Respond to this post with a positive response :

Ask a probing question, substantiated with additional background information, evidence or research.

Share an insight from having read your colleagues’ postings, synthesizing the information to provide new perspectives.

Offer and support an alternative perspective using readings from the classroom or from your own research in the Walden Library.

Validate an idea with your own experience and additional research.

Make a suggestion based on additional evidence drawn from readings or after synthesizing multiple postings.

Expand on your colleagues’ postings by providing additional insights or contrasting perspectives based on readings and evidence.

Use  references

EXAMPLE OF A REFERENCE:

If you cannot locate a doi number, this is how the reference should look: 

Quelly, S. B. (2017). Characteristics Associated with School Nurse Childhood Obesity Prevention Practices. Pediatric Nursing, 43(4). Retrieved from https://www.pediatricnursing.net/issues/17julaug/abstr5.html

                                             MAIN POST

Scholarly Writing and Plagiarism

                Learning is a journey and not a destination. A part of this journey was to use Grammarly and SafeAssign. I will discuss my experience with those two platforms as well as my perception of paraphrasing and plagiarism. The internet is full of resources, so I will be sharing an online resource that supports scholarly writing. Finally, I will share two American Psychological Association (APA) formatting rules that I believe are useful for academic writers.

                I have never used Grammarly before, but I like that I can check grammar in real time. I did not know such a tool was in existence and I will be using Grammarly for all my assignments going forward before sending. However, SafeAssign is not a new tool for me. When I went to Western Governors University, I used TurnItIn, which is similar to SafeAssign. It checks how much of your paper matches other known scholarly works. I wrote a sample paragraph with SafeAssign, and it was a 0% match. I like to see my works matching at 5% or less as a matter of philosophy. It is easy to avoid plagiarism if two things are remembered. Use thoughts that originate from your cranium and cite works according to APA rules and Walden University requirements. During this process, my insight was learning how to paraphrase better. Walden University (2012) states that paraphrasing is beyond simply rearranging a sentence and choosing synonyms. I realized paraphrasing is about turning the whole idea into your own words and then citing the author.

                Scholarly writing is a term that can be confusing for many students. I had no idea what it meant until I researched the topic. According to Jackson State University (2015), scholarly writing is structured and seeks feedback from the audience. It would seem that this is the purpose of using discussion boards in an online learning environment. I believe that this online resource is useful, and I plan on adding it as a bookmark as a reminder of the essentials of scholarly writing.

                As previously mentioned, proper APA style and formatting is essential in scholarly writing. A rule that I was not versed in was related to in-text citations with more than five authors. The APA Manual states, “when a work has six or more authors, cite only the surname of the first author followed by et al” (American Psychological Association, 2010, p. 175). Also, I did not know that the following rule existed. According to the American Psychological Association (2010, p. 170), presenting your existing work as new when it is not is the definition of self-plagiarism. I found this to be an interesting rule that I had not considered before and will make sure I never do.

References

American Psychological Association. (2010). Publication Manual of the American Psychological Association (6th ed.). Washington, DC: American Psychological Association.

Jackson State University. (2015). What Is “Scholarly Writing”? Retrieved from http://www.jsums.edu/wrightcenter/2015/04/29/what-is-scholarly-writing/

Walden University. (2012). Walden University: Proofreading and revising. Retrieved from http://writingcenter.waldenu.edu/872.htm

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Respond to this post with a positive response :

Ask a probing question, substantiated with additional background information, evidence or research

Share an insight from having read your colleagues’ postings, synthesizing the information to provide new perspectives.

Offer and support an alternative perspective using readings from the classroom or from your own research in the Walden Library.

Validate an idea with your own experience and additional research.

Make a suggestion based on additional evidence drawn from readings or after synthesizing multiple postings.

Expand on your colleagues’ postings by providing additional insights or contrasting perspectives based on readings and evidence.

