How does the community health nurse recognize bias, stereotypes, and implicit bias within the community? How should the nurse address these concepts to ensure health promotion activities are culturally competent? Propose strategies that you can employ to reduce cultural dissonance and bias to deliver culturally competent care. Include an evidence-based article that address the cultural issue. Cite and reference the article in APA format.
Apply Guido’s MORAL model to resolve the dilemma presented in the case study described in EXERCISE 4–3 (Guido textbook). How might the nurses in this scenario respond to the physician’s request? How would this scenario begin to cause moral distress among the nursing staff, and what are the positive actions that the nurses might begin to take to prevent moral distress?
Create a 5- to 6-slide PowerPoint presentation that can be used in a staff development meeting on presenting different approaches for implementing the stepwise approach for asthma treatment. Be sure to address the following:
Excellent Good Fair Poor Describe the long-term control and quick relief treatment options for the asthma patient from your practice, as well as the impact these drugs might have on your patient. Points Range: 27 (27%) – 30 (30%) The presentation clearly and accurately describes in detail the long-term control and quick relief treatment options for the asthma patient from their practice.
The presentation clearly and accurately describes in detail the impact these drugs might have on their patient. Points Range: 24 (24%) – 26 (26%) The presentation accurately describes the long-term control and quick relief options for the asthma patient from their practice.
The presentation accurately describes the impact these drugs might have on their patient. Points Range: 21 (21%) – 23 (23%) The presentation inaccurately or vaguely describes the long-term control and quick relief options for the asthma patient from their practice.
The presentation inaccurately or vaguely describes the impact these drugs might have on their patient. Points Range: 0 (0%) – 20 (20%) The presentation inaccurately and vaguely describes the long-term and quick relief options for the asthma patient from their practice, or is missing.
The presentation inaccurately and vaguely describes the impact these drugs might have on their patient, or is missing. Explain the stepwise approach to asthma treatment and management for your patient. Points Range: 27 (27%) – 30 (30%) The presentation clearly and accurately explains in detail the stepwise approach to asthma treatment and management for their patient. Points Range: 24 (24%) – 26 (26%) The presentation accurately explains the stepwise approach to asthma treatment and management for their patient. Points Range: 21 (21%) – 23 (23%) The presentation inaccurately or vaguely explains the stepwise approach to asthma treatment and management for their patient. Points Range: 0 (0%) – 20 (20%) The presentation inaccurately and vaguely explains the stepwise approach to asthma treatment and management for their patient. Explain how stepwise management assists health care providers and patients in gaining and maintaining control of the disease. Be specific. Points Range: 27 (27%) – 30 (30%) The presentation clearly and accurately explains in detail how stepwise management assists health care providers and patients in gaining and maintaining control of the disease.
The presentation provides accurate and detailed examples to support the explanation provided. Points Range: 24 (24%) – 26 (26%) The presentation accurately explains how stepwise management assists health care providers and patients in gaining and maintaining control of the disease.
The presentation provides accurate examples to support the explanation provided. Points Range: 21 (21%) – 23 (23%) The presentation inaccurately or vaguely explains how stepwise management assists health care providers and patients in gaining and maintaining control of the disease.
The presentation provides inaccurate or vague examples to support the explanation provided. Points Range: 0 (0%) – 20 (20%) The presentation inaccurately and vaguely explains how stepwise management assists health care providers and patients in gaining and maintaining control of the disease, or is missing.
