Respectfully agree and disagree with your peers’ responses and explain your reasoning by including your rationales in your explanation. Atleast 2 APA refernces each

Response 1

The purpose of this week’s discussion is to create a treatment plan for V.S. based off the given case study information. V.S. has conjunctivitis of the left eye. The specific goals of treatment for conjunctivitis is to relieve symptoms and to clear the infection (Woo & Robinson, 2020). There are numerous forms of conjunctivitis but given the information the symptoms this is more than likely a form on bacterial conjunctivitis. The discharge color, age of the patient, being immunocompromised with a cold prior, and only one eye being infected suggests this is a bacterial infection (Watson et al., 2018). Treatment therefore would be a broad spectrum ophthalmic antibiotic. I would suggest bacitracin which should not affect the patient’s sulfa allergy (Nguyen, 2020). To monitor success the patient should be seen by his pediatrician within a week to see if symptoms have resolved.
Education to include for this patient would be that the ointment can cause blurred vision directly after administration but should clear soon after (Woo & Robinson, 2020). If symptoms worsen in the affected eye or spread to the unaffected eye the patient should contact his pediatrician for reassessment to see if this condition is viral. If this occurs treatment should be stopped due to risk for a drug resistance (Nguyen, 2020). Another adverse reaction that would cause me to change treatment would be any sign of hypersensitivity such as swelling, hives, nausea, or vomiting. If this occurs I would recommend a medication such as erythromycin in ophthalmic form.
An over the counter method for treating bacterial conjunctivitis would be artificial tears for relief of dryness symptoms and saline flushes to wash out the pus (CDC, 2019). Lifestyle changes would include proper hand hygiene, avoiding touching the eye in general, not sharing things such as glasses, and not rubbing the eye. This is the medication I would choose for this patient due to its low risk of interactions to other drugs and/or foods. 

Response 2

V.S., age 12 Hispanic male, presents with a feeling that there is sand in his eye. He had a cold a week ago and woke up this morning with his left eye crusted with yellowish drainage. On physical examination, he has injected conjunctiva on the left side, no adenopathy, and no vision changes. His vision is 20/20. Fluorescein staining reveals no abrasion. He is allergic to sulfa.

Diagnosis: Conjunctivitis

        The goal of treatment for V.S. would be to clear his infection and make sure he doesn’t rub his eyes because that can cause the infection to get worse and spread to other individuals. According to Azari and Arabi (2020), “bacterial conjunctivitis can spread from person to person, from hand-to-eye contact or via eye contact with contaminated objects. Alternatively, changes in the usual bacteria that live on the conjunctiva can cause conjunctivitis. Bacteria can also spread by large respiratory tract droplets” (p. 374). Bacterial conjunctivitis is most often treated with  ophthalmic antibiotic eyedrops and ointments. Since V.S. is allergic to sulfa, Bleph or antibiotics with similar derivatives would not be utilized because they are sulfacetamide sodium. Ophthalmic fluoroquinolones can be prescribed such as Moxeza (moxifloxacin), Zymar (gatifloxacin), or Romycin (erythromycin).

     The parameters for monitoring success would be to see the alleviation of redness and itchiness in the patient’s eyes. According to Saher et al. (2016), most cases of viral or bacterial conjunctivitis are mild. The infection will usually clear up in 7 to 14 days without treatment and without any long-term consequences. However, in some cases, viral conjunctivitis can take 2 to 3 weeks or more to clear up. I would educate the parents to administer the drug as prescribed. I would urge the parents to continue giving the antibiotics even if the infection seems to subside. According to Shetty et al. (2020), it has been widely accepted that stopping antibiotic treatment early encourages bacteria to develop antibiotic resistance. As a result, current medical advice is to finish taking a prescribed course of antibiotics as recommended by a healthcare professional, even if you start to feel better. 

      I would educate the parents to assist in alleviating some discomfort V.S. can take ibuprofen or another over-the-counter pain killer. He can also use over-the-counter lubricating eye drops (artificial tears) if his eyes feel excessively dry. In addition, a warm, damp washcloth over your eyes for a few minutes. Nausea, diarrhea, and headaches can be adverse effects seen in the agents mentioned above. A second line treatment would be Bacticin (bacitracin). V.S. should be encouraged to drink plenty of water and take his antibiotics with water. According to Azari and Arabi (2020), moxifloxacin should not be taken with dairy products such as milk or yogurt, or with calcium-fortified juice.  They could make the medication less effective.

