see below

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see below

Response TO WEEK 8 DISC

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PLEASE RESPOND TO THE FOLLOWING IN 50 WORDS OR MORE:

My thoughts on trends in nursing have shifted a bit since week 1. A topic I addressed was nurse-to-patient ratios and how they are incompatible with providing the best care to patients. Although that issue still proves to be a problem, I feel more informed on the causes and effects of this trend. I’ve learned about legislative and environmental factors that come into play. Funding for institutions is limited and in order to address this issue properly, we must be informed and have background knowledge of the people we are appointing who make the decisions to allocate health care funds. Also, being more inclusive when giving positions in higher departments would be helpful. Nurses should have access to take on more leadership roles to be able to be involved in decision making. Nurses have first hand knowledge on what is needed on the floor. They understand the resources needed and they also can advocate for nurses who come from different backgrounds or have different levels of expertise. All in all, I have a better understanding of why this problem exists and also the ways in which we could actively rectify the situation.

AIDS

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Consider what you’ve learned about the topic you presented.

  • How does this topic relate to something you might see in clinical practice?
  • Which ideas make the most sense and why?
  •  How does this topic to current events?
  • What might make this problem more treatable?

POLICY/REGULATION FACT SHEET

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POLICY/REGULATION FACT SHEET

As a professional nurse, you are expected to apply your expertise to patient care. On occasion, you will also be expected to share that expertise.

With evolving technology and continuous changes to regulations designed to keep up these changes, there is usually a need to share information and expertise to inform colleagues, leadership, patients, and other stakeholders.

In this Assignment, you will study a recent nursing informatics-related healthcare policy, and you will share the relevant details via a fact sheet designed to inform and educate.

To Prepare:

· Review the Resources on healthcare policy and regulatory/legislative topics related to health and nursing informatics.

· Consider the role of the nurse informaticist in relation to a healthcare organization’s compliance with various policies and regulations, such as the Medicare Access and CHIP Reauthorization Act (MACRA).

· Research and select one health or nursing informatics policy (within the past 5 years) or regulation for further study.

The Assignment: (1 page not including the title and reference page)

Create a 1-page fact sheet that your healthcare organization could hypothetically use to explain the health or nursing informatics policy/regulation you selected. Your fact sheet should address the following:

· Briefly and generally explain the policy or regulation you selected.

· Address the impact of the policy or regulation you selected on system implementation.

· Address the impact of the policy or regulation you selected on clinical care, patient/provider interactions, and workflow.

· Highlight organizational policies and procedures that are/will be in place at your healthcare organization to address the policy or regulation you selected. Be specific.

· Use APA format and include a title page, in-text citations, and reference page.

· Use the Safe Assign Drafts to check your match percentage before submitting your work.

FEEDBACK

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PLEASE FOLLOW ALL DIRECTIONS 

m5 diss

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Sandra is a 27-year-old female admitted with a possible Deep Vein Thrombosis (DVT). She smokes one pack per day and is on birth control. She has a history of hypertension and obesity. She is admitted to the hospital and placed on bedrest. Heparin drip is started per protocol. The Provider is anticipating on sending her home with Coumadin.

  • Can Sandra be placed on Coumadin and Heparin at the same time? Explain your answer.
  • Develop 3 teaching points important for Sandra to know about her medications regimen.
  • What questions would you ask Sandra to verify that she understand the 3 teaching points?

Write 1 sentence that explains your understanding of communication.

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  • Write 1 sentence that explains your understanding of communication.
  • Expand on your ideas by highlighting the following in your meeting:
    • What are 2 components of the communication process that you think are important, and why?
    • How can you spot miscommunication? Illustrate with an example.

The materials found in the MUSE may help you with this assignment such as the article Elements of Communication. 

public health

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 Give an example of community health needs assessment (CHNA) data from the organization where you have Practicum or Public Health clinical. Identify what their top findings were. 

w9answer1II

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respond to the topic,(Peripartum depression) say I agree with what you said for this and for this. and add information that deals with the same thing but is not mentioned in that work, the answers that have an argument…

at least 3 references

Peripartum Depression

Women who are depressed during pregnancy have higher rates of use of alcohol, illicit substances, and tobacco in pregnancy, with poorer nutrition and weight gain, and lower rates of prenatal care. Untreated depression in pregnancy increases the risk of low birth weight, preterm birth, and neonatal intensive care unit admission (Konstanatinou et al 2020). Peripartum Depression is one of the most common disorders of pregnancy. It has a higher morbidity and mortality risk than any other condition affecting pregnant people. Symptoms of peripartum depression persist for more than two weeks and include anhedonia, decreased energy, reduced appetite, and poor concentration (Justesen & Jourdaine, 2023).

·
Recommend one FDA-approved drug, one off-label drug, and one nonpharmacological intervention for treating your chosen disorder in older adults or pregnant women.

SSRIs are the first choice for moderate to severe peripartum depression treatment. In a randomized controlled trial comparing antidepressants with community-based psychosocial intervention for peripartum depression, SSRIs were superior, with a number needed to treat at four weeks.  Postpartum women can be sensitive to medications because of hormone effects on liver enzymes, increased volume of distribution, and increased levels of drug-binding proteins; therefore, some experts recommend starting a medication at one-half of the regular dose and titrating slowly. In contrast, pregnant women often require higher doses of medications because of larger volumes of distribution (Skånland, & Cieślar-Pobuda,2019).

