Course Project – Select Topic

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Course Project – Select Topic

Course Competency:

Analyze the increased complexity of care among older adults.

Your supervisor needs to make sure that each of the in-service topics will be covered by someone, so she is asking the staff to communicate their topic preference. Below is the list of problems your supervisor wants the nursing staff to be able to teach older adult clients (and/or their family members) about.
In-service Topic Options:

Hypertension
Diabetes
Coronary artery disease
Depression
Dementia
Polypharmacy
Increased risk of falls
Vison/hearing impairment
Nutrition and hydration

Your supervisor has asked you to submit a 1-page proposal, written using proper spelling, grammar, and APA, which addresses the following:

Identify the client problem your in-service will address.
Describe at least 5 consequences of the client problem as it relates to the health, safety, and well-being of older adults.
Explain your rationale for choosing the client problem you selected.

 

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Pain Care Plan for Nursing

Score an A in this assignment. Get an original solution.  Mr. Gordon, a 52 year-old client who was admitted to the hospital following an MVC (motor vehicle crash). He suffered rib fractures and has a laceration along his right thigh. Mr. Gordon states that his pain is 9 on a 0 – 10 scale (0 being no pain, 10 being the worst). In addition his vital signs are: BP 150/88, HR 105, RR 22, SpO2 95% on RA (room air), T 98.6 degrees Fahrenheit taken orally. 
Long term and Short term goals?

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SBAR AND COMMUNICATION

Score an A in this assignment. Get an original solution.   
Students are required to identify a research article that demonstrates the importance of communication when giving or receiving handoff report or calling a provider. The research article will be summarized in a paragraph. The APA reference will be provided. Students will be required to write a SBAR format regarding a patient you meet in clinical or a made-up scenario. 

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Read carefully due at 11 pm 08/31/2022 a must

Score an A in this assignment. Get an original solution.  
To Prepare:

Review practice agreements in your state.
Identify whether your state requires physician collaboration or supervision for nurse practitioners, and if so, what those requirements are.
Research the following:

How do you get certified and licensed as an Advanced Practice Registered Nurse (APRN) Psych in your state?
What is the application process for certification in your state?
What is your state’s board of nursing website?
How does your state define the scope of practice of a nurse practitioner?
What is included in your state practice agreement?
How do you get a DEA license?
Does your state have a prescription monitoring program (PMP)?
How does your state describe a nurse practitioner’s controlled-substance prescriptive authority, and what nurse practitioner drug schedules are nurse practitioners authorized to prescribe?

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Proposal Homework

Score an A in this assignment. Get an original solution. Please provide 3 page summary of proposal in Title of (The Relationship between Mental Workload and Job Performance among Nurses during Covid-19), that will include:
1. One paragraph on the importance of topic and some background that leads to studying the problem.
2.  One-two paragraph on the state of the science
3.  The purpose and research questions (Be sure IV and DV are clear)
4.  Proposed Design
5.  Setting and Sample( the study will take place in King Fahad Medical city in Riyadh, Saudi Arabia).
6.  Variables and their measurement
7.  Procedure
8.  Analysis

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Factors That Influence the Development of Psychopathology

Score an A in this assignment. Get an original solution.   
NOTE: 300 words with 4 resources (2 below+2 others). Kindly read the instruction below.
In many realms of medicine, objective diagnoses can be made: A clavicula is broken.  An infection is present. TSH levels meet the diagnostic criteria for hypothyroidism. Psychiatry, on the other hand, deals with psychological phenomena and behaviors. Can these, too, be “defined objectively and by scientific criteria (Gergen, 1985), or are they social constructions?” (Sadock et al., 2015).
Thanks to myriad advances during recent decades, we know that psychopathology is caused by many interacting factors. Theoretical and clinical contributions to the field have come from the neural sciences, genetics, psychology, and social-cultural sciences. How do these factors impact the expression, classification, diagnosis, and prevalence of psychopathology, and why might it be important for a nurse practitioner to take a multidimensional, integrative approach?
To Prepare:

Considering the many      interacting factors that contribute to the development of psychopathology.
Consider how theoretical      perspective on psychopathology impacts the work of the PMHNP.