The presentation provides inaccurate and vague examples to support the explanation provided, or is missing. Written Expression and Formatting – Paragraph Development and Organization:
Paragraphs make clear points that support well developed ideas, flow logically, and demonstrate continuity of ideas. Sentences are carefully focused–neither long and rambling nor short and lacking substance. Points Range: 5 (5%) – 5 (5%) Paragraphs and sentences follow writing standards for flow, continuity, and clarity. Points Range: 4 (4%) – 4 (4%) Paragraphs and sentences follow writing standards for flow, continuity, and clarity 80% of the time. Points Range: 3.5 (3.5%) – 3.5 (3.5%) Paragraphs and sentences follow writing standards for flow, continuity, and clarity 60%–79% of the time. Points Range: 0 (0%) – 3 (3%) Paragraphs and sentences follow writing standards for flow, continuity, and clarity less than 60% of the time. Written Expression and Formatting – English writing standards:
Correct grammar, mechanics, and proper punctuation Points Range: 5 (5%) – 5 (5%) Uses correct grammar, spelling, and punctuation with no errors Points Range: 4 (4%) – 4 (4%) Contains a few (1–2) grammar, spelling, and punctuation errors Points Range: 3.5 (3.5%) – 3.5 (3.5%) Contains several (3–4) grammar, spelling, and punctuation errors Points Range: 0 (0%) – 3 (3%) Contains many (≥ 5) grammar, spelling, and punctuation errors that interfere with the reader’s understanding Total Points: 100
What advocacy actions might you take to improve health care through legislation at the state or federal level?
Submission Instructions:
at least 500 words ( 2 complete pages of content) formatted and cited in current APA style 7 ed with support from at least 3 academic sources which need to be journal articles or books from 2018 up to now. NO WEBSITES allowed for reference entry. Include doi, page numbers, etc. Plagiarism must be less than 10%.
plagiarism must be less than 15% . i need the assignment is 11 hours.
Bipolar disorder is a unique disorder that causes shifts in mood and energy, which results in depression and mania for clients. Proper diagnosis of this disorder is often a challenge for two reasons: 1) clients often present as depressive or manic, but may have both; and 2) many symptoms of bipolar disorder are similar to other disorders. Misdiagnosis is common, making it essential for you to have a deep understanding of the disorder’s pathophysiology. For this Assignment, as you examine the client case study in this week’s Learning Resources, consider how you might assess and treat clients presenting with bipolar disorder.
The Assignment
Examine Case Study: An Asian American Woman With Bipolar Disorder. You will be asked to make three decisions concerning the medication to prescribe to this client. Be sure to consider factors that might impact the client’s pharmacokinetic and pharmacodynamic processes.
At each decision point stop to complete the following:
you can edit or use my sample with same medication therapy.
Walden University .. 6630n
2 Assessing and Treatment for Bipolar Disorder Patient Introduction Bipolar disorder is not an uncommon illness. It is a very chronic and severe mental disorder, affecting approximately 1-2% of the adult population. The signs and symptoms of bipolar disorder are different depending on the type of episode (i.e., manic or depressive). Each episode marks a critical change from the way a person usually acts and their typical mood, and can be characterized by a sudden change in the general attitude of the patient, the way the patient thinks and the behavior. 1 The changes will be sudden that it will be noticed by people around (Robert et al., 2017). This dangerous demonstrative unpredictability mood disorder can be found in all area of life, that is, from the poor to the rich, this disorder affects millions of people in all facets of life (Robert et al., 2017). Bipolar disorder can be seen mostly in the age starting at 25years or older, but it is not totally absent in the teenage age. It shows that about 2.6 percent of the population are diagnosed as bipolar. 3 (National Alliance on Mental Illness, 2017).
If not well treated ,Bipolar disorder can be critical; 1 early identification of symptoms with an appropriate treatment plan may include psychotherapy, medications, a healthy lifestyle and a regular schedule will keep the patient healthy (National Alliance on Mental Illness. (2017). 1 The NP should have a good understand of this disorder to be able to take care of this the patient because of its long-term management and how it affects the health in totality (National Alliance on Mental Illness. (2017). 1 My focus of this paper will look into an Asian American Woman with a bipolar disorder, symptoms management, diagnosing the symptom, and the complete treatment. The paper will consider the most safe and appropriate options of treatment and the outcome as the treatment, and care.
