2 Coments Each One 150 Words (CITATION AND REFERENCE) – 2025 REPLY1 For a long time health care was all about health care professionals

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2 Coments Each One 150 Words (CITATION AND REFERENCE) – 2025

REPLY1

For a long time health care was all about health care professionals taking control of a patients care, lacking involvement of the patient, which only enabled the patient once they were discharged from care. The last decade or so patients have been hearing the continuous message from health care professionals about getting involved in their care (Vahdat et al., 2014). Patients with chronic conditions should especially be taking control of their own health care, which includes taking medications properly and being on top of scheduling and attending appointments. I think what has changed mostly in patients having control of their own health care, is that health care professionals provide education and information to patients that uses involvement of health care professional and patient. This empowers patients to take control and see positive outcomes with their health. Doctors are known to be the point of contact of all the information, which is why I think for many years patients just had the health care professional take full control of their care because they had full trust in their knowledge and experience. Patients having control of their own health care is important when it comes to decision making about their health care. If the patient has always relies on health care professionals, they won’t have the knowledge of what decisions must be made to better their care (Flavo, 2011).

The biggest change I have seen with patients being able to have more control over their health care is patients now have full access to their own medical records which includes doctors notes, labs, and other results (Vahdat et al., 2014). Another reason why this change of patients having control of their health care has made an impact on medical costs according to a study in 2013. Patients who were encouraged to take control of their own health care were seen to have an overall of 5.3% lower medical costs, 12.5% fewer hospital admission and fewer elective surgeries (Vahdat et al., 2014). Of course, patient involvement is not new but it is becoming more of a necessity in the health care system. Overall, the best part about this change, is that empowers patients to stay healthy and have an easier access to their results and communication with their providers.

References

Falvo, D. (2011) Effective Patient Education: A guide to Increased Adherence. Retrieved from

REPLY2

The 21st Century Healthcare System has seen a shift from a paternalistic focus to a more collaborative approach with the health professional and the patient working together to plan the patient’s care. In the traditional health provider-patient relationship the physician is regarded as the authority figure with the knowledge and expertise having the sole responsibility for developing a treatment plan that was rarely challenged by the recipients. However, the healthcare system has evolved to give patients more autonomy to manage chronic conditions proactively and make informed decisions about treatment options. Research indicates that shared decision-making leads to better treatment outcomes, fewer elective surgeries, hospital admissions, and lower health costs. According to Falvo, (2011), the concept of patient-centered care has expanded to all areas of healthcare and is linked to increased patient satisfaction and increased quality of care as well as patient adherence to treatment. Patient-centered care is fostered by a partnership between the health professional and the patient that is built on mutual respect and incorporates the patient’s wishes and active participation.

Research done by the Agency for Healthcare Research and Quality indicates that when patients are engaged in their care it can lead to measurable improvements in safety and quality and has developed an evidence-based resource guide known as ‘A Guide to Patient and Family Engagement in Hospital Quality & Safety,’ that can be used to help nurses work in partnership with patients and their families. (Sherman, 2014). Health institutions stand to benefit from productive relationships with patients and families because the Centers for Medicare and Medicaid Services has also shifted its reimbursement system to a value-based program linked to patient outcomes and patient satisfaction. The ability of patients and their families to effectively engage in their healthcare is contingent on factors such as their knowledge, attitudes, and health literacy. Many patients are hesitant about taking the responsibility of participating in health decision making because they feel overwhelmed by the prospect. There are some health professionals who are also resisting the change to the new model of patient-provider partnership. The nurse is in a unique position to create an environment conducive to this model of patient partnership. 

The old model of health teaching limited to brief instructions and a few handouts at discharge is inadequate and many patients have begun to demand answers and express their dissatisfaction. Since patients are now expected to assume more personal responsibility for their health decisions, effective patient teaching requires that the health professional thinks beyond merely providing information but focus on customizing recommendations to meet the patient’s specific needs.(Falvo,2011). When patients are given adequate knowledge and the rationale for treatment, they develop the confidence and sense of control that empowers them to make health decisions that result in improved treatment outcomes. Computer technology has greatly enhanced patients’ knowledge and ability to take charge of their health and become familiar with a vast array of therapeutic options, disease prevention, and disease management methods. As nurses, we must embrace health care reform that facilitates patient engagement and assist patients in their healthcare journey throughout the continuum of care.

