Antimicrobial agents are essential components in the treatment of various bacterial infections as they help to kill or prevent the growth of microbes such as bacteria, fungi, and protozoans. Prior to the discovery of antimicrobial agents, treatment options for patients with bacterial infections were limited. For many patients, treatment often resulted in the amputation of limbs or even death. Today, treatment options for bacterial infections typically have a more positive prognosis. Due to the various types of infections presented in patients, it is essential to be able to identify the underlying cause of the infection—whether bacterial or viral—before recommending drug treatments. This will help you identify whether or not an antimicrobial agent would be appropriate and which specific agent would target the infection. In this Assignment, you consider the appropriate use of antimicrobial agents for infections.

To prepare:

• – Review this week’s media presentation      on principles of antimicrobial therapy, as well as Chapter 8 of the      Arcangelo and Peterson text.
• – Consider the categories of      antimicrobial agents.
• – Think about differences between viral      and bacterial infections.
• – Reflect on why proper identification      of the infection is key to selecting the proper antimicrobial agent.

POST a 2- to 3- page paper that addresses the following:

• – Describe the categories of      antimicrobial agents.
• – Describe differences between viral      and bacterial infections.
• – Explain why proper identification of      viral and bacterial infections is key to selecting the proper      antimicrobial agent.

This work should have Introduction and conclusion

– This work should have at 4 to 6 current references (Year 2012 and up)

– Use at least 3 references from class Learning Resources

The following Resources are not acceptable:

1. Wikipedia

2. Cdc.gov- nonhealthcare professionals section

3. Webmd.com

4. Mayoclinic.com

Required Readings

Arcangelo, V. P., Peterson, A. M., Wilbur, V., & Reinhold, J. A. (Eds.). (2017). Pharmacotherapeutics for advanced practice: A practical approach (4th ed.). Ambler, PA: Lippincott Williams & Wilkins.

• Chapter 8, “Principles of      Antimicrobial Therapy” (pp. 111-134)
       This chapter covers factors that impact the selection of an antimicrobial      treatment regimen. It also examines the clinical uses, adverse events, and      drug interactions of various antimicrobial agents such as penicillin.
• Chapter 12, “Fungal Infections      of the Skin” (pp. 163-196)
       This chapter explores the pathophysiology of several fungal infections of      the skin as well as related drug treatments and examines the importance of      patient education when managing these infections.
• Chapter 14, “Bacterial      Infections of the Skin” (pp. 181-196)
       This chapter begins by examining causes of bacterial infections. It then      explores the importance of selecting an appropriate agent for treating      bacterial infections.
• Chapter 32, “Urinary Tract      Infection” (pp. 519-526)
       This chapter covers drugs used to treat urinary tract infections and      identifies special considerations when treating geriatric patients,      pediatric patients, and women.
• Chapter 35, “Sexually      Transmitted Infections” (pp. 512-535)
       This chapter outlines the causes, pathophysiology, and drug treatment of      six sexually transmitted infections, including gonorrhea, syphilis, and      human papilloma virus infection (HPV). It also examines the importance of      selecting the proper agent and monitoring patient response to treatment.
• Chapter 49, “Human Immunodeficiency Virus” (pp.      843-860)
       This chapter presents the causes, pathophysiology, diagnostic criteria,      and prevention methods for HIV. It also covers various methods of drug      treatment and patient factors to consider when selecting, administering,      and managing drug treatments.

Krummenacher, I., Cavassini, M., Bugnon, O., & Schneider, M. (2011). An interdisciplinary HIV-adherence program combining motivational interviewing and electronic antiretroviral drug monitoring. AIDS Care, 23(5), 550–561.

This article analyzes medication adherence in HIV patients and examines factors that increase adherence as well as factors that contribute to termination or discontinuation of treatment.

Drugs.com. (2012). Retrieved from http://www.drugs.com/

This website presents a comprehensive review of prescription and over-the-counter drugs including information on common uses and potential side effects. It also provides updates relating to new drugs on the market, support from health professionals, and a drug-drug interactions checker.

Scourfield, A., Waters, L., & Nelson, M. (2011). Drug combinations for HIV: What’s new? Expert Review of Anti-Infective Therapy, 9(11), 1001–1011.

Note: Retrieved from the Walden Library databases.

This article examines current therapies and strategies for treating HIV patients. It also examines factors that impact selection of therapy, including drug interactions, personalization of therapy, costs, management of comorbidities, and patient response.

Required Media

Laureate Education, Inc. (Executive Producer). (2012). Antimicrobials. Baltimore, MD: Author.

This media presentation outlines principles of antimicrobial therapy 

Note: The approximate length of this media piece is 7 minutes.

Mayer, K. H., & Krakower, D. (2012). Antiretroviral medication and HIV prevention: New steps forward and New Questions. Annals of Internal Medicine, 156(4), 312–314.

 

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 Chapter: 20 Anus,Rectum,Prostate 

While you are examining a 1-year-old girl, the mother mentions how eager she is to begin toilet training her child. How should you respond? When is it best to begin toilet training? 

What do the rectum and anus form?

Control of the external anal sphincter is gradually achieved at what age?

Differentiate between internal and external hemorrhoids.

