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Nursing

Ludwick & Silva: ” Ethical Challenges in the Care of Elderly Persons” and discuss some of the ethical issues surrounding care of the elderly including quality of life (goals and outcomes), long-term care planning, geriatric education, frail elder care, and successful aging behaviors

Synthesize the article by Ludwick & Silva: ” Ethical Challenges in the Care of Elderly Persons” and discuss some of the ethical issues surrounding care of the elderly including quality of life (goals and outcomes), long-term care planning, geriatric education, frail elder care, and successful aging behaviors. Ludwick, R., Silva, M. (December 19, 2003). Ethics Column: “Ethical
Challenges in the Care of Elderly Persons”. Online Journal of Issues in Nursing. Vol. 9 No. 1.
Available:
www.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/TableofCon
tents/Volume92004/No1Jan04/EthicalChallenges.aspx

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Nursing

Types of Diabetes

Types of Diabetes
Type 1 diabetes, previously called juvenile diabetes or insulin-dependent diabetes can be developed at any age, it happens when the pancreas does not make enough insulin. The cause of type 1 diabetes is autoimmune in nature, where the body destroys beta cells made in the pancreas, which can happen months or even years before symptoms are present. In type 1 diabetes, diet and lifestyle do not play a role in causing the disease(What is Type 1 Diabetes, 2021) Type 2 diabetes often happens to individuals over age 45 but more children and teens are developing this disease due to diet and obesity. In Type 2 diabetes, individuals develop insulin resistance as the body’s cells stop responding in a normal way. Because of this, the pancreas works hard to produce more insulin, but over time cannot keep up so blood sugar rises and eventually leads to type 2 diabetes. While gestational diabetes appears in pregnancy and subsiding after delivery. It is managed in the same way as any diabetic pregnancy would be with diet and insulin(Burchum & Rosenthal, 2021)
Type 2 diabetes
Lifestyle modifications and drug therapy is required for glycemic control. Along with glycemic and lifestyle modifications, patients must also be assessed for comorbidities such as hypertension, nephropathy, dyslipidemia, and retinopathy, and obesity. Bariatric surgery is also considered for obesity management along with medication and behavior modification(Blaslov et al., 2018) Metformin is the most widely used oral medication, but when diabetes progresses and insulin in the body decreases, then patients with Type 2 diabetes need insulin therapy. The 4-step approach is used to treat type 2 diabetes: step 1involves lifestyle modification and metformin. In step 2 drug therapy includes lifestyle modification, Metformin, and a second drug such as thiazolidinedione, a dipeptidyl peptidase-4 inhibitor, a sodium-glucose cotransporter 2 inhibitor, a glucagon-like peptide-1 receptor agonist. If the patient does not achieve the goals of treatment on these medications, a sulfonylurea or basal insulin is considered. In Step 3, there is a three-drug combination which includes metformin. If three-drug therapy including insulin does not achieve glycemic control after 3-6 months, then the recommendation is combination therapy with injectable insulin and a GLP-1 receptor agonist(Burchum & Rosenthal, 2021)
