Part 1: An Introduction to Clinical Inquiry (workplace violence)

Create a 5-slide PowerPoint presentation in which you do the following:

• Identify and briefly describe Workplace violence in healthcare
• Describe how you used keywords to search on your chosen clinical issue of interest.
• Identify the four research databases that you used to conduct your search for the peer-reviewed articles you selected.
• Provide APA citations of the four peer-reviewed articles you selected.

Part 2: Identifying Research Methodologies

After reading each of the four peer-reviewed articles you selected, use the Matrix Worksheet template to analyze the methodologies applied in each of the four peer-reviewed articles. Your analysis should include the following:

• 1. The full citation of each peer-reviewed article in APA format.
• 2. A brief (1-paragraph) statement explaining why you chose this peer-reviewed article and/or how it relates to your clinical issue of interest, including a brief explanation of the ethics of research related to your clinical issue of interest. 
• 3. A brief (1-2 paragraph) description of the aims of the research of each peer-reviewed article.
• 4. A brief (1-2 paragraph) description of the research methodology used. Be sure to identify if the methodology used was qualitative, quantitative, or a mixed-methods approach. Be specific.
• 5. A brief (1- to 2-paragraph) description of the strengths of each of the research methodologies used, including reliability and validity of how the methodology was applied in each of the peer-reviewed articles you selected.

NEEDS CITATION WITH APA SCHOOL REFERENES ABOVE 2013. 

There is probably no greater responsibility that the psychiatric mental health nurse practitioner assumes than the responsibility of prescribing medications. While someone can be harmed by psychotherapy, the level and intensity of the harm generally does not come to the same level of harm that can occur from improper prescribing. The PMHNP must understand his/her responsibility both at a state and federal level when it comes to prescribing medications. 

In this Practicum Journal Assignment, you will explore the legalities associated with prescribing controlled substances, as well as what a DEA number is, how to obtain one, and, most importantly, how to prescribe controlled substances in your state.

Learning Objectives

Students will:

• Analyze roles of the Drug Enforcement Administration 
• Analyze PMHNP responsibilities when issued a DEA number 
• Analyze DEA number application procedures 
• Analyze state requirements for safe prescribing and prescription monitoring 
• Analyze PMHNP responsibilities for safe prescribing and prescription monitoring 
• Analyze Schedule II-V drug levels 

** Assigned in Week 2 and submitted in Week 4.

To prepare for this Practicum Journal:

• Review the Learning Resources. 

In 2-3 pages:

• Describe the role of the Drug Enforcement Administration (DEA) as it pertains to the PMHNP. 
• Explain your responsibilities when having a DEA number.
• Explain how you apply for a DEA number. 
• Explain your state’s requirements for a safe prescribing and prescription monitoring program. Explain your responsibility as a PMHNP to follow these requirements.
• Provide an example of a drug you may prescribe from each of the Schedule II-V drug levels.

  

Your written assignment for this module should be a 1-2 page paper (not including title page and reference page) that describes the following:

• You are caring for a patient with c-diff as part of your workload assignment. Discuss what c-diff is and how it is transmitted (how you can get it)?
• What actions will you take as a nurse to protect yourself and the other patients on the unit when taking care of your patient?

Module 07- C-Diff

Scoring Rubric:

Criteria

Points

You are caring for a patient with c-diff as part of your workload assignment. Discuss what c-diff is and how it is transmitted (how you can get it)?

4

What actions will you take as a nurse to protect yourself and the other patients on the unit when taking care of your patient?

4

Grammar, APA and Organization

2

Total

10

Assignment Details

MN551-2: Apply knowledge of tissue and organ structure and function to physiologic alterations in systems and analyze the cause and effect relationship in response to disease.

Select one of the case studies below. In your discussion be sure to include evidence of your knowledge of tissue and organ structure and function to physiologic alterations in systems and analyze the cause and effect relationship in response to disease.

Requirements

1. Make sure all of the topics in the case study have been addressed. 
2. Cite at least three sources—journal articles, textbooks, or evidenced-based websites—to support the content. 
3. All sources must have been written within five years. 
4. Do not use .com, Wikipedia, or up-to-date, etc., for your sources. 

Case Study 1

Mechanisms of Infectious Disease 

Thirty-two–year-old Jason is a general laborer, who fell ill shortly after working on a job digging up old water pipes for the town he lived in. The task involved working around shallow pools of stagnant water. Ten days after the contract ended, Jason developed a fever and aching muscles. He also had nausea, vomiting, and diarrhea. Jason’s friend took him to his physician who listened carefully to Jason’s history. She told him she suspected West Nile fever and ordered serological testing. Jason went home to recover and was feeling better by the end of the week.