References

Falvo, D. (2011). Effective patient education. A guide to increased adherence. https://viewer.gcu.edu/RQBKXW

Sherman, R. (2014). The patient engagement imperative. American Nurse Today. https://reasearchgate.net/publication/200036096_The_patient_engagement_imperative/link

https://viewer.gcu.edu/RQBKXW

Vahdat, S., Hamzehgardeshi, L., Hessam, S., & Hamzehgardeshi, Z. (2014). Patient involvement in health care decision making: a review. Iranian Red Crescent medical journal, 16(1), e12454. https://doi.org/10.5812/ircmj.12454

2 Coments Each One 150 Words (CITATION AND REFERENCE) – 2025 REPLY1 It was expected by both patients and health professionals that health professionals were the ultimate

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2 Coments Each One 150 Words (CITATION AND REFERENCE) – 2025

REPLY1

It was expected by both patients and health professionals that health professionals were the ultimate authority by virtue of their expertise and would therefore make the final decision about what was best for patients (Stone, 1979). Patients were not expected to play an active role in their healthcare. Nor did providers expect patients to abide by their teaching. In fact, information about their health was typically held from them (Flavo, 2011). The patients knowing too much would make the physicians feel less important and the patient would have less respect for them.

Now, patients have total control over their health and the care they receive as well as the ability to remain compliant or not. Despite what they believed back in the day; patients respect providers more when they give information to the patient about their condition. “Patients frequently misinterpret a lack of information as meaning that the truth is so negative that it cannot be shared with them” (Flavo, 2011). I have found that in my practice, patients are more willing to open up, ask for help and return to follow up appointments if the provider and nurses are more open and hands on with the patient teaching.

However, patients must want to participate in their care. They must be active and engaged to have the best possible outcomes. By telling the patient the consequences of not adhering to the care plan can build trust, enforce teaching, and assure the patient is aware of what is going on.

In my field, I always assess the readiness of my patient to learn. Most are post-surgery, so they do not get up without pain medication or wanting to lay in bed all day and not get in the chair. After assessing readiness, I begin planning the day they are admitted, and that plan continues through till the day of discharge.

Falvo, D. R. (2011). Effective patient education: A guide to increased adherence(fourth ed., pp. 1 & 221). Sudbury, MA: Jones and Bartlett Publishers. Retrieved from https://viewer.gcu.edu/RQBKXW

Stone, G. C. (1979). Patient compliance and the role of the expert. Journal of Social Issues, 35(1), 34–59.

REPLY2

The involvement of the patient in the decisions concerning their own health has increased over the years. Patients are now expected to assume more personal responsibility for health outcomes, and patient participation in health and health care has been promoted as best practices. In the past, patients were viewed as passive recipients of health care (Stone, 1979). Generally, neither patients were expected to play any active role in their health care by health care professionals too. (Stone, 1979). Today, this has changed drastically. Patients can now ask questions about their health and demand answers.

Today’s health care system accommodates the personal feelings that patients have on the various treatment plans available. Clinicians and nurses are now being trained on involving patient in their health care practice decision making process from school. I still remember reading patient right, informed consent chapters in nursing school which always guide us to inform patient any all his health issues and get permission before performing and treatment plan. This is an example of empowering patients to make decision in their health care. Technology is considered to be one of the significant sources of developing control over health in people. Patient gain lot of health information related to their health problems in internet so they can get more information and easily understand the therapeutic intervention and make decision appropriately Internet where we can get preventive measures to illness in primary level has enabled people to practice healthy health habit to avoid illness . People are gaining control over health. For example looking to internet and practicing yoga is also an example of gaining control over fitness and health. My 20 year old cousin has DM and he is aware about his disease, sign and symptoms of hypoglycemia, hyperglycemia ,diabetic diet, he states “ aunty I learnt all this from health related websites”. This in just an example how people have knowledge about their health condition and can make decision based upon this knowledge with health care team.

Reference

Falvo, D. R. (2011). Effective patient education: A guide to increased adherence. (4th ed.). Jones & Bartlett Publishers. Retrieved from: https://viewer.gcu.edu/RQBKXW

Stone, G. C. (1979). Patient compliance and the role of the expert. Journal of Social Issues, 35(1), 34–59.

