As your EBP skills grow, you may be called upon to share your expertise with others. While EBP practice is often conducted with unique outcomes in mind, EBP practitioners who share their results can both add to the general body of knowledge and serve as an advocate for the application of EBP.

In this Discussion, you will explore strategies for disseminating EBP within your organization, community, or industry.

To Prepare:

• Review the Resources and reflect on the various strategies presented throughout the course that may be helpful in disseminating effective and widely cited EBP.
  • This may include: unit-level or organizational-level presentations, poster presentations, and podium presentations at organizational, local, regional, state, and national levels, as well as publication in peer-reviewed journals.
• Reflect on which type of dissemination strategy you might use to communicate EBP.

Post at least two dissemination strategies you would be most inclined to use and explain why. Explain which dissemination strategies you would be least inclined to use and explain why. Identify at least two barriers you might encounter when using the dissemination strategies you are most inclined to use. Be specific and provide examples. Explain how you might overcome the barriers you identified.

3 to 5 references within 5 years

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n this Discussion, you will explore strategies for disseminating EBP within your organization, community, or industry.

To Prepare:

• Review the Resources and reflect on the various strategies presented throughout the course that may be helpful in disseminating effective and widely cited EBP.
  • This may include: unit-level or organizational-level presentations, poster presentations, and podium presentations at organizational, local, regional, state, and national levels, as well as publication in peer-reviewed journals.
• Reflect on which type of dissemination strategy you might use to communicate EBP.

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Wellness visits are an important part of pediatric primary care. During these visits, patient growth and development are assessed. As an advanced practice nurse who performs these assessments, you must be able to distinguish between normal and abnormal growth and development to recognize red flags. While some patients may not meet milestones due to differences in rates of development, abnormal development might also be a red flag of an underlying problem. In this Discussion, you examine the following case studies and consider potential developmental red flags:

Case Study 1

A mother brings in her 16-month-old, Brittany, for treatment of an acute illness. During the history, the mother reports that her mother-in-law is concerned about the toddler’s development. Further questioning reveals the following:

• Brittany was a term infant born vaginally with no intrapartum complications. Birth weight was 8 pounds 1 ounce and current weight is 26 pounds 9 ounces.
• She was breastfed until 12 months of age and now drinks 24 ounces of whole milk and eats table foods daily.
• Physical milestones are as follows: Rolled front to back at 6 months, developed pincer grasp at 11 months, crawled at 8 months, and began cruising at 10 months. She does not walk independently.
• Social development includes mimicking adult behavior, four-word vocabulary (mama, dada, baba, and no), follows one-step commands, and quiets easily when comforted.

Case Study 2:

You see a 30-month-old named Brian for a well-child visit. His mother reports the following development:

• Physical: Walks independently, runs, able to climb stairs alternating feet, makes a tower of nine cubes, and is able to button his pants.
• Social: Follows one-step commands, uses one-word sentences, and has a vocabulary of approximately six words. He is resistant to nighttime and feeding routines, he has marked temper tantrums, and Mom states he does not calm when she tries to comfort him.

Case Study 3

Jose is a 36-month-old who presents for a preschool evaluation. His father reports the following development:

• Physical: Walks, runs, and jumps independently, walks up stairs alternating feet, pedals a three-wheeler, scribbles, copies circles and squares, and is able to balance on one foot for 2 to 3 seconds.
• Social: Recognizes three colors; speech is 75% understandable; uses three- to four-word sentences; talks about friends, favorite activities, and family; frequently engages in imitative play; has an imaginary friend; does stutter on occasion when excited or when intent on getting something said. Will typically repeat the first word in a sentence three to four times, but does not repeat syllables or consonants. This happens three to four times a week.

To prepare:

• Review this week’s media presentations, as well as “Developmental Management of Infants” and “Developmental Management of Toddlers and Preschoolers” in the Burns et al. text.
• Think about how physical, social, and cognitive development vary during infancy, toddlerhood, and the preschool years. Reflect on normal versus abnormal growth and development and consider the decision-making process of identifying and managing red flags of abnormal development.
• Select one of the three case studies provided. Reflect on the patient information included in the case study and consider any developmental red flags.
• Reflect on standardized screening tools, clinical guidelines, and management strategies that would be used to assess and manage the patient in your selected case study.

By Day 3

Post an explanation of any developmental red flags that presented in the case study you selected based on the stages of normal physical, social, and cognitive development for infants, toddlers, and preschoolers. Explain how you differentiated between normal and abnormal growth and development for this patient and identify which standardized screening tools, clinical guidelines, and management strategies you might use to assess and manage this patient and why.

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According to the American Diabetes Association (2011), 25.8 million children and adults have been diagnosed with diabetes in the United States. Approximately 2 million more are diagnosed every year, with another 79 million people considered to be in a pre-diabetes state. These millions of people are at risk of several alterations, including heart disease, stroke, kidney failure, neuropathy, and blindness. Since diabetes has a major impact on the health of millions of people around the world, it is essential for nurses to understand the pathophysiology and associated alterations of this disorder. In this Discussion, you compare two types of diabetes—diabetes mellitus and diabetes insipidus.

To Prepare

• Review Chapter 19 in the Huether and McCance text and Chapter 18 in the Hammer and McPhee text. Identify the pathophysiology of diabetes mellitus and diabetes insipidus. Consider the similarities and differences between resulting alterations of hormonal regulation.
• Select two of the following patient factors: genetics, gender, ethnicity, age, or behavior. Think about how the factors you selected might impact the diagnosis and prescription of treatment for these two types of diabetes.

Post an explanation of the pathophysiology of diabetes mellitus and diabetes insipidus. Describe the differences and similarities between resulting alterations of hormonal regulation. Then explain how the factors you selected might impact the diagnosis and prescription of treatment for these two types of diabetes.

4 references:

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 Write a brief explanation of the differences between the types of diabetes, including type 1, type 2, gestational, and juvenile diabetes. Describe one type of drug used to treat the type of diabetes you selected, including proper preparation and administration of this drug. Be sure to include dietary considerations related to treatment. Then, explain the short-term and long-term impact of this type of diabetes on patients. including effects of drug treatments. Be specific and provide examples. 

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