L.N. is a 49-year-old white woman with a history of type 2 diabetes, obesity, hypertension, and migraine headaches. The patient was diagnosed with type 2 diabetes 9 years ago when she presented with mild polyuria and polydipsia. L.N. is 5′4″ and has always been on the large side, with her weight fluctuating between 165 and 185 lb.

Initial treatment for her diabetes consisted of an oral sulfonylurea with the rapid addition of metformin. Her diabetes has been under fair control with a most recent hemoglobin A1c of 7.4%.

Hypertension was diagnosed 5 years ago when blood pressure (BP) measured in the office was noted to be consistently elevated in the range of 160/90 mmHg on three occasions. L.N. was initially treated with lisinopril, starting at 10 mg daily and increasing to 20 mg daily, yet her BP control has fluctuated.

One year ago, microalbuminuria was detected on an annual urine screen, with 1,943 mg/dl of microalbumin identified on a spot urine sample. L.N. comes into the office today for her usual follow-up visit for diabetes. Physical examination reveals an obese woman with a BP of 154/86 mmHg and a pulse of 78 bpm.

Questions

1. What are the effects of controlling BP in people with diabetes?
2. What is the target BP for patients with diabetes and hypertension?
3. Which antihypertensive agents are recommended for patients with diabetes?

Week 5 Project

Compilation

Summarize, in 3-4 pages, this assignment that provides information from Weeks 1 to 4.

In addition to the work you completed in the last four weeks, your assignment should also:

• Include an introduction and a conclusion.
• Implement the recommendations from the instructor.
• Describe the role of nursing informatics.
• Explain how nursing informatics or technology in health care will help or hinder your leadership.

On a separate references page, cite all sources using APA format. Helpful APA guides and resources are available in the South University Online Library. Below are guides that are located in the library and can be accessed and downloaded via the South University Online Citation Resources: APA Style page. The American Psychological Association website also provides detailed guidance on formatting, citations, and references at APA Style.

• APA Citation Helper
• APA Citations Quick Sheet
• APA-Style Formatting Guidelines for a Written Essay
• Basic Essay Template

Please note that the title and reference pages should not be included in the total page count of your paper.

Theory Utilization and Application Paper Using the nursing theory by Hildegard Peplau’s Theory of Interpersonal Relations in Nursing which consists of the Orientation phase, working phase, termination phase, and working phase, identify an area of interest in nursing, locate examples of the theory’s application and utilization in practice. Additionally, opportunities for enhancement of existing nursing environments by utilization of theory application will be addressed. The paper should be no more than ten typewritten pages, using appropriate APA format. Theory Usage and Application Paper – Guidelines and Grading Criteria In this paper, you will describe a nursing theory and its application to nursing practice. This paper should be no more than 10 pages long. It should coincide with the theory presentation that you have submitted. The focus of this paper is on the application of theory to nursing practice. A brief description of the components of the theory should be presented in this paper, however, since this should be done in your presentation the focus here will be on application. The proposed guidelines are based on Chinn and Kramer (2004). 

Criteria 

APA format please use resources with in the last 5 years and most of all DO NOT TURNITIN

Components of the theory 

• Major concepts of theory 

• Philosophical basis/underpinnings; worldview 

• Conceptual model (if available) 

Structural aspects of the theory (including but not limited to) 

• Assumptions, theorems, propositions, etc.

• relations of concepts and assumptions 

• clarity, simplicity, and ease of application of theory

• consistency and adequacy of theory 

Use of theory in: 

• nursing practice

• nursing education 

• nursing administration 

• nursing research 

A literature review will provide the basis for this section 

Identify an area of your practice where this theory could be applicable. 

• The area may be used to theory test, theory generate, etc.

• What is the question that the theory will help to answer? 

• Describe the area of interest in relation to the theory/theoretical model. Why or how is it appropriate to use this theory. 

• Discuss the use of theory in pursuing this area of interest. What are the steps /methods that you might use? 

• Are there weaknesses in this theory that make it difficult to use in real situations? If so, what are they? 

Evaluation of theory – your thoughts about the theory 

• How “user friendly” is the theory? 

• What are some of the difficulties you encountered or would you anticipate you might encounter in trying to use this theory. 

