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Part 1 .Scope Creep . This week’s discussion on scope creep has been very interesting and fitting for our intervention class. Articles that discuss scope creep have discussed real problems with the outcome of practice implementation. As we prepare to implement a new project, we must ensure that the scope of the project must be clearly articulated as there is a significant risk of about 50% of project failure which is a result of scope creep (Komal et al., 2020). The DNP student is expected to implement their project within 8-10 weeks, so all steps must be taken to prevent scope creep for the successful completion of the implementation process. As healthcare needs change so rapidly, from day to day, and can negatively impact my proposed project. I will implement methods such as 1. effective communication with participants staff and stakeholders, 2. Involvement of the office staff (end-users of the project), and 3. Provide a continuous supportive environment for the project staff and participants. (Mian, Khan & Al-Yafei, 2020).
Stakeholder Communication
Stakeholder communication is an important attribute for the success of the project. The communication proposed within the project will be ongoing while allowing a two-way forum. This will entail the effective flow of communication between the DNP nurse, project staff, and participants where questions can be asked and answered, and uncertainties clarified Rajhans, 2018). The DNP student must ensure that the stakeholders are engaged and that their input and needs are managed appropriately (Rajhans, 2018). The DNP student must be cognizant of their responsibility to the stakeholders so all efforts can be made to uphold effective communication for the success of the project.

Read the following case study and answer the reflective questions. Please provide evidence-based rationales for your answers. APA, 7th ed. must be followed.
CASE STUDY: An Older Immigrant Couple: Mr. and Mrs. Arahan
Mr. and Mrs. Arahan, an older couple in their seventies, have been living with their oldest daughter,
her husband of 15 years, and their two children, ages 12 and 14. They all live in a middle-income
neighborhood in a suburb of a metropolitan city. Mr. and Mrs. Arahan are both college educated and
worked full-time while they were in their native country. In addition, Mr. Arahan, the only offspring
of wealthy parents, inherited a substantial amount of money and real estate. Their daughter came to
the United States as a registered nurse and met her husband, a drug company representative. The
older couple moved to the United States when their daughter became a U.S. citizen and petitioned
them as immigrants. Since the couple was facing retirement, they welcomed the opportunity to come
to the United States.
The Arahans found life in the United States different from that in their home country, but their
adjustment was not as difficult because both were healthy and spoke English fluently. Most of their
time was spent taking care of their two grandchildren and the house. As the grandchildren grew older,
the older couple found that they had more spare time. The daughter and her husband advanced in
their careers and spent a great deal more time at their jobs. There were few family dinners during
the week. On weekends, the daughter, her husband, and their children socialized with their own
friends. The couple began to feel isolated and longed for a more active life.
Mr. and Mrs. Arahan began to think that perhaps they should return to the home country, where
they still had relatives and friends. However, political and economic issues would have made it
difficult for them to live there. Besides, they had become accustomed to the way of life in the United
States with all the modern conveniences and abundance of goods that were difficult to obtain in their
country. However, they also became concerned that they might not be able to tolerate the winter
months and that minor health problems might worsen as they aged. They wondered who would take
care of them if they became very frail and where they would live, knowing that their daughter had
only saved money for their grandchildren’s college education. They expressed their sentiments to
their daughter, who became very concerned about how her parents were feeling.
This older couple had been attending church on a regular basis, but had never been active in other
church-related activities. The church bulletin announced the establishment of parish nursing with
two retired registered nurses as volunteers. The couple attended the first opening of the parish clinic.
Here, they met one of the registered nurses, who had a short discussion with them about the services
offered. The registered nurse had spent a great deal of her working years as a community health
nurse. She informed Mr. and Mrs. Arahan of her availability to help them resolve any health-related
issues.
Reflective Questions
1. What strategies could be suggested for this older adult couple to enhance their quality of life?
2. What community resources can they utilize?
3. What can the daughter and her family do to address the feelings of isolation of the older couple?
4. What health promotion activities can ensure a healthy lifestyle for them?

Topic
Nurses are well positioned for reforming health care in ways that promote a healthier public and reduce healthcare cost. Discuss the role nurse plays in COVID vaccination mandate, telemedicine, and prescription drug pricing as advocates in the healthcare system.
Rationale must be provided
May use examples from your nursing practice
150 words minimum (excluding the reference)
Minimum of two references in APA format within the last five years published
2 scholarly references. You must post two answers to your peers of 200 words to the same topic

