Category: Questions

Evaluating Design Choice and Threats to Validity in a Quasi-Experimental Design

Being a critical researcher requires practice and thought into the reasoning behind various research design choices. In this Discussion, you will consider a quasi-experimental design used in a study within your discipline and evaluate it for its appropriateness and any potential flaws it has that may have impacted the research.

Review the assigned article for your program within the Research Articles document located in the Learning Resources. Evaluate the choice of the design used in the assigned article. Why was that design used and not another one? Assess the authors’ performance in explaining this.

What are the types of validity presented and the critical differences among them? Assess the authors’ performance in explaining them.

How would you assess the study’s validity? What information would you need in order to be able to do, and is that information present in the article?

Assessment Tools and Diagnosic Test

Assessment Tools and Diagnostic Tests

When seeking to identify a patient’s health condition, advanced practice nurses can use a diverse selection of diagnostic tests and assessment tools; however, different factors affect the validity and reliability of the results produced by these tests or tools. Nurses must be aware of these factors in order to select the most appropriate test or tool and to accurately interpret the results.
In this Discussion, you will consider the validity and reliability of different assessment tools and diagnostic tests. You will explore issues such as sensitivity, specificity, and positive and negative predictive values.
To prepare:
Review this week’s Learning Resources, and consider the factors that impact the validity and reliability of various assessment tools and diagnostic tests.
Select one of the following assessment tools or diagnostic tests to explore for the purposes of this Discussion:
o Mammogram
o Physical tests for sore throat (inspecting the throat, palpating the head and neck lymph nodes, listening to breath sounds)
o Prostate-specific antigen (PSA) test
o Dix-Hallpike test
o Body-mass index (BMI) using waist circumference for adults
Search from any accredited Library and credible sources for resources explaining the tool or test you selected. What is its purpose, how is it conducted, and what information does it gather?
Examine the literature and resources you located for information about the validity and reliability of the test or tool you selected. What issues with sensitivity, specificity, and predictive values are related to the test or tool?
Are there any controversies or issues related to any of these tests or tools?
Consider any ethical dilemmas that could arise by using these tests or tools.

Differential Diagnosis for Skin Conditions

Differential Diagnosis for Skin Conditions
Properly identifying the cause and type of a patient’s skin condition involves a process of elimination known as differential diagnosis. Using this process, a health professional can take a given set of physical abnormalities, vital signs, health assessment findings, and patient descriptions of symptoms, and incrementally narrow them down until one diagnosis is determined as the most likely cause.
In this Discussion, you will examine several visual representations of various skin conditions, describe your observations, and use the techniques of differential diagnosis to determine the most likely condition.
To prepare:
Review the Skin Conditions document provided (the picture of different skin condition document will be uploaded for you), and select two conditions to closely examine for this Discussion.
Consider the abnormal physical characteristics you observe in the graphics you selected. How would you describe the characteristics using clinical terminologies?
Explore different conditions that could be the cause of the skin abnormalities in the graphics you selected.
Consider which of the conditions is most likely to be the correct diagnosis, and why.
1) Post on or before Day 3 a description of the two graphics you selected (identify each graphic by number).please use the document of the skin condition uploaded.
2) Use clinical terminologies to explain the physical characteristics featured in each graphic.
3) Formulate a differential diagnosis of three to five possible conditions for each.
4) Determine which is most likely to be the correct diagnosis, and explain your reasoning.

Drug Treatments for HIV/AIDS

While HIV/AIDS is still currently incurable, the prognosis for patients with this infectious disease has improved due to advancements in drug treatments. Consider the case of Kristy Aney. Kristy was diagnosed with HIV in 1992 and was told she would survive, at most, 10 more years. Despite unfavorable odds, Kristy is still alive 20 years later. Since her diagnosis, she has witnessed tremendous improvements in HIV/AIDS treatments which have helped patients live longer with fewer side effects. While she acknowledges that these drug treatments have kept her alive, she fears that improvements in drug therapy have led to more people becoming complacent about the disease (Idaho Statesmen, 2012). In fact, the number of people living with HIV/AIDS in the United States is higher than it has ever been (CDC, 2012). This poses the question: Is there a relationship between drug advancements, societal complacency, and infection?
To prepare:
Review Chapter 48 of the Arcangelo and Peterson text, as well as the Krummenacher et al. and Scourfield articles in the Learning Resources.
Reflect on whether or not the prevalence of HIV cases might be attributed to increased complacency due to more advanced drug treatment options for HIV/AIDS.
Consider how health care professionals can help to change perceptions and make people more aware of the realities of the disease.
Think about strategies to educate HIV positive patients on medication adherence, as well as safe practices to reduce the risk of infecting others.
ASSIGNMENT PAPER:
WRITE
1) An explanation of whether or not you think the prevalence of HIV cases might be attributed to increased complacency due to more advanced drug treatment options.
2) Explain how health care professionals can help to change perceptions and increase awareness of the realities of the disease.
3) Describe strategies to educate HIV positive patients on medication adherence.
4) What are the safety practices to reduce the risk of infecting others?

