Category: Nursing

Please see instructions and grading Rubic, I have included some of the websites just in case you don’t work at a hospital or can’t get the information. Hope this helps.

Find one story, blog, news article, etc related to Cross Border Concerns  OR Dealing with Disease. Post the story, article, news article as an attachment in your post.
Within the text of the discussion board thread, complete the following:
1-      1-Provide a synopsis of your attached article, including main theme, main findings, interesting facts, etc.
2-      2-Discuss how this story/article/blog/etc relates to this issue both for the region and globally to other regions. 
3-      3-APA formatting and references to support.

one of the references that has to be used & the other two can be journal articles from the last 5 years.
American Psychiatric Association (2022). Diagnostic and statistical manual of mental disorders 5-
TR (5th ed. Text revised).
ISBN: 978-0890425756 (Hardcover)
ISBN: 978-0890425763 (Paperback)

MUST USE THE TEMPLATE AND FOLLOW THE RUBRIC INSTRUCTIONS and TEMPLATE FORMAT
Concept Mapping Spring 23 edits
Concept Mapping Spring 23 edits
Criteria Ratings Pts
This criterion is linked to a Learning OutcomeDisease Process and Pathophysiology Risk Factors
5 pts
Satisfactory
Learner performs a thorough review of the disease process pathophysiology; identifies risk factors.
3.5 pts
Beginning
There are critical aspects of pathophysiology missing. This entry is incomplete.
0 pts
Unsatisfactory
The pathophysiology information is missing.
5 pts
This criterion is linked to a Learning OutcomeRecognizing Cues
What matters most?
5 pts
Satisfactory
Based on available patient data, the learner identifies at least four (4) critical cues that are significant and could impact the patient condition. The learner may consider both subjective and objective patient data.
3.5 pts
Beginning
Based on available patient data, the learner identifies two (2) or three (3) critical cue(s) that are significant and could impact the patient condition. The learner may consider both subjective and objective patient data.
0 pts
Unsatisfactory
Based on available patient data, the learner identifies zero (0) or one (1) critical cue(s) that are significant and could impact the patient condition. The learner may consider both subjective and objective patient data.
5 pts
This criterion is linked to a Learning OutcomeAnalyzing Cues
What could it mean?
5 pts
Satisfactory
Based on the identified cues, the learner is able to create three (3) – four (4) supporting connections between the relevant cues and client conditions/problems.
3.5 pts
Beginning
Based on the identified cues, the learner is able to create two (2) supporting connections between the cues and patient condition/problems.
0 pts
Unsatisfactory
Based on the identified cues, the learner is able to create one (1) or zero (0) supporting connection(s) between the cues and patient condition/problems.
5 pts
This criterion is linked to a Learning OutcomePrioritizing Hypotheses
Where do I start?
5 pts
Satisfactory
Based on the identified connections between cues and patient conditions/problems, learner is able to identify and rank three (3) client conditions/problems critical to positive patient outcomes. These should be listed with most urgent problems first.
3.5 pts
Beginning
