Discussion
In this assignment, you will be writing a 1,000-1,250-word essay describing the differing approaches of nursing leaders and managers to issues in practice. To complete this assignment, do the following:

1. Select an issue from the following list: nursing shortage and nurse turn-over, nurse staffing ratios, unit closures and restructuring, use of contract employees (i.e., registry and travel nurses), continuous quality improvement and patient satisfaction, and magnet designation.
2. Compare and contrast how you would expect nursing leaders and managers to approach your selected issue. Support your rationale by using the theories, principles, skills, and roles of the leader versus manager described in your readings.
3. Identify the approach that best fits your personal and professional philosophy of nursing and explain why the approach is suited to your personal leadership style.
4. Identify a possible funding source that addresses your issue. Consider looking at federal, state, and local organizations. For example: There are many grants available through the CDC, HRSA, etc.
5. Use at least two references other than your text and those provided in the course.

Kurt Lewin’s Change Theory in Nursing Essay
Health care organizations are continuously immersed in change from the emergence of new policies, to promote quality care and improve patient safety to keeping pace with the rapid growth in knowledge and best practices. Establishing a solid framework for planning and implementing change is a wise move, as it provides a foundation for the extensive coordination that will be needed to successfully facilitate the change.
For this Kurt Lewin’s Change Theory in Nursing Essay Assignment, you propose a change at the department or unit level and develop a plan for guiding the change effort.
To prepare:
Review Chapter 8 in the course text. Focus on Kurt Lewin’s change theory, and contrast it with other classic change models and strategies.
Reflect on problems, inefficiencies, and critical issues within a specific department, unit, or area in your organization or one with which you are familiar. Select one issue as a focal point for this assignment, and consider a change that could be made to address the issue.
Think about how the change would align with the organization’s mission, vision, and values as well as relevant professional standards.
Using one of the change models or strategies discussed in Chapter 8, begin formulating a plan for implementing the change within the department/unit. Outline the steps that you and/or others should follow to facilitate the change effort. Align these steps to the change model or strategy you selected.
Determine who should be involved in initiating and managing the change. Consider the skills and characteristics that are necessary to facilitate this change effort.
To complete:
Write a 3- to 5-page Kurt Lewin’s Change Theory in Nursing Essay paper that addresses the following:
Identify a problem, inefficiency, or issue within a specific department/unit.
Describe a specific, realistic change that could be made to address the issue.
Summarize how the change would align with the organization’s mission, vision, and values as well as relevant professional standards.
Identify a change model or strategy to guide your planning for implementing the change. Provide a rationale for your selection.
Outline the steps that you and/or others would follow to facilitate the change. Align these steps to your selected change model or strategy.
Explain who would be involved in initiating and managing this change. Describe the skills and characteristics that would be necessary to facilitate the change effort.
Reminder: The School of Nursing requires that all papers submitted include a title page, introduction, summary, and references. The Sample Paper provided at the Writing Center provides an example of those required elements. All papers submitted must use this formatting.
Note: This Kurt Lewin’s Change Theory in Nursing Essay Assignment will serve as your Portfolio Assignment for this course.

Assessment and Care of Patients With Adrenal and Urogynecologic Conditions Essay Assignment Papers

Week 9: Assessment and Care of Patients With Adrenal and Urogynecologic Conditions

From severe abdominal pain to urinary frequency, urinary incontinence, sexual health issues, and the overproduction of hormones, adrenal and urogynecologic symptoms often cause frustration and embarrassment for patients. These feelings might cause patients to hold back information, making assessment and diagnosis of adrenal and urogynecologic conditions challenging. Because patients may require surgery to minimize the impact of these conditions on their daily lives, it is essential that you establish trust with patients and carefully ask questions to quantify complaints appropriately.

This week, as you examine the pre- and post-operative care of patients with adrenals and urogynecology conditions, you explore strategies for assessment, diagnosis, and treatment.
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Learning Objectives

By the end of this week, students will:

• Evaluate medical and surgical patients with adrenal and urogynecologic conditions
• Develop differential diagnoses for medical and surgical patients with adrenal and urogynecologic conditions
• Develop treatment plans for medical and surgical patients with adrenal and urogynecologic conditions

Photo Credit: Andrew Brookes/Cultura/Getty Images. Assessment and Care of Patients With Adrenal and Urogynecologic Conditions Essay Assignment Papers

Required Readings

Colyar, M. R. (2015). Advanced practice nursing procedures (1st ed.). Philadelphia, PA: F. A. Davis Company.