1. Jason’s physician ordered serological tests. How would antibody titers assist the doctor in confirming his diagnosis?
2. When Jason was feeling at his worst, he had extreme malaise, vomiting, and diarrhea. What stage of the illness was he experiencing at that time? What are the physiological mechanisms that give rise to the signs and symptoms of infectious illness?
3. West Nile virus has a single-stranded RNA genome. How does this virus replicate? In general terms, what are the various effects viruses can have on host cells?

Case Study 2

Innate and Adaptive Immunity

Melissa is a 15-year-old high school student. Over the last week, she had been feeling tired and found it difficult to stay awake in class. By the time the weekend had arrived, she developed a sore throat that made it difficult to eat and even drink. Melissa was too tired to get out of bed, and she said her head ached. On Monday morning, her mother took her to her doctor. Upon completing the physical exam, he told Melissa the lymph nodes were enlarged in her neck and she had a fever. He ordered blood tests and told Melissa he thought she had mononucleosis, a viral infection requiring much bed rest. 

1. Innate and adaptive immune defenses work collectively in destroying invasive microorganisms. What is the interaction between macrophages and T lymphocytes during the presentation of antigen?
2. Melissa’s illness is caused by a virus. Where are type I interferons produced, and why are they important in combating viral infections?
3. Humoral immunity involves the activation of B lymphocytes and production of antibodies. What are the general mechanisms of action that make antibodies a key component of an immune response?

Case Study 3

Disorders of the Immune Response

Ahmed has worked as a phlebotomist in the local hospital for the last 7 years. Last year, he began to complain of watery, nasal congestion and wheezing whenever he went to work. He suspected he was allergic to something at the hospital because his symptoms abated when he was at home over the weekends. One day he arrived at work for the morning shift and put on his gloves. Within minutes, he went into severe respiratory distress requiring treatment in the emergency ward. It was determined at that time his allergic response was due to latex exposure.

1. Ahmed experienced a type I, IgE-mediated hypersensitivity response. How can this be determined by his signs and symptoms? How might another type of latex hypersensitivity reaction present?
2. How do T2H cells, mast cells, and eosinophils function to produce the signs and symptoms typical of a type I hypersensitivity disorder?
3. How is it that someone who does not come into direct contact with latex can still have a hypersensitivity response to the material? What do food allergies have to do with latex allergies?

Case Study 4

Inflammation, Tissue Repair, and Wound Healing

Carlton, a six-year-old boy, was playing on a sandy beach with his mother. He began to run along the shoreline when he stepped on the sharp edge of a shell, giving himself a deep cut on his foot. His mother washed his foot in the lake and put on his running shoe to take him home. One day later, Carlton’s foot looked worse. The gash was red and painful. The foot was warm to touch and appeared swollen. Carlton’s mom put some gauze over the wound and prepared to take him to the local community health clinic. 

1. What is the physiologic mechanism causing the wound to become red, hot, swollen, and painful? How is this different than the inflammatory response that might occur in an internal organ?
2. What are the immunologic events that are happening at the local level during Carlton’s acute inflammatory response?
3. Nutrition plays an important factor in wound healing. What stages of wound healing would be affected by a deficiency in vitamins A and C?

Case Study 5

Acquired Immunodeficiency Syndrome 

Patience is 29 years old and has been HIV positive for nine years. She has remained asymptomatic and is not taking antiretroviral medication. Recently she was at the drop-in clinic to talk to a public health nurse about having a baby through artificial insemination. She said she had met a man who wanted to marry her and have children with her, but she was concerned about the baby contracting HIV. Her latest blood tests indicated her CD4+ count was 380/µL. The PCR test indicated her viral load was 850. The nurse referred her to the physician to discuss antiretroviral therapy during her pregnancy. 

1. What are the factors that increase the chance of HIV transmission from mother to infant, and how the transmission occurs? 
2. Patience was told that after she became pregnant, she would begin HAART therapy. Describe what this therapy is and what particular antiretroviral medication would be particularly useful to her during her pregnancy. What concern is there about administering certain antiretrovirals early in the pregnancy?
3. Individuals with HIV are prone to contracting opportunistic infections. What are opportunistic infections and the risk factors that leave an individual with HIV particularly prone to contracting this type of illness?

Case Study 6

Blood Cells and the Hematopoietic System

Charlie is a 53-year-old man with non-Hodgkin lymphoma. His treatment has been only modestly successful in delaying the progression of the disease, and he has recently relapsed. His medical team decided to administer aggressive chemotherapy. Knowing that the intensive treatment would have a destructive effect on Charlie’s bone marrow, they removed stem cells from his blood before the chemotherapy began. Afterward, the stem cells were returned by IV to reestablish his bone marrow function.