Based on the identified connections between cues and patient conditions/problems, learner is able to identify and rank two (2) client conditions/problems critical to positive patient outcomes. These should be listed with most urgent problems first. This point value is also chosen if client/problems are not listed with the priority concern(s) first.
0 pts
Unsatisfactory
Based on the identified connections between cues and patient conditions/problems, learner identifies zero (0) or one (1) client conditions/problems critical to positive patient outcomes.
5 pts
This criterion is linked to a Learning OutcomeGenerating Solutions
What can I do?
5 pts
Satisfactory
List five (5) solutions/outcomes with appropriate interventions that will positively impact client outcomes and are appropriate to the care of the client. Outcomes/goals are listed in the SMART format.
3.5 pts
Beginning
List three (3) to four (4) solutions/outcomes with appropriate interventions that will positively impact client outcomes and are appropriate to the care of the client. Outcomes/goals are listed in the SMART format.
0 pts
Unsatisfactory
List zero (0) to two (2) solutions/outcomes with appropriate interventions that will positively impact client outcomes and are appropriate to the care of the client. This point value is also chosen if outcomes/goals are not listed in the SMART format.
5 pts
This criterion is linked to a Learning OutcomeTaking Actions
What will I do?
5 pts
Satisfactory
Describe how each of the five (5) identified nursing interventions will be performed, implemented, administered, communicated, or taught.
3.5 pts
Beginning
Describe how three (3) to four (4) of the identified nursing interventions will be performed, implemented, administered, communicated, or taught.
0 pts
Unsatisfactory
Describe zero (0) to two (2) of the identified nursing interventions will be performed, implemented, administered, communicated, or taught.
5 pts
This criterion is linked to a Learning OutcomeEvaluating Outcomes
Did it help?
2.5 pts
Satisfactory
Describe how you will determine the effectiveness of the five (5) priority nursing interventions you implemented. How will you know if your interventions are effective or not?
1.5 pts
Beginning
Describe how you will determine the effectiveness of three (3) to four (4) priority nursing interventions you implemented. How will you know if your interventions are effective or not?
0 pts
Unsatisfactory
Describe how you will determine the effectiveness of zero (0) to two (2) priority nursing interventions you implemented.
2.5 pts
This criterion is linked to a Learning OutcomeNursing Process template
2.5 pts
Satisfactory
Recognizing the completion of this template will assist the learner with the concept map assignment, all six (6) boxes are thoroughly completed. The SBAR information is thoroughly identified, and the chosen concept for the assignment is clearly identified.
1.5 pts
Beginning
Information is missing from one (1) to three (3) box(es). The SBAR information is thoroughly identified, and the chosen concept for the assignment is clearly identified.
0 pts
Unsatisfactory
Information is missing from four (4) to six (6) boxes. This point value is also chosen if the SBAR information is missing and/or the chosen concept for the assignment is not identified.
2.5 pts
Total Points: 35

