Need Powerpoint done.

Address the following Topics/Questions:

· How do licensure, accreditation, certification, and education (LACE) considerations differ for APN clinical roles for these three states: California, Washington, and Illinois? Provide evidence for your response.

· Discuss what evidence-based strategies should be implemented to achieve continuity between state regulatory boards? Provide evidence for your response.

· Is independent NP practice allowed in your state? Discuss your opinion regarding independent NP practice. Provide evidence for your response.

Presentation Guidelines: . .

· The presentation should contain appropriate scholarly evidence to support the information presented per APA format.

· PowerPoint slides should be used as cues to topics and key concepts without lengthy sentences and paragraphs- reading information from slides is not professional and therefore not acceptable. 

· Add speaker notes under each slide for presentation aspect. 

· A professional presentation includes an introduction both of yourself and of the topic, the touch points of information you’re going to discuss as well as a conclusion. A professional presentation should be covered in approx. 5-15 slides. 

· 12 pt font Times New Roman is the recommended font size/style. Slides should include bullet points you intend to cover, 4-5 bullet points per slide. The bullet points should be expanded upon with oral information. Direct quotes and paragraphs are discouraged. 

· The student’s oral presentation should demonstrate clear understanding of all concepts along with specific examples to represent concepts

 

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Week 2: Question for Discussion
Chapter 4 – Traditional Chinese
Chapter 5 –  Ayurvedic Medicine  

Question(s):   

Discuss Ayurvedic medicine (What is Ayurvedic medicine?). Explain the meaning of the word Ayurvedic. Do you see any value of Ayurvedic medicine in the United States nowdays? (Explain your answer). Would you integrate any of the Ayurveda practices into your practices while caring for patients.

Guidelines: The answer should be based on the knowledge obtained from reading the book, no just your opinion. If there are 4 questions in the discussion, you must answer the four of them. Your grade will be an average of the questions. 

 

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APA format 3 peer references 1 from walden university library MSN 1 page long and due Sept 15,2018 at 4pm.  There are references attached to use

 

The prostate-specific antigen (PSA) test is a blood test used to screen males for prostate cancer. Prostate cancer is the second leading cause of death related to cancer among men in the United States. It is important that men approaching increasing age have their PSA levels checked. Obana and O’Lawrence (2015) stated that males over the age of 40 who have a family history of prostate cancer can benefit from electing to have their PSA levels checked. Those that do not have a family history of prostate cancer can also benefit from PSA testing, but it is not recommended as strictly until the population nears 50 years of age. The test is a simple blood test that involves a blood sample being drawn and sent to a laboratory for analysis. Once the results are determined, a healthcare provider can inform the patient of the results and discuss the indications. The test detects high levels of PSA in the blood, which should not be present in large amounts. High levels of PSA in the blood may indicate prostate cancer. Nordström, Adolfsson, Grönberg, and Eklund (2017) stated that PSA tests are an extremely useful first-line risk assessment for prostate cancer, but the test needs to be followed up with more conclusive testing for diagnosis if a man’s PSA levels are elevated. PSA testing is quick and inexpensive, making it an attractive option for initial prostate cancer screening. However, for diagnosis, more definitive diagnostic tests such as ultrasound, biopsy, or MRI fusion need to be performed (Nordström, Adolfsson, Grönberg, & Eklund, 2017).

            Other conditions, such as enlarged or inflamed prostate, can also increase the PSA levels. For this reason, PSA tests are not completely full-proof in terms of diagnosing prostate cancer, but they do provide a very good indicator. PSA tests serve as a very valid and reliable detector of potential prostate cancer and provide men with data proving that they need to seek additional screening for potential prostate cancer. However, PSA testing is not a very reliable indicator of definitive prostate cancer. Lawrentschuk (2016) stated that roughly 75 percent of men with elevated PSA levels are proven to not have prostate cancer after tissue biopsy. This proves the lack of reliability in predicting prostate cancer. PSA tests should be used to promote awareness concerning a man’s risk of developing prostate cancer. Upon increased serum PSA levels, it is recommended that men undergo more definitive screening for prostate cancer to determine diagnosis. Most often, the biggest indicator for whether or not prostate cancer is beatable is the time of the diagnosis. Prostate cancer that has progressed in stage is a lot more fatal than prostate cancers that are still in the initial stage. Obana and O’Lawrence (2015) noted that at times, men are not diagnosed with prostate cancer until the cancer has reached stage three or four and metastasized to other tissues and structures throughout the body. At this point, treatment becomes significantly more difficult. PSA tests provide men with an initial means of prostate cancer detection that can save their lives.