Decision Selected My patient is an Asian American woman age 39 years with 4 children and 3 ground children. The husband notices that sometimes she will be singing loud to the top of her voice and dancing not to the music she sang. In another time she will just fill like not doing anything and nothing will interest her, and she will lay on the bed for hours without going to the business she spent her years building and love so much.Patient is withdrawn and non-interactive. 4 She is diagnosed Bipolar disorder.
1 Decision # 1 Reason Selected My best treatment of choice for this disorder will be to begin Risperdal 2 mg orally twice a day. Risperdal is the best choice to treat bipolar disorder. (Lee et al., 2011). Risperdal called risperidone is in the chemical class benzisoxazole derivatives which are antipsychotic. It is an effective medication for bipolar disorder (Lee et al., 2011). The reasons of choosing Risperdal is because it is used to treat schizophrenia and the risperidone works with the brain to stabilize the brain (Lee et al., 2011). Risperidone rebalances dopamine and serotonin to improve thinking, mood, and behavior. Risperidone belongs to a class of drugs called atypical antipsychotics approved by U.S. Food and Drug Administration (FDA) The drug is also used to treat symptoms of bipolar disorder and irritability (NAMI, 2017).
Expected Results We will need to have some subjective and objective changes. 1Patient should be able to verbalize changes within the first month of the treatment.
During the next visit with the patient after one month, she is expected to express changes in the clarity of her brain. The freedom from indistinctness or ambiguity because of the medicine will help her to balance certain natural substances in her brain.She should also notice a change in her ability to concentrate on her activities (Lee et al., 2011). No side effects.
Differences between Expected outcome and Actual outcome Patient came back after a month (4 WEEKS) and report that she experiences some improvement in the symptom including some improvement with concentration. My patient reported some drowsiness. 1 Drowsiness is one of the side effect of high dose of Risperdal. The genetic testing, reveals that she is positive for CYP2D6. Asians are more likely to have decreased CYP2D6 activity compared to Caucasians (Lee et al., 2011). I will reduce the dosage of this medication. 1 A positive outcome should be that there was a little bit of improvement in symptoms, patient able to sleep, more concentration. Patient and family report drowsiness during the day time which is one the side effect of high dose Risperdal.
Decision Point Two Reason Selected The next best option is not to discontinue Risperdal, but to lower dose to Risperdal 1 mg orally at hours of sleep (HS) since expected outcome was not achieved based on decision one. My patient and , her family reported that patient has been drowsy during the day because of Risperdal 2mg. I will continue on Risperdal because the patient confirm improvement on the symptoms and the side effect observed was a regular adverse reaction because of her descendant background (American Psychiatric Association, 2017). The reduction to Risperdal 1mg BID to Risperdal 1 mg will be closely monitor.
Expected Results Risperdal 1mg orally at bedtime is a reduced dosage from the 2mg which is expected to eliminate the drowsiness and toxicity in the patient Stahl, (2013).The patient is expected to continue to have decrease in the bipolar symptom. The effect of the medication should be observable and notice by the family member as a testimony (American Psychiatric Association, 2017).
Differences between Expected outcome and Actual outcome During the patient four weeks follow up examination shows that the bipolar disorder symptom dissipated to noticeable level. This indicate a therapeutic effect of Risperdal 1mg at night brought about the therapeutic effect on the patient and patient is tolerating and adjusting to the medication in a positive way (Dean, 2017). The patient did not experience the drowsiness and there was no toxicity, therefore the expected result and the actual result were the same. Risperdal therapy will continue with this medication and the dosage, and a close monitoring will still be needed until the next four weeks appointment (Dean, 2017).
Decision Point Three Decision Selected Risperdal 1mg orally at HS will be continued Reason for Selection The decision to continue with the medication was because the desire result, and the actual result are in pari-passu. To change the current medication or tamper with the dosage may offset the patient and thereby destabilize the rate of her healing (Dean, 2017). The patient is still under assessment and close monitoring continue until the next appointment date.