Insulin Preparations
Insulin injectables are medications used to treat type 2 diabetes. Types of injectable insulin include rapid-acting, short-acting, immediate duration, long duration, and ultralong duration. They are injected subcutaneously before or after meals. One insulin used to treat type 2 diabetes is NPH insulin which has intermediate duration with the onset of 60 to 120 minutes (Humulin N, Novolin N), is injected subcutaneously twice daily at the same time each day. The patient should use gentle agitation when preparing this drug which is administered at mealtime to control blood sugar after meals, rather it is used between meals at night. Patients should be advised that NPH insulin should only be mixed with short-acting insulins; the short-acting insulin is drawn into the syringe first to avoid contaminating the short-acting insulin with NPH insulin. Hypoglycemia can occur with reduced food intake, vomiting, diarrhea, unusually intense exercise, childbirth, and excessive consumption of alcohol. Patients should also be aware that beta blockers can mask symptoms of hypoglycemia, hyperglycemic agents such as glucocorticoids can counteract insulin’s desired effects and hypoglycemic oral agents such as sulfonylureas can intensify hypoglycemia brought on by insulin(Burchum & Rosenthal, 2021)
Short and long term consequences of type 2 diabetes
Long-term effects of diabetes include heart disease, myocardial infarction, stroke, and higher mortality after CABG, when compared to those without type two diabetes(Bundhun et al., 2017) Type 2 diabetes increases the risk of heart failure, peripheral artery disease, diabetic retinopathy, and microvascular complications such as chronic kidney disease(Oieru et al., 2014) A Short term effect of type 2 diabetes is hypoglycemia which can be heightened by insulin and sulfonylureas(Freeland & Bigelow, 2017)
References
Blaslov, K., Naranđa, F. S., Kruljac, I., & Renar, I. P. (2018). Treatment approach to type 2 diabetes: Past, present, and future. World Journal of Diabetes, 9(12), 209–219. https://doi.org/10.4239/wjd.v9.i12.209
Bundhun, P. K., Bhurtu, A., & Yuan, J. (2017). Impact of type 2 diabetes mellitus on the long term mortality in patients who were treated by coronary artery bypass surgery. Medicine, 96(22). https://doi.org/10.1097/MD.0000000000007022
Burchum, J., & Rosenthal, L. (2021). Lehne’s Pharmacotherapeutics for Advanced Practice Nurses and Physician Assistants (2nd ed.). Elsevier, Inc.
Freeland, B., & Bigelow, A. (2017). Type 2 Diabetes Care in the Elderly. The Journal for Nurse Practitioners, 13(3). https://doi.org/10.1016/j.nurpra.2016.08.010
Oieru, D. S., Vlad, I., Popa, A. R., & Zaharia, M. (2014). Long Term Complications of Diabetes – A Review. Romanian Journal of Diabetes Nutrition and Metabolic Diseases, 21(4). https://doi.org/10.2478/rjdnmd-2014-0042
What is Type 1 Diabetes. (2021, March 25). CDC Centers for Disease Control. https://www.cdc.gov/diabetes/basics/what-is-type-1-diabetes.html