References

Lawrentschuk, N. (2016). PSA testing and early management of test-detected prostate cancer–consensus at last. BJU International, 117 Suppl 45-6. doi:10.1111/bju.13481

Nordström, T., Adolfsson, J., Grönberg, H., & Eklund, M. (2017). Effects of increasing the PSA cutoff to perform additional biomarker tests before prostate biopsy. BMC Urology, 17(1), 92. doi:10.1186/s12894-017-0281-8

Obana, M., & O’Lawrence, H. (2015). Prostate cancer screening: PSA test awareness among adult males. Journal of Health and Human Services Administration, 38(1), 17-43. Retrieved from the Walden Library databases.

 

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APA format 1 page long 3 references  1 from walden university and please use one from the references below

This is for a MSN degree

 

Our team´s selected setting is Suncrest Home Care and Hospice located in rural Iowa.  The focus of our proposed curriculum is to provide hospice caregivers and patients with the education needed to adequately manage pain at the end-of-life.  The hospice nurse would provide the education to family, caregivers, and patients during their initial and follow up visits with patients.  Our audience will largely consist of mature learners at a highly emotional time, therefore I will look at strategies that fall under the adult learning theory.

          The first strategy I would apply is that of self-directed learning.  Initially, information would be provided to caregivers and patients, giving them the opportunity to review the education on their own time and develop questions, reinforcing that the information provided will be useful when caring for their hospice patient.  As stated by Keating, “adults are self-directed and will learn information that is useful and relevant to them” (Keating & DeBoor, 2018, p. 111).  This strategy allows the teacher to encompass the role of mentor or coach, encouraging active learning by the participants (Keating & DeBoor, 2018). 

            The second strategy I would utilize is that of hands-on, or direct demonstration and practice of skills.  As hospice care providers, medication management and symptom recognition are two very important skills to have when caring for a loved one at the end of life (Lau et al., 2009).  An example of utilizing this strategy, would be to utilize pillboxes to dispense medications, as well as keeping a log of symptoms in order to evaluate efficacy.  Adequate pain control and management is a Community Health Accreditation Partner (CHAP) hospice care standard (2018).  Although the hospice nurse will be available for support and as a guide, the main provider of symptom relief will be family or caregivers in the patient´s home; education that will increase medication management knowledge and skill is imperative to provide relief (Chi & Demiris, 2017).

References

Chi, N.-C., & Demiris, G. (2017). Family Caregivers’ Pain Management in End-of-Life Care: A Systematic Review. AMERICAN JOURNAL OF HOSPICE & PALLIATIVE MEDICINE, 34(5), 470–485. https://doi-org.ezp.waldenulibrary.org/10.1177/1049909116637359

Community Health Accreditation Partner [CHAP]. (2018).  About our history.  Retrieved from https://chapinc.org/contact-about-us/

Keating, S. B., & DeBoor, S. S.  (Ed.). (2018). Curriculum development and evaluation in nursing (4th ed.). New York, NY: Springer.

Lau, D. T., Kasper, J. D., Hauser, J. M., Berdes, C., Chang, C. H., Berman, R. L., Masin-Peters, J., Paice, J., & Emanuel, L. (2009). Family caregiver skills in medication management for hospice patients: a qualitative study to define a construct. The journals of gerontology. Series B, Psychological sciences and social sciences, 64(6), 799–807. doi:10.1093/geronb/gbp033

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APA format 3 peer references needs to review case study and document on differential diagnosis as to agreeing or disagreeing  Due October 20.2018 at 5pm

 

Episodic/Focused SOAP Note Template

Patient Information:

A.S., 46 F, Caucasain

S.

CC “ankle pain in both ankles; worse in right ankle, after hearing ‘pop’ while playing soccer.”

HPI: A.S. is a 46 year old Caucasian female who presents with bilateral ankle pain which she describes as chronic for the last 3 months. She acutely injured her right ankle 3 days ago while playing soccer. The pain is described as aching with intermittent sharp characteristics. Associated symptoms include limited ROM. The pain is worse with weight bearing and OTC pain medications have included alternating doses of Tylenol and Motrin with moderate relief.

Current Medications:

            Motrin 200 mg by mouth every 4-6 hours as needed for pain

Hydrochlorothiazide 12.5mg by mouth daily for 6 months for HTN

Allergies: PCN- rash, no known food/environmental allergies

PMHx: HTN; immunizations are up to date- last tetanus 12/2017; flu shot 10/2018 cholecystectomy 2015

Soc Hx: A.S. is employed as a Registered Nurse and remains active by playing soccer three times a week. She is married with two teenage daughters. She denies tobacco and alcohol use.  

