Nursing  response 2

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The nursing practice and scope are defined by the nurse practice act that is regulated by the board of nursing in all the states in the United States. Cimiotti et al., (2019) discuss that the laws and regulations are developed by the BON to ensure that nurses in practice are qualified and have met the educational requirements as well as certification to be a nurse. This is important because it helps in preventing unqualified nurses from practicing thus avoiding malpractice and medical errors from happening. Additionally, this is improving patient safety (Chesney, & Duderstadt, 2017). Therefore, in the state of Pennsylvania, advanced practice registered nurses follow state law and regulation that allows them to diagnose medical conditions, implement treatment plans, order and perform diagnostic tests among other responsibilities with a written collaborative agreement with a certified and licensed physician (Pittman et al., 2020). Another state law regulation in this state is that APRNs may prescribe drugs, devices, and schedules II-V controlled substances following the collaborative agreement signed by the APRN alongside a licensed physician. On the other hand, the APRNs in the state of Pennsylvania with proper training and experience can receive a federal waiver to dispense products containing buprenorphine while being supervised by a licensed physician.When compared with the state of New Jersey, APRNs require a joint protocol agreement with a licensed physician to perform their responsibilities. Additionally, APRNs in the state of New Jersey are required to have an additional six hours in pharmacological education to be allowed to prescribe medication and devices (Weaver, et al., 2021). Certification from the New Jersey state board of nursing is required for any nurse who wishes to practice as an APRN. However, they must have an advanced level of education like a Master of Science in nursing.APRNs in the state of Pennsylvania are not allowed to have full practice authority; however, they obtain their prescriptive authority by signing a collaborative agreement with a licensed physician. On the other hand, APRNs in Pennsylvania adheres to the prescriptive authority and practice authority by signing a collaborative agreement that is reviewed and updated after every two years.ReferencesChesney, M. L., & Duderstadt, K. G. (2017). States’ progress toward nurse practitioner full practice authority: Contemporary challenges and strategies. Journal of Pediatric Health Care, 31(6), 724-728.Cimiotti, J. P., Li, Y., Sloane, D. M., Barnes, H., Brom, H. M., & Aiken, L. H. (2019). Regulation of the nurse practitioner workforce: implications for care across settings. Journal of nursing regulation, 10(2), 31-37.Pittman, P., Leach, B., Everett, C., Han, X., & McElroy, D. (2020). NP and PA privileging in acute care settings: Do scope of practice laws matter?. Medical Care Research and Review, 77(2), 112-120.Weaver, S. H., de Cordova, P. B., Leger, A., & Cadmus, E. (2021). Licensed Practical Nurse Workforce in New Jersey as Described by LPNs and Employers. Journal of Nursing Regulation, 12(1), 60-70.

 
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Nursing  Health care in the US

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Search the web to research what patient outcomes are negatively impacted by nursing staff reduction. After you have found the necessary information, please write a short response (4-5 sentences) answering the question below.After researching the impact of patient outcomes and nursing ratios, what conclusion did you come to?     Were your findings expected, or were there startling discoveries made in the midst of your research?