Assessing A Healthcare Program/Policy Evaluation – 2025 Assignment Assessing a Healthcare Program Policy Evaluation Program policy evaluation is a valuable tool that

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Assessing A Healthcare Program/Policy Evaluation – 2025

Assignment: Assessing a Healthcare Program/Policy Evaluation

Program/policy evaluation is a valuable tool that can help strengthen the quality of programs/policies and improve outcomes for the populations they serve. Program/policy evaluation answers basic questions about program/policy effectiveness. It involves collecting and analyzing information about program/policy activities, characteristics, and outcomes. This information can be used to ultimately improve program services or policy initiatives.

Nurses can play a very important role assessing program/policy evaluation for the same reasons that they can be so important to program/policy design. Nurses bring expertise and patient advocacy that can add significant insight and impact. In this Assignment, you will practice applying this expertise and insight by selecting an existing healthcare program or policy evaluation and reflecting on the criteria used to measure the effectiveness of the program/policy.

To Prepare:

  • Review the Healthcare Program/Policy Evaluation Analysis Template provided in the Resources.
  • Select an existing healthcare program or policy evaluation or choose one of interest to you.
  • Review community, state, or federal policy evaluation and reflect on the criteria used to measure the effectiveness of the program or policy described.

The Assignment: (2–3 pages)

Based on the program or policy evaluation you selected, complete the Healthcare Program/Policy Evaluation Analysis Template. Be sure to address the following:

  • Describe the healthcare program or policy outcomes.
  • How was the success of the program or policy measured?
  • How many people were reached by the program or policy selected?
  • How much of an impact was realized with the program or policy selected?
  • At what point in program implementation was the program or policy evaluation conducted?
  • What data was used to conduct the program or policy evaluation?
  • What specific information on unintended consequences was identified?
  • What stakeholders were identified in the evaluation of the program or policy? Who would benefit most from the results and reporting of the program or policy evaluation? Be specific and provide examples.
  • Did the program or policy meet the original intent and objectives? Why or why not?
  • Would you recommend implementing this program or policy in your place of work? Why or why not?
  • Identify at least two ways that you, as a nurse advocate, could become involved in evaluating a program or policy after 1 year of implementation.

Nursing Leadership In A Diverse Society W1 – 2025 Discussion Question Using the University Online Library or the Internet choose and research about a professional nursing organization Based on

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Nursing Leadership In A Diverse Society W1 – 2025

Discussion Question 

Using the University Online Library or the Internet, choose and research about a professional nursing organization. Based on your understanding of the organization, answer the following questions:

  • What was the organization’s response to the COVID-19 pandemic?
  • What political involvement did they have in the COVID-19 response?
  • How did they support nurses and the members of the organization?
  • Do you think the response was adequate? Why or why not?

As in all assignments, cite your sources in your work and provide references for the citations in APA format. Support your work, using your course lectures and textbook readings. Helpful APA guides and resources are available in the University Online Library. Below are guides that are located in the library and can be accessed and downloaded via the University Online Citation Resources: APA Style page. 

Walden NURS6003 Week 4 Quiz Part 1 – 2025 Walden NURS6003 Week 4 Quiz Part 1 Latest 2019 JULY Question NURS6003 TRANSITION TO

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Walden NURS6003 Week 4 Quiz Part 1 – 2025

 

Walden NURS6003 Week 4 Quiz Part 1 Latest 2019 JULY

Question

NURS6003 TRANSITION TO GRADUATE STUDY FOR NURSING

Week 4 Quiz Part 1

Question
1In APA, the paper should be ________ spaced.

Question 2The
recommended font to be used in an APA paper is:

Question 3A
level 2 heading in APA should be:

Question
4Which of the following is true regarding the title page in an APA paper?

Question
5In relation to comma usage in APA, which of the following follows the correct
format?

Question
6According to APA, the list of references which appear at the end of the paper
is referred to as the:

Question
7When should the author’s first initial be included in the citation?

Question
8Which of the following is in-text citations below is correct?

Question
9Below is a reference page listing for a book with two authors. How should the
title of the book be formatted?

Jones, A.
& Smith, P. (2016). Nursing ethics: Keeping the patient at the center of
care (2nd ed). Boston, MA: Pearson Education

Question
10Based on the URL or web-address, which of the following websites would more
likely contain scholarly research-based resources on heart disease?

Question
11Which of the following is correct when citing five authors the first time
within the text of an APA paper?

Question
12In APA, the writer should avoid the use of back to back parentheses.

Question
13Which of the following is correct regarding an in-text citation for direct
quotes?

Question
14In some papers for APA, an abstract will be required. The word length
typically for an abstract in a journal is between _______ and ______ words.

