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Discussion 13.1: Novice NP(Nurse Practitioner)

1. Reflecting on the semester’s practicum experience, how do you feel you have grown in the role change from expert RN to novice NP? Provide a follow up discussion/response to this classmates discussion that was posted. This is for a Student Nurse Practitioner Rotation

This semester has been an interesting one for sure, with that being said, I do feel like I have grown from an RN role to an NP role. I see myself looking at patients differently, instead of just assessing patients and stopping there, I’m taking the next steps to r/o diagnoses. From last semester to this semester even, I already feel more confident. Learning to assess patients as a provider, I feel more confident now in ruling out my differentials. However, I do feel like I am still a little uncertain about some things at times, but I’m learning to use my resources to help me make a safe decision for my patients.

This semester, I really started realizing that soon I will be making these clinical decisions without my preceptor and that did make me nervous. But what my preceptor has taught me is to always use my resources. If my preceptor is unsure about something she always asks for suggestions, from other NP’s or the Physician in our office. They all kind of work together and help each other out. One study suggests that, the most commonly discussed relationship is with NP’s and primary care physicians. The analysis of both qualitative and survey data demonstrated favorable relationships, characterized by ongoing communication, trust, respect, and willingness for collaborative practice (Martsolf, Norful, Poghosyan, 2017).

Another event that has helped us all grow as providers this semester is learning how to juggle our “new normals” because of covid-19. While I’m just a student and I am not able to continue clinicals in my part of the state of Florida at this time, it has made me proud to be a part of the healthcare team. Doctors, Nurse Practitioners, nurses, cna’s (and many others) are all stepping up during this time and it has made me more determined in wanting to become an NP. So I know I still have a lot to learn in this role but I’m excited and ready to continue pushing forward and working hard so I can start my journey as a Nurse Practitioner.

Refrences:

Martsolf, G., Norful, A., Phoghosyan, L., 2017. .Primary Care Nurse Practitioner Practice Characteristics Barriers and Opportunities for Interprofessional Teamwork. Retrieved from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5484049/

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Dosage forms are a convenient way of administering therapeutic agents to humans among other things. Evaluate and discuss with relevant examples, the characteristics of drugs that determine whether they will be formulated as oral liquid dosage forms or as modified release systems

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What impact does positive reinforcement, constant critique, or silence have on the efficiency of a high school basketball players 3-point jump shot while training?

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Topic: Differential Diagnosis

A 29-year-old single, sexually active woman reporting that she is in a monogamous relationship, has experienced five attacks of acute cystitis in the past year, all characterized by dysuria, increased frequency, and urgency. Each case was diagnosed on the basis of the clinical picture and a laboratory finding of bacteriuria. The urine bacterial counts in these cases ranged from 104 to 106 organisms/ml. Lab tests indicated that the third and fourth infections were caused by Escherichia coli, while the fifth infection was caused by an enterococcus and the second infection was caused by Proteus mirabilis. Each infection responded to short-term treatment with trimethoprim-sulfamethoxazole. The recurrences occurred at intervals of 3 weeks to 3 months following completion of antibiotic therapy. For the past two days, the woman has once again been experiencing dysuria, increased frequency, and urgency, so she goes to see her nurse practitioner provider. Her vital signs are T = 37.6°C, P = 100, R = 18, and BP = 110/75 mm Hg. Physical examination reveals a mild tenderness to palpation in the suprapubic area, but no other abnormalities. A bimanual pelvic examination reveals a normal-sized uterus and adnexae with no apparent adnexal tenderness. No vaginal discharge is noted. The cervix appears normal.

Questions:

What is the differential diagnosis for this set of symptoms? What is your preliminary diagnosis?
What tests should you order to confirm your preliminary diagnosis?
What are the possible causes of recurrent lower UTIs? Which of these is most likely in this case?
When would you collaborate with other professionals and refer your patient to a specialist and why?
Please support with an up-to-date evidence-based standard of care guidelines.



3 References

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Choose a specific immune system disorder (multiple sclerosis). Investigate and describe in your OP relevant morbidity/mortality/survival data, and other significant features of the disease.

MUST INCLUDE AS LEAST 1 SCHOLARLY SOURCE WITH CITATION

Is there any indication that risk for this disorder (multiple sclerosis) is inherited?

Are there any behavior/lifestyle changes that might decrease the risk of developing this disorder?

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• Revisit the Congress.gov website provided in the Resources and consider the role of RNs and APRNs in policy-making.
  •    Reflect on potential opportunities that may exist for RNs and APRNs to participate in the policy-making process.
  
  
  Give an explanation of at least two opportunities that exist for RNs and APRNs to actively participate in policy-making. Explain some of the challenges that these opportunities may present and describe how you might overcome these challenges. Finally, recommend two strategies you might make to better advocate for or communicate the existence of these opportunities to participate in policy-making. Be specific and provide examples.
  
  
  2/3 references, and they should not be over 5 years old.

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HIPAA: An Issue of Patient Privacy

The HHS Office for Civil Rights administers the HIPAA Privacy and Security Rules. The HIPAA Privacy Rule describes protected health information and how protected information can be used and disclosed. The HIPAA Security Rule describes what is covered by the HIPAA privacy protections and the safeguards, which must be in place to ensure appropriate protection of electronic protected health information (Office of the National Coordinator for Health Information Technology, 2015)

*********************review the following from this week’s Resources:
Academic Writing checklist

HIPAA paper template. (No abstract or reference list required for AWE 2000/3000.)

