guide:

1. Specify the Service Category
2. Delineate the Service Area.
   1. General
   2. Economic
   3. Demographic
   4. Psychographic
   5. Health Status
3. Perform a Service Area Structure Analysis
   1. Threat of New Entrants
   2. Intensity of Rivalry
   3. Threat of Substitutes
   4. Power of Customers
   5. Power of Suppliers
4. Do a Competitor Analysis/Identify Service Category Critical Success Factors
   
   1. Competitor Strengths and Weaknesses
   2. Critical Success Factors
   3. Strategic Groups
   4. Map Competitors
   5. Likely Responses of Competitors
5. Identify and Map Strategic Groups
6. Provide a Synthesis.

Program/policy evaluation is a valuable tool that can help strengthen the quality of programs/policies and improve outcomes for the populations they serve. Program/policy evaluation answers basic questions about program/policy effectiveness. It involves collecting and analyzing information about program/policy activities, characteristics, and outcomes. This information can be used to ultimately improve program services or policy initiatives.

Nurses can play a very important role assessing program/policy evaluation for the same reasons that they can be so important to program/policy design. Nurses bring expertise and patient advocacy that can add significant insight and impact. In this Assignment, you will practice applying this expertise and insight by selecting an existing healthcare program or policy evaluation and reflecting on the criteria used to measure the effectiveness of the program/policy.

To Prepare:

• Review the Healthcare Program/Policy Evaluation Analysis Template provided in the Resources.
• Select an existing healthcare program or policy evaluation or choose one of interest to you.
• Review community, state, or federal policy evaluation and reflect on the criteria used to measure the effectiveness of the program or policy described.

The Assignment: (2–3 pages)

Based on the program or policy evaluation you selected, complete the Healthcare Program/Policy Evaluation Analysis Template. Be sure to address the following:

• Describe the healthcare program or policy outcomes.
• How was the success of the program or policy measured?
• How many people were reached by the program or policy selected?
• How much of an impact was realized with the program or policy selected?
• At what point in program implementation was the program or policy evaluation conducted?
• What data was used to conduct the program or policy evaluation?
• What specific information on unintended consequences was identified?
• What stakeholders were identified in the evaluation of the program or policy? Who would benefit most from the results and reporting of the program or policy evaluation? Be specific and provide examples.
• Did the program or policy meet the original intent and objectives? Why or why not?
• Would you recommend implementing this program or policy in your place of work? Why or why not?
• Identify at least two ways that you, as a nurse advocate, could become involved in evaluating a program or policy after 1 year of implementation.

By Day 7 of Week 10

Submit your completed healthcare program/policy evaluation analysis.

The unapproved use of approved drugs, also called off-label use, with children is quite common. This is because pediatric dosage guidelines are typically unavailable, since very few drugs have been specifically researched and tested with children.

When treating children, prescribers often adjust dosages approved for adults to accommodate a child’s weight. However, children are not just “smaller” adults. Adults and children process and respond to drugs differently in their absorption, distribution, metabolism, and excretion. 

Children even respond differently during stages from infancy to adolescence. This poses potential safety concerns when prescribing drugs to pediatric patients. As an advanced practice nurse, you have to be aware of safety implications of the off-label use of drugs with this patient group.

To Prepare

· Review the interactive media piece in this week’s Resources and reflect on the types of drugs used to treat pediatric patients with mood disorders.

· Reflect on situations in which children should be prescribed drugs for off-label use.

· Think about strategies to make the off-label use and dosage of drugs safer for children from infancy to adolescence. Consider specific off-label drugs that you think require extra care and attention when used in pediatrics.

Write a 1-page narrative in APA format that addresses the following:

· Explain the circumstances under which children should be prescribed drugs for off-label use. Be specific and provide examples.

· Describe strategies to make the off-label use and dosage of drugs safer for children from infancy to adolescence. Include descriptions and names of off-label drugs that require extra care and attention when used in pediatrics.

Reminder: The College of Nursing requires that all papers submitted include a title page, introduction, summary, and references.