Question
15The author in APA should use numerals to express the numbers 10 and above.

Question
16In APA, a level 1 heading should appear:

Question
17When a writer uses another person’s ideas and research without citing the
source of the information, this is called plagiarism.

Question
18Which of the following is correct regarding the format of a periodical on the
reference page?

Question
19It is permissible to present one’s own published work as new scholarship.

Question
20Which of the following is correct regarding the Reference list in APA?

Nurs495 Journal – 2025 Each week you will be expected to provide the following information to

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Nurs495 Journal – 2025

Each week you will be expected to provide the following information to your community practice instructor through your journal entries:

  1. What are your upcoming week’s specific learning goals and objectives?
  2. What is your upcoming week’s detailed schedule at your community practice experience placement?
  3. Were there any placement items/issues that occurred this week that you feel your instructor should be aware of that are private in nature and are more appropriately shared here than in the discussion board with your classmates?
  4. Give a brief description of an objective you worked on this week. Make sure to cite at least one reference showing how your objective relates to the public health knowledge you’ve studied during this course or the public health course. You may choose to reference your e-text, journal articles, or videos you’ve studied during these courses or you may find an outside reference on your own to further enhance your public health knowledge and practices.

Remember, your journal entries are an important aspect of clinical learning as they serve to help you reflect upon and get the most out of your community practice experience. Therefore, your journal entry should include the who, what, where, and when of your community practice experience. Remember, this should simulate a dialogue that would normally take place face-to-face with your community practice experience instructor.

Scholarly Activities (TOPIC FALL PREVENTION STRATERGIES IN HOSPITALS) – 2025 Scholarly Activities TOPIC FALL PREVENTION STRATEGIES IN HOSPITALS Throughout the RN to BSN program

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Scholarly Activities (TOPIC FALL PREVENTION STRATERGIES IN HOSPITALS) – 2025

 

Scholarly Activities (TOPIC FALL PREVENTION STRATEGIES IN HOSPITALS)

Throughout the RN-to-BSN program, students are required to participate in scholarly activities outside of clinical practice or professional practice. Examples of scholarly activities include attending conferences, seminars, journal club, grand rounds, morbidity and mortality meetings, interdisciplinary committees, quality improvement committees, and any other opportunities available at your site, within your community, or nationally.

You are required to post at least one documented scholarly activity by the end of this course. In addition to this submission, you are required to be involved and contribute to interdisciplinary initiatives on a regular basis.

Submit, by way of this assignment, a summary report of the scholarly activity, including who, what, where, when, and any relevant take-home points. Include the appropriate program competencies associated with the scholarly activity as well as future professional goals related to this activity. You may use the “Scholarly Activity Summary” resource to help guide this assignment.

While APA style is not required for the body of this assignment, solid academic writing is expected, and in-text citations and references should be presented using APA documentation guidelines, which can be found in the APA Style Guide, located in the Student Success Center.

APA style is not required, but solid academic writing is expected.

You are not required to submit this assignment to LopesWrite.

Discussion 2 ,250 Words And Reply 1 And 2 ,150 Words Each One By 10/29/2020 At 6: 00 Pm,please Add References – 2025 Discussion 2 Describe the difference between research and quality improvement Provide a workplace

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Discussion 2 ,250 Words And Reply 1 And 2 ,150 Words Each One By 10/29/2020 At 6: 00 Pm,please Add References – 2025

 Discussion 2

Describe the difference between research and quality improvement. Provide a workplace example where qualitative and quantitative research is applied and how it was used within your organization. When replying to peers, discuss how these research findings might be incorporated into another health care setting. 

Reply 1

Research is a systematic study that aims to increase knowledge and understanding about a particular variable studied, for example, determining how effective a drug is based on a therapeutic result. On the other hand, quality improvement involves a systematic collection of data and statistics to improve healthcare outcomes (Al-Surimi, 2018). An example of such redesigning systems in the healthcare setting to determine the effect on healthcare outcomes. Research primarily follows a specific chronological order with a fixed hypothesis and assesses the study’s effectiveness through data analysis. Conversely, quality improvement has a flexible hypothesis, which variates as the survey continues (Al-Surimi, 2018). Quality improvement is mainly aimed at providing safe, effective, timely, and patient-centered care. In contrast, the main aim of a research undertaking is to determine the usefulness and utility of a medication given to patients (Al-Surimi, 2018).

