Category: Nursing

The purpose of this assignment is to refine the PICOT question you developed in the discussion forum this week and begin evaluating literature that you will use in subsequent weeks to write your research paper.
Use the “Literature Evaluation Table” to complete this assignment. Prior to starting the “Literature Evaluation Table,” complete the following:
Review the feedback you have received in the discussion forum related to your PICOT question so far. Make any necessary edits to your PICOT question.
Conduct a literature search to locate four research articles focused on your selected nursing practice problem of interest. Note: This literature search should include two quantitative and two qualitative, peer-reviewed, primary research articles to support your nursing practice problem. A mixed methods article can qualify towards meeting a qualitative or quantitative methodology. The two articles identified in Topic 1 DQ 2 can be used should you still find them relevant to your PICOT question.
Articles must be published within the past 5 years, appropriate for the assignment criteria, and relevant to nursing practice.
The PICOT question and four peer-reviewed research articles you chose will be utilized for subsequent assignments. 
Note: For best search results, do not include the words qualitative and quantitative in your search terms. Do include words that narrow or broaden your main topic. For example: Search for diabetes and pediatric and dialysis. To determine what research design was used in the articles the search produced, review the abstract and the methods section of the article. The author will provide a description of data collection using qualitative or quantitative methods. Systematic reviews, literature reviews, and metanalysis articles are good resources and provide a strong level of evidence but are not considered primary research articles. Therefore, they should not be included in this assignment.
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.  
This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

