NUR-621-D4Q1R2

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Minimum of 250 words with at least 2 peer review reference in 6th edition apa style.

 What were the positives, and are there any negative issues with any aspects of EHR? 

Benchmark – Research Critiques and PICOT Statement Final Draft

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 Details:

Prepare this assignment as a 1,500-1,750 word paper using the instructor feedback from the Topic 1, 2, and 3 assignments and the guidelines below.

PICOT Statement 

Revise the PICOT statement you wrote in the Topic 1 assignment.

The final PICOT statement will provide a framework for your capstone project (the project students must complete during their final course in the RN-BSN program of study).

Research Critiques

In the Topic 2 and Topic 3 assignments you completed a qualitative and quantitative research critique. Use the feedback you received from your instructor on these assignments to finalize the critical analysis of the study by making appropriate revisions.

The completed analysis should connect to your identified practice problem of interest that is the basis for your PICOT statement.

Refer to “Research Critique Guidelines.” Questions under each heading should be addressed as a narrative in the structure of a formal paper.

Proposed Evidence-Based Practice Change

Discuss the link between the PICOT statement, the research articles, and the nursing practice problem you identified. Include relevant details and supporting explanation and use that information to propose evidence-based practice changes.

Prepare this assignment according to the APA 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.

Need help writing nursing research paper

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Rubric attached below

Paper must be in APA format

Needs 3 pages excluding title and reference pages

Topic: Pressure Ulcer

Please review rubric

Assignments

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Two nursing students cheated on several assignments.  Although the evidence is irrefutable, both students deny cheating.  Discuss these students in terms of virtue ethics.  Do these students have integrity?  Do these students have the character to become good nurses? Should the instructor allow them another chance? 

APA FORMAT with REFERENCE

db menopause 2 replies

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Reply Hollie 

Although there are still many things we do not understand about sleep, it is well known that there are numerous health concerns that can result from inadequate sleep (Hackley & Kriebs, 2017). Both short-term and long-term consequences can result from sleep disturbances. Short-term consequences of inadequate sleep include: increased stress response, headaches, abdominal pain, mood disorders, fatigue, and decreased cognitive performance (Medic, Wille, & Hemels, 2017). Women with sleep issues during perimenopause and menopause are likely to suffer sleep disturbances for an extended period of time due to hot flashes, night sweats, and other factors (Hackley & Kriebs, 2017). These extended episodes of poor sleep may increase the risk of developing long-term consequences. One long term consequence of inadequate sleep is cardiovascular disease (Medic et al., 2017). Long-term sleep issues are associated with hypertension, higher cholesterol levels, increased atherosclerosis risk, and increased risk of myocardial infarction (Medic et al., 2017). Metabolic issues are also associated with long-term sleep disturbances (Medic et al., 2017). Sleep loss is known to affect energy metabolism, which can ultimately impair insulin sensitivity and increase food intake (Medic et al., 2017). These factors are known to contribute to type 2 diabetes and obesity (Medic et al., 2017). A third health concern of long-term sleep disturbance is the development of different types of cancers (Medic et al., 2017). Melatonin, an important hormone involved in the circadian rhythm and in sleep, has numerous important properties including DNA repair, inhibition of tumor growth, and scavenging free radicals (Medic et al., 2017). During clinic visits, it is always important to take the time to revisit healthy bedtime habits. It is always my goal to avoid medication unless absolutely necessary. Sometimes by revisiting healthy routines or discussing nonpharmacological interventions, patients can see great improvement in their sleep. Some basic sleep hygiene interventions include: having a consistent bed time; choosing relaxing activities before bed; avoiding alcohol, coffee, tea, or other stimulants 4 to 6 hours before bed; avoiding smoking before bed; avoiding heavy meals or spicy foods before bed; increasing daytime physical activity; and creating a comfortable sleeping environment (Santos et al., 2018). Patient should be encouraged to read or journal before bed instead of using electronic devices (Santos et al., 2018). Cognitive behavioral therapy has also been proven effective for treating insomnia (Santos et al., 2018).

