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Week 2: Discussion
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Purpose
The purpose of the graded collaborative discussions is to engage faculty and students in an interactive dialogue to assist the student in organizing, integrating, applying, and critically appraising knowledge regarding advanced nursing practice. Scholarly information obtained from credible sources as well as professional communication are required. Application of information to professional experiences promotes the analysis and use of principles, knowledge, and information learned and related to real-life professional situations. Meaningful dialogue among faculty and students fosters the development of a learning community as ideas, perspectives, and knowledge are shared.
Activity Learning Outcomes
Through this discussion, the student will demonstrate the ability to:
Explain the pathophysiology of heart failure by analyzing a patient’s symptoms. (CO1)
Differentiate between systolic and diastolic heart failure. (CO1)
Explain the significance of physical exam and diagnostic findings in the diagnosis of heart failure. (CO4)
Due Date:
Initial post is due on Wednesday by 11:59 p.m. MT. All posts are due by Sunday, 11:59 p.m. MT
A 10% late penalty will be imposed for discussions posted after the deadline on Wednesday, regardless of the number of days late. NOTHING will be accepted after 11:59pm MT on Sunday (i.e. student will receive an automatic 0). Week 8 discussion closes on Saturday at 11:59pm MT.
Total Points Possible: 100
Requirements:
Read the case study below.
In your initial discussion post, answer the questions related to the case scenario and support your response with at least one evidence-based reference by Wed., 11:59 pm MT.
Provides a minimum of two responses weekly on separate days; e.g., replies to a post from a peer; AND faculty member’s question; OR two peers if no faculty question using appropriate resources, before Sun., 11:59 pm MT.
Case Scenario:
A 72-year-old male presents to the primary care office with shortness of breath, leg swelling, and fatigue. He reports that he stopped engaging in his daily walk with friends three weeks ago because of shortness of breath that became worse with activity. He decided to come to the office today because he is now propping up on at least 3 pillows at night to sleep. He tells the NP that he sometimes sleeps better in his recliner chair. PMH includes hypertension, hyperlipidemia and Type 2 diabetes.
Physical Exam:
BP 106/74 mmHg, Heart rate 110 beats per minute (bpm)
HEENT: Unremarkable
Lungs: Fine inspiratory crackles bilateral bases
Cardiac: S1 and S2 regular, rate and rhythm; presence of 3rd heart sound; jugular venous distention. Bilateral pretibial and ankle 2+pitting edema noted
ECG: Sinus rhythm at 110 bpm
Echocardiogram: decreased wall motion of the anterior wall of the heart and an ejection fraction of 25%
Diagnosis: Heart failure, secondary to silent MI
Discussion Questions:
Differentiate between systolic and diastolic heart failure.
State whether the patient is in systolic or diastolic heart failure.
Explain the pathophysiology associated with each of the following symptoms: dyspnea on exertion, pitting edema, jugular vein distention, and orthopnea.
Explain the significance of the presence of a 3rd heart sound and ejection fraction of 25%.
Category Points % Description
Application of Course Knowledge
30
30%
The student:
Differentiates between systolic and diastolic heart failure.
States whether the patient is in systolic or diastolic heart failure. 
Explains the pathophysiology associated for each of the following symptoms: dyspnea on exertion, pitting edema, jugular vein distention, and orthopnea. 
Explains the significance of the presence of a 3rd heart sound and an ejection fraction of 25%. 
Support from Evidence-Based Practice
30
30%
Initial discussion post is supported with appropriate, scholarly sources; AND
Sources are published within the last 5 years (unless it is the most current CPG); AND
Reference list is provided and in-text citations match; AND
All answers are fully supported with an appropriate EBM argument
Interactive Dialogue
30
30%
In addition to providing a response to the initial post due by Wednesday, 11:59 p.m. MT, student provides a minimum of two responses weekly on separate days; e.g., replies to a post from a peer; AND faculty member’s question; OR two peers if no faculty question. A response to faculty could include a question posed to a student or the entire class or a faculty question directed towards another student. AND
Evidence from appropriate scholarly sources are included; AND
Reference list is provided and in-text citations match
90
90%
Total CONTENT Points= 90 pts
Discussion Format
Category
Points
%
Description
Organization
5
5%
Organization:
Case study responses are presented in a logical format; AND
Responses are in sequence with the numbered questions; AND
The case study response is understandable and easy to follow; AND
All responses are relevant to the case topic
Format
5
5%
Discussion post has minimal grammar, syntax, spelling, punctuation, or APA format errors*
(*) APA style references and in text citations are required; however, there are no deductions for errors in indentation or spacing of references. All elements of the reference otherwise must be included.
10
10%
Total FORMAT Points= 10 pts
100
100%
DISCUSSION TOTAL=____ out of 100 points
(*) APA style references and in text citations are required; however, there are no deductions for errors in indentation or spacing of references. All elements of the reference otherwise must be included.
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During this week, you are expected to examine the protection of human subjects in research from early research studies, through the development of research codes to current research standards. The aim is to familiarize you with the ethical issues associated with research and gain firsthand information of the processes used to protect research participants. After viewing each video attached, write two paragraphs about each video describing the purpose of the video and discussed one point from each video that you think is important regarding protecting human subjects in research and provided rationale. Your submission should be 400-500 words, using APA style.

analyze the theory of their choice and identify its concepts, constructs, conceptual model, and philosophy. The paper should include a discussion that is specific to a nursing situation in which the theory could be used to guide nursing practice. The paper will include a citation from credible sources and a reference page.
Virginia Henderson, 1966 Definition of nursing. Nursing assists patients with 14 essential functions toward independence.