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Nursing

Reducing Medication Errors in Medical-Surgical

Chosen Topic: Reducing Medication Errors in Medical-Surgical Units
The point of the paper is to research ways to improve an aspect in nursing. Medication errors are very common in the inpatient settings. There are many protocols and interventions that have been placed in order to prevent these errors. How effective are these interventions and what can be done to improve and reduce the occurence of medication errors? Find studies to see how medical-surgical units manage to reduce medication errors.
Rubric is attached. 3-4 scholarly nursing journals must be cited in APA 7th edition format.
The paper must include all of these components.
· Cover page
· Introduction
· Background
· Aim/Purpose
· Review of Literature
· Content of scholarly paper to include Research Method 5-7
pages for the body
· Implications for Nursing Practice
· Conclusion
· Reference page
Thank you!

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Nursing

Juvenile Diabetes, also known as Diabetes Type I often occurs in the youth.

Juvenile Diabetes, also known as Diabetes Type I often occurs in the youth. This is a disorder, genetic in nature, that is classified as an insulin-dependent form of diabetes. Here, the pancreas does not produce adequate insulin to help regulate, the patients’ blood glucose. The organ system is compromised as there is autoimmune destruction of the pancreatic beta cells needed to produce insulin (Rassart et al., 2021). This is a chronic disorder that follows the patient through to their adult life, and there is no amount of medication, exercise, or intervention that will rid them of the disorder.
Diabetes type II occurs progressively over the patient’s lifetime. Excessive consumption of sugar spills over into the bloodstream and leads to damage to the circulatory vessels and nervous system. The pancreas is overwhelmed and cannot produce sufficient insulin to regulate the sugar and push it back into the cells (Muzurovic et al, 2021). This rise of this disorder occurs in middle adulthood. It is becoming increasingly common in adolescence in current times.
Gestational diabetes is diagnosed in pregnancy. Like the other types of diabetes discussed previously, gestational diabetes affects sugar is used and distributed in the body. The result is elevated glucose in the blood. Elevated blood glucose affects the mother’s and infant’s health. Research suggests that over half of the women who are diagnosed with gestational diabetes go on to develop Diabetes type II (Venkatesh & Landon, 2021). When left untreated, or unmanaged by diet control or medication, gestational diabetes can lead to premature birth, intrauterine fetal demise, and infant macrosomia.
I chose Diabetes type II as my focus for diabetes and treatment. The first choice for treatment for Diabetes type II is Metformin or Glucophage. The prescription is initially, Metformin 1000mg to be taken orally twice a day. This medication is to be taken with food with a full glass of water as it has the likelihood to cause gastrointestinal side effects such as flatulence and diarrhea that occur when the medication is initially taken (Padhi et al., 2020). Tablets or capsules should be taken whole and not crushed, broken, or chewed. With proper diet control, exercise, and compliance, patients on metformin may no longer need to take the medication to control their sugar. If the patient continues to remain non-compliant with diet, medication, and an exercise regime, they may require higher dosing of metformin or the administration of insulin subcutaneously on a sliding scale.
There are short-term and long-term complications of diabetes. Some of the short-term complications are hypoglycemia and hyperosmolar hyperglycemia nonketotic syndrome (HHNS). Hypoglycemia is the result of too much insulin in the system, poor diet, and glucose regulation. HHNS occurs in uncontrolled diabetes type II, or medication noncompliance (Muzurovic et al. 2021). Characterized by symptoms of extreme thirst, frequent urination, confusion, and blurry vision. HHNS can lead to blood glucose levels as high as 600 mg/dl, fever, paralysis, and hallucination.
The long-term effects of diabetes mellitus II occur in microorganism damage. This is seen in retinopathy, nephropathy, and neuropathy. Accumulation of sugar in the blood causes damage to blood vessels and can lead to disorders of the system reliant on said blood vessels. Damaged blood vessels in the eye can lead to a loss in vision in both eyes through cataracts and glaucoma. This is the same for blood vessels in the kidney, and nervous system. Another common example of the long-term effect of uncontrolled diabetes is diabetic peripheral neuropathy. This can lead to damage to the feet due to infections from poorly healing wounds. The treatment for this is often amputation.
References
Padhi, S., Nayak, A. K., & Behera, A. (2020). Type II diabetes mellitus: a review on recent drug-based therapeutics. Biomedicine & Pharmacotherapy, 131. https://doi-org.ezp.waldenulibrary.org/10.1016/j.biopha.2020.110708
Rassart, J., Oris, L., Prikken, S., Goethals, E. R., Raymaekers, K., Weets, I., Moons, P., & Luyckx, K. (2021). Illness identity and adjusting to type I diabetes: A four-wave longitudinal study. Health Psychology, 40(5), 326–336. https://doi-org.ezp.waldenulibrary.org/10.1037/hea0001063.supp (Supplemental)
Muzurović, E., Kraljević, I., Solak, M., Dragnić, S., & Mikhailidis, D. P. (2021). Homocysteine and diabetes: Role in macrovascular and microvascular complications. Journal of Diabetes and Its Complications, 35(3). https://doi-org.ezp.waldenulibrary.org/10.1016/j.jdiacomp.2020.107834
VENKATESH, K. K., & LANDON, M. B. (2021). Diagnosis and Management of Gestational Diabetes: What every OB/GYN needs to know to manage this complication. Contemporary OB/GYN, 66(5), 9–15.

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Nursing

What were the components that impacted your nursing practice?