Resources on the HIPAA Privacy and Security Rules

Resources on privacy and security and the use of mobile devices in patient care

Privacy and Confidentiality Scenario

As you reflect on the Privacy and Confidentiality Scenario (located in this week’s Resources), consider the following points and write a 2-3-pages proposal addressing privacy issues: 
Identify the issues related to patient privacy and confidentiality in this scenario.
Describe strategies your organization (or one with which you are familiar) might use to safeguard patient information from the use of mobile devices.
Discuss the use of mobile devices for patient care in your organization (or one with which you are familiar) and any organizational policies related to mobile devices. Specifically, address the use of text messages to communicate patient care information and explain what happens to a message after it is sent.
Analyze your personal strategies used to protect patient health information on mobile devices.
Do your personal strategies adequately protect information in a patient care setting?
Provide examples of alternate or additional methods that could be used to insure patient privacy and confidentiality is maintained.

Include a minimum of three resources from the professional nursing literature in the assigned course readings and other references in the Walden Library. If they are relevant, you may use one or two professional web sites in addition to the literature references. Be sure to use 12 pt. Times New Roman font, 1 inch margins, and double space your paper. 

ADDITIONAL INFO NEEDED

https://www.youtube.com/watch?v=V30T3YSPV64

https://www.youtube.com/watch?v=VIUXVJmXL7E&feature=youtu.be

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A recent foodborne illness has been discovered within your community, and there is uncertainty where the outbreak has originated. As a public health official located within your community, you have been asked to address the city council, community stakeholders, and political stakeholders regarding this serious outbreak. The paper should demonstrate the following initiatives that you feel would be beneficial in discovering where the outbreak source may have originated:

1-Identification of as many cases as possible, and location.
2- Hypothesis of where the outbreak may have originated based on any interviews you have done.
3- Describe the type of epidemiological analysis that you would have to complete in order to demonstrate research is being completed:
        1- People, time, and location
        2- Variables that are creating an impact
        3- Nonaffected communities and persons who are not involved with the impact of the 
        illness. 
        4- Those who are impacted by the illness outbreak, listing the food items that are 
        involved, or products that are involved
        5- Demonstrate the signs and symptoms of the outbreak
        6- Map the cases and their locations where the main occurrences have been
        7- Demonstrate how you would collect samples, provide diagnosis, and how you 
        would provide corrective actions regarding the outbreak of this foodborne illness

The paper should be typed and five (5) pages in length, and follow the APA Style which includes using a cover page, one inch margins, double-spaced, 12 inch font (Times New Roman, Arial or Verdana) with a reference page.

Attached are references please use at least two listed on the word doc.

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Competency
Utilize various communication skills that demonstrate understanding of client privacy and dignity issues.

Scenario
Excellent communication skills, both verbal and non-verbal, are essential in the medical field. Patients put their trust in the staff and depend on them to provide excellent health care. It is crucial to make sure that both correct and proper communication is used with a patient; this ensures that they receive accurate medical care. As the Nurse at Rassy Medical Center, your objective is to ensure your team is aware of appropriate provider-patient communication practices by creating a delivering training presentations on various elements of communication in health care. Your current focus is nonverbal communication.

Instructions
Create a presentation demonstrating various facial expressions and examples of body language. Include discussion about the meaning of each nonverbal communication element.

Be creative with your facial expressions and body language by taking "selfies" of yourself, photos of others (with permission), and/or images from other resources. Ensure that you include the following, one per slide (minimum of ten slides):

Five different facial expressions with an explanation of each.
Five different examples of body language with an explanation of each.
Describe how therapeutic communication can assist you in understanding patient privacy and dignity.
You may use PowerPoint, Prezi, or a similar presentation application of your choice.

Put on a word document and I will make the powerpoint

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Scenario
Due to an epidemic of strep throat that has recently occurred in the community that Rassy Medical Center serves, the clinic has been forced to open earlier and close later to accommodate that amount of patients that have needed to be seen. The clinic is attempting to assist all of their patients promptly and efficiently, but the long hours have taken a toll on the staff in spite of sending informational voice messages to the patients regarding the epidemic.

The fields of medicine and technology have increasingly paired up to present medical issues via social media. This may help to communicate this issue to the patients and the community.

Instructions
Create a series of social media posts to present the strep throat epidemic to the community. Include images (where appropriate) and text that will clearly and effectively communicate the infectious spread of the strep throat bacteria. The details of the actual announcement are yours to decide. These posts will not be live posts and should be created and submitted in a Word document, PowerPoint presentation, or PDF file.

Be sure to include the following:

2 Facebook posts
2 Instagram posts
2 Tweets (Twitter)
Preventable health measures
When to make an appointment with a healthcare provider

put on a word document

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Why is there a geographic maldistribution of the physician labor force in the United States?
NOTE: Include in-text citations and references (2016-present) in your post.  If you use an in-text citation, you must have a Reference to support it, posted at the bottom of your post. 

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Topic: Case Study

A 30-year-old woman comes to your office because of a persistent cough that has been bothering her for the past 3 months. Her cough is dry and is more frequent during the evenings. She also notes frequent nasal congestion, especially when she is exposed to dust and cold weather. She reports no hemoptysis, weight loss, wheezing, fever, or changes in his appetite. What additional questions would you ask to learn more about her cough? What would be included in your HPI and your subjective questioning?

How would you classify her cough based on the duration to help with the diagnosis?
What diagnostic tests do you want to include to help you with your diagnosis?
Create a differential diagnosis flow sheet for this patient and include the diagnostics as well as the pharmacological management and rationale related to the differentials. Support your discussion with evidence-based research that is no older than 5 years.

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