Hormone Replacement Therapy a Controversial Issue In recent years, hormone replacement therapy has become a controversial issue.
Hormone Replacement Therapy a Controversial Issue
When prescribing therapies, advanced practice nurses must weigh the strengths and limitations of the prescribed supplemental hormones. If advanced practice nurses determine that the limitations outweigh the strengths, then they might suggest alternative treatment options such as herbs or other natural remedies, changes in diet, and increase in exercise.
Hormone Replacement Therapy a Controversial Issue Scenario
Consider the following scenario:
As an advanced practice nurse at a community health clinic, you often treat female (and sometimes male patients) with hormone deficiencies. One of your patients requests that you prescribe supplemental hormones. This poses the questions: How will you determine what kind of treatment to suggest? What patient factors should you consider? Are supplemental hormones the best option for the patient, or would they benefit from alternative treatments?
Hormone Replacement Therapy a Controversial Issue Chapter Review
To prepare:
Review Chapter 56 of the Arcangelo and Peterson text, as well as the Holloway and Makinen and Huhtaniemi articles in the Learning Resources.
Review the provided scenario and reflect on whether or not you would support hormone replacement therapy.
Locate and review additional articles about research on hormone replacement therapy for women and/or men. Consider the strengths and limitations of hormone replacement therapy.
Based on your research of the strengths and limitations, again reflect on whether or not you would support hormone replacement therapy.
Consider whether you would prescribe supplemental hormones or recommend alternative treatments to patients with hormone deficiencies.
With these thoughts in mind:
Post a description of the strengths and limitations of hormone replacement therapy. Based on these strengths and limitations, explain why you would or why you would not support hormone replacement therapy. Explain whether you would prescribe supplemental hormones or recommend alternative treatments to patients with hormone deficiencies and why.
Neurological System and Drug Misuse According to an article published in the Los Angeles Times, drug misuse is the leading cause of accidental death in the United States. Some of the most common drugs found in association with drug-related deaths are drugs prescribed to treat neurological disorders.
Neurological System and Drug Misuse
These prescription drug-related deaths are often attributed to painkillers such as OxyContin and Vicodin, as well anti-anxiety drugs such as Valium and Xanax (Girion, Glover, & Smith, 2011).
Neurological System and Drug Misuse and Prescription
This issue emphasizes the importance of the regulation and management of prescription drugs. You must be aware of this when prescribing controlled drugs commonly used to treat neurological disorders such as headaches, sleep disorders, anxiety, and depression. As an advanced practice nurse, you have the responsibility to carefully diagnose and prescribe treatment, as well as to closely monitor the effects of drug therapies on the physical and mental health of your patients.
In the previous weeks of this course, you began to explore disorders and treatments as they relate to specific body systems. This week, you continue this exploration with the nervous system, but with special considerations in mind. Treatments for nervous system disorders present unique issues not just because of the scope and breadth of the disorders, but also because the types of drugs that are often used for treatment. You examine types of drugs prescribed to treat neurological disorders, as well as the impact of patient factors on the effects of the drugs.
Neurological System and Drug Misuse Learning Objectives
By the end of this week, students will:
Analyze types of drugs prescribed to treat neurological disorders
Evaluate the impact of patient factors on the effects of prescribed drugs for neurological disorders
Evaluate drug therapy plans for neurological disorders
Analyze patient education strategies for treatment and management of neurological disorders
Understand and apply key terms, concepts, and principles related to prescribing drugs to treat neurological disorders
Photo Credit: akindo/DigitalVision Vectors/Getty Images
Learning Resources
This page contains the Learning Resources for this week. Be sure to scroll down the page to see all of this week’s assigned Learning Resources. To access select media resources, please use the media player below.
Neurological System and Drug Misuse Required Readings
Arcangelo, V. P., Peterson, A. M., Wilbur, V., & Reinhold, J. A. (Eds.). (2017). Pharmacotherapeutics for advanced practice: A practical approach (4th ed.). Ambler, PA: Lippincott Williams & Wilkins.
Chapter 7, “Principles of Pharmacology in Pain Management” (pp. 93-109)
This chapter begins by examining acute and chronic pain. It also explores the pathophysiology of pain, general principles for managing pain, and drugs used in pain management.
Chapter 38, “Headaches” (pp. 629-654)
This chapter covers the causes, pathophysiology, and diagnostic criteria for tension and migraine headaches. It then outlines the process of selecting, administering, and managing drug therapy for headaches, including migraines and cluster headaches.