Case Study
Mr. T is a 21-year-old man who is brought to the ER by his mother after he began talking about “aliens” who were trying to steal his soul. Mr. T reports that aliens left messages for him by arranging sticks outside his home and sometimes send thoughts into his mind.
On exam, he is guarded and often stops talking while in the middle of expressing a thought. Mr. T appears anxious and frequently scans the room for aliens, which he thinks may have followed him to the hospital. He denies any plan to harm himself but admits that the aliens sometimes want him to throw himself in front of a car, “as this will change the systems that belong under us.”
The patient’s mother reports that he began expressing these ideas a few months ago, but that they have become more severe in the last few weeks. She reports that during the past year, he has become isolated from his peers, frequently talks to himself, and has stopped going to community college. He has also spent most of his time reading science fiction books and creating devices that will prevent aliens from hurting him. She reports that she is concerned because the patient’s father, who left while the patient was a child, exhibited similar symptoms many years ago and has spent most of his life in a psychiatric hospital.
Questions:
Remember to answer these questions from your textbooks and clinical guidelines to create your evidence-based treatment plan. At all times, explain your answers.
1. Summarize the clinical case including the significant subjective and objective data.
2. Generate a primary and two differential diagnoses. Use the DSM5 to support the assessment. Include the DSM5 and ICD 10 codes.
3. Discuss a pharmacological treatment would you prescribe? Use the clinical guidelines to support the rationale for this treatment.
4. Discuss non-pharmacological treatment would you prescribe? Use the clinical guidelines to support the rationale for this treatment.
5. Describe a health promotion intervention that would be appropriate for this patient.
Submission Instructions:
Your initial post should be at least 500 words, formatted, and cited in current APA 7 style with support from at least 5 academic sources.
– No Plagiarism
– Plagiarism report required
Fallow the Rubric
Please if you have any questions, do not hesitate in contact me

Please see Resume and based of my education and work expereince discuss the following question. Thank you.
Discuss reasons for applying to the BSN-to-DNP Nurse Anesthesia program at the University of Miami and how it fits into personal, educational, and professional goals.

Case Study
A 74-year-old African American woman, Ms. Richardson, was brought to the hospital emergency room by the police. She is unkempt, dirty, and foul-smelling. She does not look at the interviewer and is apparently confused and unresponsive to most of his questions. She knows her name and address, but not the day of the month. She is unable to describe the events that led to her admission.
The police reported that they were called by neighbors because Ms. Richardson had been wandering around the neighborhood and not taking care of herself. The medical center mobile crisis unit went to her house twice but could not get in and presumed she was not home. Finally, the police came and broke into the apartment, where they were met by a snarling German shepherd. They shot the dog with a tranquilizing gun and then found Ms. Richardson hiding in the corner, wearing nothing but a bra. The apartment was filthy, the floor littered with dog feces. The police found a gun, which they took into custody. The following day, while Ms. Richardson was awaiting transfer to a medical unit for treatment of her out-of-control diabetes, the psychiatric provider attempted to interview her. Her facial expression was still mostly unresponsive, and she still didn’t know the month and couldn’t say what hospital she was in. She reported that the neighbors had called the police because she was “sick,” and indeed she had felt sick and weak, with pains in her shoulder; in addition, she had not eaten for 3 days. She remembered that the police had shot her dog with a tranquilizer and said the dog was now in “the shop” and would be returned to her when she got home. She refused to give the name of a neighbor who was a friend, saying, “he’s got enough troubles of his own.” She denied ever being in a psychiatric hospital or hearing voices but acknowledged that she had at one point seen a psychiatrist “near downtown” because she couldn’t sleep. He had prescribed medication that was too strong, so she didn’t take it. She didn’t remember the name, so the interviewer asked if it was Thorazine. She said no, it was “allal.” ‘Haldol?”, ask the interviewer. She nodded.
The interviewer was convinced that was the drug, but other observers thought she might have said yes to anything that sounded remotely like it, such as “Elavil.” When asked about the gun, she denied, with some annoyance, that it was real and said it was a toy gun that had been brought to the house by her brother, who had died 8 years ago. She was still feeling weak and sick, complained of pain in her shoulder, and apparently had trouble swallowing. She did manage to smile as the team left her bedside.
Questions
Remember to answer these questions from your textbooks and clinical guidelines to create your evidence-based treatment plan. At all times, explain your answers.
1. Summarize the clinical case including the significant subjective and objective data.
2. Generate a primary and two differential diagnoses. Use the DSM5 to support the assessment. Include the DSM5 and ICD 10 codes.
3. Discuss a pharmacological treatment would you prescribe? Use the clinical guidelines to support the rationale for this treatment.
4. Discuss non-pharmacological treatment would you prescribe? Use the clinical guidelines to support the rationale for this treatment.
5. Describe a health promotion intervention that would be appropriate for this patient.
Submission Instructions:
Your initial post should be at least 500 words, formatted, and cited in current APA 7 style with support from at least 5 academic sources.
– No Plagiarism
– Plagiarism report required
Fallow the Rubric
Please if you have any questions, do not hesitate in contact me