Please read the instructions:
Peer 1
Eve
Summarize the clinical case, including the significant subjective and objective data. 
Ms. Richardson’s complex situation suggests cognitive and mental disability. Ms. Richardson subjectively struggles with time, place, and current occurrences. Her inability to recollect the month or characterize her current situation, combined with her history of illness and weakness, suggests mental illness. Her denial of her predicament, attributing her symptoms to physical disease, and rejecting neighbors’ concerns may indicate anosognosia, a typical hallmark of neurocognitive disorders (Emmady et al., 2020). 
Ms Richardson’s uncleanliness, bad smell, and filthy living conditions, as noted by police and healthcare experts, demonstrate her environmental and personal hygiene negligence. Cognitive problems are highlighted by her poor facial expression and psychiatric interview response. Her responses to medication questions and mistaking an actual firearm for a toy from her deceased brother suggest perceptual disturbances and possible psychotic symptoms, aligning with DSM-5 criteria for delirium or major neurocognitive Disorder (Echeverría et al., 2022). 
Generate a primary and two differential diagnoses. Use the DSM5 to support the assessment. Include the DSM5 and ICD 10 codes. 
The main diagnosis 
Alzheimer’s Disease-related Major Neurocognitive Disorder (DSM-5: 331.0, ICD-10: F00) 
Major Neurocognitive Disorder entails severe cognitive deterioration in one or more cognitive domains, such as memory, and impairs daily independence. Her presentation meets DSM-5 criteria. Ms. Richardson has significant cognitive impairment, including memory deficits (inability to recall recent events and forgetting medication names), disorientation (not knowing the day of the month or hospital location), and functional decline. These signs suggest Alzheimer’s Disease, a common neurocognitive condition in elderly persons. 
Differential Diagnoses 
Delirium (DSM-5: 293.0, ICD-10: F05): Her uncontrolled diabetes may have exacerbated her underlying medical problem. Metabolic abnormalities or infections can cause acute confusion, disorientation, and altered awareness in delirium. Given her admittance to diabetes treatment, Ms. Richardson’s weakness, confusion, and perceptual problems may indicate delirium due to her poorly managed diabetes. 
Psychotic Disorder due to Another Medical Condition (DSM-5: 293.81, ICD-10: F06.2): Ms. Richardson’s history of psychiatric treatment for insomnia, perceptual disturbances (such as believing her dog was tranquilized and sent for repair), and confusion about past psychiatric medications (mentioning “Haldol” incorrectly) may indicate psychotic symptoms. Due to her age and medical history, an underlying medical cause, such as uncontrolled diabetes, should be investigated to distinguish a primary psychotic condition from a later presentation. 
Discuss a pharmacological treatment you would prescribe. Use the clinical guidelines to support the rationale for this treatment. 
Ms. Richardson’s symptoms suggest psychosis, disorientation, and perceptual problems; therefore, low-dose haloperidol may be examined. Haloperidol can treat psychosis (Rahman & Marwaha, 2020). Antipsychotics could help Ms Richardson’s disordered thinking, disorientation, and perceptual abnormalities, such as believing her dog was tranquilized and sent for repair. Clinical guidelines advise older adults to use antipsychotics cautiously due to increased sensitivity and side effects; thus, haloperidol should be started at a low dose and monitored for side effects, especially extrapyramidal symptoms and drowsiness (Rahman & Marwaha, 2020). This treatment would reduce Ms Richardson’s psychotic symptoms and enhance her mental health, allowing for a more accurate cognitive and functional assessment. However, her medical complexity and age require careful examination and continuing monitoring to guarantee pharmaceutical safety and efficacy. 
Discuss the non-pharmacological treatment you would prescribe. Use the clinical guidelines to support the rationale for this treatment. 
Cognitively challenged adults like Ms. Richardson need non-pharmacological treatments. Her Major Neurocognitive Disorder from Alzheimer’s requires non-pharmacological therapies. Clinical criteria show that psychosocial and environmental interventions increase dementia patients’ quality of life and diminish behavioral symptoms (Emmady et al., 2020). Thus, a complete care plan for Ms Richardson should include environmental adjustments for safety and comfort, daily routines for familiarity and agitation reduction, and carer education and support for social engagement and well-being. Sensory stimulation, memory, and music therapy may benefit cognitive and emotional dementia sufferers (Begali, 2020). These non-pharmacological treatments aim to improve Ms Richardson’s mental and social relationships and distressing symptoms. Evidence-based psychosocial therapy tailored to Ms. Richardson’s cognitive impairment and behavioral symptoms can enhance her well-being and functional independence. 
Describe a health promotion intervention that would be appropriate for this patient. 