• Chapter 42, “Breast Biopsy (Fine Needle Aspiration)”
• Chapter 44, “Colposcopy (Endocervical Curettage and Cervical Biopsy)”
• Chapter 45, “Endometrial Biopsy”
• Chapter 49, “Bartholin Cyst Abscess (Incision and Drainage)”
• Chapter 51, “Cervical Lesions—Cryotherapy”
• Chapter 52, “Circumcision and Dorsal Penile Nerve Block”
• Chapter 58, “Paracervical Nerve Block”
• Chapter 61, “Vasectomy”

Doherty, G. M. (2015). Current diagnosis and treatment: Surgery (14th ed.). New York, NY: McGraw Hill.

• Chapter 17, “Breast Disorders”
• Chapter 33, “Adrenals”
• Chapter 38, “Urology”
• Chapter 39, “Gynecology”

Weber, E. C., Vilensky, J. A., & Fog, A. M. (2013). Practical radiology: A symptom-based approach. Philadelphia, PA: F. A. Davis Company.
 

• Chapter 7, “Breast”
• Chapter 9, “Male and Female Urinary Tract and Male Genital Tract”
• Chapter 10, “Female Pelvic Imaging”

American Cancer Society. (2014). American Cancer Society guidelines for the early detection of cancer. Retrieved from http://www.cancer.org/healthy/findcancerearly/cancerscreeningguidelines/american-cancer-society-guidelines-for-the-early-detection-of-cancer. Assessment and Care of Patients With Adrenal and Urogynecologic Conditions Essay Assignment Papers

Required Media

i-Human Patient Cases. (2014). Retrieved from https://ih2.i-human.com/users/sign_in

Optional Resources

Massad, L. S., Einstein, M. H., Huh, W. K., Katki, H. A., Kinney, W. K., Schiffman, M. … Lawson, H. W. (2013). 2012 updated consensus guidelines for the management of abnormal cervical cancer screening tests and cancer precursors. Journal of Lower Genital Tract Disease, 17(5), S1–S27.

Discussion Part I: Assessment and Care of Patients With Adrenal and Urogynecologic Conditions

Many genitourinary (GU) disorders such as kidney disease start developing during adolescence (Johns Hopkins Children’s Center, 2010). This early onset of disease makes it essential for you, as the advanced practice nurse caring for adolescent patients, to identify potential signs and symptoms. Although some adolescent GU disorders require long-term treatment and management, other disorders such as urinary tract infections are more common and frequently require only minor interventions. In your role with adolescent patients, you must evaluate symptoms and determine whether to treat patients or refer them for specialized care. For this Discussion, consider potential diagnoses, treatment, and/or referral options for the patients in the following 3 case studies. Assessment and Care of Patients With Adrenal and Urogynecologic Conditions Essay Assignment Papers

Case Study 1

Alicia is an 18-year-old female who is brought into urgent care by her mother. She is complaining of dizziness. She recently started to lift weights for softball season. She has been healthy up to this point. Vitals are: temp 101.9°F, HR 120, RR 24, BP 90/54. She has lower extremity edema and decreased skin turgor. She states that her shoulders, thighs, and lower back hurt. She is having trouble moving her arms and legs. She also complains of vague abdominal pain, with nausea and vomiting. Labs came back with CK 10,000, uric acid 40 mg/dl, WBC 14.3, BUN:creatinine ratio 6:1, K 5.8. Urinalysis shows a presence of myoglobin of more than 25. Assessment and Care of Patients With Adrenal and Urogynecologic Conditions Essay Assignment Papers

Case Study 2

Mark is a 15-year-old male with a complaint of acute left scrotal pain with nausea. The pain began approximately 6 hours ago as a dull ache and gradually has worsened such that he can no longer stand without doubling over. He is afebrile and in marked pain. Physical exam results are negative except for elevation of the left testicle, diffuse scrotal edema, and the presence of a blue dot sign. Assessment and Care of Patients With Adrenal and Urogynecologic Conditions Essay Assignment Papers