Assignment
Explain the biological (genetic and neuroscientific); psychological (behavioral and cognitive processes, emotional, developmental); and social, cultural, and interpersonal factors that influence the development of psychopathology.
Sources
Sadock, B. J., Sadock, V. A., & Ruiz, P. (2015). Kaplan & Sadock’s synopsis of psychiatry (11th ed.). Wolters Kluwer.
Butcher, J. N., & Kendall, P. C. (2018). Introduction to childhood and adolescent psychopathology. In J. N. Butcher & P. C. Kendall (Eds.), APA handbook of psychopathology: Child and adolescent psychopathology., Vol. 2. (pp. 3–14). American Psychological Association. https://doi.org/10.1037/0000065-001

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USA Healthcare Comparison

Score an A in this assignment. Get an original solution. Assess the degree and quality of care established in 18th-century U.S. hospitals, as compared to the level of care seen in 21st-century hospitals.
Compare and contrast the U.S. health care delivery system relative to spending per capita and ranking of health care outcomes with the health care systems of two other countries.
Determine whether the U.S. health care delivery spending per capita is detrimental to the quality of care provided in the 21st-century hospitals. Provide specific examples to support your rationale from readings throughout your program or from peer-reviewed journal articles.

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project considerations

Score an A in this assignment. Get an original solution.  Why is professional Collaboration and a good implementation plan crucial to developing a DNP project?
What are possible barriers and challenges that could be anticipated to grant a project? (like balanced budged, needed resources and staff, lack of knowledge, interest in the project or education by the stakeholder). Or any other aspect that you consider important as part of planning for a project.
 Your post will be checked in Turnitin for plagiarism. Responses should be a minimum of 250 words, scholarly written, APA formatted, and referenced.  A minimum of 3 references are required (other than your textbook). 

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Pharm W1 ASSIGN 1

Score an A in this assignment. Get an original solution. Be sure to provide 5 APA citations of the supporting evidence- based peer reviewed articles you selected to support your thinking.
Please be sure to follow EACH AND EVERY BULLET POINT.
Make sure to ANSWER EACH QUESTION ACCURATELY.
(TOPIC: In attachment) *** 2 Page assignment
Please do not plagiarize nor reword another persons assignment that has been previously submitted.
Look at the attachment for the assignment and SOURCES to NOT USE!!!
DO NOT turn in late, please pay attention to the DUE DATE.

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Nursing situation CHF

Score an A in this assignment. Get an original solution.  
CHF nursing situation
Patient is a 82 year old male who presented to the ED at 5am for shortness of breath worsening over the past day, PMH includes CHF, HTN, hyperlipidemia, CAD s/p cardiac stents in 2014, DM, osteoarthrtis, BPH, depression, CKD st 3
Admitted for CHF exacerbation, pneumonia, acute on chronic renal disease
You receive him on the floor at 11:30 am, he appears to be alert and oriented, but lethargic, states he hasn’t taken any home meds yet today, has not eaten yet either.  Lives at ALF, uses walker
In the ED, he received IV furosemide 40mg, 650mg Tylenol, 500mg IV levofloxacin and an albuterol/ipratropium nebulizer treatment
Selected labs, diagnostics, and orders
WBC
18.2
Hgb
10.4
K (potassium)
3.1
creatinine
4.1
blood glucose
308
BNP
8023
Urine – blood
large
Urine – leukocytes
+3
Urine – culture
pending
COVID 19 PCR – negative
chest x-ray
bilateral infiltrates, pleural effusions
sputum sample to be collected
normal sinus rhythm on tele monitor
vital signs
170/64, P55, R23, O2 90% room air, temp 100.4, ht 178cm, wt 90kg
Diet: cardiac, 1800 ADA, 1 liter free water restriction
Activity: as tolerated
Strict I&O
home medications – have all been profiled to  MAR
Hospital meds
metoprolol
25mg
BID
albuterol/ipratropium
Q6hrs
amlodipine
5mg
QAM
furosemide IV
40mg
once 6pm
lisinopril
20mg
QAM
levafloxacin IV
500mg
Q24hrs
atorvastatin
40mg
QPM
tylenol
650mg
Q6hrs  PRN
tamsulosin
0.4mg
QPM
IV potassium  10 meq
x3
clopidogrel
75mg
QAM
aspirin
81mg
QAM
escitalopram
10mg
QAM
metformin
1000mg
BID
tramadol
50mg
Q8hrs PRN
gabapentin
200mg
BID
temazepam
7.5mg
QHS PRN
Consults pending – cardiology, ID, nephrology
Personal history
former smoker, quit 35 years ago
does not drink alcohol
did not get flu shot this year
Discussion 
What would you expect breath sounds may be like (document this in EHR)?
What would you expect skin condition/lower extremities to be like (document this in EHR)?
What interventions would you perform (safety, patient care, medication, etc)
What else are you concerned about when assessing?
Think about questions to ask the patient so you have a better report to give to consulting providers if they call
What does each medication do?  Would you hold any?
Additional assessment to document in EHR:
GI – bowel sounds in all quadrants, soft non-tender
GU – noted this in urinal