References

Hackley, B. K., & Kriebs, J. M. (2017). Primary care of women(2nd ed.). Burlington, MA: Jones & Bartlett Learning.Medic, G., Wille, M., & Hemels, M. E. (2017). Short- and long-term health consequences of sleep disruption. Nature and science of sleep, 9, 151–161. doi:10.2147/NSS.S134864

Santos, M., Conceição, A., Ferretti-Rebustini, R., Ciol, M. A., Heithkemper, M. M., & Cruz, D. (2018). Non-pharmacological interventions for sleep and quality of life: A randomized pilot study. Revista Latino-Americana de Enfermagem, 26, e3079. doi:10.1590/1518-8345.2598.3079

Reply Hollie 

Women experiencing perimenopause and menopause often report sleep disturbances. Identify three health concerns related to inadequate sleep and clinically relevant interventions to address these concerns.

Perimenopause                  As a 54-year-old woman currently in perimenopause, I can attest to sleep disturbances. For about a month this past year, I had hot flashes and insomnia. It miraculously all went away, I’m hoping for good. Getting a full night’s rest is so wonderful when you have experienced the opposite. As I’ve learned from my preceptor, you have to have 1 full year with absolutely no bleeding before considered in full menopause; a chapter that I’m sure is in my future.

Inadequate sleep Depression and Anxiety Baker, Zambotti, Colrain, and Bei, (2018) discuss the relationship between sleep problems with menopausal women and depression. In general, depression increases in menopausal women but the tendency is more with women who are sleep deprived (Baker, Zambotti, Colrain, & Bei, 2018). Once study showed that women who have difficulty getting to sleep have more problems with anxiety and those who have their sleep interrupted have problems with depression (Baker, Zambotti, Colrain, & Bei, 2018). The authors discuss the fact that the circadian rhythm, interrupted during sleep deprivation, plays a role in depression in anxiety (Baker, Zambotti, Colrain, & Bei, 2018).To treat insomnia and depressive symptoms during menopause, there are a few options. Hormone replacement therapy (HRT), serotonin reuptake inhibitors, and behavioral therapy have been investigated (Baker, Zambotti, Colrain, & Bei, 2018). Supplements such as soy isoflavones have assisted in reducing menopausal symptoms including sleep deprivation in some women (Baker, Zambotti, Colrain, & Bei, 2018).

Cardiovascular challengesSleep problems interrupt the efficient automaticity of the cardiovascular system and cardiovascular recovery (Baker, Zambotti, Colrain, & Bei, 2018). Insomnia, specifically the shortened amount of sleep has been associated with coronary heart disease, heart failure, hypertension, and acute coronary syndrome (Javaheri & Redline, 2017). Cardiovascular problems are more prevalent when insomnia is chronic; lasting more than three months (Javaheri & Redline, 2017).Behavioral therapy has been known to not only assist with insomnia but with corresponding cardiovascular disease as well (Baker, Zambotti, Colrain, & Bei, 2018).

Physiologic changes in Inflammation and Immune FunctionAukley (2018) discusses the relationship between sleep deprivation and immune function. In studies involving animal models there was shown to be a link between impaired immune function and a loss of sleep (Aukley, 2018). Asif, Iqbal, and Nazir (2017) inform us that wakefulness, rapid eye movement and non-rapid eye movement regulate the immune response. Inflammatory mediators increase in response to sleep loss (Asif, Iqbal, & Nazir, 2017).In addition to regulation of sleep, melatonin, a pineal hormone plays a role in immune system regulation (Jehan et al., 2017). Melatonin has been known to assist with sleep deprivation and related immune challenges (Jehan et al., 2017)

.References

Asif, N., Iqbal, R., & Nazir, C. F. (2017). Human immune system during sleep. American journal of clinical and experimental immunology, 6(6), 92–96.Aukley, D. (2018). Poor sleep in the hospital: Contributing factors and interventions. Retrieved from https://www.uptodate.com/contents/poor-sleep-in-the-hospital-contributing-factors-and-interventions?search=inadequate sleep&source=search_result&selectedTitle=2~150&usage_type=default&display_rank=2Baker, 