Case Study 3

Maya is a 16-year-old female who presents to the ER for urinary pain. She is a healthy adolescent with complaints of lower abdominal pain, low back pain, and burning with urination. She had a fever of 102°F at home. Physical examination results are normal. Routine urinalysis indicates 2+ proteinuria; specific gravity 1.020; negative for glucose, blood. Leukocytes are moderate and nitrites, moderate. Her blood pressure is normal, and she is at the 60th percentile for height and weight. Vitals are: temp 103.1°F, HR 116, RR 18, BP 100/58. P Ox is 98% (Johns Hopkins Children’s Center, 2010).
To prepare:

• Review and select 1 of the 3 provided case studies. Analyze the patient information.
• Consider a differential diagnosis for the patient in the case study you selected. Think about the most likely diagnosis for the patient.
• Think about a treatment and management plan for the patient. Be sure to consider appropriate dosages for any recommended pharmacologic and/or nonpharmacologic treatments.
• Consider strategies for educating patients and families on the treatment and management of the genitourinary disorder.

By Day 3

Post an explanation of the differential diagnosis for the patient in the case study you selected. Explain which is the most likely diagnosis for the patient and why. Include an explanation of unique characteristics of the disorder you identified as the primary diagnosis. Then, explain a treatment and management plan for the patient, including appropriate dosages for any recommended treatments. Finally, explain strategies for educating patients and families on the treatment and management of the genitourinary disorder. Assessment and Care of Patients With Adrenal and Urogynecologic Conditions Essay Assignment Papers
Read a selection of your colleagues’ responses.

By Day 6

Respond to at least two of your colleagues on 2 different days in both of the ways listed below. Respond to colleagues who selected different case studies from yours. Assessment and Care of Patients With Adrenal and Urogynecologic Conditions Essay Assignment Papers

• Describe how culture might affect the diagnosis, management, and follow-up care of patients with the genitourinary disorders your colleagues discussed.
• Based on your personal and/or professional experiences, expand on your colleagues’ postings by providing additional insights or different perspectives.​

Discussion Part II: Pharmacology

Read the following articles to enhance your knowledge of commonly prescribed medications:

Daley, B. (2015, February 23). Peritonitis and abdominal sepsis. Retrieved from http://emedicine.medscape.com/article/180234-overview

Shahedi, K., Chudasama, Y. N., Dea, S. K., & Cooperman, A. (2015, January 14). Diverticulitis treatment and management. Retrieved from http://emedicine.medscape.com/article/173388-treatment

Tobias, J. D., & Leder, M. (2011). Procedural sedation: A review of sedative agents, monitoring, and management of complications. Saudi Journal of Anasthesia, 5(4), 395–410. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3227310/

All of the following groups of medications are commonly prescribed in the acute care setting. Choose one of the topics below to discuss. If it is a medication group, select a specific drug within that group. (This is a good way for you to prepare for clinical practice, because you will get to know the drugs you will prescribe for patients.). Focus your discussion on the hospital or ICU setting and IV usage.

• Sedation
  1. Diazepam
  2. Fentanyl
  3. Ketamine
  4. Lorazepam
  5. Midazolam
  6. Propofol
  7. Benzodiazepines
• Nonsedation
  7. Chlorpromazine
  8. Peritonitis—what antibiotics are chosen for peritonitis?
  9. Nerve blocks—what drugs are used with nerve blocks?
  10. Diverticulitis—what drugs are used with diverticulitis?

Note: When sharing your initial post, select a topic that has not yet been discussed. If all topics have been discussed, then you may select that topic again, but select a different drug within the medication group. Assessment and Care of Patients With Adrenal and Urogynecologic Conditions Essay Assignment Papers

By Day 3

For this Discussion, address 1 of the following options:

Option 1

Post a description of a patient you have taken care of (inpatient as an RN, or as an NP student) who has been prescribed the medication you selected. Include the scenario, indication, dosing, complications, and outcome. Then explain whether or not you would have ordered the same drug and same dose.

Option 2

Conduct an evidence-based drug search on the drug you selected and post an explanation of any possible issues. Are there any drug interactions? Any black box warnings? To what type of patient would you prescribe this medication?

Option 3

Post an explanation of the properties of the drug you selected, including usages and dosing in the hospital or ICU. Describe a patient to whom you would prescribe this medication.

Note: To be considered as one of your required responses, your pharmacology rationale must include a supporting reference.