Capstone Project Change Proposal Presentation 

Review  the feedback on the change proposal professional presentation and make  required adjustments to the presentation. Present your evidence-based  intervention and change proposal to an interprofessional audience of  leaders and stakeholders. Be prepared to answer questions and accept  feedback.

After presenting your capstone project change proposal,  write a 250-350 word summary of the presentation. Include a description  of the changes that were suggested by your preceptor before your  presentation and how you incorporated that feedback. Describe how this  interprofessional collaboration improved the effectiveness of your  presentation. Include a description of the feedback and questions from  your audience after your presentation, and how this experience will  affect your professional practice in the future.

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.

You are not required to submit this assignment to LopesWrite.

Click here to download and analyze the case study for this week. Create a SOAP note for disease prevention, health promotion, and acute care of the patient in the clinical case. Your care plan should be based on current evidence and nursing standards of care.

Visit the online library and research for current scholarly evidence (no older than 5 years) to support your nursing actions. In addition, consider visiting government sites such as the CDC, WHO, AHRQ, Healthy People 2020. Provide a detailed scientific rationale justifying the inclusion of this evidence in your plan.

Next determine the ICD-10 classification (diagnoses). The International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-10-CM) is the official system used in the United States to classify and assign codes to health conditions and related information.

Click here to access the codes.

Download the SOAP template to help you design a holistic patient care plan. Utilize the SOAP guidelines to assist you in creating your SOAP note and building your plan of care. You are expected to develop a comprehensive SOAP note based on the given assessment, diagnosis, and advanced nursing interventions. Reflect on what you have learned about care plans through independent research and peer discussions and incorporate the knowledge that you have gained into your patient’s care plan.  If the information is not in the provided scenario please consider it normal for SOAP note purposes, if it is abnormal please utilize what you know about the disease process and write what you would expect in the subjective and objective areas of your note.

Format

• Your care plan should be formatted as a Microsoft Word document. Follow the current APA edition style. Your paper should be no longer than 3-4 pages excluding the title and the references and in 12pt font.
• Name your document: SU_NSG6001_W2A2_LastName_FirstInitial.doc.
• Submit your document to the Submissions Area by the due date assigned.

Your quest to purchase a new car begins with an identification of the factors important to you. As you conduct a search of cars that rate high on those factors, you collect evidence and try to understand the extent of that evidence. A report that suggests a certain make and model of automobile has high mileage is encouraging. But who produced that report? How valid is it? How was the data collected, and what was the sample size?

In this Assignment, you will delve deeper into clinical inquiry by closely examining your PICO(T) question. You also begin to analyze the evidence you have collected.

To Prepare:

• Review the Resources and identify a clinical issue of interest that can form the basis of a clinical inquiry.
• Develop a PICO(T) question to address the clinical issue of interest you identified in Module 2 for the Assignment. This PICOT question will remain the same for the entire course.
• Use the key words from the PICO(T) question you developed and search at least four different databases in the Walden Library. Identify at least four relevant systematic reviews or other filtered high-level evidence, which includes meta-analyses, critically-appraised topics (evidence syntheses), critically-appraised individual articles (article synopses). The evidence will not necessarily address all the elements of your PICO(T) question, so select the most important concepts to search and find the best evidence available.
• Reflect on the process of creating a PICO(T) question and searching for peer-reviewed research.

Part 2: Advanced Levels of Clinical Inquiry and Systematic Reviews

Create a 6- to 7-slide PowerPoint presentation in which you do the following:

• Identify and briefly describe your chosen clinical issue of interest.
• Describe how you developed a PICO(T) question focused 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 relevant peer-reviewed articles at the systematic-reviews level related to your research question. If there are no systematic review level articles or meta-analysis on your topic, then use the highest level of evidence peer reviewed article.
• Describe the levels of evidence in each of the four peer-reviewed articles you selected, including an explanation of the strengths of using systematic reviews for clinical research. Be specific and provide examples.