Antimicrobal Agents

Antimicrobial Agents

Antimicrobial agents are essential components in the treatment of various bacterial infections as they help to kill or prevent the growth of microbes such as bacteria, fungi, and protozoans. Prior to the discovery of antimicrobial agents, treatment options for patients with bacterial infections were limited. For many patients, treatment often resulted in the amputation of limbs or even death. Today, treatment options for bacterial infections typically have a more positive prognosis. Due to the various types of infections presented in patients, it is essential to be able to identify the underlying cause of the infection whether bacterial or viral
before recommending drug treatments. This will help you identify whether or not an antimicrobial agent would be appropriate and which specific agent would target the infection. In this Assignment, you consider the appropriate use of antimicrobial agents for infections.
To prepare:
Review this week’s media presentation on principles of antimicrobial therapy, as well as Chapter 8 of the Arcangelo and Peterson text.
Consider the categories of antimicrobial agents.
Think about differences between viral and bacterial infections.
Reflect on why proper identification of the infection is key to selecting the proper antimicrobial agent.
To complete this Assignment Paper:
Write a 2-3 page paper that addresses the following:
1) Describe the categories of antimicrobial agents.
2) Describe differences between viral and bacterial infections.
3) Explain why proper identification of viral and bacterial infections is key to selecting the proper antimicrobial agent.
Readings/Recommended References (you may choose your own textbook or article for this paper

Hormone Replacement Therapy

HORMONE REPLACEMENT THERAPY
In recent years, hormone replacement therapy has become 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.
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?
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.
ASSIGNMENT PAPER
WRITE:
1) A description of the strengths and limitations of hormone replacement therapy.
2). Based on these strengths and limitations, explain why you would or why you would not support hormone replacement therapy.
3). Explain whether you would prescribe supplemental hormones or recommend alternative treatments to patients with hormone deficiencies and why.

Strategies to treat and manage patients with hypertension

In clinical settings, advanced practice nurses frequently use various strategies to treat and manage patients with hypertension and other cardiovascular disorders. These strategies often include pharmacologic and nonpharmacologic therapies, natural remedies, and/or changes in patient behavior. For hypertension patients, behavioral changes including increased exercise, healthier diet, and smoking cessation have proven to be particularly beneficial. However, it is important to recognize that treatment and management plans centered around changes in behavior often require greater patient commitment. This creates the need for patient-provider collaboration, as well as appropriate patient education. When patients are actively involved in their own care and better understand implications of their disorders, they are more likely to adhere to treatment plans.
To prepare:
Review Part 11 of the Buttaro et al. text and the National Heart Lung Blood Institute article in this week’s Learning Resources.

Reflect on your Practicum Experiences and observations. Select a case from these experiences that involves a patient who presented with a hypertension problem. When referring to your patient, make sure to use a pseudonym or other false form of identification. This is to ensure the privacy and protection of the patient.

Think about the patient’s history including drug treatments and behavioral factors such as diet, exercise, smoking, etc.

Review the National Heart Lung Blood Institute article in the Learning Resources. Reflect on health promotion strategies for the patient. Consider ways to reinforce hypertension management.
Post on or before Day 3
1) A description of a patient who presented with a hypertension problem during your Practicum Experience.
2) Explain the patient�s history including drug treatments and behavioral factors.
3) Then, suggest two health promotion strategies for the patient.
4) Include suggestions for reinforcing hypertension management.

