Category: Nursing

Purpose
The purpose of the graded reflection is to provide the student an opportunity to reflect on learning in the course related to course outcomes, program outcomes, and competencies. Reflective inquiry allows for expansion in self-awareness, identification of knowledge gaps, and assessment of learning goals.
Course Outcomes
This assignment enables the student to meet the following course outcomes:
CO 1: Apply advanced practice nursing knowledge to collecting health history information and examination findings for psychiatric mental health patients across the lifespan. (POs 1, 2)
CO 2: Adapt health history and mental status examination to the developmental, gender-related, age-specific, and special population needs of the individual patient. (POs 1, 2)
Reflect on your readiness to practice as a psychiatric mental health nurse practitioner (PMHNP). Guiding questions are provided or you may write about what you felt was most significant to you for the week.
Week 5 Guiding Questions
This week you learned about the mental status exam.
Which element of the mental status exam do you think you will find most challenging?
Were any of the descriiptive terms new to you?
Have you observed any of the less common speech terms in your role as a nurse such as staccato or pressured speech?
Include the following sections:
Reflection:
Write 1-2 paragraphs reflecting on your learning for the week. Address the guiding question or relate the reflection to what you found most significant for the week.

1. Describe the pathophysiology of stroke in your own words.
A. What are the patients risk factors for this diagnosis?
B.pathophysiology of stroke
C. Causes risk factor
1. Genetic 2, ethnic 3.physical
2. What are the patients signs and symptoms for stroke
A. How does a stroke impact.
Integumentary system, skeletal system, muscular system, nervous system, endocrine system, cardiovascular, lymphatic system, respiratory system, digestive system, urinary system, reproductive system.
B.What are the complication of the effected body system
( if the body system isn’t effected put n/a)
3. What are other potential diagnosis that present in a similar way to this diagnosis (differentials)?
4. What diagnosis test or labs would you order to rule out the differential for this patient or confirm the primary diagnosis.
5. What treatment options would you consider ? Include possible referrals and medication

Phase III: Program Design: Students will design a primary prevention health care program with the goal of decreasing exposure of the target population to the risk considering how the program will function within the current health care environment.
Program Design Criteria:
1. Program title
2. Target population
3. Priority risk that will be targeted for reduction by this program
4. List two formal Goals for the program & three Objectives for each goal (goals should have a time frame. Objectives should be issue or participant centered, have a time frame and be measurable. See Bloom’s taxonomy for measurable verbs.
5. Relate the vision of the program as it will be (core components) including:
a. Location of the program
b. Key players to maintain the program and implement it
c. Day to day functions, activities etc. How it works.
d. Accessibility, availability, affordability of the program
6. Budget and funding
7. Evaluating the program’s outcome based on the set goals and objectives.
Be creative! Think out of the box! Use your community members and other stakeholders!
You will need to make sure that the goals and objectives you discuss are measurable and participant-focused. Here is a link to how to develop SMART goals from the University of California. I also included a link to Bloom’s taxonomy for measurable verbs to use as well.