Ms. Richardson’s lecture shows that Alzheimer’s Disease produces Major Neurocognitive Disorder, making career support and education essential health promotion tools. Alzheimer’s disease, its course and symptoms, and behavior management can be taught to caregivers. Guardians must learn how to maintain their houses safely and effectively. Begali (2020) recommends cleanliness, food, and managing behavioral indicators like agitation and roaming. Respite care can minimize Ms. Richardson’s carer burden and fatigue; for her health and cognition, Ms. Richardson must address her physical health difficulties, especially her poorly managed diabetes. Effective diabetes management requires medication adherence, dietary adjustments, and regular blood glucose testing (Echeverría et al., 2022). To improve Ms. Richardson’s quality of life and postpone illness progression, doctors must establish a personalized treatment plan that includes cognitive and physical health therapies. Support networks and community resources can improve health promotion activities. Local Alzheimer’s support groups or elder care organizations may help Ms Richardson and her carers. Carer education, diabetes management, and community assistance can improve Ms. Richardson’s health and independence. 
Peers 2
Jessica
Summary of the clinical case
Module 6 case is about an older woman (74-year-old) named Ms. Richardson. Ms. Richardson was brought to the hospital by police, accusing her of having mental challenges. She appeared unkempt and foul-smelling. During the interview, she failed to look at the interviewer, seemed confused, and did not respond to most of the interviewer’s questions. However, she knows her name and address well but does not know the month’s date. Her neighbors called the police, reporting Ms. Richardson was unwell. She was reported as wandering around and not caring for herself. The medical officers had been sent twice to look for her but could not find her. Finally, the police broke into her house and found her with a dog. They used a tranquilizing gun to contain the dog and get Ms. Richardson, who was hiding in a corner naked. Her apartment was dirty, with her dog’s feces everywhere. The house had a gun, which the police took into custody for her safety. 
The following morning, before she was transferred to a medical facility, the interviewer tried to ask her some questions. She remembered that her neighbor called the police since she was not feeling well, which was true, and the police shot her dog. She remembered that her dog had been taken to a shop and expected it when she was at home. She also respects her neighbor’s privacy and refuses to state his name, saying he had his own troubles. 
She repudiated visiting any psychiatric hospital or hearing voices but accepted that she was assigned a psychiatric near her home. The psychiatrist recommended some medication that was too strong, and she did not take them for long. She could not remember the drug’s name, but when the interviewer asked if it was Thorazine, she nodded. The interviewer was persuaded that the drug influenced her condition, but other observers tried to find something else that could have affected her condition. When asked about the gun, she denied it with irritation, arguing it was a toy gun. Ms. Richardson was still feeling weak and complained her back was aching. 
In this case, the objective data include overall poor health, confusion, dementia, signs of neglect, memory loss, and attention. On the other hand, the subjective data could consist of mental illness, poor living status, mood, age, cognitive deficits, and denial of her real gun, stating it was a toy. The collection of both subjective and objective data would help psychiatrists develop a well-personalized treatment plan for Ms. Richardson.
Diagnosis
Ms. Richardson’s disturbance could be due to another medical condition or exposure to toxins. Therefore, according to DSM-5 292.0 and ICD-10 F05.0 codes, the primary diagnosis could be delirium due to another medical condition (ICD-10, n.d.) (Pedersen, 2021). Her acute confusion, disorientation, and altered consciousness could result from uncontrolled diabetes or other medical factors. The two differential diagnoses could be major neurocognitive disorder due to Alzheimer’s disease and Schizophrenia, residual type. According to DSM-5 code 331.0 and ICD-10 code F00, the age of a patient and cognitive deficit issues lead to dementia and memory loss (ICD-10, n.d.) (Pedersen, 2021). Ms. Richardson appeared to have a memory loss condition resulting from a major neurocognitive disorder due to Alzheimer’s disease. Besides, DSM-5 code 295.60 and ICD-10 code F20.5 describe a patient with vague medical references and a history of psychiatric treatment to have Schizophrenia, residual type.
Pharmacological treatment
The possibility of delirium in the patient will be due to other underlying medical conditions such as blood sugar. Therefore, medical officers should start by treating underlying medical conditions, like stabilizing the blood glucose levels for diabetic patients. This would help lower the effect of delirium on a patient’s mental condition. Besides, low doses of antipsychotic drugs like haloperidol or risperidone can be prescribed to treat Ms. Richardson’s agitation and psychotic symptoms (Prendergast et al., 2022).
Non-pharmacological treatment
Psychiatrists should recommend the establishment of a calm, structured environment with frequent re-orientation. Ms. Richardson should also maintain consistent sleep and wake cycles and move frequently to manage delirium (Williams et al., 2019). This will help calm down how psychotic behaviors.
Health promotion intervention
Ms. Richardson should be admitted to a long-term care facility. The case reveals that she appeared to be neglected. She is old and has no one to take care of her in her mental health status. Therefore, she should be admitted to a long-term care facility where she can get both physical and mental health treatment while being taken care of.

