Category: Solved Questions

Initial Post

Please choose one of the following topics and respond to the thread corresponding to the question you select. Please include at least three scholarly sources within your initial post.

Note: As you are choosing a topic, please try to make sure that all topics are chosen at least by one person. You can see this by noting if anyone has posted to the topic within the corresponding threads.

1. Dementia in the elderly. Discuss ways in which the cost associated with dementia can be curtailed along with maintaining the individual’s quality of life. Dementia is not only Alzheimer’s disease, so please consider multiple types of dementia within your answers (types of dementia include Alzheimer’s disease, vascular dementia, dementia with Lewy bodies [DLB], mixed dementia, Parkinson’s disease, frontotemporal dementia, Creutzfeldt-Jakob disease, and normal pressure hydrocephalus).
2. Elder abuse. Include physical, emotional, sexual, etc. How, as an APRN, can you screen for and address elder abuse? What types of health promotion concepts can be used to help advocate for the personal safety of our elders? Are there screening tools available? In what unconventional locations within your community might an elder screening be performed?
3. Fall prevention. What are specific geriatric risk factors that create an increase in fall risks? What can be done from a health promotion standpoint to decrease falls in the elderly? Define fall risk and what types of assessments are available in the outpatient and inpatient settings.
4. Financials, levels of neglect in the elders. Consider financial risk, scams, family, and other pitfalls the elderly may find themselves in relating to their finances. Provide examples and ways to advocate for our patients and our communities as an advanced practice nurse.
5. Components of a well elder evaluation. Define a well elder evaluation. Make sure you address components that pertain to the home environment and the communities in which they live. How can an APRN assist in these evaluations and promote different aspects within your community.
6. Functional status. Consider ADLs and IADLs. What is the difference? What types of assessment can be done and by whom to determine if an elder is capable of caring for themself at home? In addition, what types of services are available to help promote overall elder health not only in their homes but when living with family or in assisted living and nursing homes? What types of supportive services are available to assist the elderly in staying in their own homes?
7. Cognition. Describe how cognitive functioning may change as we age. What are neuropsychological examinations, and when should these be requested? Describe what this type of testing can accomplish and how, as a provider, you would use these results. Discuss ways in which we can improve and maintain our cognitive health (for example, diet, exercise). Provide specifics.
8. Polypharmacy. Consider medication compliance, risk of adverse effects, creatinine clearance <50ml/min. As an Advanced Practice Nurse, how can you address this growing problem? What type of surveillance will you put into place within your own practice, and how can you advocate to help address this concern within your own community?
9. Pain assessment and treatment. Discuss specifics regarding pain within the elder population: perception of pain, pain assessment scales, etc. In addition, provide evidence-based cited information relating to the opioid epidemic within your state and what percentage of addicted individuals are elderly. What type of resources are available in your community to help those with substance abuse problems? Are there any services specific to the elderly?

Reply Posts

Respond to ONE  of your peers who chose a different topic and discuss two separate resources they did not mention. One resource should be aimed at patient education and the second resource should be written for the health professional. Replies to your peers must be on two separate days (minimum) and must utilize at least two scholarly references per peer post.

Please refer to the Grading Rubric for details on how this activity will be graded.  You will receive points as if you submitted two peer posts as mentioned in the rubric, despite only one being required this week.

Read and Reflect

• Millions of Americans are one paycheck away from the street
• Most Americans live paycheck to paycheck
• One Paycheck Away

No matter how much you earn, “getting by” is still a struggle for most people these days. Seventy-eight percent of full-time workers indicated that they live paycheck to paycheck, which is up from 75 percent for the previous year, according to a report from CareerBuilder (August 24, 2017). Most of us make New Year’s resolutions, and budgeting or staying on budget is frequently in the top three. According to Statistia.com, after reviewing more than 22,500 sources, the top three New Year’s resolutions for 2018 tied at 37 percent each – eat healthier, get more exercise, and save more money. At the same time, 32 percent of those polled did not intend to make a New Year’s Resolution.

When thinking about the mindset of Americans, their New Year’s resolutions, and the state of our health, as Advanced Practice Nurses, we need to understand that we are dealing with more than the “health” or “disease” of our patients, but also cultural mores and financial constraints. The studies may recommend a certain course of treatment, but when most of us are “one paycheck away” from disaster, the study recommendations do not take into account who’s going to keep the lights on or food on the table.

Reflect on the learning material for this week, other people you may know, and your own personal situation in relation to money. Consider how an individual’s financial well-being directly affects their overall health and their ability to receive preventative services and evidence-based care.