Two-page (body) APA 7th edition reflective response which summarizes what you learned from the chapter with at least one reference. (Reference will come from powerpoint/pdf attached). See below rubric. Reflections must demonstrate a high degree of critical thinking in applying, analyzing, and evaluating key course concepts and theories from readings, lectures, media, discussions activities, and/or assignments. Insightful and relevant connections are made through contextual explanations, inferences, and examples.
What did I learn? (Personal reflection)
What were the components that impacted your nursing practice?
Recommendations for future experiences or practice?
The reference for the book used is:
Marquis, B. L., & Huston, C. J. (2021). Leadership roles and management functions in nursing: theory and application (10th ed.). Wolters Kluwer.
Please include reference in paper. Thank you!
0 point
1 point
2 points
Rudimentary and superficial. No analysis or insight is displayed.
Substantial information (describes) but lacks either the insight or analysis.
Rich in content. Full of thought, insight, and analysis.

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Nursing

Leadership roles and management functions in nursing: theory and application

Two-page (body) APA 7th edition reflective response which summarizes what you learned from the chapter with at least one reference. (Reference will come from powerpoint/pdf attached). See below rubric. Reflections must demonstrate a high degree of critical thinking in applying, analyzing, and evaluating key course concepts and theories from readings, lectures, media, discussions activities, and/or assignments. Insightful and relevant connections are made through contextual explanations, inferences, and examples.
What did I learn? (Personal reflection)
What were the components that impacted your nursing practice?
Recommendations for future experiences or practice?
The reference for the book used is:
Marquis, B. L., & Huston, C. J. (2021). Leadership roles and management functions in nursing: theory and application (10th ed.). Wolters Kluwer.
Please include reference in paper. Thank you!
0 point
1 point
2 points
Rudimentary and superficial. No analysis or insight is displayed.
Substantial information (describes) but lacks either the insight or analysis.
Rich in content. Full of thought, insight, and analysis.

Categories
Nursing

The nursing process is a tool that puts knowledge into practice.

The nursing process is a tool that puts knowledge into practice. By utilizing this systematic problem-solving method, nurses can determine the health care needs of an individual and provide personalized care.
Write a paper (1,750-2,000 words) on cancer and approach to care based on the utilization of the nursing process. Include the following in your paper:
Describe the diagnosis and staging of cancer.
Describe at least three complications of cancer, the side effects of treatment, and methods to lessen physical and psychological effects.
Discuss what factors contribute to the yearly incidence and mortality rates of various cancers in Americans.
Explain how the American Cancer Society (ACS) might provide education and support. What ACS services would you recommend and why?
Explain how the nursing process is utilized to provide safe and effective care for cancer patients across the life span. Your explanation should include each of the five phases and demonstrate the delivery of holistic and patient-focused care.
Discuss how undergraduate education in liberal arts and science studies contributes to the foundation of nursing knowledge and prepares nurses to work with patients utilizing the nursing process. Consider mathematics, social and physical sciences, and science studies as an interdisciplinary research area.
You are required to cite to a minimum of four sources to complete this assignment. Sources must be published within the last 5 years and appropriate for the assignment criteria and relevant to nursing practice.
Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.
This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.
You are required to submit this assignment to LopesWrite. Refer to the LopesWrite Technical Support articles for assistance.
Benchmark Information
This benchmark assignment assesses the following programmatic competencies:
RN-BSN
2.1: Incorporate liberal arts and science studies into nursing knowledge.
3.1 Utilize the nursing process to provide safe and effective care for patients across the life span.

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Nursing

What happens to the nurse role stress or strain becomes too overwhelming?

APA format paper of 1000 words with a required 3 sources used through out the paper, cited and referenced correctly in APA.
What happens to the nurse role stress or strain becomes too overwhelming?
What happens to patient care?
Discuss how nurses can manage or reduce role stress and role stain.
explain two issues that lead to nurse burnout and discuss a solution for each issue.
Think of an experience in your nursing proffesion where your either felt starin or burnout and how you overcame this event.(since this is a per sona; experience, you can use first person narratiob for this portion of your essay.)