Fam Hx: Maternal grandmother deceased at age 56 from MI. Maternal father deceased at age 75 from complications of COPD. Paternal grandparents unknown. Father history is unknown. Mother is alive with type 2 diabetes that is well controlled with oral agents. Sibling age 43 alive and well. Children are alive and well with no medical hx.

ROS:.

GENERAL:  No weight loss, fever, chills, weakness or fatigue.

HEENT:  Eyes:  No visual loss, blurred vision, double vision or yellow sclerae. Ears, Nose, Throat:  No hearing loss, sneezing, congestion, runny nose or sore throat.

SKIN:  No rash or itching.

CARDIOVASCULAR:  No chest pain, chest pressure or chest discomfort. No palpitations or edema,

RESPIRATORY:  No shortness of breath, cough or sputum.

GASTROINTESTINAL:  No anorexia, nausea, vomiting or diarrhea. No abdominal pain or blood.

GENITOURINARY:  No burning on urination.

NEUROLOGICAL:  No headache, dizziness, syncope, paralysis, ataxia, numbness or tingling in the extremities. No change in bowel or bladder control.

MUSCULOSKELETAL: pain and swelling to right ankle, limited weight bearing and ROM in b/l ankles, worse in the right ankle. No muscle cramping.  No back pain.

HEMATOLOGIC:  No anemia, bleeding or bruising.

LYMPHATICS:  No enlarged nodes. No history of splenectomy.

PSYCHIATRIC:  No history of depression or anxiety.

ENDOCRINOLOGIC:  No reports of sweating, cold or heat intolerance. No polyuria or polydipsia.

ALLERGIES:  No history of asthma, hives, eczema or rhinitis.

O.

GENERAL:  AAOx 3, limping gait, no distress. No fever.  Skin is warm, dry, and intact. Skin of the lower extremities is warm and pink in color.

CARDIOVASCULAR: chest is symmetric with symmetrical expansion, PMI noted at fifth intercostal space at the midclavicular line, normal S1 and S2, no m/r/g, no edema in legs, dorsalis pedis 2/4 bilaterally, normal hair distribution in legs and no pigmentation of b/l legs.

MUSCULOSKELETAL: limited ROM and weight bearing in b/l ankles, worse in right ankle. No clubbing, cyanosis, or edema.

NEUROLOGICAL: mood and affect appropriate, CN II-XII intact. Motor: 5/5 in upper and lower extremities, DTRs 2+ bilaterally.

Diagnostic results:

Ankle x-ray- If the Ottawa ankle rule is positive (bone tenderness at posterior malleolus, bone tenderness at posterior medial malleolus, or inability to bear weigh > 4 steps) ankle radiographs are indicated (Polzer, Kanz,  Prall, Haasters, Ockert, Mutschler, & Grote, 2012).

If ankle radiographs negative- assess ligament in affected extremity as compared to un-injured extremity by doing the crossed leg test, squeeze test, external rotation test, anterior drawer test, and talar tilt test. These tests will assist in determining the need for an MRI and also grading the sprain  (Polzer, Kanz,  Prall, Haasters, Ockert, Mutschler, & Grote, 2012).

Labs may include a uric acid level which is elevated with gout and a WBC which would be elevated with  osteomyelitis. MRI imaging may also be indicted.

A.

Sprain- because the patient heard the “pop” sound, her injury is likely related to an ankle sprain in which the ligaments and tissue that surround the bones of the ankle are injured causing swelling, pain, and limited ROM  (PubMed Health, 2018).

Fracture- a fracture would be unlikely if the patient was able to bear weight after the injury. The area would also become ecchymotic with limited to no ROM (PubMed Health, 2018).

Osteomyelitis- the extremity would be warm, erythematous, not usually associated with an acute injury, potential fever present, usually associated with a systemic infection or a wound (Ball, Dains, Flynn, Solomon, & Stewart, 2015)

Gout- associated with hot, swollen joints, pain and limited ROM (Ball, Dains, Flynn, Solomon, & Stewart, 2015)

Bursitis- limited ROM, swelling, pain, warmth, and point tenderness (Ball, Dains, Flynn, Solomon, & Stewart, 2015)

References

Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2015). Seidel’s guide  to physical examination (8th ed.). St. Louis, MO: Elsevier Mosby.

Polzer, H., Kanz, K. G., Prall, W. C., Haasters, F., Ockert, B., Mutschler, W., & Grote, S. (2012).

Diagnosis and treatment of acute ankle injuries: development of an evidence-based algorithm. Orthopedic Reviews, 4(1), e5. http://doi.org/10.4081/or.2012.e5

PubMed Health. (2018). Ankle sprains: overview. Retrieved from

https://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0072736/  

 

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