Workplace Example

Qualitative research can be used to examine healthcare professionals’ change in behavior concerning difficulties and barriers they experience while delivering care to patients, whose findings are usually in words to be interpreted. On the other hand, quantitative research collects statistical information concerning a healthcare determinant, enabling empirical investigation (Rutberg & Bouikidis, 2018). In the surgical unit, we conducted qualitative and quantitative research on healthcare professionals to determine why physicians frequently got infections. From the data collected, it was discovered that it was due to lack of enough physicians’ gloves and washing stations. When this data was represented on a graph, a bigger percentage of participants complained of a lack of a washing station. This information was used for quality improvement in the facility, and more cleaning stations were put in place to ensure physicians practice regular handwashing hygiene

References

Al-Surimi, K. (2018). Research versus quality improvement in healthcare.

Rutberg, S., & Bouikidis, C. D. (2018). Focusing on the fundamentals: A simplistic differentiation between qualitative and quantitative research. Nephrology Nursing Journal, 45(2), 209-213

Reply 2

 

The purpose of performing research is to find new knowledge about the effect of a medicine, treatment, or procedure. Health care providers and health care organizations collect data for several different reasons. Data collection is performed to meet the requirements of mandatory reporting by the Centers for Medicare and Medicaid Services. Data are also collected for quality improvement, and data are collected for research purposes. If data are collected for research purposes, different procedures are required. For health care, data collection for quality can be done without acquiring approval or consent, which is required for research studies.

Quality Improvement (QI) is data-driven and usually done to improve the quality of care provided to patients. QI may benefit a process, system, and possibly the patient. QI, as defined by the Department of Health and Human Services (2011), consists of “systematic and continuous actions that lead to measurable improvement in health services and the health status of targeted patient groups” (p. 1). When health care providers and nurses carry out a QI project, it may not be the implementation of something new, but an improvement upon something already in place. QI takes a team to produce results. A QI project does not subject the participant to any risk, and the participant may not even be aware of being involved in a QI project. The QI project usually occurs at the facility where the problem was found. Monthly data are collected regarding patient safety at most facilities. Facilities include health care institutions such as hospitals, skilled nursing facilities, long-term facilities, clinics, and doctors’ offices (Helbig 2018).

In dialysis, we have the IDT that uses qualitative and quantitative research to review methods of modality, patient and family knowledge of hemodialysis. To Measure support and focus on patient and family preparation, knowledge of different modalities and the lifestyle implications of different modality choices. Home hemodialysis, peritoneal dialysis.

Reference

Helbig, (June 2018.) Applied Statistics in Healthcare. Statistical Analysis. Retrieved from: https//www.gcumedia.com/digital-resources/grand-canyon-university/2018/applied-statistcis-for-heatlh-care_1e.php

Reply 1 And 2 ,150 Words Each One By 10/28/2020 At 6:00 Pm ,please Add References – 2025 Reply 1 CAT For the research of relationship of smoking and lung cancer is it an experimental quasi experimental

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Reply 1 And 2 ,150 Words Each One By 10/28/2020 At 6:00 Pm ,please Add References – 2025

Reply 1

 CAT: For the research of relationship of smoking and lung cancer, is it an experimental, quasi-experimental, and nonexperimental research? Why 

Reply 2

Experimental Group: The group in a research study that receives the experimental drug, treatment, or procedure (Helbig, 2018).

Experimental [Randomized] Research Design: A type of quantitative research design that is highly controlled to study cause and effect with independent and dependent variables (Helbig, 2018).

  • Example: Researcher manipulates one or more areas (independent) in the effects of temperature and humidity on work performance with at least two variables (high temp, low humidity and low temp, high humidity, etc.) within as many different workplace settings as available. The researcher could then measure the performance of workers in each condition (dependent) (Stone-Romero, 2011).

Quasi-Experimental Research Design: A type of quantitative research design that is partially controlled that studies cause and effect of variables (Helbig, 2018). No randomization.

  • Example: People received performance-contingent pay based on their work but their supervisors would be responsible for the planned and unplanned treatment (performance-contingent treatment) or if their supervisor did not deliver as planned could offset the design (Stone-Romero, 2011). The studies need to be fair across the board and we cannot guarantee that all supervisors will “grade” their employees on the same scale or fairly, people are picked accordingly without randomization but can be useful when experimental experiments are not possible.

Nonexperimental Research: A research study that does not involve an experimental drug, treatment, or procedure (Helbig, 2018). Quantitative or qualitative.