Note: For this Discussion, you are required to complete your initial post before you will be able to view and respond to your colleagues’ postings. Begin by clicking on the “Post to Discussion Question” link and then select “Create Thread” to complete your initial post. Remember, once you click on Submit, you cannot delete or edit your own posts, and you cannot post anonymously. Please check your post carefully before clicking on Submit! Assessment and Care of Patients With Adrenal and Urogynecologic Conditions Essay Assignment Papers

Submission and Grading Information

Grading Criteria

Week 9 Discussion Rubric

Post by Day 3 and Respond by Day 6

To participate in this Discussion:
Week 9 Discussion

Assignment: Assessing, Diagnosing, and Treating Pre- and Post-Operative Care Patients – Adrenal and Urogynecologic Conditions

While some adrenal and urogynecologic conditions are specific to male or female patients, many are common among both. The presentations of these common conditions, however, can vary greatly depending on sex. Because such variations may lead to challenges in assessment and diagnosis, it is essential for you to have strong examination and diagnostic skills. For this Assignment, as you examine this week’s i-Human patient case study, consider how you might evaluate and treat pre- and post-operative patients who present with adrenal and urogynecologic conditions.
To prepare:

• Review this week’s Learning Resources. With adrenal and urogynecologic conditions in mind, consider how to assess, diagnose, and treat patients in pre- and post-operative care.
• Review this week’s i-Human case study. Based on the patient information provided, think about the health history you would need to collect from the patient.
• Consider what physical exams and diagnostic tests would be appropriate to gather more information about the patient’s condition. Reflect on how the results would be used to make a diagnosis.
• Identify three to five possible conditions to consider in a differential diagnosis for the patient.
• Consider the patient’s diagnosis. Think about clinical guidelines that might support this diagnosis.
• Develop a treatment plan for the patient that includes health promotion and patient education strategies for medical and surgical patients with adrenal and urogynecologic conditions. Assessment and Care of Patients With Adrenal and Urogynecologic Conditions Essay Assignment Papers

To complete:
As you interact with this week’s i-Human patient, complete the assigned case study. For guidance on using i-Human, refer to the i-Human Patients Case Player Student Manual in the Week 2 Learning Resources.
Assessment and Care of Patients With Adrenal and Urogynecologic Conditions Essay Assignment Papers

Assessment and Care of Patients With Adrenal and Urogynecologic Conditions Essay Assignment Papers

Assessment and Care of Patients With Adrenal and Urogynecologic Conditions Essay Assignment Papers

Biology Lab: Forces of Evolution
Question 1
Report the calculated survival frequencies (these will be in decimal form) of each phenotype of shell bugs at each generation for Exercise 2A and 2B. Two simple tables would be preferred.
Question 2
The procedure asked you to graph the survival frequencies of the two phenotypes of shell bug for the two different sized populations. Look at the two graphs that you plotted for Exercise 2A and 2B. Consider their similarities and differences. Explain how genetic drift effects the phenotype proportions differently in the large (150) population and the small (50) population. Do the different phenotypes trend steadily up or down or do they fluctuate? Do they stay the same over the generations? Consider each of these question for each sized population.
Question 3
Write a Discussion/Conclusion to Exercise 1. An appropriate discussion is a paragraph or two that includes identification and restatement of the hypothesis, a sentence that definitively states whether or not your data supported (NOT PROVED) your hypothesis followed by specific examples from your data that defends that statement of support of lack of support. There should be an explanation of the concept being investigated (how predators can influence a phenotype frequency), and finally describe anything that occurred during the experiment that may have biased your results (i.e. trouble with calculations, dog ate your data sheet, children at your shell bugs, etc.) This question is worth 4 points. You should have at least four sentences.
Question 4
Evolution is defined in your lab procedures a “changes in the frequency of a particular phenotype over several generations”. Look at your data table for Exercise 1. Did your population of shell bugs should undergo evolution. How do you know?
Question 5
What “force” or mechanism for evolution is demonstrated in Exercise 1?
Question 6
Report the calculated survival frequencies (these will be in decimal form) of each phenotype of shell bugs at each generation of Exercise 1. A simple table format would be preferred.
Question 7
From reading your procedures and textbook on the topic, what size population, large (150) or small (50) is more likely to be influenced by genetic drift? Did your results reflect this?
Question 8
Some examples of “artificial” selection might be
a. development of “tea-cup” poodles
b. the creation of dinosaurs that occurred long ago
c. development of drought-resistant corn
d. breeding of race horses
e. breeding of hairless cats
Question 9
Genetic drift is most significant for ____ populations.
a. small
b. all of these are equal
c. medium-sized
d. large
Question 10
How would biologists determine if a population is evolving?
Question 11
Biologists consider evolution to be
a. just a theory
b. some relatively insignificant thinking
c. a fundamental part of the biological sciences
d. a hypothesis
Question 12
Genetic drift is defined as random changes that can occur in a population’s allele frequency. In this case, _______________ would not play a role in the reproductive success of individuals
a. bottleneck affect
b. different phenotypes
c. inbreeding
d. storms and other natural disasters
Question 13
Charls Darwin suggested _______________ as a mechanism that causes evolution.
a. artificial selection
b. natural selection
c. genetic drift
Chapter 16 Ecology(Biology)
Question 1
Describe a mutualistic interaction between two (or more) species.
Question 2
What is an ecological pyramid, and why does it narrow toward the top? Describe the pathway of energy flow through the ecosystem.
Question 3
What is a niche?
A. A mating system in which one male mates with several females
B. An example of population cycling
C. An evolutionary arm race
D. A plant structure containing many flowers
E. The particular set of resources a species uses
Question 4
Describe the pathway and main resevoir of the following: (a) the carbon cycle, (b) the oxygen cycle, and (c) the nitrogen cycle. what are these cycles known as?
Question 5  
What is the competitive exclusion principle?