Cardiac S1S2, pulses ok in all ext, normal cap refill
HEENT – seems a bit hard of hearing, head without wounds, eyes, nose, oral mucosa ok. Has dentures (upper and lower)
Resp – seems to cough a lot after drinking water/taking pills
Pain – no issues
IV – left forearm 20g, flushes well, no leaks
Possessions – has glasses, iPhone, bottle of home tramadol
Retired engineer, married, lives at ALF with spouse

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Week 2: Healthcare Systems Leadership

Score an A in this assignment. Get an original solution.  
Part I 
Please answer the following questions:
1. What is the impact of the DNP-prepared healthcare systems leader on the healthcare systems of today?
2. How do you anticipate integrating this role into your current or future career?
3. In your opinion, what is needed for successful professional identity formation in DNP students to achieve healthcare system leadership roles after graduation?
Part II: For Case Study Students
·       Please hear state your practice question in PICOT format to start. Please use the bullet points below as headings, bold the questions as headings, and respond separately to each question. Every week, please answer each bullet point.
 ***PICOT question:
In overweight adult patients in a primary care clinic, what is the impact of implementing the American Heart Association Diet and Lifestyle recommendations, compared to standard care, on body weight in 8-10 weeks?*****
·       Discuss best practices for implementing evidence-based practice guidelines with citations and matching references sufficient to support your discussion.
·       Discuss strategies for overcoming barriers in implementing evidence-based practice with citations and references to support strategies.
·       Discuss your formative evaluation plan to check intervention fidelity.
·       In Week 2, your formative evaluation plan reveals a few staff did not implement the evidence-based intervention as intended. What is your next step?
·       In your simulated Case Study, some staff state, “I am too busy” or “I do not see a need for change since the ‘way we have always done it’ works fine.” How will you address this?
·       You identify that stakeholders were not included in the project planning meetings and are resisting change.  How will you work with these stakeholders to turn their resistance into support?
·       Thinking about a live implementation, are there additional resources that may be necessary for a successful implementation?   If so, what are those resources?
Class, each week, when you share your implementation progress, successes, challenges, and barriers, your classmates may be feeling the same way, or have experienced a similar situation and can share their experiences as well. 
 Your post will be checked in Turnitin for plagiarism. Responses should be a minimum of 350 words, scholarly written, APA formatted, and referenced.  A minimum of 3 references are required (other than your textbook).  
  
****Weeks 2-9: Implementation: Project participants will follow the American Heart Association Diet and Lifestyle recommendations guidelines, that focus on knowing how many calories an individual should be eating and drinking to maintain body weight and aiming for at least 150 minutes of moderate physical activity or 75 minutes of vigorous physical exercise (or an equivalent combination of both) each week. As a formative evaluation, the DNP student will call participants weekly to reinforce them to follow the diet and lifestyle recommendations, audit the smartphone Fitbit app, track their usage, and answer any questions. The DNP student will meet with staff weekly to discuss questions and concerns with calorie and activity tracking and offer support for the program. The DNP student will collect participants’ compliance data with app and tracker usage during each phone call.***