Chapter 39, “Seizure Disorders” (pp. 655-680)
This chapter explores the causes, pathophysiology, and diagnostic criteria of seizures. It also describes the process of selecting, administering, and managing drug therapy for patients with seizures.
Chapter 40, “Major Depressive Disorder” (pp. 681-699)
This chapter begins by identifying the causes, pathophysiology, and diagnostic criteria of major depressive disorder (MDD). It then examines types of depressions and drugs prescribed to treat patients suffering from MDD.
Chapter 41, “Anxiety” (pp. 701-718)
This chapter examines the causes, pathophysiology, and diagnostic criteria for anxiety. It also outlines the process of selecting, administering, and managing drug therapy for patients with anxiety.
Chapter 42, “Insomnia and Sleep Disorders” (pp. 721-755)
This chapter covers the causes, pathophysiology, and diagnostic criteria of three sleep disorders: insomnia, restless leg syndrome and periodic limb movement disorder, and narcolepsy. It also examines the process of selecting, administering, and managing drug therapy for patients with these sleep disorders.
Chapter 44, “Alzheimer’s Disease” (pp. 757-780)
This chapter examines the causes and pathophysiology of Alzheimer’s disease (AD). It also describes various drugs used to treat symptoms of AD, including proper dosages and possible adverse reactions.
American Academy of Family Physicians. (2012). Dementia. Retrieved from http://www.aafp.org/afp/topicModules/viewTopicModule.htm?topicModuleId=5
This website provides information relating to diagnosis, treatment, and patient education of dementia. It also presents information on complications and special cases of dementia.
Drugs.com. (2012). Retrieved from http://www.drugs.com/
This website presents a comprehensive review of prescription and over-the-counter drugs including information on common uses and potential side effects. It also provides updates relating to new drugs on the market, support from health professionals, and a drug-drug interactions checker.
Required Media
Laureate Education, Inc. (Executive Producer). (2012). Pharmacology for the nervous system. Baltimore, MD: Author.
This media presentation outlines drug treatment options for disorders of the nervous system.
Note: The approximate length of this media piece is 7 minutes.
Optional Resources
Refer to the Optional Resources listed in Week 1.
The Ethics and Legalities of Medication Error Disclosure American writer Nikki Giovanni once said: “Mistakes are a fact of life. It is the response to the error that counts” (Goodreads, 2012).
The Ethics and Legalities of Medication Error Disclosure
Whenever you make an error when writing a prescription, you must consider the ethical and legal implications of your error—no matter how seemingly insignificant it might be. You may fear the possible consequences and feel pressured not to disclose the error. Regardless, you need to consider the potential implications of non-disclosure. How you respond to the prescription error will affect you, the patient, and the health care facility where you practice. In this Assignment, you examine ethical and legal implications of disclosure and nondisclosure of personal error.
Consider the following scenario:
You are working as an advanced practice nurse at a community health clinic. You make an error when prescribing a drug to a patient. You do not think the patient would know that you made the error, and it certainly was not intentional.
To prepare:
Consider the ethical implications of disclosure and nondisclosure.
Research federal and state laws for advanced practice nurses. Reflect on the legal implications of disclosure and nondisclosure for you and the health clinic.
Consider what you would do as the advanced practice nurse in this scenario including whether or not you would disclose your error.
Review the Institute for Safe Medication Practices website in the Learning Resources. Consider the process of writing prescriptions. Think about strategies to avoid medication errors.
The Ethics and Legalities of Medication Error Disclosure Assignment Description
Write a 2- to 3- page paper that addresses the following:
Explain the ethical and legal implications of disclosure and nondisclosure. Be sure to reference laws specific to your state.
Describe what you would do as the advanced practice nurse in this scenario including whether or not you would disclose your error. Provide your rationale.
Explain the process of writing prescriptions including strategies to minimize medication errors.
Reminder: The School of Nursing requires that all papers submitted include a title page, introduction, summary, and references. The Sample Paper provided at the Walden Writing Center provides an example of those required elements (available at http://writingcenter.waldenu.edu/57.htm). All papers submitted must use this formatting.
3: Cardiovascular System
Alterations of the cardiovascular system can cause serious adverse events and may lead to death when not treated in a timely and safe manner. Unfortunately, many patients with cardiovascular disorders are unaware until complications appear. Consider hypertension. An estimated 68 million people in the United States have this disorder (CDC, 2012). However, about 30 percent of these patients are not treated at all, and of those who are treated, less than 50 percent have properly controlled blood pressure levels (University of Maryland Medical Center, 2009). In clinical settings, patients often present with symptoms of hypertension and other cardiovascular disorders making it essential for you, as the advanced practice nurse, to be able to recognize these symptoms and recommend appropriate drug treatment options.
