You will take on the role of a clinician who is building a health history for one of the following cases.

CASE STUDY: 

CHIEF OF COMPLAINT “I had a severe headache yesterday with difficulty to speak”

History of Present Illness (HPI) A 64-year-old African American female who reports having a severe pulsatile diffuse headache yesterday with sudden difficulty to talk with last for about two hours. She did not seek medical attention. This morning she woke up with no problems but is here today due her husband advise.

PMH: Atrial Fibrillation, Hypertension. Is allergic to Non-steroidal Anti-inflammatory drugs Aspirin

Drug Hx: Losartan 50 mg, Xarelto 15 mg BID

Subjective: Feels Palpitations, joint pain with yesterday’s episode

Objective Data

VS: B/P 131/80; temperature 98.2°F;  (RR) 18;  (HR) 84, irregular; oxygen saturation (PO2) 96%;

General: well-developed female, no acute distress

HEENT: Atraumatic, normocephalic, PERRLA, EOMI, conjunctiva and sclera clear; nares patent, nasopharynx clear, good dentition.

Lungs: CTA AP&L

Card: Irregular heart beat with normal rate

Abd: No tenderness normoactive bowel sounds x 4;

Rectal exam: Non contributory

Integument: intact without lesions masses or rashes.

Neuro: No obvious deficits and CN grossly intact II-XII

Then answer the following questions:

1. What other subjective data would you obtain?
2. What other objective findings would you look for?
3. What diagnostic exams do you want to order?
4. Name 3 differential diagnoses based on this patient presenting symptoms?
5. Give rationales for your each differential diagnosis.
6. What teachings will you provide?

Your initial post should be at least 500 words, formatted and cited in current APA style with support from at least 2 academic source

Chamberlain Care emphasizes person-centered communication. Provide an example of using person-centered care in communicating to another who disagrees with you.

P.S, please follow the instructions as it asks and answer the question.

I only need half-page and two references from  Potter, P, A., Perry book and Scholar article that are less than five years of publication.
Thank you 

 

Write a 4-6-page analysis of a current problem or issue in health care, including a proposed solution and possible ethical implications.

Introduction

In your health care career, you will be confronted with many problems that demand a solution. By using research skills, you can learn what others are doing and saying about similar problems. Then you can analyze the problem and the people and systems it affects. You can examine potential solutions and their ramifications. This assessment allows you to practice this approach with a real-world problem.

Demonstration of Proficiency

By successfully completing this assessment, you will demonstrate your proficiency in the course competencies through the following assessment scoring guide criteria:

• Competency 1: Apply information literacy and library research skills to obtain scholarly information in the field of health care.
  • Use scholarly information to describe and explain a health care problem or issue and identify possible causes for it.
• Competency 2: Apply scholarly information through critical thinking to solve problems in the field of health care.
  • Analyze a health care problem or issue by describing the context, explaining why it is important and identifying populations affected by it.
  • Discuss potential solutions for a health care problem or issue and describe what would be required to implement a solution.
• Competency 3: Apply ethical principles and academic standards to the study of health care.
  • Analyze the ethical implications if a potential solution to a health care problem or issue was implemented.
• Competency 4: Write for a specific audience, in appropriate tone and style, in accordance with Capella’s writing standards.
  • Write clearly and logically, with correct use of spelling, grammar, punctuation, and mechanics.
  • Write following APA style for in-text citations, quotes, and references.

Instructions

Note: The requirements outlined below correspond to the grading criteria in the scoring guide. At a minimum, be sure to address each point. In addition, you are encouraged to review the performance-level descriptions for each criterion to see how your work will be assessed.