You may journal in first-person and this assignment does not require references as it is your thoughts; however, be sure to review the rubric as a minimum of one reference is required to be considered exemplary work. If you choose to use quotes or citable material, you are expected to follow APA formatting.

Please refer to the Grading Rubric for details on how this activity will be graded.

Initial Post

Read the Mental Health Case Study (Word) and complete the following tasks:

1. Examine current practice guidelines related to suicide screening and prevention and how they could pertain to John.
2. Choose one of the following questions to answer as part of your initial post.
   1. What events in John’s life created a “downward spiral” into homelessness and hopelessness? Which events were related to social needs, mental health needs, and medical needs, and which could health care have addressed?
   2. What were some of the barriers John faced in accessing medical care and mental health care?
   3. How does homelessness and mental illness intersect? Do you believe homelessness may develop because of a mental health issue, or do you believe those who become homeless eventually sink into psychological despair?
   4. The tipping point for many people who live at the margins of society may be things that could have been managed given the right support. How can your role as an APRN help identify, alleviate, or support those who are in need like John?
   5. In your own experience, have you encountered a homeless individual? What was that like? Do you recall what you were thinking?
3. Please include at least three scholarly sources within your initial post.

Reply Posts

Reply to at least TWO of your classmates who chose two different questions.

1. Do you agree with their post? Why or why not?
2. Find an online resource related to health promotion and disease prevention of mental health issues for families that you think would be helpful to those who are struggling. This resource should focus on families and their needs, not the person with mental illness.

Reply on two separate days (minimum) utilizing at least two scholarly references per peer post.

Please refer to the Discussion Grading Rubric for details on how this activity will be graded.

The final exam is to be taken during Week 15 and will focus on the following list of preventive guidelines. For the exam, you will be asked to provide five bullet points related to each of these guidelines. It is recommended that you utilize the United States Preventive Services Task Force Guidelines, SAMHSA, JNC, CDC, and other specialty organizations’ guidelines, as applicable, to prepare yourself for the exam.

Guidelines to be covered

Guidelines
1. Lung Cancer	11. Colorectal Cancer
2. Prostate Cancer	12. Testicular Cancer
3. Adult Immunizations	13. Pediatric Immunizations
4. Breast Cancer	14. Cervical Cancer
5. Human Papillomavirus	15. Fall Prevention
6. Cardiovascular Disorders	16. Smoking/Vaping
7. Hypertension	17. Suicide
8. Intimate Partner Violence	18. Depression
9. Hepatitis B	19. Hepatitis C
10. Sexually Transmitted Infections (for example, Gonorrhea, Chlamydia, HIV, Syphilis)

The following is an example of what you will see on the final exam. The point is to be brief, direct, and to the point; no more than a sentence or two for each bullet. Faculty know that everyone has their own style of answering these types of questions, so there is not necessarily a “right or wrong” way to complete the final; just be brief and to the point.

List five bullet points related to Skin Cancer Preventive Guideline. Use information learned from the United States Preventive Service Task Force website along with other specialty-specific organizational guidelines as applicable.

1. Skin cancer occurs more commonly in men than women, those who are fair skinned, use indoor tanning beds, and have a hx of sunburns or previous skin cancer, OR Risk: men > women; fair skinned, use of tanning beds, hx of sunburns or previous skin cancer.
2. The appropriate screening test is the clinical visual skin exam using the “ABCDE rule” OR Use ABCDE screening test.
3. The ABCDE rule consists of looking for the following characteristics: asymmetry, border irregularity, non-uniform color, diameter > 6mm, and evolving over time, OR Look for ABCDE = asymmetry, border irregularity, non-uniform color, diameter > 6mm, and evolving over time.
4. Treatment and intervention – generally would be excision/biopsy; referral to dermatology, OR TX: excision/biopsy, referral to dermatology.
5. Children, adolescents, and young adults age 10–24 years who have fair skin should be counseled about minimizing exposure to UV radiation to reduce their risk of developing skin cancer, OR Counsel people 10–24 years of age with fair skin to avoid UV radiation exposure to decrease risk.

Note: You can see where applicable ages, race, gender are utilized. You must include specific demographic aspects in your 5 bullet points and address those aspects of the guidelines to get credit for your answers. Do not list examples of the 5 levels of prevention as that is not what is being asked specifically.