https://www.ucop.edu/local-human-resources/_files/performance-appraisal/How%20to%20write%20SMART%20Goals%20v2.pdf
https://edspace.american.edu/ctrl/blooms_taxonomy/
While this says for HR purposes it is the same step-by-step process you should use to develop the goals and then the subsequent objectives for your primary prevention program. Make sure you don’t go too broad with your goals and objectives. One way is to look back at the risk factors you listed and choose one as the basis of your program that you feel is the priority risk and provide the rationale for your selection. Write goals and objectives that can bring measurable changes in the outcomes of the population you chose. They don’t have to be huge changes, the point is to be measurable and each has a time frame. Sometimes small changes make the biggest difference in overall outcomes.
The core components of the program should be in these goals and objectives as well. Where is the location of your program? Who are the key players to maintain the program and implement it? What are the day-to-day functions, or activities you will implement? Remember to focus on primary prevention (reduce the risk/prevent the onset of the issue). This is to be your own original program not one that exists already. The funds for the program can come from wherever you want: a grant, the city or county, or a donor … Make sure the budget is detailed.
For reference, I will include Phase one and two to know what we spoke about:
Phase one:
Epidemiological Research on Falls among Elders in New York Nursing Homes
1. Epidemiological Perspective
Occurrence (Prevalence and Incidence)
Falls remain one of the most common causes of injuries among the adult population, particularly older adults (Vaishya & Vaish, 2020). Research reveals that the rate of falls in nursing homes is high across New York, with several research works citing the figure to be between 50-75% of the nursing home residents falling annually.
Severity (Mortality Incidence)
Falls are the leading cause of injury-related death among the elderly (Haagsma et al., 2020). The mortality rates associated with falls in nursing homes are very high, and many of the victims had pre-existing conditions.
· Demographics
Gender: Females are more likely to fall in nursing homes than males due to the longer span of their age and higher prevalence of conditions like osteoporosis (Niznik et al., 2021).
Education and Income: This could be due to disparities in health literacy and access to preventive care among individuals with limited formal education and income.
Geographical Areas: Nursing homes in the urban setting have higher incidences of fallers, more than likely because of the higher concurrency of residents and variations in staffing patterns.
· Epidemiological Model Explanation
Falls in the context of the Web of Causation Model refer to the occurrence of the fall being due to a number of factors, such as the patient’s general state of health, mobility, medication impact, and physical barriers within the nursing home.
2. Ecological Perspective
Political Factors
Health policies, such as staffing ratios in nursing homes and state funding for elder care services, determine the extent of fall prevention care programs offered.
Economic Factors
Economic challenges have repercussions on the quality of care and the facilities in nursing homes, as well as, consequently, the rate of falls.
Social and Cultural Factors
Preventative measures taken due to cultural attitudes towards the elderly and perceived importance given to their care affect fall incidence reportage.
Environmental Factors
Unsuitable architectural design, such as poor lighting and slippery floors, is one of the leading causes of falls among the elderly.
References
Vaishya, R., & Vaish, A. (2020). Falls in older adults are serious. Indian Journal of Orthopaedics, 54(1), 69–74. https://doi.org/10.1007/s43465-019-00037-x.
Haagsma, J. A., Olij, B. F., Majdan, M., van Beeck, E. F., Vos, T., Castle, C. D., Dingels, Z. V., Fox, J. T., Hamilton, E. B., Liu, Z., Roberts, N. L. S., Sylte, D. O., Aremu, O., Bärnighausen, T. W., Borzì, A. M., Briggs, A. M., Carrero, J. J., Cooper, C., El-Khatib, Z., & Ellingsen, C. L. (2020). Falls in older aged adults in 22 European countries: incidence, mortality and burden of disease from 1990 to 2017. Injury Prevention, 26(Supp 1), i67–i74. https://doi.org/10.1136/injuryprev-2019-043347.
Niznik, J. D., Li, X., Gilliam, M. A., Hanson, L. C., Aspinall, S. L., Colon-Emeric, C., & Thorpe, C. T. (2021). Are Nursing Home Residents With Dementia Appropriately Treated for Fracture Prevention? Journal of the American Medical Directors Association, 22(1), 28-35.e3. https://doi.org/10.1016/j.jamda.2020.11.019.
Phase 2:
Research studies have estimated that the nursing home fall rate in New York is between 50% and 75% of residents who fall each year (New York State Department of Health, n.d.).
Cluster 1: Risk – Environmental Factors
· Poor architectural design, including inadequate lighting and slippery floors.
· Insufficient handrails and assistive devices throughout the facility.
· Higher resident density in urban nursing homes.
· Weather-related conditions, such as snow, rain, and wind.
· Hallways and rooms cluttered with furniture or personal items can obstruct movement.
Impact:
· These environmental hazards create unsafe conditions, making it difficult for elderly residents to navigate without falling.
· Poor maintenance can exacerbate risks, especially during adverse weather conditions, leading to slippery outdoor areas.
Cluster 2: Risk – Physiological Factors
· Age-related health issues, including osteoporosis, balance impairments, and muscle weakness.
· Cognitive decline, particularly in residents with dementia, increases fall risk.
· Side effects of medications, such as dizziness and confusion, further compromise mobility and stability.
· Declining eyesight in elderly residents can reduce their ability to detect obstacles.
Impact:
· Physiological vulnerabilities make elderly residents more prone to falls, especially when combined with environmental hazards.
· Pre-existing health conditions can amplify the severity of injuries sustained during falls.
Cluster 3: Risk – Cultural/Social Factors
· Disparities in health literacy and access to preventive care based on education and income levels.
· Cultural attitudes toward elderly care.
· Social isolation within nursing homes.
· Diverse linguistic backgrounds may not fully understand safety instructions.
Impact:
· Cultural and social factors can hinder the implementation of effective fall prevention strategies.
· Residents from lower-income backgrounds may not receive adequate support or resources for fall prevention.
Prioritization of Risks
· Environmental Hazards: Unsafe physical surroundings in nursing homes.
· Physiological Vulnerabilities: Age-related health issues that increase fall risk.
Cultural and Social Disparities: Inequities in access to care and fall prevention resources.
The topic name is Falls among Elders

Participate in your entity/department Journal Club discussion by formally responding (in 100 words or more) the following article. Please see attached article bellow about Neurogenic Shock.
What is the key issue or question pertaining to the nursing practice identified in the article and why is it important?

Using the bill selected for the Discussion Board: Healthcare Bills, write a 1-page letter to your legislator. Include the following in your letter:
Identify the bill number.
Clearly indicate and explain if you are for or against the bill.
Sign the letter with your name and credentials (LVN/LPN, RN, APRN, etc.).
Submission and Assessment Guidelines
The activity should be no more than 1 double-spaced page in length.
Be sure to cite your sources, if applicable.
Submit your written assignment as a Microsoft Word document through Turnitin.
Review the Writing Assignment Rubric for grading criteria.