 
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Nursing  Response two

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According to Dynamed’’ Chronic nonspecific low back pain is a diagnosis of exclusion in patients with pain in the low back lasting for more than 3 months without a pathologic cause identified’’.In this case a 79year old white male is taking hydrocodone/APAP 10/325 for lower back pain (pt diagnosed with degenerative disc disease several months ago). After a Doctor visit, prescription of Vicodin 10/325 Q 4-6 hrs PRN with a quantity of 120.If patient take pain meds Every 6 hrs/day PRN, patient will be taking a maximum of 4 tablets a day.If patient is taking this medicine Q4hrs/day PRN, the total maximum tablets /day will be 6 tablets.In this case, this patient is taking 12 tablets /day because the pain is too much and it is unbearable. This is an overdose of narcotic that could put patient to tolerance for this pain medication and need conversion to a new drug that could best control the pain.According to the opioid calculator recommended by the instructor, Morphine extended release should be prescribe as: 10mg Q4-6hrs PRN for more consistent pain control.3.CM is suffering of migraine, she has some precipitating factors such as sleeping problem, her use of inhaler for her asthma treatment can be a trigger to her migraine because inhalers are vasodialtors’’ Until recently, the major contributing pathophysiological event thought to initiate migraine was cerebral and meningeal arterial vasodilation’’ (Jacobs &Dussor, 2016).Non-pharmacological treatment: sleep hygiene such as sleeping at least 6-8hrs a day, drinking warm milk or taking warm bath during bedtime, decrease white light in the room and darkening the room during her sleep.I will also recommend a different Asthma medications, relaxation technic could also help in management of migraine.Base on CM condition, she may benefit from prophylactic treatment. She is qualified for the prophylactic treatment because she has headache that last 2 to 3 days and 2 times a month, and a severe and prolonged migraine attack. According to Peters (2019)’’Preventive therapy should be considered for patients with migraines who routinely have more than 6 headache-days per month, or in other special circumstances, such as recurring migraines producing disability, acute therapies that are ineffective or contraindicated, when serious adverse reactions are produced, or even when it is the patient’s preference’’.The 1st line prophylactic treatment will be: ‘’ Preventive migraine agents that are FDA approved include propranolol, timolol, divalproex sodium, and topiramate’’ (Peters, 2019).ReferencesDynamed: Chronic low back painhttps://wilkes.idm.oclc.org/login?url=http://www.dynamed.com/topics/dmp~AN~T116935/http://opioidcalculator.practicalpainmanagement.com/Jacobs,B., Dussor, G. (2016). Neurovascular contributions to migraine: moving beyondvasodilationPeters, G.L(2019). Migraine Overview and Summary of Current and Emerging Treatment Options

 
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Nursing  Financial healthcare management

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Case Study: You are assessing the payer–patient mix for a health care organization. Currently, your payer mix is 40% Medicare, 10% Medicaid, 25% traditional indemnity insurance, 20% managed care, and 5% self-pay patients. Complete the following:Using the most common office visit, CPT code 99214, determine the reimbursement from the Centers for Medicare and Medicaid Services (online fee schedule available for Medicare).Using the same CPT code, 99214, determine the be possible to obtain actual reimbursement information from your personal insurance carrier. If the information is not available, assume reimbursement by traditional indemnity insurance is usually 200% reimbursed more than Medicare and Medicaid, and managed care is usually 133% more than Medicare and Medicaid.Compose an accounts receivable benchmark from this information showing columns for current, 30–60, 61–90, 90–120, and greater than 120 days.Assess the information for areas of improved reimbursement of at least 20% or more.Evaluate the options available to change the payer–patient mix with consideration of related legal and ethical issues.Propose a best strategy with justification and rationale based on effective decision-making tenets.Spreadsheets demonstrating the accounts receivable analysis will be attached as appendices, and there will be at least 7 relevant peer-reviewed academic or professional references published within the past 5 years. Also attach appropriate fee schedules.

 
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Nursing  week 8 capstone journal

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Bi-weekly Practicum JournalingEvery two weeks, you will submit a reflective journal to the discussion forum for review by course faculty and your classmates. All are expected to engage and support one another by sharing these experiences in a supportive, constructive, professional environment. Journaling is an active learning technique that is meant to enhance reflective practice (Blake, 2005). Reflective practice involves looking back over what has happened in the practice setting in an effort to improve performance or to encourage professional growth (Ruth-Sahd, 2003).Your Weekly Practicum Journal is:A personal, introspective subjective account of your practicum experience and how your practicum experience relates to Healthy People 2020 and course objectives. Include events that occurred in your practicum experience, and be sure to describe your thoughts and feelings about those events.  How did your perceptions change? What did you learn that was unexpected? Describe your thinking about your thoughts and feelings regarding the new learning you experienced.Connected to South University’s College of Nursing Conceptual Framework Pillars (Caring, Communication, Critical Thinking, Professionalism, and Holism)Connected to prior coursework and experiences through reflective analysis.Written in a scholarly, academic style using APA style format. Two or three sentences are not sufficient nor are daily logs/reports of activities.Citations should conform to APA guidelines. You may use this APA Citation Helper as a convenient reference for properly citing resources or connect to the APA Style website.the assignment has to be on a diabetic/hypertensive patient admitted to a cardiac/ telemetry floor. re-admitted because of uncontrolled diabetes and hypertension.