1. Describe the health care problem or issue you selected for use in Assessment 2 (from the Assessment Topic Areas | Transcript media piece) and provide details about it.
   • Explore your chosen topic. For this, you should use the first four steps of the Socratic Problem-Solving Approach to aid your critical thinking. This approach was introduced in Assessment 2.
   • Identify possible causes for the problem or issue.
2. Use scholarly information to describe and explain the health care problem or issue and identify possible causes for it.
   • Identify at least three scholarly or academic peer-reviewed journal articles about the topic.
     • You may find the How Do I Find Peer-Reviewed Articles? library guide helpful in locating appropriate references.
     • You may use articles you found while working on Assessment 2 or you may search the Capella library for other articles.
     • You may find the applicable Undergraduate Library Research Guide helpful in your search.
   • Review the Think Critically About Source Quality to help you complete the following:
     • Assess the credibility of the information sources.
     • Assess the relevance of the information sources.
3. Analyze the health care problem or issue.
   • Describe the setting or context for the problems or issues.
   • Describe why the problem or issue is important to you.
   • Identify groups of people affected by the problem or issue.
   • Provide examples that support your analysis of the problem or issue.
4. Discuss potential solutions for the health care problem or issue.
   • Describe what would be required to implement a solution.
   • Describe potential consequences of ignoring the problem or issue.
   • Provide the pros and cons for one of the solutions you are proposing.
5. Analyze the ethical implications if the potential solution (the one for which you provide pros and cons) were to be implemented.
   • Provide examples from the literature to support the points you are making.
   • Discuss the pros and cons of implementing the proposed solution from an ethical principle point of view.
   • Describe what would be required to implement the proposed solution.

Example Assessment: You may use the following to give you an idea of what a Proficient or higher rating on the scoring guide would look like:

• Assessment 3 Example [PDF].

Additional Requirements

Your assessment should also meet the following requirements:

• Length: 4–6 typed, double-spaced pages, not including the title page and reference page.
• Font and font size: Times New Roman, 12 point.
• APA template: Use the APA Style Paper Template [DOCX] as the paper format and the APA Style Paper Tutorial [DOC] for guidance.
• Written communication: Write clearly and logically, with correct use of spelling, grammar, punctuation, and mechanics.
• Using outside sources: Integrate information from outside sources into academic writing by appropriately quoting, paraphrasing, and summarizing, following APA style.
• References: Integrate information from outside sources to include at least three scholarly or academic peer-reviewed journal articles and three in-text citations within the paper.
• APA format: Follow current APA guidelines for in-text citations of outside sources in the body of your paper and also on the reference page.

Organize your paper using the following structure and headings:

• Title page. A separate page.
• Introduction. A brief one-paragraph statement about the purpose of the paper.
• Elements of the problem/issue. Identify the elements of the problem or issue or question.
• Analysis. Analyze, define, and frame the problem or issue.
• Considering options. Consider solutions, responses, or answers.
• Solution. Choose a solution, response, or answer.
• Ethical implications. Ethical implications of implementing the solution.
• Implementation. Implementation of the potential solution.
• Conclusion. One paragraph.

1. Group 2 : 40-year-old black recent immigrant from Africa without health insurance

Post a summary of the interview and a description of the communication techniques you would use with your assigned patient. Explain why you would use these techniques. Identify the risk assessment instrument you selected, and justify why it would be applicable to the selected patient. Provide at least five targeted questions you would ask the patient.

With the information presented in Chapter 1 of Ball et al. in mind, consider the following:

• By Day 1 of this week, you will be assigned a new patient profile by your Instructor for this Discussion. Note: Please see the “Course Announcements” section of the classroom for your new patient profile assignment.
• How would your communication and interview techniques for building a health history differ with each patient?
• How might you target your questions for building a health history based on the patient’s social determinants of health?
• What risk assessment instruments would be appropriate to use with each patient, or what questions would you ask each patient to assess his or her health risks?
• Identify any potential health-related risks based upon the patient’s age, gender, ethnicity, or environmental setting that should be taken into consideration.
• Select one of the risk assessment instruments presented in Chapter 1 or Chapter 5 of the Seidel’s Guide to Physical Examination text, or another tool with which you are familiar, related to your selected patient.
• Develop at least five targeted questions you would ask your selected patient to assess his or her health risks and begin building a health history.

By Day 3 of Week 1

Post a summary of the interview and a description of the communication techniques you would use with your assigned patient. Explain why you would use these techniques. Identify the risk assessment instrument you selected, and justify why it would be applicable to the selected patient. Provide at least five targeted questions you would ask the patient.

Assignment: Ethical and Legal Implications of Prescribing Drugs

What type of drug should you prescribe based on your patient’s diagnosis? How much of the drug should the patient receive? How often should the drug be administered? When should the drug not be prescribed? Are there individual patient factors that could create complications when taking the drug? Should you be prescribing drugs to this patient? How might different state regulations affect the prescribing of this drug to this patient?