1. What are the therapeutic advantages of an autologous stem cell transplant on Charlie’s bone marrow and immune system?
2. Before harvesting stem cells, a cytokine growth factor is administered to the patient. What is the benefit of this procedure?
3. Non-Hodgkin lymphoma is a disease involving B and T lymphocytes. What aspects of the immune response are these cells responsible for?
4. When considering erythrocytes, how is the body able to meet hematopoietic demand in conditions such as hemolytic anemia or blood loss?

Case Study 7

Disorders of Hemostasis 

Leona is 52 years old and smokes. She is also overweight and has atherosclerosis. When she was given a two-week vacation from work, she packed up her bags and flew from Minnesota to Sydney, Australia, for the trip she always wanted to take. Unfortunately, just three days after she arrived, she was hospitalized when her left calf became inflamed, causing her considerable pain. The physician attending to her told her she developed a deep vein thrombosis. 

1. Explain, using your knowledge of hypercoagulability, why the trip to Australia contributed to Leona’s DVT? Why was Leona already at risk for thrombus development?
2. How does Leona’s atherosclerosis affect platelet function? Conversely, what is the effect of increased platelet activity on the development of atherosclerosis?
3. How do atherosclerosis and immobility promote changes in blood coagulation?
4. When Leona was in hospital, she received heparin therapy. Explain why this course of action was taken to treat her DVT. Why was she not given heparin tablets to take back to the hotel with her?

Case Study 8

Disorders of Red Blood Cells

Henry is 77 years old and lives with his daughter and son-in-law. He has chronic renal failure, but likes to get out whenever he can to work in his daughter’s backyard garden. Over the last few months, he began to go outside less often. He said he was feeling unusually tired and he was running out of breath doing the simplest of tasks. He also said his head ached and he often felt dizzy. His daughter took him to his doctor who performed a complete physical examination and diagnosed Henry with anemia. 

1. From what you know of Henry’s history, what type of anemia do you suspect he has? How would Henry’s red blood cells appear on a peripheral blood smear?
2. What is the physiological basis that would explain why Henry’s anemia would cause him to have the symptoms he is experiencing?
3. Predict the cellular adaptations erythrocytes undergo when chronic hypoxia is present. How would this be evident on an oxygen–hemoglobin dissociation curve?

Case Study 9

Disorders of White Blood Cells and Lymphoid Tissues

Max is a 60-year-old living in Iowa. For the 27 years, he has been working in the agricultural industry, particularly in the management of corn production. Recently he began to feel weak during work and tired easily. During the night he woke up sweating, and he often felt unusually warm during the day. Max was also surprised that, in spite of eating regularly, his weight was declining and his work pants were now too large for him. Upon physical examination, his physician noted his inguinal lymph nodes were swollen although Max said they were not sore. Subsequent laboratory tests confirmed follicular, non-Hodgkin lymphoma. Chemotherapy in conjunction with rituximab was immediately initiated. 

1. What are the key cellular differences between non-Hodgkin lymphoma and Hodgkin lymphoma?
2. The early manifestations of non-Hodgkin lymphoma and Hodgkin lymphoma in lymphatic tissue appear differently. In terms of lymphatic presentation, how would these two diseases appear clinically?
3. What are the pharmacologic properties of rituximab, and what is its mechanism of action on malignant cells?
4. Outline the structure of lymph node parenchyma including the areas where B and T lymphocytes reside. Where did Max’s lymphoma arise?

Assignment Requirements:

Before finalizing your work, you should:

• Ensure you have written at least four double-spaced pages.
• be sure to read the Assignment description carefully (as displayed above);
• consult the Grading Rubric (under the Course Resources) to make sure you have included everything necessary; and
• utilize spelling and grammar check to minimize errors.
• follow the conventions of Standard American English (correct grammar, punctuation, etc.);
• be well ordered, logical, and unified, as well as original and insightful;
• display superior content, organization, style, and mechanics; and
• use APA 6th Edition format.

To see your assignment instructions and grading rubric, go to Course Resources / Grading Rubrics.

 

The purpose of this assignment is to become familiar with various data sources used by health care organizations to obtain quality data. The Agency for Healthcare Research and Quality (AHRQ) creates an annual report, the National Healthcare Quality and Disparities Report, which assesses the performance of the U.S. health care system. This report identifies strengths and weaknesses of the health care system in addition to disparities for access to health care and quality of health care. The report is based on more than 250 measures of quality and disparities, and it covers a broad range of health care services and settings.

Access the “2017 National Healthcare Quality and Disparities Report Data Sources” through the AHRQ website, using the link provided in the topic materials. Select five data sources from this report and fill in the required components on the “Quality Data Sources Organizer.”

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, 

 NUR-630-RS-QualityDataSourcesOrganizer.docx