SSRIs are off-label and prescribed for the treatment of bulimia nervosa leading to trials to evaluate their effect on binge eating disorder. Antidepressants that have shown promising results include 
bupropionLinks to an external site., 
duloxetineLinks to an external site., 
escitalopramLinks to an external site., 
fluvoxamineLinks to an external site., fluoxetine, imipramine, 
sertralineLinks to an external site., and 
venlafaxineLinks to an external site..  

lisdexamfetamineLinks to an external site.
, a 
prodrugLinks to an external site. of D-amphetamine, is the only FDA-approved medication for binge eating disorder and should, as a rule, be preferred over antidepressants.

A nonpharmacological intervention for treating peripartum depression is psychotherapy. Nonpharmacologic treatment strategies are similar to prevention strategies, with the U.S. Preventive Services Task Force recommending referral for psychotherapy as the mainstay of treatment. Cognitive behavior therapy and interpersonal psychotherapy are the best studied and have the most robust supporting evidence. Group and individual approaches are effective. The two most common psychotherapies include interpersonal therapy (focus on improving social interactions and coping skills) and cognitive behavioral therapy (focus on adjusting patients' self-detrimental thought processes). Interpersonal therapy has been shown to improve mood during pregnancy, but cognitive behavioral therapy has only been validated for postpartum depression (Spinelly, 2003).

·
Explain the risk assessment you would use to inform your treatment decision making. What are the risks and benefits of the FDA-approved medicine? What are the risks and benefits of the off-label drug?

Risks of medication use during pregnancy and breastfeeding must be weighed against the risks of untreated or inadequately treated depression. Inadequately treated depression has the potential to progress to active suicidality and can lead to impaired bonding for the birth parent, impaired childhood development, and adverse pregnancy outcomes, including preterm birth, low birth weight, and hypertensive disorders. Paroxetine might be associated with major malformations, especially cardiac defects. Some evidence is available of an association between neonatal behavioral syndrome and exposure to SSRIs in utero during the last trimester. Infants with continuous exposure to mother's depression and continuous exposure to SSRIs throughout gestation were more likely to be born preterm than were infants with partial or no exposure. Guidelines suggest that SSRIs should be used with caution during pregnancy, and that paroxetine be avoided (Kupfer, Frank & Phillps, 2012).

·
Explain whether clinical practice guidelines exist for this disorder, and if so, use them to justify your recommendations. If not, explain what information you would need to take into consideration.

·
Support your reasoning with at least three current, credible scholarly resources, one each on the FDA-approved drug, the off-label, and a nonpharmacological intervention for the disorder.

Consistent with the goals of the new FDA and Pregnancy and Lactation Labeling Rule, clinicians must consider the risks of untreated illness as well as pharmacotherapy-related maternal adverse reactions, infant outcomes, and birth complications when counseling patients about medications in pregnancy and postpartum. Discussion of dosing requirements during gestation and any adverse effects related to breastfeeding must also be addressed (Betcher et al, 2019). Nurse practitioners and others who prescribe these drugs need to be aware of potential adverse effects and counsel depressed pregnant women appropriately. Some of the possible risks are drug perfusion to the fetus, adverse birth outcomes, neonatal withdrawal syndrome, and impaired child development. Before nurses can help to treat depression, they must first be able to recognize it. To screen for depression, it is important to be clear about the definition, risk factors, and comorbidity of depression in pregnant women.

SSRI antidepressant use in the final trimester also has been associated with 

persistent pulmonary hypertensionLinks to an external site.
 in the newborn. Researchers utilizing the Medicaid Database with nearly 3.79 million pregnant women compared outcomes of women taking an SSRI, another class of antidepressant, or no antidepressant in the last 90 days of pregnancy. Pregnant women who discontinued their antidepressants proximal to conception were nearly three times more likely to suffer a recurrence of depressive symptoms during pregnancy than women who continued their medication. Small case series studies show that the concentrations of the SSRI 
fluoxetineLinks to an external site., 
sertralineLinks to an external site., 
citalopramLinks to an external site., and 
escitalopramLinks to an external site. decrease throughout pregnancy. Doses may need to be adjusted for pregnant women taking SSRIs. Monitoring symptoms frequently, especially in the second and 

third trimestersLinks to an external site.
, and 

dose increasesLinks to an external site.
 with early symptoms of relapse is a strategy to avoid symptom recurrence (Ververs et al, 2009).

 

What would you do?

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Betty, the chief nursing officer, had to make a decision about buying 120 new hospital beds for patient rooms. After she interviewed nurse mangers at the units where the beds were going to be placed, Betty compiled her findings and decided to contact a well-known equipment company to obtain prices and contracts. The equipment company’s executive salesperson, Jim, discussed options at length with her and invited her and her significant other to an upcoming all-expenses-paid lavish retreat at a five-star hotel in Hawaii to see demonstrations of the beds and to hear a comprehensive sales pitch. Betty thought to herself, “We badly need some relaxation and stress relief. Hawaii would be so much fun. Would it be wrong for us to go?”

  • If you were Betty, what would you do? Give your rationale. Justify your answer with an ethical framework—a theory, approach, or principle.
  • Do you consider this situation a conflict of interest? Why or why not? Give your rationale.
  • What policies, if any, should be in place regarding a scenario such as this one? Do you have any such policies in place at work for similar situations? Do such policies impact day-to-day activities in any way? Explain.