Expected Results It is expected that the patient will increase in good mental stability and continue to maintain reduction in bipolar disorder symptom with the dosage of Risperdal 1mg at night (Robert et al., 2017). The patient is anticipated to having good sleep at night and well improve in her interaction with relatives and friends, with ability to concentrate on matters that concern her and carrier (Robert et al., 2017).
Differences between Expected outcome and Actual outcome The therapeutic decision is working in this patient in accordance to the expectation. The treatment agrees with the standard way of treatment of an Asian descendant, the starting procedural treatment for bipolar disorder to the maintaining of such patient that are been positive for CYP2D6.The side effect of drowsiness in the day and toxicity is agreement with Asian descent (Robert et al., 2017). The patient will have to be place on the same medication till the next visit for examination. The actual result is that the medication is achieving the therapeutic effect that is needed by the patient (Dean, 2017).
Ethical Considerations for Treatment plan Ethics demand that a patient should agree to treatment before it could be administering unto the patient. The law concerning patient’s preferences for treatment are overlook when the patient is in jeopardy of life threatening or severe psychiatric illness. Psychiatric advance directives are employing to make decision on the patient (Srivastava, 2011). When a practitioner treating a patient with bipolar is confronted with ethical conflicts of helping the patient to attain best result or their autonomy. The autonomy will be the choice of the practitioner (Srivastava, 2011). The law clearly stipulate that practitioners should always carefully consider what moral weight should be given to the values of doing well and avoiding harm (U.S. Food and Drug Administration, 2017).
2 Conclusion Psychiatric nurses should assess the function of the client not only during admission even during remission period and plan for rehabilitation services since functioning is a complex and demanding task. However, it is very important to bring back the client to his fullest possible level to normal life by planning effective psychoeducation about illness, communication training and teaching problem solving skills to client and family. 1 Many drugs are available for the treatment of bipolar disorder, but the professional will have to carefully select a medication that will be the best treatment for the patient. It is worth knowing that genetics influences the absorption of drugs, metabolism, excretion, and distribution. In the case study the Asian woman with positive CYP2D6 will exhibit a certain side effect which will not be in a patient with negative CYP2D6 (Dean, 2017). Therefore, the dosage and frequent of dispensing of drugs be based on the genetic testing (National Alliance on Mental Illness, 2017). The treatment of bipolar disorders in Asian descent must be handled carefully and in accordance with the Food and Drug Administration set guidelines (U.S. Food and Drug Administration, 2017). In conclusion the safety of the patient and the life of family and friends should be the paramount concern of the practitioners.
References American Psychiatric Association. (2017). 1 Treatment of Patients with Bipolar Disorder.
Retrieved from: 1http://psychiatryonline.org/pb/assets/raw/sitewide/practice_guidelines/guidelines/bipolar.pdf Dean, L. (2017). 1 Risperidone Therapy and CYP2D6 Genotype. Retrieved from:
1 https://www.ncbi.nlm.nih.gov/books/NBK425795/ Lee, S. Y., Martins, S. S., Keyes, K. M., & Lee, H. B. (2011). 1 Mental Health Service Use by Persons of Asian Ancestry With DSM-IV Mental Disorders in the United States. Psychiatric Services (Washington, D.C.), 62(10), 1180–1186.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3698479/ Nami National Alliance on Mental Illness. (2017). 1 What Is Risperdal and What Does It Treat?
Retrieved from: 1 https://www.nami.org/learn-more/treatment/mental-health-medications/risperidone (Risperdal).
Robert, M., Keck, P., & David Solomon, D. (2017). 1 Bipolar disorder in adults:Choosing maintenance treatment. Retrieved from: 1https://www.uptodate.org/contents/bipolar-isorder-in-adults-choosing-maintenance-treatment Srivastava, S. (2011). Ethics Commentary: Bipolar Disorder: 1 Ethical Considerations in the Treatment of Bipolar Disorder. Retrieved from:
1 https://focus.psychiatryonline.org/doi/abs/10.1176/foc.9.4.foc461?journalCode=foc Stahl, S. M. (2013). 1 Stahl’s essential psychopharmacology: Neuroscientific basis and practical applications (4th ed.). New York, NY: Cambridge University Press.