F. C., de Zambotti, M., Colrain, I. M., & Bei, B. (2018). Sleep problems during the menopausal transition: prevalence, impact, and management challenges. Nature and science of sleep, 10, 73–95. doi:10.2147/NSS.S125807Javaheri, S., & Redline, S. (2017). Insomnia and Risk of Cardiovascular Disease. Chest, 152(2), 435–444. doi:10.1016/j.chest.2017.01.026Jehan, 

S., Jean-Louis, G., Zizi, F., Auguste, E., Pandi-Perumal, S. R., Gupta, R., … Brzezinski, A. (2017). Sleep, Melatonin, and the Menopausal Transition: What Are the Links?. Sleep science (Sao Paulo, Brazil), 10(1), 11–18. doi:10.5935/1984-0063.20170003

COMMUNITY AND PUBLIC HEALTH(discussion 4 topic 1)

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 Research the delivery, finance, management, and sustainability methods of the U.S. health care system. Evaluate the effectiveness of one or more of these areas on quality patient care and health outcomes. Propose a potential health care reform solution to improve effectiveness in the area you evaluated and predict the expected effect. Describe the effect of health care reform on the U.S. health care system and its respective stakeholders. Support your post with a peer-reviewed journal article. 

(References needed)

Module 10 Discussion – Advanced Directives

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Investigate the different advanced directives in your text and online for your state. Write at least 2 paragraphs on why you think advanced directives are important or not important in end-of-life decisions. Include which of the advanced directives you would choose to adopt regarding your own end-of-life care and explain why you chose it/them. Please APA Formatting Reference

SFLT-Endocrine part 3

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The form attached is to be filled out on each one of these condition for a total of FIVE separate assignment please save each one under the specified condition name. 

  

Obesity

Anorexia nervosa

Bulimia nervosa

Binge eating

Polycystic ovarian syndrome (PCOS)

Discussion Topic/ Topic reading

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This is a discussion post, about 250 words, tittle page not require In- text citation is required original work please, reference source.

QUESTION

What aspects of the topic readings do you find the most interesting? What is your view of the analysis of disease and healing in the readings? Explain. ( Read introduction and chapter 1)

DQ1WK3 ans Stephanie

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From Medicine Men before Christianity began to today, there has been much change.  There are similarities of past nursing practice to present, but the scope of practice has changed (Spector, 2004), (Chapter 2 History of Professional Nursing by Stacey Whitney, 2018).  Key leaders in this change would start with Florence Nightingale in 1837, where she began the change in a hospital in Turkey (Cohen, 1984).  There she and her nurses took care of the wounded soldiers in unsanitary conditions.  She felt a change in environment was needed in order to decrease the death rate of infections.  It was because she took the leadership role to request a change and formed research and data analysis to convince those that could help her implement the environmental change (Cohen, 1984).  She then wrote a book of her experiences and founded a school in London in 1859, called the Nightingale Training School for Nurses (Cohen, 1984).  In 1867-1940, Mary Brewster and Lillian Wald founded a Visiting Service of New York and the Henry Street Settlement House.  The Settlement House was where they cared for poor immigrants.  Lillian Wald also helped student absenteeism in New York Schools due to sickness, to decrease by having one of her nurses, Lina Rogers, to be responsible for the care of the poor sick children in their homes so that they may return to school.  With nursing services needed in the American Civil War (1821-1912), Clara Barton volunteered and became the founder of the American Red Cross.  With the difference she made in the military, military officials saw the need and convinced Congress to allow trained female nurses to be members of the military.  It was in (1862-1919) that Jane Delano founded the American Red Cross Nursing Service (Sarnecky, 1999).  As the advancement of nursing continued, the need for professional nursing education was recognized during the Civil War.  Linda Richards became the first graduate as a professional trained American nurse.  By the early 1913, Nurse training programs was on the rise in the United States and Japan where Linda Richards began nurse training programs (Faison, 2012).

This history is the reason for the advancement of nursing practice.  With research and evidence of conditions and needs to ensure quality care of patients, and the foundation of focus on health promotion, disease prevention, and risk reduction. Nursing practice has taken this foundation and moved forward with understanding the importance of continuing education, the use of technology, and the importance of continuing research for the purpose of quality care and future knowledge of even better ways to meet the needs of the patients and ensure positive outcomes.