Diagnosing Gastrointestinal Disorders

Diagnosing Gastrointestinal Disorders
In primary care settings, patients often present with abdominal pain. Although this is frequently a sign of a gastrointestinal (GI) disorder, abdominal pain could also be the result of other systemic disorders, making this type of pain difficult to assess. While abdominal pain is most common, many other GI symptoms also overlap multiple disorders, further increasing the difficulty in diagnosing and treating patients. This makes provider-patient communication essential. You must be able to formulate questions that will prompt the patient to provide the necessary information, as this will guide your assessment and diagnosis. For this Discussion, consider potential diagnoses for the patients in the following case studies.
Case Study 1:
A 49-year-old man presents to the office complaining of vague abdominal discomfort over the past few days. He states he does not feel like eating and has not moved his bowels for the last 2 days. His patient medical history includes an appendectomy at age 22 and borderline hypertension, which he is trying to control with diet and exercise. He takes no medications and has no known allergies. Positive physical exam findings include a temperature of 99.9 degrees Fahrenheit, heart rate of 98, respiratory rate of 24, and blood pressure of 150/72. The abdominal exam reveals abdominal distention, diminished bowel sounds, and lower left quadrant tenderness without rebound.
Case Study 2:
A 40 year-old female presents to the office with the chief complaint of diarrhea. She has been having recurrent episodes of abdominal pain, diarrhea, and rectal bleeding. She has lost 9 pounds in the last month. She takes no medications, but is allergic to penicillin. She describes her life as stressful, but manageable. The physical exam reveals a pale middle- aged female in no acute distress. Her weight is 140 pounds (down from 154 at her last visit over a year ago), blood pressure of 94/60 sitting and 86/50 standing, heart rate of 96 and regular without postural changes, respiratory rate of 18, and O2 saturation 99%. Further physical examination reveals:
Skin: w/d, no acute lesions or rashes
Eyes: sclera clear, conj pale
Ears: no acute changes
Nose: no erythema or sinus tenderness
Mouth: membranes pale, some slight painful ulcerations, right buccal mucosa, tongue beefy red, teeth good repair
Neck: supple, no thyroid enlargement or tenderness, no lymphadenopathy
Cardio: S1 S2 regular, no S3 S4 or murmur
Lungs: CTA w/o rales, wheezes, or rhonchi
Abdomen: scaphoid, BS hyperactive, generalized tenderness, rectal +occult blood
Case Study 3:
A 52-year-old male presents to the office for a routine physical. The review of symptoms reveals anorexia, heartburn, and weight loss over the past 6 months. The heartburn is long standing, occurring most days during the week. He takes TUMS or Rolaids to relieve the discomfort. The patient describes occasional use of ibuprofen for back pain, but denies other medications including herbals. He has no known allergies. He was adopted so does not know his family history. Social history reveals that, although he stopped smoking ten years ago, he smoked for 20 years. He occasionally consumes alcohol on the weekends only. The only positive physical exam finding for this patient was slight epigastric tenderness. The remainder of his exam was negative and the rectal exam was negative for blood.

Practicum Experience:Journal Entry on abdominal pain

Reflect on a patient who presented with abdominal pain, (Write a description of a patient with abdominal pain including signs and symptom).
Describe the patient’s personal and medical history
What are the patient’s drug therapy and treatments?
What are the patient’s follow-up care?

Diagnosis and Management of Eye, Ear, Nose, and Throat Disorders

In clinical settings, eye, ear, nose, and throat (EENT) disorders account for the majority of pediatric visits. With the prevalence of these disorders, you must be familiar with their signs and symptoms as well as evidence-based practices for assessment and treatment. Although many pediatric patients present with common EENT disorders such as ear infections, allergies, and strep throat, some patients present with rare disorders requiring specialist care. In your role, making this distinction between when to treat and when to refer is essential. For this Discussion, examine the following case studies and consider potential diagnoses and management strategies.
Case Study
A mother presents with her 2-year-old child with complaints of ear pain and decreased sleep. Earlier this week, he had a runny nose and congestion with a mild cough that occurred mostly when lying down. His temperature is 100.7F. You note the following physical findings: shotty anterior cervical adenopathy, mild nasal congestion, clear postnasal drainage, and lungs clear to auscultation. Ear examination reveals the following: right tympanic membrane is red, translucent, in a neutral position, with no pus or fluid noted; left tympanic membrane is full, reddish orange in appearance, and opaque with pus.
Assignment Paper:
Write two pages only on this discussion assignment (Let me give you a clue, the diagnosis of this case study is ACUTE OTITIS MEDIA)
1).write an explanation of the differential diagnosis for the patient in the case study
2). Explain which is the most likely diagnosis for the patient and why.
3) Include an explanation of unique characteristics of the disorder you identified as the primary diagnosis.
4). explain a treatment and management plan for the patient, including appropriate dosages for any recommended treatments.
5).Finally, explain strategies for educating parents on their child’s disorder and reducing any concerns/fears presented in the case study.