U.S. 1 Food and Drug Administration. (2017). 1 The Facts on Bipolar Disorder and FDA- Approved Treatments. Retrieved from: 1https://www.fda.gov/ForConsumers/ConsumerUpdates/ucm530107.htm
Review your problem or issue and the study materials to formulate a PICOT question for your capstone project change proposal. A PICOT question starts with a designated patient population in a particular clinical area and identifies clinical problems or issues that arise from clinical care. The intervention used to address the problem must be a nursing practice intervention. Include a comparison of the nursing intervention to a patient population not currently receiving the nursing intervention, and specify the timeframe needed to implement the change process. Formulate a PICOT question using the PICOT format (provided in the assigned readings) that addresses the clinical nursing problem.
The PICOT question will provide a framework for your capstone project change proposal.
In a paper of 500-750 words, clearly identify the clinical problem and how it can result in a positive patient outcome.
Describe the problem in the PICOT question as it relates to the following:
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
Create a 4-6 page paper with you , as a presenter, in which you will propose an evidence-based plan to improve the outcomes for a patient and examine how remote collaboration provided benefits or challenges to designing and delivering the care.
As technologies and the health care industry continue to evolve, remote care, diagnosis, and collaboration are becoming increasingly more regular methods by which nurses are expected to work. Learning the ways in which evidence-based models and care can help remote work produce better outcomes will become critical for success. Additionally, understanding how to leverage EBP principles in collaboration will be important in the success of institutions delivering quality, safe, and cost-effective care. It could also lead to better job satisfaction for those engaging in remote collaboration.
By successfully completing this assessment, you will demonstrate your proficiency in the course competencies through the following assessment scoring guide criteria:
Remote care and diagnosis is a continuing and increasingly important method for nurses to help deliver care to patients to promote safety and enhance health outcomes. Understanding best EBPs and building competence in delivering nursing care to remote patients is a key competency for all nurses. Additionally, in some scenarios, while you may be delivering care in person you may be collaborating with a physician or other team members who are remote. Understanding the benefits and challenges of interdisciplinary collaboration is vital to developing effective communication strategies when coordinating care. So, being proficient at communicating and working with remote health care team members is also critical to delivering quality, evidence-base care.
The Vila Health: Remote Collaboration on Evidence-Based Care simulation provide the context for this assessment.
Before beginning this assessment, make sure you have worked through the following media:
For this assessment, you are a presenter! You will create a 5–10-minute video using Kaltura or similar software. In the video:
Be sure you mention any articles, authors, and other relevant sources of evidence that helped inform your video. Important: You are required to submit an APA-formatted reference list of the sources you cited specifically in your video or used to inform your presentation.
The following media is an example learner submission in which the speaker successfully addresses all competencies in the assessment.
Make sure that your video addresses the following grading criteria:
Your assessment should meet the following requirements:
For this assignment, you are asked to discuss the nursing management of patients (adults including the elderly) with respiratory disorders. Please list Special therapies, alternative therapies, Nursing interventions, and Drugs used to treat the following pediatric conditions.
-Sickle cell disease
-Aplastic anemia
-Iron-deficiency anemia
-Hemolytic anemia
-Fanconi anemia
Beta thalassemia
-Diamond-Blackfan anemia
-Shwachman-Diamond Syndrome
Congenital amegakaryocytic thrombocytopenia
(1 sentence each topic)
Question
Week 6 quiz
Question 1
A 65-year-old woman has an advanced form of rheumatoid arthritis. Her treatment includes a regular dosage of methotrexate. The nurse will advise her to take which of the following vitamin supplements while taking the drug?