Talking With Patients About Quitting SmokingBecause of the serious detrimental effects of smoking, education about quitting smoking is a priority for nursing interventions when caring for patients who smoke. Major organizations that emphasize the role of nurses in helping patients quit smoking include the American Nurses Association, the U.S. Department of Health and Human Services, and The Joint Commission on Accreditation of Healthcare Organizations.
You have been charged with developing a Quick Facts Information Sheet on the Risks of E-cigarettes for Kids, Teens, and Young Adults.
You start with the following information below: what else do you believe would be important to include in your one page FLYER.
Create a flyer to use in a community outreach clinic with your teens and young adults. Please include references on a separate page. Review the rubric to avoid losing EASY points.
What Are E-cigarettes?
E-cigarettes are electronic devices that heat a liquid and produce an aerosol, or mix of small particles in the air.
E-cigarettes come in many shapes and sizes. Most have a battery, a heating element, and a place to hold a liquid.
Some e-cigarettes look like regular cigarettes, cigars, or pipes. Some look like USB flash drives, pens, and other everyday items. Larger devices such as tank systems, or “mods,” do not look like other tobacco products.
E-cigarettes are known by many different names. They are sometimes called “e-cigs,” “e-hookahs,” “mods,” “vape pens,” “vapes,” “tank systems,” and “electronic nicotine delivery systems (ENDS).”
Using an e-cigarette is sometimes called “vaping.”
Create a flyer to use in a community outreach clinic with your teens and young adults.
Sample below:
Please ensure you cite all your sources on a separate page and be creative.

Library Assignment Instructions for Nursing Students
Purpose:
The purpose of this library assignment is to help nursing students to develop their research skills and to become familiar with different credible data sources available through the Library page at the FNU.edu website. In addition, this assignment will help students to apply the PICOT (Population, Intervention, Comparison, Outcome, and Time) question format to develop a research question and to locate and evaluate scholarly sources.
Instructions:
Topic Selection: Select a topic that interests you and that is relevant to nursing Psychiatric practice. Your topic should be broad enough to allow for an in-depth exploration but narrow enough to be manageable within the scope of an 250-500-word (1 page) research paper. You may select a topic related to patient care, nursing education, health promotion, or any other area of nursing practice that interests you in the realm of psych.
Searching for Literature: Use the Library page at the FNU.edu website to search for scholarly sources related to your topic. You must utilize at least 3 scholarly sources that have been published within the last 5 years. You may use databases such as CINAHL, MEDLINE, Embase, Clinical Key, The Cochrane Library. Be sure to use appropriate keywords and to apply search filters to limit your search to scholarly, peer-reviewed articles.
Evaluating Sources: Once you have identified potential sources, use the CRAAP test (Currency, Relevance, Authority, Accuracy, and Purpose) to evaluate their credibility and relevance to your research question. Be sure to select sources that are relevant to your topic, written by credible authors, and based on rigorous research methods.
Writing the Paper: Your research paper should follow APA 7 guidelines and include the following sections: Introduction, Literature Review, Methodology, Results, Discussion, and Conclusion. Be sure to use in-text citations and to include a reference list at the end of your paper.
Please keep in mind that the paper will be checked for plagiarism, and similarity above 25% will not be accepted for submission.

Week 6: Discussion Forum for Chapters 16 – 17
Discussion
Discussion Prompt:
(Respond to both questions this week please)
Read Alligood (2022) Chapter 16. Neuman states that the human system is dynamic and moves towards negentropy or wellness. In your initial post, while maintaining confidentiality, what have you experienced in your nursing practice that supports her theory?
Read Alligood (2022) Chapter 17. In your initial post, discuss the meaning of Sister Callista’s Roy’s adaptation model. While maintaining confidentiality, what aspect of her theory do you think you could apply to your personal nursing practice?
In both your initial post and your reply post, it is important that you maintain confidentiality in discussions. Reference your posts in APA format and be sure to answer all questions posed in narrative form.
Your initial post is due on Wednesday at 11:59pm EST and your reply post is due on Sunday at 11:59pm EST.
For detailed grading criteria, refer to the discussion board rubric.
Reference
Alligood, M.R. (2022). Nursing theorists and their work (10th ed.). Elsevier.
Reply

Topic: The Importance of Emotional Intelligence in Nursing Leadership
Reflect on the significance of emotional intelligence in nursing leadership.
Discuss how emotional intelligence enhances the effectiveness of nurse leaders in conflict resolution, team building, and decision-making.
Share examples from personal experiences or observations in healthcare settings to support your points.
Explore ways to develop and improve emotional intelligence skills to become a more effective nursing leader.
Discussion Board Assignment 2:
Topic: Ethical Challenges in Nursing Leadership
Identify and analyze a specific ethical challenge nursing leaders may face.
Discuss potential consequences of the ethical dilemma on patients, staff, and the healthcare institution.
Propose strategies for nursing leaders to navigate ethical challenges while upholding professional standards and ensuring quality patient care.

Participate in your entity/department Journal Club discussion by formally responding (in 100 words or more) the following article. Please see attached article bellow about Neurogenic Shock.
What is the key issue or question pertaining to the nursing practice identified in the article and why is it important?