This week you examine the impact of changes in pharmacokinetic and pharmacodynamic processes on patient drug therapy for cardiovascular disorders. You also explore ways to improve drug therapy plans for these disorders.
The Ethics and Legalities of Medication Error Disclosure Learning Objectives
students will:
Evaluate the influence of patient factors on pharmacokinetic and pharmacodynamics processes
Analyze the impact of changes in pharmacokinetic and pharmacodynamic processes on patient drug therapy
Evaluate drug therapy plans for cardiovascular disorders
Understand and apply key terms, concepts, and principles related to prescribing drugs to treat cardiovascular disorders
Photo Credit: GIPhotoStock/Cultura/Getty Images
Urban Traffic Congestion in a City Assessment Brief:
With reference to recent research, evaluate the potential solutions to the problem of urban traffic congestion in a city of your choice.
Urban Traffic Congestion in a City
Provide a report of 1,500 words in total for the city’s leaders, making recommendations on potential solutions to the urban traffic congestion problem.
Your report should provide significant evidence of research through reference to published sources, demonstrating analysis/critical appraisal of your findings, leading to appropriate recommendations. This should be professionally presented, incorporating illustrations and referenced examples where appropriate.
A developer is considering purchasing a piece of development land to build a speculative open plan office block. Using the information in the table below, calculate the residual land value that the developer would be willing to bid for the site.
Word count equivalent: approximately 500
Gross Floor Area: 12,500 m²
Net Lettable Area: 10,625 m²
Rental Income p.a.: £264/m²
Purchaser’s Costs: £2,000,000
Building Costs (Including external works and professional fees):
£1,200/m²
Developer’s required contingency: 3% of cost of construction, external works and fees.
Other costs and fees: £735,000
Marketing and sales costs: £128,000
Investor’s gross yield: 7%
Loan interest rate: 5.25% p.a.
Developer’s required profit: 20% on costs
Developer’s site acquisition costs: £830,000
Site acquisition to building start: 3 months
Construction period: 9 months
Rental void: 3 months
(25 Marks)
Advice for Interviewing Preparation and Approach As with the other project, it is often easiest to approach someone you know. Be respectful and ask politely if you can interview them.
Advice for Interviewing Preparation and Approach
Set up a time when you can meet and focus on the interview. If you meet someone you don’t know well, make sure you meet in a public place, such as a coffee shop.
Come prepared. Make sure you have read the textbook chapter on their religion – it shows you are interested and invested. Also, come up with some questions ahead of time. A good strategy might be to start with some basic questions about their beliefs from the textbook, then move to more open-ended questions. For example, if you were interviewing a Hindu you might ask about his or her belief in karma – “Do all Hindus believe in karma?” or maybe “I’ve learned that there are a lot of gods in Hinduism… Is that true?” But also prepare questions that ask about how they live their religion – “What are your favorite holidays?” “Were you raised in your religion? What family figure shaped your beliefs?” for some examples. The best interview is the one where the subject being interviewed gets talking, telling stories, genuinely wanting to share.
One more thing. This report should be an essay, not just a transcript of your interview. Use the interview as data, as examples for the points in your essay. Your essay is about what you learned about how people live in this religion, based on your interview – but also cross-checked with the textbook.
Introduction to Advice for Interviewing Preparation and Approach
The introduction describes the time, setting, and context of the interview. It identifies the interview subject and adequately identifies other key details that may relate to what was learned.
The introduction describes the time, setting, and context of the interview. It identifies the interview subject and discusses the background to the interview. The introduction describes the time, setting, and context of the interview. It identifies the interview subject. Background information is missing or may not be germane to the setting of the interview.
Introduction identifies some but not all of the following details: the time, the setting, the context, or the interviewee.
Introduction is missing relevant setting and context details.
Organization – Feature 1
Essay is organized around four key features. This first feature is relevant, significant, and described in some detail. The feature is described quoting both the interviewee’s own words and is also cross-checked with references to the textbook.
Essay is organized around four key features. This first feature is mostly relevant, significant, or described in some detail. The feature is described quoting both the interviewee’s own words and is also cross-checked with references to the textbook.