A) Vitamin A
B) Vitamin B
C) Vitamin C
D) Vitamin D
Question 2
To minimize the risk of adverse effects of glucagon when given to an unconscious diabetic patient, as the patient regains consciousness, the nurse should
A) administer calcium supplements.
B) position the patient in the side-lying position.
C) administer carbohydrates.
D) monitor for nausea and vomiting.
Question 3
A female patient with a diagnosis of type 1 diabetes mellitus has been experiencing increasing neuropathic pain in recent months, a symptom that has not responded appreciably to conventional analgesics. The patient’s care provider has begun treatment with gabapentin (Neurontin). How is the addition of this drug likely to influence the management of the patient’s existing drug regimen?
A) The patient may be required to temporarily hold her other medications until a stable serum level of gabapentin is achieved.
B) It is unlikely to influence the patient’s other medications because gabapentin does not interact with other drugs.
C) Gabapentin is contraindicated with the use of exogenous insulin.
D) The patient’s medication-related risk for renal failure must be assessed prior to the use of gabapentin.
Question 4
A nurse is caring for a patient who has been diagnosed with hypothyroidism. Levothyroxine (Synthroid) has been prescribed. Before the drug therapy is started, the nurse will assess for which of the following?
A) History of taking anticoagulant drugs
B) Allergy to seafood
C) Hirsutism
D) The patient’s age
Question 5
A nurse is caring for a male patient who has a spinal cord injury due to a motorcycle accident. He has been taking dantrolene (Dantrium) for 2 weeks. The nurse will monitor which of the following?
A) Prothrombin time and partial thromboplastin time
B) Urine specific gravity
C) Alanine aminotransferase and total bilirubin levels
D) Follicle-stimulating hormone levels
Question 6
A nurse is assessing a patient who has come to the emergency department complaining of back spasms. The patient states that he has a history of opioid addiction and does not want to take any drug that “puts me at risk of becoming physically dependent.” Which of the following medications would the nurse question, if ordered?
A) Methocarbamol (Robaxin)
B) Orphenadrine (Norflex)
C) Cyclobenzaprine (Flexeril)
D) Metaxalone (Skelaxin)
Question 7
A 40-year-old woman with a diagnosis of fibromyalgia has been prescribed cyclobenzaprine (Flexeril) as an adjunct to her existing drug regimen. What nursing diagnosis should the nurse prioritize when updating the nursing care plan for this patient?
A) Risk for Injury related to CNS depressant effects
B) Diarrhea related to anticholinergic effects
C) Altered Nutrition, Less than Body Requirements, related to appetite suppression
D) Impaired Swallowing related to increased muscle tone
Question 8
A nurse is working with a 57-year-old man who is a former intravenous drug abuser. He has been prescribed a weekly dosage of methotrexate for his rheumatoid arthritis. Which of the following will the nurse include in her teaching plan for this patient?
A) Avoid high-fat foods
B) Drink plenty of water every day
C) Take the tablets before bedtime
D) Avoid red meat
Question 9
Following an assessment by her primary care provider, a 70-year-old resident of an assisted living facility has begun taking daily oral doses of levothyroxine. Which of the following assessment findings should prompt the nurse to withhold a scheduled dose of levothyroxine?
A) The resident has not eaten breakfast because of a recent loss of appetite
B) The resident’s apical heart rate is 112 beats/minute with a regular rhythm
C) The resident had a fall during the night while transferring from her bed to her bathroom
D) The resident received her annual influenza vaccination the previous day
Question 10
A nurse is caring for a 61-year-old man who has had a severe attack of gout while in the hospital for food poisoning. The nurse administers colchicine intravenously in order to
A) avoid aggravating the gastrointestinal tract.
B) ensure quick distribution of the drug.
C) prevent the risk of infection or bleeding.
D) minimize the risk of depressed bone marrow function.
Question 11
A patient receives 25 units of NPH insulin at 7.AM. At what time of day should the nurse advise the patient to be most alert for a potential hypoglycemic reaction?