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Nursing

Identify and discussion basic designs, corresponding or additional questions, analytical methods related to research questions, and limits on implications of findings (e.g., causal vs. relational)

Objectives
Identify and discussion basic designs, corresponding or additional questions, analytical methods related to research questions, and limits on implications of findings (e.g., causal vs. relational)
Deliverables
Write a 3-4 page (not including the title and reference pages) paper
APA formatted paper with an introduction and conclusion.
APA headings for each section of the paper
At least 5 peer reviewed articles
Step 1: Research
Review the readings and video and research basic designs, corresponding questions, analytical methods related to research questions and limitation on implication of findings (causal vs relational).
You may want to base this research on your idea for your Capstone Project.
Step 2: Consider
Related to the research questions and limitations on implications or findings (causal vs relational):
What are the basic research designs?
What are the corresponding or additional questions used?
What analytical methods are used?
Step 3: Write
Write a paper that addresses the questions above.
Step 4 Save and submit
When you have completed your assignment, save a copy for yourself in an easily accessible place and submit a copy to your instructor using the dropbox.

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Nursing

Create a concept map of a chosen condition, disease, or disorder with glucose regulation or metabolic balance considerations.

Create a concept map of a chosen condition, disease, or disorder with glucose regulation or metabolic balance considerations. Write a brief narrative (2-3 pages) that explains why the evidence cited in the concept map and narrative are valuable and relevant, as well as how specific interprofessional strategies will help to improve the outcomes presented in the concept map.
Introduction
Note: Each assessment in this course builds on the work you completed in the previous assessment. Therefore, you should complete the assessments in this course in the order in which they are presented.
The biopsychosocial (BPS) approach to care is a way to view all aspects of a patient’s life. It encourages medical practitioners to take into account not only the physical and biological health of a patient, but all considerations like mood, personality, and socioeconomic characteristics. This course will also explore aspects of pathophysiology, pharmacology, and physical assessment (the three Ps) as they relate to specific conditions, diseases, or disorders.
The first assessment is one in which you will create a concept map to analyze and organize the treatment of a specific patient with a specific condition, disease, or disorder.
The purpose of a concept map is to visualize connections between ideas, connect new ideas to previous ideas, and to organize ideas logically. Concept maps can be an extremely useful tool to help organize and plan care decisions. This is especially true in the biopsychosocial model of health, which takes into account factors beyond just the biochemical aspects of health. By utilizing a concept map, a nurse can simplify the connection between disease pathways, drug interactions, and symptoms, as well as between emotional, personality, cultural, and socioeconomic considerations that impact health.
Preparation
As you prepare to complete this assessment, you may want to think about other related issues to deepen your understanding or broaden your viewpoint. You are encouraged to consider the questions below and discuss them with a fellow learner, a work associate, an interested friend, or a member of your professional community. Note that these questions are for your own development and exploration and do not need to be completed or submitted as part of your assessment.
The assessment will be based on the case of a specific patient with a specific condition, disease, or disorder. Think about an experience you have had treating a patient with a condition, disease, or disorder that interests you, or one of the cases presented in the Vila Health: Concept Maps as Diagnostic Tools media simulation.
What is the primary condition, disease, or disorder affecting the patient?
What types of experience have you had working with patients with this condition, disease, or disorder?
How does this condition, disease, or disorder typically present?
What are the recommended treatment options?
What, if any, characteristics of an individual patient should be kept in mind when determining a course of treatment.
How have you used concept maps to help plan and organize care?
What are the advantages of concept maps, from your point of view?
How could concept maps be more useful?
How can interprofessional communication and collaboration strategies assist in driving patient safety, efficiency, and quality outcomes with regard to specific clinical and biopsychosocial considerations?