Essay is organized around four key features. This first feature is mentioned but not described in detail. The feature is described quoting the interviewee’s own words or is also cross-checked with references to the textbook.
Essay is organized around four key features. This first feature is mentioned but not described in detail. The description does not quote the textbook or the interviewee. Feature 1 is missing or not identified.
Organization – Feature 2
Essay is organized around four key features. This second feature is relevant, significant, and described in some detail. The feature is described quoting both the interviewee’s own words and is also cross-checked with references to the textbook.
Essay is organized around four key features. This second feature is mostly relevant, significant, or described in some detail. The feature is described quoting both the interviewee’s own words and is also cross-checked with references to the textbook.
Essay is organized around four key features. This second feature is mentioned but not described in detail. The feature is described quoting the interviewee’s own words or is also cross-checked with references to the textbook.
Essay is organized around four key features. This second feature is mentioned but not described in detail. The description does not quote the textbook or the interviewee. Feature 2 is missing or not identified.
Organization – Feature 3
Essay is organized around four key features. This third feature is relevant, significant, and described in some detail. The feature is described quoting both the interviewee’s own words and is also cross-checked with references to the textbook.
Essay is organized around four key features. This third feature is mostly relevant, significant, or described in some detail. The feature is described quoting both the interviewee’s own words and is also cross-checked with references to the textbook.
Essay is organized around four key features. This third feature is mentioned but not described in detail. The feature is described quoting the interviewee’s own words or is also cross-checked with references to the textbook.
Essay is organized around four key features. This third feature is mentioned but not described in detail. The description does not quote the textbook or the interviewee. Feature 3 is missing or not identified.
Organization – Feature 4
Essay is organized around four key features. This fourth feature is relevant, significant, and described in some detail. The feature is described quoting both the interviewee’s own words and is also cross-checked with references to the textbook.
Essay is organized around four key features. This fourth feature is mostly relevant, significant, or described in some detail. The feature is described quoting both the interviewee’s own words and is also cross-checked with references to the textbook.
Essay is organized around four key features. This fourth feature is mentioned but not described in detail. The feature is described quoting the interviewee’s own words or is also cross-checked with references to the textbook.
Essay is organized around four key features. This fourth feature is mentioned but not described in detail. The description does not quote the textbook or the interviewee. Feature 4 is missing or not identified.
Analysis
Field Report provides analysis by noting how well (or poorly) the textbook description differs from interview data and why. The Field Report also provides substantial analysis with justification of what was learned from the interview in the summary.
Field Report provides analysis by noting how well (or poorly) the textbook description differs from interview data and why OR the Field Report provides substantial analysis with justification of what was learned from the interview in the summary.
Field Report provides analysis by noting how well (or poorly) the textbook description differs from interview data OR the Field Report provides substantial analysis of what was learned from the interview in the summary. Explanation of these findings is missing.
Analysis is minimal. Conclusion of the interview is given but does not reflect specifically on the substance of the interview. No relevant analysis or reflection is included.
Clarity The essay is clear, cogent, and organized overall. Writing flows, has a good tone, and shows control over the language used.
The essay is clear, cogent, and organized overall. The writing flows and shows control over the language used, but may have some awkward or unclear passages. The essay is clear and organized overall. The writing shows control over the language used but has several awkward or unclear passages. The writing is unclear or disorganized in several places and generally is meandering or needs significantly more revision. Writing is unclear or disorganized throughout.
Advice for Interviewing Preparation and Approach Citations
All quoted or paraphrased passages are cited appropriately using APA style. The textbook and any additional references have full and complete bibliographic entries in the reference list. Interviewee contact information is present.
Quoted or paraphrased passages are mostly cited appropriately using APA style. The textbook and any additional references have full and complete bibliographic entries in the reference list. Interviewee contact information is present.
Quoted or paraphrased passages are mostly cited appropriately using APA style. The textbook and any additional references do not have full and complete bibliographic entries in the reference list. Interviewee contact information is present.
Quoted or paraphrased passages not cited appropriately using APA style. The textbook and any additional references do not have full and complete bibliographic entries in the reference list. Interviewee contact information is missing.
Differences between Delirium and Dementia Describe delirium and dementia.
Differences between Delirium and Dementia
What are the main differences? Delirium and dementia are two separate mental states that can be characterized by impaired memory and judgment, confusion, disorientation, and variable degrees of paranoia and hallucinations.