 
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Nursing  discussion reply 2

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A middle-aged white male complains of chest tightness, shortness of breath, and feelings of impending doom. After an electrocardiogram (EKG) rules out myocardial infarction, the patient is diagnosed with anxiety. This patient has stressors that are contributing to his anxiety: he fears for his job due to a harsh management team, and he’s currently caring for his aging parents. The patient also admits to daily alcohol drinking. According to Watkins, (2019) anxiety and alcohol use are commonly connected due to the fact that people enjoy drinking alcohol, and think of it as a way to relax; however, alcohol abuse can also cause anxiety. Despite the sedative effect of alcohol, using alcohol as a cure for anxiety can have the opposite effect and worsen the symptoms of the person’s anxiety.For the interactive media decision tree, I first decided to begin this patient’s treatment with Zoloft 50mg orally daily. Allgulander et al. (2015) conducted a study that examined the efficacy of Zoloft in patients with a Hamilton Anxiety Rating Scale of 18 or higher. After four weeks, it was evident that patients that received Zoloft had greater improvement than those who received the placebo. The patient in the interactive media was no different, as the four week check-up revealed no chest tightness or shortness of breath, a decrease in the amount of worrying about work for several days, and a Hamilton Anxiety Rating Scale score of 18, down from the original score of 26. At the second decision tree point, I decided to increase the patient’s dose of Zoloft to 75mg orally daily because although his symptoms are improving, they are not yet optimal.After four weeks at 75mg, the patient returns with a further reduction in symptoms, and a Hamilton Anxiety Scale score of 10. Because of the 61% reduction in symptoms, I believe it’s best to maintain the current dose. Allgulander et al. (2015) states that the full efficacy of Zoloft can be assessed after 12 weeks. If at that point this patient’s symptoms have worsened, the dose may be increased.A necessary point of patient education for this patient would be to stop drinking alcohol. Herxheimer and Menkes (2011) discuss the pathological intoxication that occurs when alcohol and selective serotonin reuptake inhibitors (SSRIs) are mixed. A possible explanation for this pathological intoxication could be attributed to a change in alcohol tolerance when on this medication. The consequences of drinking while taking an SSRI such as Zoloft could include an increase in violent or sexual behavior, and commonly without memories of the incident. It would be imperative to discuss this topic with the patient to prevent any harm.ReferencesAllgulander, C., Dahl, A., Austin, C., Morris, P., Sogaard, J., Fayyad, R., Kutcher, S., & Clay, C. (2015). Efficacy of Sertraline in a 12-week trial for generalized anxiety disorder. The American Journal of Psychiatry, 161(9).https://ajp.psychiatryonline.org/doi/pdf/10.1176/appi.ajp.161.9.1642Herxheimer, A., & Menkes, D. B. (2011). Drinking alcohol during antidepressant treatment – a cause for concern? The Pharmaceutical Journal.https://www.pharmaceutical-journal.com/news-and-analysis/drinking-alcohol-during-antidepressant-treatment-a-cause-for-concern/11091677.articleWatkins, M. (2019). The connection between anxiety and alcohol. Retrieved fromhttps://americanaddictioncenters.org/alcoholism-treatment/anxiety