A) After breakfast
B) Before lunch
C) Late afternoon
D) Bedtime
Question 12
A male patient is to begin glyburide (Diabeta) for type 2 diabetes. Before the drug therapy begins, a priority action by the nurse will be to assess the patient’s
A) blood pressure.
B) potassium level.
C) use of alcohol.
D) use of salt in his diet.
Question 13
A male patient with a diagnosis of relapsing-remitting multiple sclerosis is in the clinic to discuss with the nurse the possibility of self-administration of glatiramer. During the patient education session for self-administration, the nurse will emphasize
A) the need to rotate the injection site of the drug.
B) the need to avoid crushing the tablet.
C) the need to place the tablet under the tongue.
D) the need to use only the thigh muscle for the drug injection site.
Question 14
A diabetic patient being treated for obesity tells the nurse that he is having adverse effects from his drug therapy. The patient has been taking dextroamphetamine for 2 weeks as adjunct therapy. Which of the following adverse effects would need the nurse’s immediate attention?
A) Decreased libido
B) Increased blood glucose
C) Dry eyes
D) Jittery feeling
Question 15
A patient with diabetes has had a cough for 1 week and has been prescribed a cough syrup (an expectorant). What special instructions should the nurse include in the patient teaching for this situation?
A) Wash hands before and after taking the medicine
B) Keep track of any gastrointestinal tract infections
C) Monitor glucose levels closely
D) Note the time the medicine is taken each day
Question 16
A 13-year-old patient has juvenile arthritis. He has recently had oral surgery and was told by the surgeon to take aspirin for the pain. The nurse will monitor for which of the following?
A) Bronchoconstriction
B) Hepatotoxicity
C) Aplastic anemia
D) Agranulocytosis
Question 17
A nurse has been invited to speak to a support group for persons with movement disorders and their families. Which of the following statements by the nurse addresses the chronic nature of these diseases and the relevant drug therapies?
A) “Drug therapy can consist of one or more drugs to eliminate the symptoms of these diseases.”
B) “Drugs do not cure these disorders; they instead enhance quality of life.”
C) “Persons of all cultures are treated similarly and respond in similar ways to treatment.”
D) “Drugs used to treat these disorders always pose a risk of severe liver and kidney dysfunction.”
Question 18
A patient in need of myocardial infarction prophylaxis has been prescribed sulfinpyrazone for gout. Which of the following will the nurse monitor the patient most closely for?
A) Hypothermia
B) Hypotension
C) Renal dysfunction
D) Bleeding
Question 19
A nurse is developing a care plan for a patient who has multiple sclerosis. An expected outcome for the patient who is receiving glatiramer would be a decrease in
A) chest pain.
B) fatigue.
C) breathing difficulties.
D) heart palpitations.
Question 20
A 32-year-old female patient is taking tizanidine (Zanaflex) for spasticity related to her multiple sclerosis. The nurse will inform the patient and her husband that the adverse effect that poses the greatest safety risk to the patient is
A) constipation.
B) dry mouth.
C) fatigue.
D) hypotension.
Question 21
A 34-year-old male patient is prescribed methimazole (MMI).The nurse will advise him to report which of the following immediately?
A) Vertigo
B) Intolerance to cold
C) Loss of appetite
D) Epigastric distress
Question 22
A 43-year-old woman was diagnosed with multiple sclerosis 2 years ago and has experienced a recent exacerbation of her symptoms, including muscle spasticity. Consequently, she has been prescribed Dantrolene (Dantrium).In light of this new addition to her drug regimen, what teaching point should the woman’s nurse provide?
A) “This will likely relieve your muscle spasms but you’ll probably develop a certain amount of dependence on the drug over time.”
B) “We’ll need to closely monitor your blood sugar levels for the next week.”
C) “There’s a small risk that you might experience some hallucinations in the first few days that you begin taking this drug.”
D) “You might find that this drug exacerbates some of your muscle weakness while it relieves your spasticity.”