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student response 1

Score an A in this assignment. Get an original solution.  
Case B 14-year-old biracial male living with his grandmother in a high-density public housing complex.
To start, we should always keep in mind how personal their experience with us can be. They can be coming to us with many issues as far as health both physical and mental, socioeconomic issues, potential unsafe living situations, and many other stresses that life can throw at people. These are all important things that should be discussed besides the chief complaint. We must assess home situations, access to care, social situations, etc. It is important to make sure that we are being personable and not just going through the motions.
We should always knock before coming into the room, introduce yourself and get your patient’s name, make sure that the room has good lighting and is a temperature that is comfortable to the patient, discuss what has brought them in, and discuss what their understanding of the problem is (Ball, Dains, Flynn, 2019). This will show the patient that you care and that you seem them as an individual rather than just another patient for the day. This also instills confidence and makes them more likely to open up to you about different issues. It is always important to include the patient in their care rather than just discussing only your thoughts with them while dismissing their thoughts. Including the patient in their care is known as patient-centered care and is an important part of providing safe and high quality care (Santana, Manalili, Jolley, Zelinsky, Quan, Lu, 2018). That is the reasoning behind using the listed techniques.
I think for the risk assessment instrument, I would use IHELLP. It stands for income, housing, education, legal status, literacy, and personal safety. Since my patient is only 14 and living with a grandmother in a public housing complex, I would have concerns about access to care and resources as well as their living situation and education. This would allow me to explore things like employment status, whether or not the patient has any health coverage or is on any kind of assistance, whether or not they are in safe housing, if they have any substance use disorders, proper education, and safe living situations (Berman, Patel, Belamarich, Gross, 2018). I would be interested in the patient’s chief complaint as well, but we must assess home situations also. We must ensure that our patients are in good hands and properly cared for both in and outside of the office or hospital setting.
It is difficult to narrow it down to just five targeted questions, but if I had to ask only five, they would be the following.

Do you feel safe at home?
How do you cope with stress?
How do you feel about your time spent in school?
Do you feel you have good access to care and resources?
How do you view your health and what are your expectations for care?

I would hope that this would give me an idea of what the patient’s life is like as far as education, safety, concerns, resources, how they see themselves, and what their goals are as far as health. There would be much more to discuss. Sometimes patients of this age can have an especially difficult time expressing themselves or feel nervous about discussing certain topics or even seeking help. Great care would be needed as well as a delicate approach and close attention to all verbal and non-verbal cues.
Resources
Ball, J. W., Dains, J. E., & Flynn, J. A. (2019). Seidel’s Guide to Physical Examination (9th Edition). Elsevier Health Sciences (US). https://mbsdirect.vitalsource.com/books/9780323481953
Berman, R. S., Patel, M. R., Belamarich, P. F., & Gross, R. S. (2018). Screening for Poverty and Poverty-Related Social Determinants of Health. Pediatrics in review, 39(5), 235–246. https://doi.org/10.1542/pir.2017-0123
Santana, M. J., Manalili, K., Jolley, R. J., Zelinsky, S., Quan, H., & Lu, M. (2018). How to practice person-centred care: A conceptual framework. Health expectations : an international journal of public participation in health care and health policy, 21(2), 429–440. https://doi.org/10.1111/hex.12640