  • Example: Causes are assumed to be measured instead of manipulated; studying the relation between job enrichment and satisfaction. This is not a randomized study the data are collected from units that have independent variable from unknown causes. “The assumption would be erroneous if the self-reports systematically as a function of factors other than objective levels of enrichment” (Stone-Romero, 2011). Since this design deals with measured levels, it can be found to have very low levels of validity. This type of design may be more likely to be manipulated since it is measured instead of manipulated so there may be “favoritism” so this type should be avoided if possible.

The differences between each can be seen in the definitions but an experimental research design is quantitative that is highly controlled study where the dependent and independent variables matter, quasi-experimental is also quantitative but is only partially controlled with no randomization, and last, nonexperimental it is research that does not involve experimental drugs, treatments or procedures; it can be qualitative or quantitative.

 References
Helbig, J. (2018). Applied statistics for health care.Retrieved from https://lc.gcumedia.com/hlt362v/applied-statistics-for-health-care/v1.1/
Stone-Romero, E. F. (2011). Research strategies in industrial and organizational psychology: Nonexperimental, quasi-experimental, and randomized experimental research in special purpose and nonspecial purpose settings. In APA handbook of industrial and organizational psychology, Vol 1: Building and developing the organization. (pp. 37–72). American Psychological Association. https://doi-org.lopes.idm.oclc.org/10.1037/12169-002

 

Respondo Nano – 2025 Reply in a well developed paragraph 300 350 words to each Response integrating an evidence based resources Respectfully

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Respondo Nano – 2025

  Reply in a well-developed paragraph (300-350 words) to each Response , integrating an evidence-based resources.  Respectfully agree and disagree with your peers’ responses and explain your reasoning by including your rationales in your explanation. 