What interprofessional strategies do you recommend health care providers take in order to meet patient-centered safety and outcome goals?
Scenario
You have already learned about evidence-based practice and quality improvement initiatives in previous courses. You will use this information to guide your assessments, while also implementing new concepts introduced in this course. For this assessment, you will develop a concept map and provide supporting evidence and explanations. You may use the case studies presented in the Vila Health: Concept Maps as Diagnostic Tools media, a case study from the literature or your practice that is relevant to the list of conditions below, or another relevant case study you have developed. This case study will provide you with the context for creating your concept map. You may also use the practice context from the case study or extrapolate the case study information and data into your own practice setting. Think carefully when you are selecting the case study for this assessment, as you may choose to build upon it for the second assessment as well.
Some example conditions, diseases and disorders that are relevant to metabolic balance and glucose regulation considerations are:
Cancer.
Diabetes (type 2).
HIV/AIDS.
Hyperthyroidism.
Hypothyroidism.
Metabolic syndrome.
Obesity.
Polycycstic ovary syndrome.
Prediabetes.
Pregnancy.
Instructions
Develop a concept map and a short narrative that supports and further explains how the concept map is constructed. You may choose to use the Concept Map Template as a starting point for your concept map, but are not required to do so. The bullet points below correspond to the grading criteria in the scoring guide. Be sure that your evidence-based plan addresses all of them. You may also want to read the Concept Map scoring guide and the Guiding Questions: Concept Map document to better understand how each grading criterion will be assessed.
Part 1: Concept Map
Develop an evidence-based concept map that illustrates a plan for achieving high-quality outcomes for a condition that has impaired glucose or metabolic imbalance as related aspects.
Concept Map Template [DOCX]. You may choose to use this template for completing this component of the assignment.
Part 2: Additional Evidence (Narrative)
Justify the value and relevance of the evidence you used as the basis for your concept map.
Analyze how interprofessional strategies applied to the concept map can lead to achievement of desired outcomes.
Construct concept map and linkage to additional evidence in a way that facilitates understanding of key information and links.
Integrate relevant sources to support assertions, correctly formatting citations and references using current APA style.
Use the APA Style Paper Tutorial [DOCX] to complete this narrative component.
Example Assessment
You may use the following to give you an idea of what a Proficient or higher rating on the scoring guide would look like:
Assessment 1 Example [PDF].
Additional Requirements
Length of submission: Your concept map should be on a single page, if at all possible. You can submit the concept map as a separate file, if you need to. Your additional evidence narrative should be 2–3 double-spaced, typed pages. Your narrative should be succinct yet substantive.
Number of references: Cite a minimum of 3–5 sources of scholarly or professional evidence that supports your concept map, decisions made regarding care, and interprofessional strategies. Resources should be no more than five years old.
APA formatting:
For the concept map portion of this assessment: Resources and citations are formatted according to current APA style. Please include references both in-text and in the reference page that follows your narrative.
For the narrative portion of this assessment: use the APA Style Paper Tutorial [DOCX] to help you in writing and formatting your analysis. You do not need to include an abstract for this assessment.
Competencies Measured
By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and assessment criteria:
Competency 1: Design patient-centered, evidence-based, advanced nursing care for achieving high-quality patient outcomes.
Develop an evidence-based concept map that illustrates a plan for achieving high-quality outcomes for a condition that has impaired glucose or metabolic imbalance as related aspects.
Justify the value and relevance of the evidence used as the basis for a concept map.
Competency 4: Evaluate the efficiency and effectiveness of interprofessional care systems in achieving desired health care improvement outcomes.
Analyze how interprofessional strategies applied to the concept map can lead to achievement of desired outcomes.
Competency 5: Communicate effectively with diverse audiences, in an appropriate form and style, consistent with organizational, professional, and scholarly standards.
Construct concept map and linkage to additional evidence in a way that facilitates understanding of key information and links.
Integrate relevant sources to support assertions, correctly formatting citations and references using current APA style.