Integumentary Function

K.B. is a 40-year-old white female with a 5-year history of psoriasis. She has scheduled an appointment with her dermatologist due to another relapse of psoriasis. This is her third flare-up since a definitive diagnosis was made. This outbreak of plaque psoriasis is generalized and involves large regions on the arms, legs, elbows, knees, abdomen, scalp, and groin. K.B. was diagnosed with limited plaque-type psoriasis at age 35 and initially responded well to topical treatment with high-potency corticosteroids. She has been in remission for 18 months. Until now, lesions have been confined to small regions on the elbows and lower legs.

Case Study Questions

1. Name the most common triggers for psoriasis and explain the different clinical types.

2. There are several types of treatments for psoriasis, explain the different types and indicate which would be the most appropriate approach to treat this relapse episode for K.B. Also include non-pharmacological options and recommendations.

3. Included in question 2

4. A medication review and reconciliation are always important in all patient, describe and specify why in this particular case is important to know what medications the patient is taking?

5. What others manifestation could present a patient with Psoriasis?

Sensory Function

C.J. is a 27-year-old male who started to present crusty and yellowish discharged on his eyes 24 hours ago. At the beginning he thought that washing his eyes vigorously the discharge will go away but by the contrary increased producing a blurry vision specially in the morning. Once he clears his eyes of the sticky discharge her visual acuity was normal again. Also, he has been feeling throbbing pain on his left ear. His eyes became red today, so he decided to consult to get evaluated. On his physical assessment you found a yellowish discharge and bilateral conjunctival erythema. His throat and lungs are normal, his left ear canal is within normal limits, but the tympanic membrane is opaque, bulging and red.

1.- Based on the clinical manifestations presented on the case above, which would be your eyes diagnosis for C.J. Please name why you get to this diagnosis and document your rational.

2.- With no further information would you be able to name the probable etiology of the eye affection presented? Viral, bacterial, allergic, gonococcal, trachoma. Why and why not.

3.- Based on your answer to the previous question regarding the etiology of the eye affection, which would be the best therapeutic approach to C.J problem.

 

understanding the strengths of each type of therapy and which type of therapy is most appropriate for each client is an essential skill of the Psychiatric Mental Health Nurse Practitioner. In this assignment, you will compare Existential-Humanistic therapy to a therapy you select from the previous weeks of this course. You will identify the strengths and challenges of each and describe a fictional client that you think is best suited for each. 

 NOTE: 

  

Applied Cognitive Behavioral Therapy in treating patients it’s important, since CBT approach significantly assists in changing the behavior of the patients in order to come with an evidence based results. Utilizing this approach will assist in patients to improve on their social interactions, learn new skills, and to maintain positive behaviors (Wheeler, 2014).

Post a summary of the psychotherapy that you selected and explain why it resonates with you the most at this time. Then compare the psychotherapy you selected with existential-humanistic therapy. What are the strengths and challenges of each type of psychotherapy? Describe a fictional client that you think would be best suited for the therapy you selected and one fictional client you think would be best suited for existential-humanistic therapy. Exp

 

Architect Daniel Libeskind is credited with saying “To provide meaningful architecture is not to parody history, but to articulate it.” The suggestion is that his work does not copy the efforts of others but relies on it.

Understanding the work of others is critically important to new work. Contributions to the nursing body of knowledge can happen when you are able to analyze and articulate the efforts of previous research. Hence research analysis skills are critical tools for your toolbox.

In this Assignment, you will locate relevant existing research. You also will analyze this research using a tool helpful for analysis.