Use  references

EXAMPLE OF A REFERENCE:

If you cannot locate a doi number, this is how the reference should look: 

Quelly, S. B. (2017). Characteristics Associated with School Nurse Childhood Obesity Prevention Practices. Pediatric Nursing, 43(4). Retrieved from https://www.pediatricnursing.net/issues/17julaug/abstr5.html

                                                     MAIN POST

                               Scholarly Writing and Plagiarism

Learning is a journey and not a destination. A part of this journey was to use Grammarly and SafeAssign. I will discuss my experience with those two platforms as well as my perception of paraphrasing and plagiarism. The internet is full of resources, so I will be sharing an online resource that supports scholarly writing. Finally, I will share two American Psychological Association (APA) formatting rules that I believe are useful for academic writers.

 I have never used Grammarly before, but I like that I can check grammar in real time. I did not know such a tool was in existence and I will be using Grammarly for all my assignments going forward before sending. However, SafeAssign is not a new tool for me. When I went to Western Governors University, I used TurnItIn, which is similar to SafeAssign. It checks how much of your paper matches other known scholarly works. I wrote a sample paragraph with SafeAssign, and it was a 0% match. I like to see my works matching at 5% or less as a matter of philosophy. It is easy to avoid plagiarism if two things are remembered. Use thoughts that originate from your cranium and cite works according to APA rules and Walden University requirements. During this process, my insight was learning how to paraphrase better. Walden University (2012) states that paraphrasing is beyond simply rearranging a sentence and choosing synonyms. I realized paraphrasing is about turning the whole idea into your own words and then citing the author.

Scholarly writing is a term that can be confusing for many students. I had no idea what it meant until I researched the topic. According to Jackson State University (2015), scholarly writing is structured and seeks feedback from the audience. It would seem that this is the purpose of using discussion boards in an online learning environment. I believe that this online resource is useful, and I plan on adding it as a bookmark as a reminder of the essentials of scholarly writing.

As previously mentioned, proper APA style and formatting is essential in scholarly writing. A rule that I was not versed in was related to in-text citations with more than five authors. The APA Manual states, “when a work has six or more authors, cite only the surname of the first author followed by et al” (American Psychological Association, 2010, p. 175). Also, I did not know that the following rule existed. According to the American Psychological Association (2010, p. 170), presenting your existing work as new when it is not is the definition of self-plagiarism. I found this to be an interesting rule that I had not considered before and will make sure I never do.

                                             References

American Psychological Association. (2010). Publication Manual of the American Psychological Association (6th ed.). Washington, DC: American Psychological Association.

Jackson State University. (2015). What Is “Scholarly Writing”? Retrieved from http://www.jsums.edu/wrightcenter/2015/04/29/what-is-scholarly-writing/

Walden University. (2012). Walden University: Proofreading and revising. Retrieved from http://writingcenter.waldenu.edu/872.htm

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Respond to at least two of your colleagues who selected a different factor than you, in one of the following ways:

Make a suggestion based on additional evidence drawn from readings or after synthesizing multiple postings.

Share insights based on your own experience and additional research.

                                                       Main post

Cardiovascular Alterations

It is essential to understand the typical structure and function of the cardiovascular system because alterations occur. Some changes can be pathologic and others not. Alhadheri (2005) states that 50 to 90 percent of children have a benign or functional murmur. In this post, I will explain how I would diagnose and prescribe treatment for the patient in the scenario, including how genetics impacts the diagnosis and treatment.

Diagnosis and Treatment

Making a proper diagnosis is necessary before allowing the teenager to engage in sports. The patient had no significant family history of cardiac death and an unremarkable medical history. The lack of patient medical history leads me to conclude that the problem is not acquired, but congenital. The physical assessment is not enough information to definitively determine the etiology of the murmur. It would be wise to run additional tests to rule out a pathological murmur. Appropriate tests include a chest x-ray, electrocardiogram, blood work, and echocardiogram (Alhadheri, 2005). The patient is asymptomatic, so I would order an echocardiogram looking for structural abnormalities. I suspect that the patient has mitral regurgitation based on the location and description of the sound in the scenario. Hammer and McPhee (2019) state that a murmur can be heard best at the apex of the heart with mitral regurgitation. Another possibility is coarctation of the aorta, but this is unlikely because the patient does not have diminished blood pressure nor pulses in the lower extremities. If mitral regurgitation is the case, the treatment may be surgical intervention. Either way, I would refer the patient for treatment to a pediatric cardiologist knowing that it is outside of my scope. A registered nurse practitioner is required to make a referral to a physician for a patient condition that is beyond their knowledge or experience (Arizona State Board of Nursing, 2018, p. 46).