Response 1

The purpose of this week’s discussion post is to describe two diagnoses and the medications used for their symptoms. This week I will be focusing on migraines and insomnia. Both conditions are neurological by nature and have negative effects on people’s lives. They interfere with activities of daily living as well as mental and physical health.
Migraines are defined as either a classic migraine that has momentary focal symptoms-with aura or a common migraine that has specific symptoms- without aura (Woo & Robinson, 2020). Although the exact catalyst for migraines is not clear there are various theories that help to navigate the course of treatment. Some theories include heightened brain activity from genetics, intracranial vasodilation, and a sensitivity to trigeminovascular systems which causes alterations in structure and function (Woo & Robinson, 2020). Treatment course depends on if migraines are acute or chronic and if the patient has success with preventing or aborting symptoms. One drug class used for acute/abortive migraines are analgesics (Woo & Robinson, 2020). Aspirin and Naprosyn are often used as first line recommendations for acute migraines. It was found that the use of high dose aspirin (900-1,300mg) was successful in aborting, as well as preventing, the symptoms of an acute migraine attack without associated nausea (Alpert, 2020). Aspirin helps alleviate symptoms by interfering with prostaglandins and platelet activity as well as possibly effecting the serotonin activity (Woo & Robinson, 2020). Of course, high doses of aspirin have a long list of warning to teach the patient. Gastrointestinal bleeding, ulcers, and discomfort should be educated and reported. Aspirin is also contradicted in pregnancy, children, prior to surgeries, with any active bleeds or ulcers, and caution with hepatic dysfunction (Woo & Robinson, 2020). The patient should report any signs of bleeding, dizziness, hearing issues, or new pain. The use of aspirin should also be avoided if taking anticoagulants, antihypertensives, NSAIDs, and glucocorticoids (Woo & Robinson, 2020). Naprosyn or naproxen is the other analgesic that is used for the treatment of migraines. Naproxen is used for menstrual specific migraines as well and is contradicted in the last trimester of pregnancy (Woo & Robinson, 2020). Caution should be taken with naproxen with comorbidities such as kidney disease, ulcers, and gastritis. This medication has similar side effects and interactions as aspirin. Gastrointestinal bleeds being the most common. Medication interactions include antihypertensive, antithrombotic, antidepressants, and corticosteroids (Cooney et al., 2015). Being a COX inhibitor, naproxen works for migraines by decreasing pain and inflammation.
Another drug class utilized for migraines are beta blockers. One beta blocker used for migraines include propranolol which is a beta-1 and beta-2 antagonist. This drug works by preventing chronic migraines from occurring and the exact reason how is not clear, but it is believed it is from effecting the catecholaminergic system and brain serotonin receptors (Linde & Rossnagel, 2017). This medication would begin with a 3 month trial and be reassessed every 6 months (Woo & Robinson, 2020). Propranolol can cause a decrease in heart rate as well as respiratory distress so should be avoided in patients with underlying respiratory illnesses or preexisting heart conditions such as bradycardia. Adverse drug reactions include lethargy and depression (Woo & Robinson, 2020). These drugs should also be used in caution with diabetics and be tapered. Another beta blocker that acts only on the beta-1 receptor is metoprolol. Metoprolol is selective for beta-1 so cardiac comorbidities should try alternative methods as this can cause more issues such as bradycardia (Woo & Robinson, 2020). This drug also has many drug interactions because it is metabolized through CYP450.
Insomnia is difficulty falling or remaining asleep which consequently results in a decrease in ability to function during the daytime (Krystal et al., 2019). There are many causes of insomnia including medication reactions, hormone imbalances, mental illness, diabetes, chronic pain, and stress. Because the pathology of insomnia is multifaceted there are numerous medications recommended depending on the cause. One medication group are benzodiazepines. Benzodiazepines work by targeting the GABA receptors which induce sedation and a disease in anxiety (Krystal et al., 2019). Alprazolam or Xanax is known as one of the short-acting benzodiazepines used for insomnia. Another long-acting benzodiazepine utilized is clonazepam. Both medications have the same mechanism of action as stated above. And there are similar interactions as well. All benzodiazepines are CNS-depressants and can cause dependency (Woo & Robinson, 2020). Xanax has a higher prevalence of this than that of a long-acting medication such as clonazepam. These medications can cause respiratory depression, cardiac rates to slow, dizziness, altered mental status, hypotension, or depression (Woo & Robinson, 2020). Clonazepam has a side effect of increased salivation. These medications should not be taken with other depressants or digoxin (Woo & Robinson, 2020).
The other class of medications that is utilized for insomnia are antidepressants. Trazadone is one of the most used antidepressants for insomnia and is no longer used as much for depression (Jaffer et al., 2017). Trazadone is a serotonin antagonist and reuptake inhibitors (SARI) and interferes with the serotonin receptor as well as the histamine 1, and alpha receptors (Jaffer et al., 2017). The main side effects of this medication are sedation, headaches, dizziness, and tolerance. Less commonly trazadone can cause dry mouth, hypotension, QT prolongation, suicidal ideation, and hallucinations (Shin, 2020). Caution should be taken with MAOIs, triptans, TCA, and fentanyl. This drug is also metabolized by the liver and kidneys so those functions should be monitored (Shin, 2020). Another antidepressant that can be used for insomnia treatment is sertraline (Zoloft). This medication is in the selective serotonin reuptake inhibitors (SSRIs) class of antidepressants and works by inhibiting the serotonin reuptake which increases serotonin levels (Singh, 2020). This mediation has a lot of side effects including fainting, GI upset, perspiration, xerostomia, altered mental status, hallucinations, sexual dysfunctions, and drowsiness (Singh, 2020). There is also an increased risk for bleeds, prolonged QT intervals, suicide ideation, and should be taken in caution with elderly populations (Singh, 2020). Because of all these risks this would not be a first line choice for an off-label use such as insomnia but does benefit certain people. 