These are some of the questions you might consider when selecting a treatment plan for a patient.  

Photo Credit: Getty Images/Caiaimage

As an advanced practice nurse prescribing drugs, you are held accountable for people’s lives every day. Patients and their families will often place trust in you because of your position. With this trust comes power and responsibility, as well as an ethical and legal obligation to “do no harm.” It is important that you are aware of current professional, legal, and ethical standards for advanced practice nurses with prescriptive authority. Additionally, it is important to ensure that the treatment plans and administration/prescribing of drugs is in accordance with the regulations of the state in which you practice. Understanding how these regulations may affect the prescribing of certain drugs in different states may have a significant impact on your patient’s treatment plan. In this Assignment, you explore ethical and legal implications of scenarios and consider how to appropriately respond.

To Prepare

• Review the Resources for this module and consider the legal and ethical implications of prescribing prescription drugs, disclosure, and nondisclosure.
• Review the scenario assigned by your Instructor for this Assignment.
• Search specific laws and standards for prescribing prescription drugs and for addressing medication errors for your state or region, and reflect on these as you review the scenario assigned by your Instructor.
• Consider the ethical and legal implications of the scenario for all stakeholders involved, such as the prescriber, pharmacist, patient, and patient’s family.
• Think about two strategies that you, as an advanced practice nurse, would use to guide your ethically and legally responsible decision-making in this scenario, including whether you would disclose any medication errors.

By Day 7 of Week 1

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

• Explain the ethical and legal implications of the scenario you selected on all stakeholders involved, such as the prescriber, pharmacist, patient, and patient’s family.
• Describe strategies to address disclosure and nondisclosure as identified in the scenario you selected. Be sure to reference laws specific to your state.
• Explain two strategies that you, as an advanced practice nurse, would use to guide your decision making in this scenario, including whether you would disclose your error. Be sure to justify your explanation. 
• Explain the process of writing prescriptions, including strategies to minimize medication errors.

Reminder: The College of Nursing requires that all papers submitted include a title page, introduction, summary, and references. The College of Nursing Writing Template with Instructions provided at the Walden Writing Center offers an example of those required elements (available at https://academicguides.waldenu.edu/writingcenter/templates/general#s-lg-box-20293632). All papers submitted must use this formatting.

Learning Resources

Required Readings (click to expand/reduce)

Rosenthal, L. D., & Burchum, J. R. (2021). Lehne’s pharmacotherapeutics for advanced practice nurses and physician assistants (2nd ed.) St. Louis, MO: Elsevier.
Chapter 1, “Prescriptive Authority” (pp. 1–3)
Chapter 2, “Rational Drug Selection and Prescription Writing” (pp. 4–7)
Chapter 3, “Promoting Positive Outcomes of Drug Therapy” (pp. 8–12)
Chapter 4, “Pharmacokinetics, Pharmacodynamics, and Drug Interactions” (pp. 13–33)
Chapter 5, “Adverse Drug Reactions and Medication Errors” (pp. 34–42)
Chapter 6, “Individual Variation in Drug Response” (pp. 43–45)

American Geriatrics Society 2019 Beers Criteria Update Expert Panel. (2019). American Geriatrics Society 2019 updated AGS Beers criteria for potentially inappropriate medication use in older adults. Journal of the American Geriatrics Society, 67(4), 674–694. doi:10.1111/jgs.15767
American Geriatrics Society 2019 updated AGS Beers criteria for potentially inappropriate medication use in older adults by American Geriatrics Society, in Journal of the American Geriatrics Society, Vol. 67/Issue 4. Copyright 2019 by Blackwell Publishing. Reprinted by permission of Blackwell Publishing via the Copyright Clearance Center.

This article is an update to the Beers Criteria, which includes lists of potentially inappropriate medications to be avoided in older adults as well as newly added criteria that lists select drugs that should be avoided or have their dose adjusted based on the individual’s kidney function and select drug-drug interactions documented to be associated with harms in older adults.

Drug Enforcement Administration. (n.d.-a). Code of federal regulations. Retrieved February 1, 2019, from https://www.deadiversion.usdoj.gov/21cfr/cfr/1300/1300_01.htm

This website outlines the code of federal regulations for prescription drugs.