For this assessment, you will develop an 8–14 slide PowerPoint presentation with thorough speaker’s notes designed for a hypothetical in-service session related to the improvement plan you developed in Assessment 2.  (PLEASE SEE ATTAHCED)
Introduction
As a practicing professional, you are likely to present educational in-services or training to staff pertaining to quality improvement (QI) measures of safety improvement interventions. Such in-services and training sessions should be presented in a creative and innovative manner to hold the audience’s attention and promote knowledge acquisition and skill application that changes practice for the better. The teaching sessions may include a presentation, audience participation via simulation or other interactive strategy, audiovisual media, and participant learning evaluation.
The use of in-services and/or training sessions has positive implications for nursing practice by increasing staff confidence when providing care to specific patient populations. It also allows for a safe and nonthreatening environment where staff nurses can practice their skills prior to a real patient event. Participation in learning sessions fosters a team approach, collaboration, patient safety, and greater patient satisfaction rates in the health care environment (Patel & Wright, 2018).
As you prepare to complete the assessment, consider the impact of in-service training on patient outcomes as well as practice outcomes for staff nurses. Be sure to support your thoughts on the effectiveness of educating and training staff to increase the quality of care provided to patients by examining the literature and established best practices.
You are encouraged to explore the AONE Nurse Executive Competencies Review activity before you develop the Improvement Plan In-Service Presentation. This activity will help you review your understanding of the AONE Nurse Executive Competencies—especially those related to competencies relevant to developing an effective training session and presentation. This is for your own practice and self-assessment, and demonstrates your engagement in the course.
Reference
Patel, S., & Wright, M. (2018). Development of interprofessional simulation in nursing education to improve teamwork and collaboration in maternal child nursing. Journal of Obstetric, Gynecologic & Neonatal Nursing, 47(3), s16–s17. 
Scenario
For this assessment, build on the work that you have done in your first two assessments and create an agenda and PowerPoint of an educational in-service session that would help a specific staff audience learn, provide feedback, and understand their roles and practice new skills related to the safety improvement plan you created. 
Instructions
The final deliverable for this assessment will be a PowerPoint presentation with detailed presenter’s notes representing the material you would deliver at an in-service session to raise awareness of your chosen safety improvement initiative focusing on a specific patient safety issue and to explain the need for such an initiative. Additionally, you must educate the audience as to their role and importance to the success of the initiative. This includes providing examples and practice opportunities to test out new ideas or practices related to the safety improvement initiative.
Be sure that your presentation addresses the following, which corresponds to the grading criteria in the scoring guide. Please study the scoring guide carefully so you understand what is needed for a distinguished score.
Describe the purpose and goals of an in-service session focusing on a specific patient safety issue.
Explain the need for and process to improve safety outcomes related to a specific patient safety issue.
Explain to the audience their role and importance of making the improvement plan successful.
Create resources or activities to encourage skill development and process understanding related to a safety improvement initiative.
Communicate with nurses in a respectful and informative way that clearly presents expectations and solicits feedback on communication strategies for future improvement.
There are various ways to structure an in-service session; below is just one example:
Part 1: Agenda and Outcomes.
Explain to your audience what they are going to learn or do, and what they are expected to take away.
Part 2: Safety Improvement Plan.
Give an overview of the current problem focusing on a specific patient safety issue, the proposed plan, and what the improvement plan is trying to address.
Explain why it is important for the organization to address the current situation.
Part 3: Audience’s Role and Importance.
Discuss how the staff audience will be expected to help implement and drive the improvement plan.
Explain why they are critical to the success of the improvement plan focusing on a specific patient safety issue.
Describe how their work could benefit from embracing their role in the plan.
Part 4: New Process and Skills Practice.
Explain new processes or skills.
Develop an activity that allows the staff audience to practice and ask questions about these new processes and skills.
In the notes section of your PowerPoint, brainstorm potential responses to likely questions or concerns.
Part 5: Soliciting Feedback.
Describe how you would solicit feedback from the audience on the improvement plan and the in-service.
Explain how you might integrate this feedback for future improvements.
Remember to account for activity and discussion time. 
Additional Requirements
Presentation length: There is no required length; use just enough slides to address all the necessary elements. Remember to use short, concise bullet points on the slides and expand on your points in the presenter’s notes. If you use 2 or 3 slides to address each of the parts in the above example, your presentation would be at least 10 slides and no more than 15 slides (not including the title, conclusion, or references slides).
Speaker notes: Speaker notes (located under each slide) should reflect what you would actually say if you were delivering the presentation to an audience. This presentation does NOT require audio or a transcript. Another presenter would be able to use the presentation by following the speaker’s notes.
APA format: Use APA formatting for in-text citations. Include an APA-formatted reference slide at the end of your presentation.
Number of references: Cite a minimum of 3 sources of scholarly or professional evidence to support your assertions. Resources should be no more than 5 years old. 
Competencies Measured
By successfully completing this assessment, you will demonstrate your proficiency in the course competencies through the following assessment scoring guide criteria:
Competency 1: Analyze the elements of a successful quality improvement initiative.
Explain the need for and process to improve safety outcomes related to a specific patient safety issue.
Create resources or activities to encourage skill development and process understanding related to a safety improvement initiative.
Competency 4: Explain the nurse’s role in coordinating care to enhance quality and reduce costs.
Describe the purpose and goals of an in-service session focusing on a specific patient safety issue.
Explain to the audience their role and importance of making the improvement plan successful.
Competency 5: Apply professional, scholarly, evidence-based strategies to communicate in a manner that supports safe and effective patient care.
Slides are easy to read and error free. Detailed speaker notes are provided. Speaker notes are clear, organized, and professionally presented.
Organize content with clear purpose or goals and with relevant and evidence-based sources (published within 5 years).