To Prepare:

• Reflect on the strategies presented in the Resources this week in support of locating and analyzing research.
• Use the Walden Library to identify and read one peer-reviewed research article focused on a topic of interest to you in your specialty field.
• Review the article you selected and reflect on the professional practice use of theories/concepts as described by the article

The Assignment:

Using the ‘Week 4 | Part 4’ section of your Academic Success and Professional Development Plan Template presented in the Resources, conduct an analysis of the elements of the research article you identified. Be sure to include the following:

• Clearly identify the topic of interest you have selected.
• Provide an accurate and complete APA formatted citation of the article you selected, along with link or search details.
• Clearly identify and describe in detail a professional practice use of the theories/concepts presented in the article.
• Provide a clear and accurate analysis of the article using the Research Analysis Matrix section of the template.
• Write a 1-paragraph justification that clearly and accurately explains in detail whether you would recommend the use of this article to inform professional practice. Note: You can use the CARP method as presented in the Resources for this week on evaluating resources.
• Write a 2- to 3-paragraph summary that you will add to your Academic Success and Professional Development Plan that includes the following:
  • Clearly and accurately describe in detail your approach to identifying and analyzing peer-reviewed research.
  • Clearly identify and accurately describe in detail at least two strategies that you would use that you found to be effective in finding peer-reviewed research.
  • Provide a complete, detailed, and specific synthesis of at least one resource you intend to use in the future to find peer-reviewed research.
  • Integrate at least one outside resource and 2-3 course specific resources to fully support your summary.

Note: Add your work for this Assignment to the original document you began in the Week 1 Assignment, which was built off the Academic Success and Professional Development Plan Template.

 Support your response with references from the professional nursing literature. Your posts need to be written at the capstone level (see checklist). APA format and 3 paragraphs. Use scholar authors only and use references in discussion.  See references.

As health care consumers, we all expect quality care and positive outcomes. It is important as professionals that we meet these demands of health care consumers. Consider the work of the major theorists you examined in this week’s Resources, and think about how these theories apply to your own experience as a health care customer and/or practitioner.

Discussion:

Post your definition of quality, and apply it to the work of one major quality theorist (e.g., Donabedian, Juran, Deming, Triple Aim (IHI) – Berwick). Identify a practice problem that you have had some experience with as a customer or as a practitioner, and explain how eliminating wasteful practices could have improved the experience. Include how your definition of quality applies to that experience.

References:

Spath, P. (2018). Introduction to healthcare quality management (3rd ed.). Chicago, IL: Health Administration Press.
Chapter 1, “Focus on Quality” (pp. 1–12)
Chapter 2, “Quality Management Building Blocks” (pp. 13–34)
Preview Chapter 3, “Measuring Performance” (pp. 43–46)
 

Yoder-Wise, P. S. (2019). Leading and managing in nursing (7th ed.). St. Louis, MO: Mosby.
Chapter 1, “Leading, Managing, and Following” (pp. 1-18)
Chapter 2, “Clinical Safety: The Core of Leading, Managing and Following” (pp. 19-31)
 

  

QP staff. (2010). Guru guide: Six thought leaders who changed the quality world forever. 

  

NURS 4220

Capstone Paper Guide

The Capstone Paper is the culminating assignment of your undergraduate-nursing program at Walden University. In this assignment you will identify a quality improvement practice problem, review and synthesize evidence-based practice evidence, and propose an evidence-based quality improvement plan that you will use to address your practice problem.

Capstone Paper Overview

The Capstone Paper is written in sections each week and submitted for grading in two parts. 

Capstone Paper: Part I (3-4 pages) includes the Practice Problem; Analysis of Evidence; and Quality Improvement Process sections that are written during the first three weeks of the course. The Capstone Paper, Part I will be submitted for grading at the conclusion of Week 3. 

Capstone Paper: Part II (3-4 pages) includes the Evidence-Based Practice Quality Improvement Plan Explanation and Project Resources sections written in weeks 4 and 5. Part II of the capstone paper is submitted for grading at the conclusion of Week 5. 

The two parts of the Capstone paper are designed to be combined into one document and used in conjunction with your storyboard to present a quality improvement plan. You may use these documents demonstrate to your employer an understanding of quality improvement processes that improve patient care and/or patient safety.

Assignment Template

You will use the Walden University APA Course Template to complete this Assignment. 

o Walden University. Walden templates: General templates: APA course paper template with advice (6th ed.). Retrieved from http://academicguides.waldenu.edu/writingcenter/templates/general#s-lg-box-2774360

§ Delete the abstract page in the template. This is not required for this course.