Similarities and Differences between Delirium and Dementia
These similarities can make distinguishing between the two disorders challenging to the inexperienced clinician; however, there are distinct, critical differences that, once recognized, can assist the clinician in making an accurate diagnosis. Delirium is a transient, usually acute and reversible cause of cerebral dysfunction with confusion that manifests clinically with a wide range of neuropsychiatric abnormalities. It can occur at any age, but is more common in elderly people with somatic illnesses or those who have compromised mental statuses. Dementia, on the other hand, is an acquired impairment of executive function in one or more cognitive domains (e.g. memory, language, executive function, judgment, attention, perceptual-motor function, social skills).
Role of supervisors and Communication Characteristics Do you believe supervisors should attempt to understand the communication characteristics of their Generation X and Millennial officers? Justify your response.
Assume that you are assigned to conduct a program audit of a grant to a municipal police department whose purpose is to reduce driving while intoxicated violations.
Role of supervisors and Communication Characteristics
What documents would you want to review and what kinds of data would you think is important?
Why is it difficult for police chiefs to bring about paradigm shifts within their own police organizations?
Do you believe that police officers should be held to a higher standard than other professions with respect to negligence in the line of duty? Justify your response.
Reading and Resources for Role of supervisors and Communication Characteristics
Management of Police Organizations
Burgess, M., Fleming, J., & Marks, M. (2006). Thinking critically about police unions in Australia: Internal
democracy and external responsiveness. Police Practice & Research, 7(5), 391-409.
doi:10.1080/15614260601076033
Calabrese, A. (2004). The evaluation of quality of organizational communications: A quantitative
model. Knowledge & Process Management, 11(1), 47-67. doi:10.1002/kpm.188
Fleming, J., Marks, M., & Wood, J. (2006). Standing on the inside looking out: The significance of police
unions in networks of police governance. Australian & New Zealand Journal of Criminology
(Australian Academic Press), 39(1), 71-89. doi:10.1375/acri.39.1.71
Heintze, T., & Bretschneider, S. (2000). Information technology and restructuring in public organizations:
Does adoption of information technology affect organizational structures, communications, and
decision making?
Effects of Employee Benefit Packages Main motivation,
Main design point (e.g. case study of the ABC company)
Some eye-catching results if any.
Effects of Employee Benefit Packages
Introduction: This section should answer the following questions.
What is the setting of the problem? This is, in other words, the problem statement.
Why is it important to study this problem? This is the importance of the problem for organizations.
Brief literature review.
Use of figures, references, and terminology: Define each term/symbol before you use it, or right after its first use.
Literature Review
Background of the topic
Previous research about the topic
Previous research in UAE context
Critique of previous research/research gap
Research Methodology
Qualitative or Quantitate Questionnaire development
Sample size and Sample selection technique
Profile of respondent
Mood and Anxiety or Depression Disorders Briefly describe mood and anxiety disorders, and then give examples of characteristics that middle to high school students may exhibit if presenting with anxiety and depression.
Mood and Anxiety or Depression Disorders
Finally, what interventions could be put in place at school to support students who may be exhibiting anxiety or depression? Mood disorders are a category of illnesses that describe a serious change in mood. Illness under mood disorders include: major depressive disorder, bipolar disorder (mania – euphoric, hyperactive, over inflated ego, unrealistic optimism), persistent depressive disorder (long lasting low grade depression), cyclothymia (a mild form of bipolar disorder), and SAD (seasonal affective disorder).
Birminghams Commonwealth Games Attendance 2022 Extrapolating attendance for 2022 Birmingham’s Commonwealth Games.
Task 1: Using trend line extrapolation, forecast the potential attendance figures for Birmingham’s Commonwealth Games 2022.
Birminghams Commonwealth Games Attendance 2022
Use linear trend line graphs to support your answer (250).
Task 2: Identify with, and explain the peaks and troughs plotted on the Commonwealth trend line (1000).
Task 3: Identify with the common challenges in estimating Birmingham’s Commonwealth future attendance (750).
Task 4: Provide a series of innovative solutions to overcome the perceived challenges of trend line extrapolation (500).
Birminghams Commonwealth Games Attendance 2022 Task Guidance
In answering the question, you may consider inclusion of the following:
A clear understanding of trend line extrapolation.
An examination of past sporting events namely the Commonwealth Games appreciating stadia capacity, international tourism statistics etc.
A historical understanding of significant events that shaped the time-scape.
An understanding of the external geo-political and economic environments and their implications e.g., Brexit.
An appreciation of the solutions available to appease trend line extrapolations shortcomings.