Its a reflective essay using the Gibbs Reflective cycle
Reference style : Harvard
Number of references :25
And page numbering
Line spacing is 1.5

Answer: (Defining the topic, relevance in nursing, examples) source citation page number of the reputed/peer-reviewed/textbook used. 
** The part written in blue is a draft where I wrote down the answer to the assigned question. I would like to add details to the part written in blue. (I should use the APA 7th style when I use Textbook or References.)
** I’d like to add 1-2 sentences in the green part using the reference.
Chapter 17: Outcome Identification and Planning
Assigned Question: Describe guidelines for writing outcomes statements.

Chisholm-Burns et al. (2022) explain that anxiety disorders are a dysfunctional response to the computation of sensory data from the fear-response system of the anthropological brain. Stimuli may be present or absent in the presence of anxiety and anxiety may even continue long after exposure to the stimuli (Chisholm-Burns et al., 2022). Per Stahl (2021) the cortico-striato-thalamo-cortical network (CSTC, a network of brain circuits) creates feedback loops and serotonin (5HT) is one neurotransmitter which modulates these circuits. Serotonin exerts an inhibitory effect in the CSTC (Chisholm-Burns et al., 2022; Stahl, 2021). Serotonin is theorized to inhibit norepinephrine (NE), another key neuromodulator in the CSTC (Chisholm-Burns et al., 2022; Stahl, 2021). A region in the brain by the name of locus ceruleus (LC) produces NE (Chisholm-Burns et al., 2022). An excess of NE because of dysregulation of the LC is thought to be the neurobiological genesis of anxiety (Chisholm-Burns et al., 2022). Fear and worry are the two core symptoms of anxiety which selective serotonin reuptake inhibitors (SSRIs) treat (Stahl, 2021).
SSRIs are first-line pharmacotherapy for anxiety due to their bearable side effect profile, lack of dependency, as well as their ability to treat cooccurring conditions (Chisholm-Burns et al., 2022). In general, the side effects of SSRIs are nausea, diarrhea, insomnia, agitation, sedation, drowsiness, sexual dysfunction, weight gain and QT prolongation (Puzantian & Carlat, 2024). These side effects vary depending on the agent used (Puzantian & Carlat, 2024). It is always advised to exercise patience to allow for acclimation to SSRIs and subsequent resolution of symptoms (Stahl, 2024). The most prominent side effect is that of sexual dysfunction and we must educate those we serve on the risks versus benefits of SSRI treatment, thus allowing them to make an informed decision. There are adjunctive treatments for sexual dysfunction secondary to SSRI treatment, but a dose reduction may also alleviate symptoms (Puzantian & Carlat, 2024). When appropriate, a dose reduction may also serve to negate other SSRI side effects (Puzantian & Carlat, 2024). QT prolongation is most notable with citalopram (Celexa) at doses over 40mg (Puzantian & Carlat, 2024). If prescribing over 40mg of Celexa, an EKG is warranted (Puzantian & Carlat, 2024).
Class warning for SSRIs also include suicidality, mania switch, serotonin syndrome, discontinuation syndrome (DS) and hyponatremia (Puzantian & Carlat, 2024). The prudent advanced practice nurse will not only equip their patients with the knowledge to address these potential concerns but will also judiciously prescribe with full consideration of the overall health and history of those they treat. This will include frequent monitoring, relevant diagnostic workups and appropriate tapering (Puzantian & Carlat, 2024). Other concerns to be aware of include the possibility of diminished release of dopamine due to the increased serotonergic action of SSRIs (Stahl, 2024) This may manifest as emotional flattening, cognitive slowing, and apathy in certain patients (Stahl, 2024). Other strategies to address side effects include taking an SSRI after a meal or a spoonful of peanut butter to address nausea (Puzantian & Carlat, 2024). Taking the SSRI in the morning if insomnia is present or at night if sedation occurs (Stahl, 2024). There are many tools in the arsenal of the psychiatric mental health nurse practitioner. When possible, adjunctive pharmacotherapy should be avoided when other methods exist that can prevent polypharmacy.
References
Chisholm-Burns, M. A., Schwinghammer, T. L., Malone, P. M., Kolesar, J. M., Lee, K. C., Bookstaver, P.B. (2022). Pharmacotherapy: Principles and practices (6th edition.). McGraw-Hill Education.
Puzantian, T., & Carlat, D. J. (2024). Medication fact book for psychiatric practice (7th ed.). Carlat Publishing, LLC.
Stahl, S. M. (2024). Prescriber’s guide: Stahl’s essential psychopharmacology (8th ed.). Cambridge University Press.
Stahl, S. M. (2021). Stahl’s essential psychopharmacology: Neuroscientific basis and practical applications (5th ed.). Cambridge University Press.