 
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Nursing  I need help

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During this course, many concepts in the physical sciences will be examined in detail. You will select an application, research it, and write a 750-1,000 word paper on it. The following are brief descriptions of the project tasks:Task 1: Identify your topic and write a brief outline.Task 2: Submit your final paper.Possible Topics for the Application PaperThese are just ideas. You are welcome to pick another topic. The purpose of Task 1 is for you to present your topic to your instructor and receive feedback on your plans.The physics of a sport (pick one)The physics of a bicycle (or any other machine)The physics of car accidentsThe physics of flyingThe physics of space explorationThe cameraThe combustion engineThe air conditionerThe chemistry of an element (or an atomic group of elements)Nuclear medicineApplication of radioactivity (pick one)Plastic – production and propertiesWaste water treatment plantsThe chemistry of a pharmaceutical (pick one)The catalytic converterThe workings of a smokestack of a factory or a power plantThe chemistry of fertilizersThe chemistry of preservativesTo successfully complete task 1, do the following:1. Briefly describe the application. This could be the draft for your introduction paragraph.2. Provide a brief outline of the topics for each of the body paragraphs.Application Paper: Task 21. An introduction.2. A minimum of three body paragraphs each describing some aspect of the application. Make sure to include how each aspect relates to one or more concept(s) from this course. You may choose to include the history of the application as one paragraph.3. A concluding paragraph.4. You must use at least two scholarly sources in addition to the textbook as references to support your paper. Make sure to properly cite your sources.

 
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Nursing  Discussion

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QD1 How can you guarantee validity and feasibility in your research study with a mixed method?QD2. Which intervention are you going to implement in your clinical experience? Why?QD3.    Upon examination of the genitalia of a newborn baby boy, you document the following: urethral opening on dorsal surface of penis, undescended testicles, right inguinal hernia, and small opening of the abdomen with an outpouching of pink tissue at the symphysis pubis.What does this documentation indicate?What major issue needs to be addressed with the baby’s family?QD4.  A kindergarten teacher at the public school where you work as a health care provider comes to you with a 5-year-old girl from her class. The teacher tells you that she is concerned about this girl because she has noticed poor eating and drinking habits, weight loss, and no apparent growth. The teacher tried to contact the parents to discuss her concerns, but they never returned her phone calls or the notes she sent home with the little girl. Further, this girl has often been late to class or missed whole days of school with no explanation from her parents as to why. You examine the child and notice that the child has a potbelly, is emotionally withdrawn, and is very passive.What are your concerns for this child?Because the parents seem uninterested, what approach would you take in attempting to get the parents to be proactive in this child’s health care?If the parents do not return your persistent phone calls, what is your responsibility to the health care of this child?

 
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Nursing  nursing

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· Develop your position about the individual rights to control the spread of communicable diseases for the good of society.· Survey the role of boards of health in your community and state to determine how communicable diseases are prevented and controlled.·150-word minimum/250-word maximum without the reference(s).·  Minimum of one reference, APA format

 
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Nursing  Global trends in nursing practice.

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Poverty: Please view the following Ted Talk and answer the question that follows.Collective compassion has meant an overall decrease in global poverty since the 1980s, says civil rights lawyer Gary Haugen. Yet for all the world’s aid money, there’s a pervasive hidden problem keeping poverty alive. Haugen reveals the dark underlying cause we must recognize and act on now.Haugen, G. (2015, March). The Hidden Reason for Poverty the World Needs to Address Now [TED2015]. Retrieved fromhttps://www.ted.com/talks/gary_haugen_the_hidden_reason_for_poverty_the_world_needs_to_address_nowQuestion to answer in your response –What is your interpretation of the complex relationships among social class, poverty, and discrimination in terms of the interconnections among race, ethnicity, culture, age, gender, and education?Please ensure you are following the discussion rubric and including a nursing, scholarly journal article in addition to your text book as sources of support.

 
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