Discussion of pharmacokinetics and pharmacodynamics related to anxiolytic medications used to treat GAD. In your discussion, utilizing the discussion highlights, compare and contrast different treatment options that can be used.
• consider the principles of pharmacokinetics and pharmacodynamics.
• Reflect on your experiences, observations, and/or clinical practices from the last 5 years and think about how pharmacokinetic and pharmacodynamic factors altered his or her anticipated response to a drug.
• Consider factors that might have influenced the patient’s pharmacokinetic and pharmacodynamic processes, such as genetics (including pharmacogenetics), gender, ethnicity, age, behavior, and/or possible pathophysiological changes due to disease.
• Think about a personalized plan of care based on these influencing factors and patient history with GAD.

A total of two annotated bibliographies are to be submitted (not to exceed one page each). The articles must come from nursing scholarly literature and may not be older than 5 years since publication. Please note that the articles must be research based and reflect a qualitative methodology (review our reading assignments). Web pages, magazines, textbooks, and other books are not acceptable.
Each annotation must address the following critical elements:
Explanation of the main purpose and scope of the cited work
Brief description of the research conducted
Value and significance of the work (e.g., study’s findings, scope of the research project) as a contribution to the subject under consideration
Possible shortcomings or bias in the work
Conclusions or observations reached by the author
Summary as to why this research lends evidence to support the potential problem identified specific to Family Nurse Practitioner.

Thesis: Nurses can prevent burnout in the workplace by setting emotional boundaries, giving recovery time, and maintaining self-care.
Doubled spaced
12 point font

Discuss the case for the ongoing development and use of nursing grand theories and conversely, make a case for the obsolescence of nursing grand theories for today’s practice and research.
Please this order require checking / reviewing the Turnitin for plagiarism.

Exercise 2-1
In 2012, the Alliance of Aging Research established the Healthspan Campaign, a coalition of organizations committed to solving the challenges brought about by the aging of the American pop-ulation. With each passing year, the percentage of people in the United States-and much of the world–over age 65 increases. This “Silver Isunami” is expected to bring a flood of chronic disease and disabilities due to aging that could overwhelm the health care systems of many nations. Watch the films The Healthspan Imperative and What Is the Silver Tsunami? at www. healthspancampaign org.
Discuss the effect of the aging population on our health system, and present recommendations for how these challenges could be addressed.

CASE STUDY ASSIGNMENT EXPECTATIONS – Avoid excessive quoting. Excessive quoting will result in the deduction of points. Use your own voice. Do not copy and paste.
– Please keep responses separated by the question they are answering. This is for grading purposes.
– Your document must be submitted in Word document or PDF format. I cannot accept PAGES format.
– Your main document does NOT need to have APA headers or title pages.
– Please use the most updated APA style guide (7th edition). References must be listed in APA format at the end of your document (references title, appropriate indentation and spacing must be according to APA rules).
– References MUST include AT LEAST ONE scholarly (and recent) reference. This can include a peer reviewed journal or a reputable website (CDC, UpToDate, online journal, .gov, .edu, .org, etc.). Wikipedia is NOT a reputable website. – You may use a textbook, but it must be supported by another scholarly reference. Please do not use a textbook as your only reference, points will be deducted.
Case Study #1_5
Mrs. H is a 45-year-old primipara who was admitted to the labor and delivery unit. She was accompanied by her 48-year-old husband. She walked in the labor room unassisted and in apparent good health. This first delivery is the culmination of an uneventful pregnancy. Mrs. H did have severe episodes of morning sickness during her first trimester but has had not further complications. Admitting blood pressure was 135/78; maternal pulse was 80; and fetal heart rate was 140 bpm. Six hours after admission Mrs. H delivered a 7 lb. 8 oz. baby boy.
Questions (Be sure to provide rationales rather than simple answers)
1. The delivery room nurse immediately noticed that the baby had low set ears, a lot flat nasal bridge, a protruding tongue, and wide epicanthal folds. These characteristics led the nurse to suspect which genetic pathological condition?
I
2. What is the chromosomal aberration that is most likely responsible for the infants condition? Describe what happens in this chromosomal aberration.
3. Explain the basic pathophysiological basis for this condition occurs?

Assessment Description
Review the National Academy of Medicine’s 2021 report, “The Future of Nursing 2020-2030: Charting a Path to Achieve Health Equity,” located in the topic Resources.
Write a 750‐1,000-word paper discussing the influence of the report on nursing practice. Include the following:
1. Review the recommendations of The National Academy of Medicine 2021 report and explain why health equity is significant in this report.
2. Define social determinants of health. Discuss one of the determinants and how this impacts health equity.
3. Describe the role nurses have in improving health equity and impacting social needs.
4. Discuss the significance of self-care to decrease nursing burnout. What self-care and evidence-based strategies are available for nurses to maintain personal and spiritual health?
You are required to cite a minimum of three sources to complete this assignment. Sources must be appropriate for the assignment and relevant to nursing practice.