Overview

Thinking about the old adage, “Never judge a book by its cover,” wouldn’t it be great to be able to see inside other people – I mean really see inside. As human beings, we keep so much of ourselves hidden, and we see only a small portion of the lives of the people we encounter. People experience things, trauma and other adverse childhood experiences, that can follow them well into adulthood. To help better understand the people we care for—what may be the driving force behind their complaints—trauma-informed care shifts the focus from “What’s wrong with you?” to “What happened to you?” In making this mental shift in our practice, we can potentially improve overall patient health outcomes along with providers and staff wellness.

Prior to answering this discussion prompt, explore the website (including the videos) for the Trauma-Informed Care Implementation Resource Center to help improve your understanding and knowledge of this concept Trauma-Informed Care Implementation Resource Center. The website has a lot of great information, and be sure to review the 10 Key Ingredients for Trauma-Informed Care (PDF) and the Fact-Sheet – Understanding the Effects of Trauma on Health (PDF) . Both will be extremely helpful in participating in this week’s discussion and on the quiz.

Initial Post

For this week’s discussion, define trauma-informed care (TIC), explain how stress and health are related, and discuss how an APRN can utilize this information in caring for vulnerable populations. Please include at least 3 scholarly sources within your initial post.

Reply Posts

Reply to at least TWO of your peers on two separate days (minimum) utilizing at least two scholarly references per peer post. In your reply to each of your peers, discuss content that you learned while exploring the website and a resource they might find helpful as well.

Please refer to the Grading Rubric for details on how this activity will be graded.

Overview

Remember that one of the goals of this assignment is to further develop your academic writing skills. To assist in this, I am asking that you utilize Smarthinking and Pearson Writing Center here at Regis. In taking advantage of these resources, you should begin to see improvements in your writing and APA formatting. Don’t forget that there are also tutoring resources available within Smarthinking.

Please review the paper requirements, which can be found in Week 10, and submit your rough draft of your paper along with a current Smarthinking report. At a minimum, your draft should include completed Sections 1–3; however, to get the most from a faculty review of your work, you are highly encouraged to submit Sections 1–4. The page guideline for this assignment is 5-8 pages with a minimum of 5 scholarly references, 2 of which should be new sources that were not provided in the course. The page requirements do not include the title page, references, or appendices.

Note: If you do not submit a current Smarthinking Report (dated from Week 5 or 6 of the course) with your rough draft, you will automatically receive a zero for this assignment.

Please refer to the Grading Rubric for details on how this activity will be graded.

Initial Post

This discussion will allow you to examine several different preventive guidelines related to men’s health. Choose one of the following topics and respond to the thread corresponding to the question you select. Please include at least three scholarly sources within your initial post.

Note: As you are choosing a topic, please try to make sure that all topics are chosen by at least one person. You can see this by noting if anyone has posted to the topic within the corresponding threads.

Topic 1: Colorectal Cancer Screening

A 47-year-old man presents to your clinic for a routine physical. He considers himself to be “fairly healthy” and doesn’t routinely go to the doctor. His last physical was five years ago. In reviewing his chart, you see that his BMI is 30, he exercises twice a week at the local gym, and he does not take any medication. Part of your discussion during today’s visit is about screening for colorectal cancers. He did endorse some constipation in the review of systems. He noted an uncle in his family history who was diagnosed at age 54 with colon cancer. You begin to talk about colorectal screening, and the patient interrupts you and tells you that he is only 47 and that he should not have to worry about it until he is 50.

1. What are the recommendations and source(s)/options for the colorectal cancer screening test?
2. The patient thinks he does not have to worry about “being screened” until age 50. Is he correct? Why or why not?
3. What age would you recommend screening for this patient and why? Does his family history come into play here?

Topic 2: Prostate Cancer Screening

Your patient is an otherwise healthy, white 55-year-old man who presents for his annual physical. He has a history of hypertension and takes Losartan 50 mg daily. His family history is negative for cardiovascular disease or cancer. His review of systems is negative. The patient is a paramedic and exercises regularly. The patient’s BMI is 23. He states that one of his friends was diagnosed with prostate cancer and asks if he needs to be screened.

1. Which screening guidelines would you utilize?
2. Keeping the guideline you used in mind, explain and provide rationales for whether you would change your recommendations if:
   1. The patient had a family history of prostate cancer.
   2. The patient was African American.
   3. The patient was 76 years old.

Topic 3: Testicular Cancer Screening

A 35-year-old African American male is being seen for a pre-employment physical. His father was recently treated for prostate cancer. His BMI is 24, and his past medical history was negative except for an appendectomy 15 years ago. He states he is too young to be screened for prostate cancer, but he wants to be screened for testicular cancer.