• What would make this theory more usable or applicable to practice, and why? 

 

Create a 5-6 slide powerpoint, 

• Create a 5- to 6-slide PowerPoint presentation that can be used in a staff development meeting on presenting different approaches for implementing the stepwise approach for asthma treatment. Be sure to address the following:
• Describe long-term control and quick relief treatment options for the asthma patient from your practice as well as the impact these drugs might have on your patient.
• Explain the stepwise approach to asthma treatment and management for your patient.
• Explain how stepwise management assists health care providers and patients in gaining and maintaining control of the disease. Be specific.

  

Assignment: Practicum: Decision Tree 

For this Assignment, you examine the client case study in this week’s Learning Resources ( follow the media link below) Consider how you might assess and treat pediatric clients presenting with symptoms noted in the case.

Students will:

· Evaluate clients for treatment of mental health disorders

· Analyze decisions made throughout diagnosis and treatment of clients with mental health disorders

The Assignment:

Examine Case 1. You will be asked to make three decisions concerning the diagnosis and treatment for this client. Be sure to consider co-morbid physical as well as mental factors that might impact the client’s diagnosis and treatment.

At each Decision Point, stop to complete the following:

· Decision #1: Differential Diagnosis

o Which Decision did you select?

o Why did you select this Decision? Support your response with evidence and references to the Learning Resources.

o What were you hoping to achieve by making this Decision? Support your response with evidence and references to the Learning Resources.

o Explain any difference between what you expected to achieve with Decision #1 and the results of the Decision. Why were they different?

· Decision #2: Treatment Plan for Psychotherapy

o Why did you select this Decision? Support your response with evidence and references to the Learning Resources.

o What were you hoping to achieve by making this Decision? Support your response with evidence and references to the Learning Resources.

o Explain any difference between what you expected to achieve with Decision #2 and the results of the Decision. Why were they different?

· Decision #3: Treatment Plan for Psychopharmacology

o Why did you select this Decision? Support your response with evidence and references to the Learning Resources.

o What were you hoping to achieve by making this Decision? Support your response with evidence and references to the Learning Resources.

o Explain any difference between what you expected to achieve with Decision #3 and the results of the decision. Why were they different?

· Also include how ethical considerations might impact your treatment plan and communication with clients and their families.

Note: Support your rationale with a minimum of three academic resources. While you may use the course text to support your rationale, it will not count toward the resource requirement.

Required Readings ( Need 3 references)

American Nurses Association. (2014). Psychiatric-mental health nursing: Scope and standards of practice (2nd ed.). Washington, DC: Author.

• Standard 5E “Pharmacological, Biological and      Integrative Therapies” (page 59)

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.

• “Neurodevelopmental Disorders”

o “Intellectual Disabilities”

o “Communication Disorders”

• “Disruptive,      Impulse-Control, and Conduct Disorders”

Sadock, B. J., Sadock, V. A., & Ruiz, P. (2014). Kaplan & Sadock’s synopsis of psychiatry: Behavioral sciences/clinical psychiatry (11th ed.). Philadelphia, PA: Wolters Kluwer.

• Chapter 3, “Contributions of the Sociocultural      Sciences” (pp. 131–150)
• Chapter 31, “Child Psychiatry” (pp. 1152–1181,      1244–1253)

Stahl, S. M. (2014). Prescriber’s Guide: Stahl’s Essential Psychopharmacology (5th ed.). New York, NY: Cambridge University Press. 

Note: All Stahl resources can be accessed through the Walden Library using the link. This link will take you to a login page for the Walden Library. Once you log in to the library, the Stahl website will appear.

To access information on the following medications, click on The Prescriber’s Guide, 5th Ed. tab on the Stahl Online website and select the appropriate medication.

       

Volkmar, F., Siegel, M., Woodbury-Smith, M., King, B., McCracken, J., & State, M. (2014). Practice parameter for the assessment and treatment of children and adolescents with autism spectrum disorder. Journal of the American Academy of Child & Adolescent Psychiatry, 53(2), 237–257. Retrieved from http://www.jaacap.com/article/S0890-8567(13)00819-8/pdf 

Required Media

Laureate Education (Producer). (2017b). A young girl with difficulties in school [Multimedia file]. Baltimore, MD: Author.