fill the attached document based on this information 
while filling out the document make sure to follow these instructions:
This criterion is linked to a Learning OutcomeClinical Judgment Plan of Care Template (20 points/25%)
2. All Clinical Judgment Plan of Care Template sections must be  complete and not left blank 
3. Content presented in the Clinical Judgment Plan of Care Template is directly relevant to areas of noted weakness.
4. Appropriate medical terminology is used in the Clinical Judgment Plan of Care Template.
patient information:
Name: Georgette Polsky
Age: 26 years
Provider: N. Grant MD
Allergies: erythromycin
Code Status: Full Code
Admit Wt: 181 lbs (82.3 kg)
Pre-pregnancy weight: 145 lbs (65.8 kg)
BMI: N/A
Nursing
Flowsheets
Lab & Diagnostics
Other
VITAL SIGN TREND
Date Temp HR RR BP SpO2 O2
12/14 0800 98.5 °F
(36.9 °C) 84 18 128/74 99% RA
Date Lab Normal Result
12/14 050 Blood type
O Neg
Rubella Immune
GBS negative
HIV Negative
Hep B Negative
Date Fetal heart rate
12/14 0800 135 beats/min
Client Information:
Medical History:
+gestational diabetes
asthma x 7 years
Surgical History:
Right knee arthroscopy, 8 years ago
Cesarean delivery, 5 years ago
Nursing Note: Alerted by the client that she felt dampness on her leg. A large amount of clear fluid was noted at the perineum. +nitrazine; sterile vaginal exam performed. 5 cm/100%/-1. Foot felt on vaginal exam. The fetal heart rate is 130 with moderate variability. The client denies pain.
NURSING ASSESSMENT & NOTES12/14 0945Nursing Note: Alerted by the client that she felt dampness on her leg. A large amount of clear fluid was noted at the perineum. +nitrazine; sterile vaginal exam performed. 5 cm/100%/-1. Foot felt on vaginal exam. The fetal heart rate is 130 with moderate variability. The client denies pain.12/14 0955
Situation: Georgette Polsky is a G2 P1 who was admitted in active labor early this morning at 38 2/7 weeks, and when I performed a sterile vaginal exam, I felt what I thought was afoot.
Background: She is planning on a VBAC. She has gestational diabetes and asthma. She is single and has a friend here for support.
Assessment: Membranes ruptured 10 minutes ago with clear fluid noted. Her vital signs are stable. FHR is 140 with moderate variability. She had an epidural placed at 0600 and is receiving good pain relief. Contractions are every 3 minutes lasting 40 seconds.
Recommendation: I think the baby is breech, and we need to get an ultrasound to confirm.12/14 1010 Nursing Note: Provider to bedside with bedside ultrasound. Confirmation of footling breech. Orders received for cesarean section. The anesthesiologist, and nurse coordinator were notified, and L&D OR was notified. Right, upper forearm IV patent, running LR at 125 mL/hr. The provider completed informed consent, and the client signed.
12/14 1015 Nursing Note: Epidural placed per anesthesiologist.
12/14 1030 Nursing Note: Client to L&D OR2 by cart. The client slid to the table. External fetal monitoring on. FHR 130s with moderate variability were noted. A Foley catheter was placed with 200 mL of clear yellow fluid, and it was returned. External fetal monitoring was removed. Sterile abdominal prep was performed. Time out was completed. Cut time 1030.
12/14 1025 Nursing Note: The client was educated on the cesarean section routine. Plan for the newborn to go to a warmer, be cleaned, be assessed, and then go to a friend at the head of the table so the client may see the newborn. The client would like to hold the newborn on the way to recovery.
12/14 0945 Nursing Note: Alerted by the client that she felt dampness on her leg. A large amount of clear fluid was noted at the perineum. +nitrazine; sterile vaginal exam performed. 5 cm/100%/-1. Foot felt on vaginal exam. The fetal heart rate is 130 with moderate variability. The client denies pain.

Submit a problem-focused SOAP note for grading. You must use an actual patient from your clinical practicum who presents with one or more chief complaints. 
Use the format below for your SOAP note. 
Use the current APA format to style your paper and cite your sources. Review the rubric for more information on how your assignment will be graded. 
Problem-focused SOAP Note Format     
Demographic Data 
Age, and gender (must be HIPAA compliant) 
Subjective 
Chief Complaint (CC): A short statement about why they are there 
History of Present Illness (HPI):  Write your HPI in paragraph form. Start with the age, gender, and why they are there (example: 23-year-old female here for…). Elaborate using the acronym OLDCART: Onset, Location, Duration, Characteristics, Aggravating/Alleviating Factors, Relieving Factors, Treatment 
Past Med. Hx (PMH): Medical or surgical problems, hospitalizations, medications, allergies, immunizations, and preventative health maintenance 
Family Hx: any history of CA, DM, HTN, MI, CVA?  
Social Hx: Including nutrition, exercise, substance use, sexual hx, occupation, school, etc. 
Review of Systems (ROS) as appropriate: Include health maintenance (e.g., eye, dental, pap, vaccines, colonoscopy) 
Objective 
Vital Signs 
Physical findings listed by body systems, not paragraph form- Highlight abnormal findings 
Assessment (the diagnosis) 
At least Two (2) differential diagnoses (if applicable) with rationale and pertinent positives and negatives for each 
Final diagnosis with rationale, pertinent positives and negatives, and pathophysiological explanation 
Plan 
Dx Plan (lab, x-ray) 
Tx Plan (meds): including medication(s) prescribed (if any), dosage, frequency, duration, and refill(s) (if any) 
Pt. Education, including specific medication teaching points 
Referral/Follow-up 
Health maintenance: including when screenings eye, dental, pap, vaccines, immunizations, etc. are next due 
Reference 
Compare care given to the patient with the National Standards of Care/National Guidelines. Cite accordingly. 
Rubric