Drug Enforcement Administration. (n.d.-b). Mid-level practitioners authorization by state. Retrieved May 13, 2019 from http://www.deadiversion.usdoj.gov/drugreg/practioners/index.html

This website outlines the schedules for controlled substances, including prescriptive authority for each schedule.

Drug Enforcement Administration. (2006). Practitioner’s manual. Retrieved from http://www.legalsideofpain.com/uploads/pract_manual090506.pdf
This manual is a resource for practitioners who prescribe, dispense, and administer controlled substances. It provides information on general requirements, security issues, recordkeeping, prescription requirements, and addiction treatment programs.

Drug Enforcement Administration. (n.d.-c). Registration. Retrieved February 1, 2019, from https://www.deadiversion.usdoj.gov/drugreg/index.html

This website details key aspects of drug registration.

Fowler, M. D. M., & American Nurses Association. (2015). Guide to the Code of Ethics for Nurses with Interpretive Statements: Development, Interpretation, and Application (2nd ed.). Silver Spring, Maryland: American Nurses Association.

This resource introduces the code of ethics for nurses and highlights critical aspects for ethical guideline development, interpretation, and application in practice.

Institute for Safe Medication Practices. (2017). List of error-prone abbreviations, symbols, and dose designations. Retrieved from https://www.ismp.org/recommendations/error-prone-abbreviations-list

This website provides a list of prescription-writing abbreviations that might lead to misinterpretation, as well as suggestions for preventing resulting errors.

Ladd, E., & Hoyt, A. (2016). Shedding light on nurse practitioner prescribing. The Journal for Nurse Practitioners, 12(3), 166–173. doi:10.1016/j.nurpra.2015.09.17

This article provides NPs with information regarding state-based laws for NP prescribing.

Sabatino, J. A., Pruchnicki, M. C., Sevin, A. M., Barker, E., Green, C. G., & Porter, K. (2017). Improving prescribing practices: A pharmacist‐led educational intervention for nurse practitioner students. Journal of the American Association ofNursePractitioners, 29(5), 248–254. doi:10.1002/2327-6924.12446

The authors of this article assess the impact of a pharmacist‐led educational intervention on family nurse practitioner (FNP) students’ prescribing skills, perception of preparedness to prescribe, and perception of pharmacist as collaborator.

Required Media (click to expand/reduce)

Introduction to Advanced Pharmacology
Meet Dr. Terry Buttaro, associate professor of practice at Simmons College of Nursing and Health Sciences as she discusses the importance of pharmacology for the advanced practice nurse. (8m)
Accessible player –Downloads–Download Video w/CCDownload AudioDownload Transcript

Nature Video. (2016). The evolution of oral anticoagulants [Video]. https://www.youtube.com/watch?v=Gp-ucDRiaUA
Note: This media program is approximately 5 minutes.

Speed Pharmacology. (2015). Pharmacology – Pharmocokinetics (Made Easy) [Video]. https://www.youtube.com/watch?v=NKV5iaUVBUI&t=16s
Note: This media program is approximately 14 minutes.

Speed Pharmacology. (2017).  Pharmacology – Diuretics (Made Easy) [Video]. https://www.youtube.com/watch?v=9OBvNpnS0h4&t=664s
Note: This media program is approximately 18 minutes.

Speed Pharmacology. (2017). Pharmacology – Antiarrhythmic Drugs (Made easy) [Video]. https://www.youtube.com/watch?v=9xSqezCMHnw&t=1205s
Note: This media program is approximately 23 minutes.

Speed Pharmacology. (2015). Pharmacology – Pharmocokinetics (Made Easy) [Video]. https://www.youtube.com/watch?v=NKV5iaUVBUI&t=16s
Note: This media program is approximately 14 minutes.

Speed Pharmacology. (2016). Pharmacology – Adrenergic receptors & agonists (MADE EASY) [Video]. https://www.youtube.com/watch?v=KtmV-yMDYPI&t=372s
Note: This media program is approximately 18 minutes.

Speed Pharmacology. (2017). Drugs for Hyperlipidemia (Made Easy) [Video]. https://www.youtube.com/watch?v=Of1Aewx-zRM&t=24s
Note: This media program is approximately 14 minutes.

pls use three resources for this assignment