Question 23
A patient with type 1 diabetes has been admitted to the hospital for orthopedic surgery and the care team anticipates some disruptions to the patient’s blood glucose levels in the days following surgery. Which of the following insulin regimens is most likely to achieve adequate glycemic control?
A) Small doses of long-acting insulin administered four to five times daily
B) Doses of basal insulin twice daily with regular insulin before each meal
C) Large doses of rapid-acting insulin combined with long-acting insulin each morning and evening
D) Divided doses of intermediate-acting insulin every 2 hours, around the clock
Question 24
During long-term desmopressin therapy in a 48-year-old woman, it will be most important for the nurse to assess which of the following?
A) The patient’s environment
B) The patient’s diet
C) The condition of the patient’s skin
D) The condition of the patient’s nasal passages
Question 25
A 49-year-old woman has been diagnosed with myalgia. The physician has recommended aspirin. The patient is concerned that the aspirin will upset her stomach. The nurse will encourage the patient to
A) crush the tablet before swallowing.
B) swallow the tablet whole.
C) swallow the tablet with milk or food.
D) avoid drinking milk for 3 hours after swallowing the tablet.
Question 26
A nurse will instruct a patient taking allopurinol to take each dose
A) at night.
B) first thing in the morning.
C) after a meal.
D) before a meal.
Question 27
The nurse is conducting a medication reconciliation of a new resident of a long-term care facility. The nurse notes that the resident takes allopurinol on a daily basis for the treatment of gout. What is the primary purpose of this drug?
A) To balance urate concentration and prevent gout attacks
B) To promote the remodeling of damaged synovium
C) To potentiate the metabolism of dietary purines
D) To achieve pain relief in joints affected by gout
Question 28
A nurse is teaching a patient about his newly prescribed drug, colchicine, for gout. The nurse will instruct the patient to avoid which of the following foods?
A) Green beans
B) Shrimp
C) Eggs
D) Milk
Question 29
A nurse is instructing a patient who was recently diagnosed with multiple sclerosis about dantrolene (Dantrium). The patient is a 38-year-old-male and the foreman for a construction company. In order to minimize one important adverse effect of the drug, the nurse will give the patient which of the following instructions?
A) Eat a high-protein diet
B) Decrease the dosage if any adverse effect is experienced
C) Wear appropriate clothing and sunscreen whenever he is in direct sunlight
D) Have a complete blood cell count done weekly
Question 30
A 33-year-old man has developed acute gouty arthritis. He has been prescribed colchicine. When developing a care plan for this patient, which factor will be most important for the nurse to consider?
A) Dietary habits
B) Work environment
C) Typical daily fluid intake
D) Ethnicity
Analysis and Evaluation of Frameworks and Theories
Theory analysis is particularly helpful in research because it provides a clear idea of the form and structure of the theory in addition to the relevance of content, and inconsistencies and gaps present. The ‘missing links’ or inconsistencies are fruitful sources of new research ideas. They also point to the next hypotheses that need to be tested.
—Walker and Avant, 2011, p. 206
Nurse scientists often find that examining the literature is a productive way to see how existing frameworks and theories have been applied in other research studies. By engaging in this process, they may gain insights about a particular framework or theory, be able to identify gaps in research, or uncover new questions they are eager to explore.
In this Discussion, you analyze existing frameworks/theories using the procedure proposed by Walker and Avant. Your analysis should provide an objective understanding of the strengths and weaknesses of each framework or theory. This, in turn, should enable you to evaluate whether the framework/theory is useful for the purposes of your theoretical foundation for a program of research.
To prepare
By Day 3
Post a description of the two frameworks/theories you analyzed and evaluated, and explain why each is considered either a framework or a theory. For framework(s) you have selected, explain which aspects would require further research to meet the requirements of a theory. Explain why one has the most potential for use in your theoretical foundation for research, noting its strengths and weaknesses. Also pose any questions that have arisen through your examination of frameworks/theories.
Read a selection of your colleagues’ postings.
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