For this assignment, you will create a clinical guiding question know as a PICOT question. The PICOT question must be relevant to a nursing practice problem.
Use the “Literature Evaluation Table” to complete this assignment. Prior to starting the “Literature Evaluation Table,” complete the following:
1. Select a nursing practice problem of interest to use as the focus of your research. Start with the patient population and identify a clinical problem or issue that arises from the patient population.
2. Following the PICOT format, write a PICOT question in your selected area of interest. The PICOT question should be applicable to your proposed capstone project (the project students must complete during their final course in the RN-BSN program of study).
3. Conduct a literature search to locate six research articles focused on your selected nursing practice problem of interest. Note: This literature search should include three quantitative and three qualitative peer-reviewed research articles to support your nursing practice problem. A mixed methods article can qualify towards meeting a qualitative or quantitative methodology.
Articles must be published within the last 5 years, appropriate for the assignment criteria, and relevant to nursing practice.

Case Study
Jill, a 24 y/o Hispanic female arrives in the emergency room where her parents brought her for evaluation. They are worried because she is giving away all of her possessions and says she is planning to move to the South Pole so she can “save the world.” Her parents say that she has hardly been sleeping at all for the last 7 days, but she seems very energetic. They say she has appeared to be “in a frenzy” lately. When you interview Jill you notice that she speaks very rapidly and is laughing uncontrollably. It is hard to get her to be quiet long enough for you to ask questions. She seems agitated and has difficulty sitting still.
Questions:
Remember to answer these questions from your textbooks and clinical guidelines to create your evidence-based treatment plan. At all times, explain your answers.
1. Summarize the clinical case including the significant subjective and objective data.
2. Generate a primary and two differential diagnoses. Use the DSM5 to support the assessment. Include the DSM5 and ICD 10 codes.
3. Discuss a pharmacological treatment would you prescribe? Use the clinical guidelines to support the rationale for this treatment.
4. Discuss non-pharmacological treatment would you prescribe? Use the clinical guidelines to support the rationale for this treatment.
5. Describe a health promotion intervention that would be appropriate for this patient.
Submission Instructions:
Your initial post should be at least 500 words, formatted, and cited in current APA 7 style with support from at least 5 academic sources.
– No Plagiarism
– Plagiarism report required
Fallow the Rubric Please if you have any questions, do not hesitate in contact me.

Review this week’s Learning Resources and consider the insights they provide about psychiatric emergencies and the ethical and legal issues surrounding these events.
The diagnosis of psychiatric emergencies can include a wide range of problems—from severe drug reactions to abuse and suicidal ideation/behaviors. Regardless of the care setting, the PMHNP must know how to address emergencies, coordinate care with other members of the health care team and law enforcement officials (when indicated), and effectively communicate with family members who are often overwhelmed in emergency situations. In their role, PMHNPs can ensure a smooth transition from emergency mental health care to follow-up care and also bridge the physical–mental health divide in healthcare.
In this week’s Assignment, you explore legal and ethical issues surrounding psychiatric emergencies and identify evidence-based suicide and violence risk assessments.
In 2–3 pages, address the following:
Explain your state laws for involuntary psychiatric holds for child and adult psychiatric emergencies. Include who can hold a patient and for how long, who can release the emergency hold, and who can pick up the patient after a hold is released.
Explain the differences between emergency hospitalization for evaluation/psychiatric hold, inpatient, and outpatient commitment in your state.
Explain the difference between capacity and competency in mental health contexts.
Select one of the following topics, and explain one legal issue and one ethical issue related to this topic that may apply within the context of treating psychiatric emergencies: patient autonomy, EMTALA, confidentiality, HIPAA privacy rule, HIPAA security rule, protected information, legal gun ownership, career obstacles (security clearances/background checks), and payer source.
Identify one evidence-based suicide risk assessment that you could use to screen patients.
Identify one evidence-based violence risk assessment that you could use to screen patients.

• In your review of evidence, you provided… (discuss one detail that put this criterion at the competence level and then give three suggestions or ask three questions to move this criterion to proficiency/mastery).
• In your explanation of priority of need, you showed… (discuss three details that put this criterion at mastery then give one suggestion or ask one question to further improve).
• In your explanation of health determinants, you illustrated… (discuss two details that put this criterion at the proficiency level and then give two suggestions or ask two questions to move this criterion to mastery).
• In your summary of the proposed solution, you assessed… (discuss two details that put this criterion at the proficiency level and then give two suggestions or ask two questions to move this criterion to mastery).
Provide feed back for each of those areticles 1 & 2
apa formatting