1. What are the primary risk factors for testicular cancer?
2. What are the screening options for testicular cancer and which guidelines did you utilize?
3. Is screening recommended for this patient, and how would you counsel this patient?

Reply Posts

Review the initial post of two other peers who chose different topics. When replying to your peers, answer at least ONE of the following questions based on each topic:

Colorectal Cancer Screening

1. Does insurance/cost of tests come into your decision-making? Why or why not?
2. What about patient reliability?

Prostate Cancer Screening

1. How would you counsel this patient?
2. How do some of the various guidelines for prostate cancer screening differ? Compare at least two.

Testicular Cancer Screening

1. Discuss the health plan you would develop for this patient considering his age, race, and family history.
2. Are there community-level plans that could influence your individual health plan for this patient?

Reply to at least two of your classmates who picked two topics different from yours on two separate days (minimum) utilizing at least two scholarly references per peer post.

Please refer to the Grading Rubric for details on how this activity will be graded.

Introduction

Obesity in the United States occurs at a greater prevalence than in other developed nations. Why is this? As part of Healthy People Initiatives, obesity has been highlighted in hundreds of articles and webinars. Many preventive guidelines address obesity and nutritional status, and the USPSTF (United States Preventive Services Task Force) guidelines specifically recommend a multidisciplinary approach and a plea to save our children.

Additional resources to enhance your knowledge about obesity in the United States are available in this week’s Learning Materials section but pay close attention to Jamie Oliver’s TED Talk: Teach Every Child about Food.

In 2018, the United States Federal government spent nearly $1.1 trillion dollars on healthcare, and 10% of this money ($110 billion) was utilized to combat obesity driven concerns. Children cannot recognize vegetables or fruits but are quick to tell you what’s in a Happy Meal and can pick the different French fries from various fast-food restaurants. American parents since the Great Depression, and before, have wanted to provide for their children, giving them more than what they had, and now we have given our children a shorter life span – 10 years less.

As APRNs, we must be aware of what is happening in society and how this affects our health as a country. For this week’s discussion, develop a powerful message that can be given to your community. NO sounds, NO words; just a strong visual message that addresses our need to combat obesity.

Initial Post

For your initial post, present a visual picture that reflects the state of obesity in our country. Consider: If a photo is worth a thousand words, then a photo on obesity must be worth a thousand pounds. So, ask yourself, how do we drive home the need for change? How do we show the price our children are paying?

The written part of your discussion post should include:

• A brief explanation, three to four sentences, of your visual submission.
• Using statistical data, your home state’s data related to obesity and how your state fairs compared to national statistics.
• The type of health disparities you see in your own community related to obesity.
• Remember to provide at least three scholarly references to support your statements and provide validity to your work.

Reply Posts

Reply to at least two of your classmates that live in different states (replies must be on two separate days). Compare and contrast your state’s obesity data to theirs and discuss obesity preventive guidelines in one reply and healthy dietary recommendations in your second reply. Replies must use at least two scholarly references per peer post.

Please refer to the Grading Rubric for details on how this activity will be graded.

Initial Post

Performing health assessments as an APRN will help you to develop a collaborative partnership with your patients. After reading Chapter 4 and 12 in your Pender text, think about the vulnerable population that you chose during Week 1. Consider what you perceive/know about this group in relation to the following topics:

1. Health assets
2. Health problems
3. Health-related lifestyle strengths
4. Key health-related beliefs
5. Health behaviors that put the person at risk
6. Changes that could improve their quality of life

Now consider the pros and cons of implementing a Community-Based Participatory Research health promotion project with the vulnerable group. You should consider not only the benefit of the actions but the active role the vulnerable will play in the development and implementation of the health promotion plan. How does your population’s health disparities and health inequities benefit and/or hinder this type of project’s success? Remember that you should include citations/references from at least three scholarly sources.

Reply Posts

Reply to at least two of your classmates. When replying to your peers, think about the ethical considerations related to research or working with a vulnerable population. Although the vulnerable share characteristics making them susceptible to health concerns, they remain unique. In the initial post, everyone discussed both strengths and weaknesses inherent to a specific vulnerable population. What steps would you recommend to ensure that your peer’s vulnerable group is ethically protected throughout the research as well as the participation element of a community-based participatory research project (that is, shelter services, food banks, case management, support groups, etc.)? Reply to at least two of your classmates on two separate days (minimum) utilizing at least two scholarly references per peer post.

Please refer to the Grading Rubric for details on how this activity will be graded.