Topic 1
Choose one component of the Framework for Safe, Reliable, and Effective Care.
Describe the component.
What is the nursing leader’s role in implementing the component?
Apply selected component to a clinical situation that you have experienced in your clinical practice.

Additional Instructions are in the word document. Please be sure to include a title slide and reference slide 
Book apa citation:
Ignatavicius, D. D., Workman, M. L., Rebar, C. & Heimgartner, N. M. (2021). Medical-surgical nursing: Concepts for interprofessional collaborative care (10th ed.). Elsevier.

attached is the file and below are the instructions. 
I just need to make sure the questioned answered is in depth based on what I have written so far, If you need to add to or take away that is ok
What are the latest and evolving reimbursement barriers for APNs, and how can APNs assist in overcoming these barriers?
The initial post is due on Wednesday at 1159 p.m. Peers must comment on a minimum of two initial postings and answer questions from peers/faculty by 11:59 p.m. on Saturday. I encourage interactive class participation.
Comments should be substantiated by one current peer-reviewed article other than your book and must be within five years or less. 
You must also include a reference from a reliable source such as a nursing journal, CDC, INH, etc. No blogs or WebMd sites will be accepted. APA 7th edition format is required for all discussions.  References should be within 5 years (from 2020 to 2024). 
i also need 3 in depth replies with references when they reply next week
thank you

I’m in the fire academy so I need a 5 page essay about atrioventricular septal defect. And a outline with it as well it’s due by Sunday 12am 

Applying the principles from the Nursing Leadership and Health Policy learning modules students will explore the role of the Registered Nurse Leader in policy advocacy.  
Directions:
Interview a nurse leader from a professional nursing organization to collect ideas for the project. A description of the interview. Description of the policy challenge chosen and the nursing association that was identified through the interview process.
Defination :Brief description of the policy challenge the team has chosen and the nursing association that was identified.
Describe the “Agenda” for the identified policy challenge. Include how the policy issue was identified, (Did the organization complete a review of the literature, an environmental scan and/or a SWOT analysis, etc.?)
Policy Challenge: The policy challenge can  be a local, state or federal policy issue. References cited in APA 7th ed. format.

INTERNET SPEECH
CRITIQUE
Carvens Lissaint’s Ted Talk
“Put the Financial Aid in the Bag”
As you view the speech, discuss what you see: Does the speaker make good eye contact, appear prepared, read from notes, connect to
the audience, and generally look competent? What do you think the speaker’s intent is in this
speech? Why? Write a one-page reflection describing what you viewed. Your paper must be in current APA style
format.
.. …

This is a Collaborative Learning Community (CLC) assignment. 
This assignment is to be completed in a group, which will be assigned by your instructor. The presentation will be submitted and graded as a group assignment.
The purpose of this assignment is to evaluate a strategic plan as a means to assess readiness for change within a health care organization or network.
Research a health care organization or network within the United States (e.g., United Healthcare, Vanguard, Banner Health, Kaiser Permanente, Cleveland Clinic, etc.). Assess the readiness of the health care organization or network you have chosen to meet the health care needs of citizens in the next decade.
Prepare a 12-15-slide PowerPoint that summarizes your assessment of the organization and proposes a strategic plan to ensure readiness. Include the following:
Identify the health care organization or network. Discuss the organization’s mission, vision, and values. Describe the types of services that this organization provides and the geographic areas it serves.
Describe the organization’s overall readiness to improve care outcomes based on your findings.
Analyze your selected organization’s strategic plan to determine to what extent it addresses issues pertaining to network growth, nurse staffing, resource management, and patient satisfaction.
Examine how interprofessional collaboration and shared governance influence organizational culture and values.
Identify a change management theory or model that could be used to support implementation of the strategic plan for this organization. Explain why this theory or model would be the best.
You are required to cite a minimum of three sources to complete this assignment. Sources must be appropriate for the assignment and relevant to nursing practice. 
Refer to the resource, “Creating Effective PowerPoint Presentations,” located in the Student Success Center, for additional guidance on completing this assignment in the appropriate style.
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.
This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

You are currently employed as a healthcare provider in a community 
hospital in your local community. The local high school is designing a 
learning unit for sophomores who have expressed an interest in computers and other technology as a potential future career. The teacher, who has 
designed this unit, has asked you to attend one of the classes as a guest 
speaker discussing how computer-related technology is used in 
healthcare. 
Given the above scenario, please answer the following questions:
1. What are the 3 to 5 key points you would want to include in this 
presentation?
Your response must be at minimum 250 words.
Please remember that you must include one citation from a scholarly 
source that is within the last 5 years using APA guidelines.