Genetics

Genetics could impact the diagnosis. There is a high incidence of congenital heart defects with trisomies 13 and 18, Turner syndrome, and Down syndrome (Huether & McCance, 2017). The diagnosis could be a ventricular septal defect instead. However, I do not think the treatment would change if genetics were a factor. Usually, surgery is the intervention when the problem is pathological regardless of origin. 

References

Alhadheri, S. A. (2005). Children with Heart Murmurs…When to be Concerned?. Retrieved from https://apcardio.com/wp-content/themes/advancedpedia/pdf/Heart_Murmurs.pdf

Arizona State Board of Nursing. (2018, May 23). Rules of the State Board of Nursing. Retrieved June 24, 2019, from https://www.azbn.gov/media/2880/ruleseffectivemay232018.pdf

Hammer, G. D., & McPhee, S. J. (2019). Pathophysiology of disease: An introduction to clinical medicine (8th ed.). New York, NY: McGraw-Hill Education.

Huether, S. E., & McCance, K. L. (2017). Understanding pathophysiology (6th ed.). St. Louis, MO: Mosby.

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Respond on to  two different days who selected different immune disorders and/or factors than you, in the following ways:

Share insights on how the factor you selected impacts the pathophysiology of the immune disorder your colleague selected.

Expand on your colleague’s posting by providing additional insights or contrasting perspectives based on readings and evidence.

                                                       Main Post

Maladaptive Responses to Immune Disorders

      For this week’s discussion post, we will discuss the maladaptive and physiological responses of HIV and Lupus.  We will first discuss the pathophysiology of each and then further break the disorders down.  We will review how the gender factor might impact the pathophysiology of the disease.

Pathophysiology of HIV

     Human Immunodeficiency Virus (HIV) is the viral infection that leads to Acquired Immune Deficiency Syndrome (AIDS).    HIV is a blood-borne pathogen.  Modes of transmission for HIV are IV drug abuse, blood product transfusion or transmission, maternal-child transmission, and both homosexual and heterosexual populations can be affected.  HIV seeks and destroys the CD-4+ Th cells.  CD-4+ cells are essential or the cytotoxic T cell and plasma cell development.  Because of the CD-4+ destruction, there is a suppressed immune response which leads to AIDS (Huether & McCance, 2017). 

Maladaptive Response and the Female Factor

     Maladaptive responses to HIV are anxiety, disturbed thought processes, imbalanced nutrition, infective coping, social isolation, this is just a few.  Women make up more than half the cases worldwide.  Approximately 50,000 new cases of HIV present each year in the United States, 25% of these new cases are from heterosexual relationships with two-thirds of that percentage being women, highest among black women (Huether & McCance, 2017).

Pathophysiology of Lupus

     Autoantibodies target specific self-antigens known as the initiation phase.  Environmental factors, such as sunlight, may be the cause for these triggers or viral infections like Epstein-Barr. SLE has long been thought to have an active genetic link.  In an average individual, apoptotic cells self destruct but for individuals with systemic lupus erythema (SLE) effectively immunize themselves with bad cells from their tissue.  The body fights itself instead of excreting the bad cells.  Propagation is the second phase of SLE; this phase involves the inflammatory response and tissue damage and can affect the heart, kidneys, brain, skin, and joints.  Thirdly is the flare stage and includes a quicker and more vigorous immune response; this stage may provoke disease flares (Hammer & McPhee, 2019).

Maladaptive Response and the Female Factor

     Maladaptive responses to SLE might be altered image issues, fatigue related to chronic inflammation, and impaired skin integrity related to skin rash.  Women are ten times more likely to develop SLE than men.  African Americans have the highest risk, followed by Hispanics, Asian Americans, and Native Americans.  The primary age to develop SLE is between 20-40 years old (the childbearing years) with the most prevalent age being around 30 (Lewis, Bucher, Heitkemper, & Harding, 2017).