You are observing an examiner take the history of a 70-year-old man as part of the musculoskeletal examination. You notice that the examiner asks the patient about exercise habits in his early years. Is this a relevant question to ask this patient? Why or why not?

A young woman is concerned about a 1-cm difference in the length of her legs. What is the best response to give this patient?  

A 3-year-old boy has had anal itching that becomes worse at night. What do these symptoms indicate?

You are assessing a pregnant woman who has had a fourth-degree perineal laceration. Why is it necessary to assess this patient’s anal sphincter function? 

You are about to perform a rectal examination of an older adult. What is the suggested position for this patient? 

What is a clue to the diagnosis of Hirschsprung disease?

What do persistent, pencil-like stools suggest?

Distinguish between the stool of a formula-fed baby and a breastfed baby.

Create a chart or two-column list that compares the risk factors for colorectal cancer with those for prostatic cancer.

What are the risk factors for colorectal cancer?

What are the risk factors for prostate cancer?

What symptoms are associated with BPH?

JF is a 42-year-old patient who presents for an annual examination, but he complains that he has had a fever for the past few days and recently some “urinary symptoms.”

1- Describe the best method for a rectal examination during the physical assessment

2- What additional past medical history questions would you ask of JF since you suspect prostatitis?

3- During the rectal examination of JF with acute prostatitis, what findings would expect on physical examination? .

A, Correct procedure for introducing finger into rectum. Press pad of finger against the anal opening. B, As external sphincter relaxes, slip the fingertip into the anal canal. Note that patient is in the hips-flexed position.

 

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4.3 Anyone Can be Sued

Introduction and Alignment

See the Workshop Four assignment Instruction.

Upon successful completion of this assignment you should be able to: 

• See the Workshop Four Outcomes.

Resources

• Textbook: Advanced practice nursing: Essentials for role development
• File: Anyone Can be Sued.docx

Instructions

1. After learning about the types of malpractice insurance available as well as the costs, in a three-four page paper (plus references) describe whether you think malpractice insurance is necessary and who should pay for it.
2. When you have completed your assignment, save a copy for yourself and submit a copy to your instructor using the 4.3 Dropbox by day seven. 

Click here to access the Dropbox.

Assessment Criteria

    

Assessed Item 

Points 

 

Discussion of different types of malpractice insurance

20

 

Discussion of costs of insurance, benefit of insurance, risk of not carrying coverage

35

 

Is malpractice insurance necessary, if so who should pay for it?

35

 

Accurate spelling, grammar; references (minimum of five) and  APA format

10

 

Total Points

100

 

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A 60-year-old man is brought to the ER by ambulance because of slurred speech and left side weakness. His wife states they went to bed at 11pm and woke up at 5am when she noticed his symptoms. He is right handed with a history of coronary artery disease, hypertension, and hypercholesterolemia and a heart attack at age 50. He currently is unable to move his left arm and leg. He had an episode of amaurosis fugux (blindness)in his right eye one month ago that lasted for 5 minutes. Around 3 months ago his wife states he had bilateral pain in his legs while they were on a walk that lasted about 15 minutes. He is taking a baby aspirin a day an ACE inhibitor, and statin as well. He does have a history of alcohol use and smoking in the past but stopped after his heart attack. His blood pressure is 195/118 Pulse 106, Respiratory rate 18, Temperature 99.8, o2 sat is 97% on room air. Although his pupils are equal and reactive, and the ocular movements are intact, he is unable to turn his eyes voluntarily toward the left side. The neck is supple, there is no jugular vein distension, and there are no bruits. The lungs are clear heart sounds regular without murmurs, and abdomen is normal. The limbs are not well perfused distally. The neurologic examination reveals that he is alert and oriented, although he does not recognize he is sick. He shows loss of awareness and attention with respect to objects or stimuli on his left side. He has mild dysarthria but, his speech is fluent, and he understands and follows commands very well. There is mild weakness on the left side of the face and left sided homonymous hemaianopsia, but there is no nystagmus or ptosis, and no tongue or uvula deviation. He is not able to move his left arm and leg, has hyperreflexia, and the left great toe is upgoing.

• What are two questions you would ask this patient?
• Identify the subjective data for this patient.
• Identify the objective data for this patient.
• What is the likely diagnosis?

Your response should include evidence of review of the course material, websites, and literature through proper citations using APA format.

 

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AP Role

How well do you know your future role in advance practice?

The elevator door opens; you step on and find yourself face to face with a known skeptical colleague, who inquires “what are you doing in your profession”? It’s your chance to share, define and possible persuade this person about your chosen role of nursing in advance practice. You have 10 floors, roughly 90 seconds to make an impression. Draft an “Elevator Speech” (approximately 300 words) reflecting the conversation about your future role in your program of study.  In three detailed paragraphs, address why you have chosen this role (your passion) and define steps to ascertain the role including certification criteria and how the role will impact patient outcomes (how you will make a difference).

Support your work with evidence based research. For example, in conversation you tell the person A recent study by Taylor in 2016 showed that NPs were efficient as MDs at treating primary care problems. (Reference at the end) Respond to at least two of your cohorts, faculty and continue the dialogue with those that responded to your initial post. Use references in your responses.

 

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