Response 2

 A seizure is a transient disruption in brain electrical function which are classified differently (McCance, Huether & Rote,2014). Seizures happen when two events occur in a group of neurons. A burst of action is produced by depolarization of the neuron caused by extracellular calcium that opens the sodium channel, which generates repetition (McCance, Huether & Rote,2014). The firing increases and the amplitude becomes greater. The discharge goes to the neurons surrounding and spreads through corticocortical synapses (McCance, Huether&Rote,2014). The firing will spread through pathways to areas in the brain like the basal ganglia, thalamus, and the brainstem, which comes to a tonic phase of muscle contraction and increased muscle tone , and loss of consciousness( McCance,Huether &Rote,2014). There are different types of seizures, they are classified by symptoms and site of origin. Seizures can be initiated due to hypoglycemia, fatigue, emotional and physical stress, lack of sleep, hyponatremia, environmental stimuli, stimulants, alcohol withdrawal, hyperventilation, or blinking lights (McCance, Huether &Rote,2014). Epilepsy is a diagnosis for when seizures continue to reoccur for no known reason, the cause cannot be found (McCance, Huether & Rote,2014).
The three major drug classes of antiepileptic drugs to treat seizures are hydantoins, iminostilbenes, and succinimides (Woo& Robinson,2016).
Examples of hydantoins are phenytoin or Dilantin (mostly used), ethotoin or peganone, and fosphenytoin or cerebyx. These drugs work by stabilizing electrical discharge in the brain by effecting the influx of sodium into the neuron during depolarization, which slows the spread and disruption in electrical function (Woo & Robinson,2016). The rate is usually oral, and these medications are absorbed slowly in the small intestine but enters the brain quickly. These medications are good because levels can be measured for a therapeutical goal of 10-20mcg/ml. When administering hydantoins iv, they must be administered with caution and not too fast because it can cause cardiovascular reactions. Patients should not be prescribed iv if they have sinus bradycardia, sinoatrial block, second- and third-degree blocks, and must be used in caution with patients who have liver disease or renal disease (Woo & Robinson,2016). Side effects of hydantoins are agitation, confusion, dizziness, ataxia, headache, drowsiness, nausea, vomiting, anorexia. Patients should be educated to take exactly as prescribed and not to miss any doses. Patients should not stop this medication abruptly. Patients should be advised that their urine may change in color to pink or red, or reddish brown and not to be alarmed (Woo & Robinson,29016).
Examples of iminostilbenes are carbamazepine or Tegretol, oxcarbazepine or Trileptal and treat epilepsy, bipolar disorder, and some neuralgias (Woo & Robinson,2016). These medications depress transmission in the nucleus of the thalamus, slowing the spread of abnormal activity (Woo & Robinson,2016). Carbamazepine can decrease WBC’s and depress bone marrow leading to leukopenia, thrombocytopenia, and aplastic anemia (Woo & Robinson,2016). CBC should be monitored closely. Side effects of Carbamazepine include thyroid function impairment, and hepatic damage. LFT and TSH should be monitored closely. Most common side effects include, dizziness, diplopia, fatigue, nausea (Woo & Robinson,2016). When patients are prescribed carbamazepine, they should be taught to report sore throat, bruising, and fever. The medication can cause fatigue so they should be on alert to be careful as these medications can be sedating (Woo & Robinson,2016).

Bells Palsy
Bell’s palsy is the most common cause of acute spontaneous peripheral facial paralysis which is unilateral. Common symptoms include the eyebrow sagging, inability to close the eye, and drooping at the affected corner of the mouth, which is drawn to the unaffected side (Ronthal & Greenstein,2020). The etiology of Bells Palsy remains unknown (McCance, Huether & Rote,2014). Bells Palsy could be caused by herpes simplex reactivation in facial cranial nerve VII (McCance, Huether & Rote,2014).
Treatment for Bells Palsy includes short term oral glucocorticoid. Prednisone 60 mg daily x 5 days followed by a 5-day taper of 10mg per day until completed is recommended (Ronthal & Greenstein,2020). Glucocorticoids inhibit the immune and inflammatory by their actions at several sites (Woo & Robinson,2916). When using short term patient may experience insomnia, mood swings and dyspepsia (Ronthal & Greenstein,2020). If a patient has diabetes, they should be educated that the patient will experience hyperglycemia (Ronthal & Greenstein,2020). In severe cases of Bells Palsy, the patient face will be asymmetric at rest, no motion to forehead, and incomplete closure of the eye (Ronthal & Greenstein,2020). With severe cases it is recommend to co -administer anti-viral medication valacyclovir with prednisone. It is unclear if anti-viral therapy adds benefit with new onset bells palsy. It is not recommended to treat with anti-viral medication alone (Ronthal & Greenstein,2020). Mild cases of Bells Palsy should be treated with prednisone alone. Mild case consists of normal facial symmetry at rest and slight weakness noted in face (Ronthal & Greenstein,2020).
Valacyclovir is rapidly converted to acyclovir after administration, the mechanism of action is the same as acyclovir. It is active against the herpes simplex virus. It distributes to areas in the brain, the lung, herpetic lesions, saliva, semen, and kidney (Woo & Robinson,2016). Renal failure has been reported, use with caution in patients with kidney disease. Thrombotic thrombocytopenic purpura has been reported. There are few side effects with acyclovir, but some include headache, rash, and nausea vomiting (Woo & Robinson,2016). Education includes should be taken at the earliest sign of disease; medication should be taken with plenty of fluids to maintain hydration to help avoid renal failure (Woo & Robinson,2016).