References

Hammer, G. D., & McPhee, S. J. (2019). Pathophysiology of disease: An introduction to clinical medicine (8th  ed.). New York, NY: McGraw-Hill Education.

Huether, S. E., & McCance, K. L. (2017). Understanding  pathophysiology (6th ed.). St. Louis, MO: Mosby.

Lewis, S.L., Bucher, L., Heitkemper, M.M., & Harding, M.M.  (2017) Medical-surgical nuring assessment and management of clinical problems (10th ed.).  St. Louis, MO:  Elsevier

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Respond  on two different days who selected at least one different factor than you, in one or more of the following ways:Offer alternative diagnoses and prescription of treatment options for urinary tract infections.Share an insight from having read your colleague’s posting, synthesizing the information to provide new perspectives

                                                Main Post

Pathophysiology of Upper and Lower Urinary Tract Infections

      Lower urinary tract infections (UTIs) involve the urethra and the  bladder; upper urinary tract infections include the ureters and the  kidneys.  Upper UTIs are rarer than lower UTIs but typically are more  severe (Healthline, 2019).  Microorganisms are the most common agent  resulting in UTI infection.  Microorganisms can include Escherichia coli  (E. Coli) and staphylococcus saprophyticus.   Less common  mircroorganisms are proteus, klebsiella, pseudomonas, viruses, fungi,  tubercular bacilli, and parasites.  Gram-negative bacilli move into the  urethra, next to bladder, then on to the ureter, and kidney.  Infection  begins as an inflammatory response producing edema within the bladder  wall.  The bladder feels full with only small amounts of urine present,  but the urgency of needing to urinate is present and appears more often  than usual (Huether & McCance, 2017).  Signs and symptoms of lower  UTIs might include frequency, nocturia, dysuria, urgency, and hematuria  (in some cases).  Signs and symptoms of upper UTIs might include nausea,  vomiting, fever, chills, low back, flank pain, abdominal pain and  mental status changes in the elderly population (Barkley, 2018).

Pathophysiology Impact and Patient Factors

      Women are more prone than men to experience UTIs, possibly because of  urethral irritation during sexual intercourse or because they have a  shorter urethra, making it easy for microorganism transmission  (Berkowitz, 2007).  Microorganisms mostly associated with a female  diagnosis would be E.Coli and microorganisms primarily related to a male  diagnosis would be proteus species.  Disorders with lower UTIs might  be, urethritis/dysuria, and cystitis. Diseases with upper UTIs might be,  renal, pyelonephritis, and renal abscess (Barkley, 2018).  Contributing  patient factors might be age, prior UTI history, pregnancy,  immunocompromised patients, urinary catheter usage, and poorly  controlled diabetes (Healthline, 2019).

Diagnosis and Treatment

      Diagnostic test for lower UTIs are urinalysis, esterase detection on  dipstick, and presence of nitrate by dipstick.  Treatment for lower UTIs  are ciprofloxacin, augmentin, bactrim (commonly), additionally  amoxicillin, macrobid, levaquin, monurol, and primsol maybe prescribed.   The preferred treatment course is 3-days instead of 7-day  to maximize  benefits and minimize treatment drawbacks (Barkley, 2018).

      Diagnostic test for upper UTIs are ESR elevation, and white blood cell  casts appearing on urinalysis.  Treatment for upper UTIs is Bactrim,  Augmentin, Cipro, tobramycin, or gentamicin.  For patients with upper  UTIs experiencing nausea and vomiting, hospitalization may be necessary  (Barkley, 2018).

References

Barkley, T.  (2018).  Adult-gerontology primary care nurse practitioner.  West Hollywood, CA:  Barkley & Associates.

Berkowitz, A. (2007).  Clinical pathophysiology made ridiculously simple. Miami, FL:  MedMaster, Inc.

Healthline.  (2019).  Everything you need to know about urinary tract infection.  Retrieved from https://www.healthline.com/health/urinary-tract-infection-adults#symptoms

Huether, S. E., & McCance, K. L. (2017). Understanding pathophysiology (6th ed.). St. Louis, MO: Mosby.

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