Chapter 17 Biodiversity and Human Affairs
Question 1
What is the Blitzkrieg Hypothesis? List one alternative hypothesis that could account for the same phenomenon. Why are we considered to be living in the 6th mass extinction, in other words, what are the two main factors leading to this event?
Question 2  
What is one possible effect of removing a keystone species from an ecosystem?

Question 3  
What are the three main components of biodiversity?

Question 4
Define the following terms: species richness, species abundance, and species evenness. Which of the following hypothesis best supports biodiversity and why?: Climate Hypothesis, Productivity Hypothesis, Stability Hypothesis
Question 5
Describe what have ecologists learned about the relationship between biodiversity and the stability of an ecosystem? How does this relate to the spotted owl controversy?
Chapter 18 Human Population Growth
Question 1
Why does a population size level off as it approaches carrying capacity? What is the difference in carrying capacity between a population experiencing exponential growth to one experiencing logistic growth?
Question 2
What are the four factors that determine a population’s growth rate?

Question 3
What information is shown in an age pyramid?

Question 4  
Briefly explain two reasons why a government would want an accurate census of its population.
Question 5
What are density-dependent factors? Give examples of potential density-dependent factors for a top predator, like a wolf, and a hibernating creature, like a bear. How did Thomas Malthus influence Darwin’s development of the Theory of Evolution?
Lab: Biodiveristy and Evolution

Question 1

1.  Do birds have anything in common with dinosaurs?

Question 2

1.  With which archaic human species did some of the ancestors of modern Europeans interbreed during the past 100,000 years?

Question 3

1.  What can you infer from the tree you just built with the primate skulls?

Question 4

1.  What trait to the Stick Insect, Goldfish, Kingsnake, and Dog all have in common?

Question 5

1.  What is the first trait that helped aquatic species evolve into creatures that live on land?

Question 6

1.  Which of the following species does not have tail flukes?

Question 7

1.  Is an animal or a plant more closely related to a fungus?

Question 8

1.  In 2013, scientists found that coelacanths are not the closest relative of four-footed amphibians and other animals. Which species is?

Question 9

1.  Based on the tree you have constructed, who is your closest living relative

Question 10

1.  The DNA sequence of the West Indian Ocean coelacanth is closest to which species?

Question 11

1.  If a new species of honeycreeper were discovered, and it had a short, straight beak, which bird in this puzzle would likely be its closest living relative?

Question 12

1.  Which ape virus is most closely related to the HIV virus that has killed about 39 million people due to AIDS

Question 13

1.  Is a banana more closely related to a lemon or an onion?

Question 14

1.  Which antivenom will save Tyler?

Question 15

1.  What is one possible evolutionary inference scientist can make using the DNA from a tree in South American that is genetically similar to one in Australia?

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