§ The template includes the correct font and formatting: 12 pt. Times New Roman font, double spacing, and 1-inch margins on all sides. 

Writing Standards

· Review the Academic Writing Expectations Checklist Capstone Level found in your Week 1 Learning Resources

o Note the new expectations for Use of evidence and Credit to Source

o Use a Scholarly Voice

§ http://academicguides.waldenu.edu/writingcenter/scholarlyvoice 

§ http://academicguides.waldenu.edu/writingcenter/webinars/scholarlywriting#s-lg-box-2773859 

o Review the Walden University Writing Center webpage: Using Evidence: Synthesis – http://academicguides.waldenu.edu/writingcenter/evidence/synthesis 

Rubrics (found on the Course Information page)

· Week 3 Assignment Rubric

· Week 5 Assignment Rubric

Capstone Paper, Part I

· Introduction (Completed in Week 1) 

o State the practice problem in measurable terms and that reflect quality indicators. 

This is the same problem described in the Week 1 Practice Experience discussion. 

Provide the rationale for selecting the practice problem

o Include a purpose statement.

· Analysis of Evidence (Completed in Week 2) 

o Synthesize a minimum of 5 evidence-based practice resources that support your practice problem. Include a minimum of two to three research studies obtained from the Walden Library. 

· Quality Improvement Process (Completed in Week 3)

o Describe the quality improvement process and a brief overview the quality model that will be used to improve your practice problem. Include a description of a quality tool that will be used in the quality improvement plan. 

o This process will be used to support the detailed proposed quality improvement plan in Week 4

o Explain why the specific quality model was selected and document your explanation with references.

o Summary  

§ Summarize the key points discussed in the paper. 

Capstone Paper, Part II

· Quality Improvement Plan (Completed in Week 4) 

o Using the Quality Improvement Model as a framework provide a detailed explanation of the quality improvement plan that you will use to address the practice problem. 

o Use the scholarly references identified in the analysis of evidence to support the quality improvement plan.

· Resources (Completed in Week 5)  

o Describe the resources needed to support the change in practice such as personnel time, supplies for staff education, cost of new equipment, or cost of software. 

o Explain why each resource is necessary. 

· Summary  

o Summarize the key points discussed in the paper. 

  

Capstone Paper Schedule and Due Dates

  

Capstone Paper, Part 1

Week Assigned

Date Due

 

Introduction 

· State the practice   problem in measurable terms and that reflect quality indicators. 

o This is the same problem described in the Week 1 Practice   Experience discussion. 

o Keep in mind that this section may need to be revised   after you complete all of the other sections.

· Provide the rationale for selecting the   practice problem.

Week 1

Day 7 of Week 3

 

Analysis of Evidence

· Synthesize a minimum   of at least five evidence-based practice resources that support your practice   problem. 

Week 2

Day 7 of Week 3

 

Quality Improvement Process 

· Describe   the quality improvement process. Include a description of a quality tool that will be used in the   quality improvement plan

· This   process will be used to support the proposed quality improvement plan.

· Explain   why the specific process was selected and document your explanation with   references.

· Summary 

o Summarize   the key points discussed in the paper.

o Submit   to Week 3 Assignment drop box

Week 3

Day 7 of Week 3

 

Dr. Ally, a 49-year-old professor, was diagnosed with essential hypertension 12 years ago and was on antihypertensive drugs. However, he did not take his medications last year because he was feeling just fine. In addition, he was very busy with work. Nevertheless, he felt tired after work and developed dyspnea while climbing the stairs. Recently, he had a bout of epistaxis (severe nose bleed) with dizziness and blurred vision. He went to the doctor for a checkup. His blood pressure was 180/110, and the doctor found rales or crackles on his chest upon auscultation. The doctor ordered rest and asked him to start his medication again.

• What are the patient’s problems?
• What pathophysiological changes are happening in his eyes and heart?
• According to the doctor, the patient might have developed congestive heart failure. Is it right-sided or left-sided?
• What medications are likely to have been used? Describe the mechanisms of actions of at least two antihypertensive drugs.