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student response 2

Score an A in this assignment. Get an original solution.  
Adolescent Hispanic/Latino boy living in a middle-class suburb
Building a therapeutic relationship requires effective communication, one of the most crucial components. Finding out if the patient speaks and understands English is vital since, in this case, communication hurdles may arise because the patient is Hispanic. It may be possible to enhance patient outcomes by effectively disseminating complex medical information to various patient populations. The patient’s age is a substantial obstacle to effective communication in this situation; thus, they may have low health literacy. The patient must articulate the agreed-upon plan, and the engagement must be easily understood. Teenagers are typically at the age when risky activities are explored.
Additionally, these patients are more reluctant to speak; maintaining confidentiality is crucial. Consequently, it is necessary to clarify the boundaries of secrecy. For the patient to communicate their requirements privately during the interview, the parent or caregiver should be asked to leave the room (Ball et al., 2019).
How would your communication and interview techniques for building a health history differ with each patient?
To build the trust necessary to help patients to disclose sensitive and personal information, breaking social challenges and working with them to find solutions is very important. The healthcare professional needs to accept people from all cultural backgrounds and avoid stereotyping by realizing that individual variation within groups is frequently more pronounced than the variation between groups (Anderman, Pang, & Newton, 2016). Effective communication establishes a successful provider-patient relationship during the initial consultation with the patient. The patient will comprehend that the physician is accessible, adaptable, and eager to assist with queries while clarifying the care provided. That the goal is to learn what matters to this patient in terms of concerns and expectations, and this is accomplished when the physician demonstrates sincere interest, curiosity, and relationship-building (Ball et al., 2019)
How might you target your questions for building a health history based on the patient’s social determinants of health?
Both parties can better grasp the challenges and issues that should be prioritized for the patient when the healthcare professional builds a relationship with the patient through development and familiarization with the patient’s health history. According to the World Health Organization (WHO 2020), social determinants of health include “a wider variety of elements and institutions that have an impact on the conditions of daily life, as well as the circumstances under which people are born, grow, work, live, and age.”
What risk assessment instruments would be appropriate to use with each patient, or what questions would you ask each patient to assess his or her health risks?
Van et al., Stated that by the time adolescents reach adulthood, they are “12 times more likely to have attempted suicide, seven times more likely to be exposed to alcohol, and ten times more likely to have injected street drugs” than their peers who have not experience multiple forms of abuse. Such as domestic violence or growing up in a home where family members are mentally ill, substance abusers, or have been imprisoned (2014). The answers to the risk-related questions would rely on several variables, including how peer pressure, a loosening of parental bonds, a lack of school attendance, and low self-esteem (Ball et al., 2019).
Identify any potential health-related risks based upon the patient’s age, gender, ethnicity, or environmental setting that should be taken into consideration.
According to Ball et al. (2019), the main problem, a brief statement explaining why the patient has come in for help, can be addressed after the identifiers are out of the way. The practitioner wants to know more about how this worries the patient so much that they are seeking assistance rather than just putting up with it and going about their everyday lives. Finding out how long this issue has been affecting the patient’s life and collecting direct quotes from them are beneficial. The next step is to gather information on the current topic, any prior medical issues, family history, and personal and social history. Understanding the current issue requires a step-by-step analysis of the facts surrounding the primary cause of this patient’s need for assistance. Any previous medical or surgical procedures are included in the past medical history since they help provide a clearer picture of the patient’s overall health. The patient’s family history may contain hints about potential genetic causes for their issues. Carefully consider the patient’s work patterns, family relationships, and interactions with coworkers while asking about their personal and social experiences. Finally, a system review needs to be finished (Ball et al., 2019).
Select one of the risk assessment instruments presented in Chapter 1 or Chapter 5 of the Seidel’s Guide to Physical Examination text, or another tool with which you are familiar, related to your selected patient.
HEEADSS is a screening assessment instrument that would be effective for adolescents. Using this evaluation tool can help the healthcare professional discover the following:
“What’s going on at home?
“Are you working? “How is school going?”
“Describe your friends to me.”
“What sort of after-school activities do you engage in?”
“What are your strengths?”
To encourage the patient to provide more information later, start by asking them open-ended inquiries. However, several technologies have been created focusing on health promotion and prevention to enhance healthcare interactions with young people. These include the Event History Calendar and the Guidelines for Adolescent Preventive Services (GAPS), the current standard of care (EHC). The GAPS was created to provide a screening tool for routine examination of adolescent psychosocial difficulties, health risk behaviors, and biological problems.
References
Andermann A, Pang T, Newton J. (2016). Evidence for health III: producing evidence for improving health and reducing inequities. Health Res Policy Syst 2016;14:18
Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2019). Seidel’s guide to physical examination: An interprofessional approach (9th ed.). St. Louis, MO: Elsevier Mosby. Low LK. (2003). Guidelines for adolescent preventive services (GAPS) Journal of Midwifery & Women’s Health. 2003;48:231–233.
Van Niel C, Pachter LM, Wade R, Jr. (2014). Adverse events in children: predictors of adult physical and mental conditions. J Dev Behav Pediatr 2014;35:549–51
World Health Organization. (2020). What are the social determinants of health? Geneva: www.who.int/social_determinants/sdh_definition/en/

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student answer Pharm 1

Score an A in this assignment. Get an original solution.  COLLAPSE
Pharmacokinetics is the study of how drugs are metabolized, distributed, excreted, and absorbed by the body (Rosenthal & Burchum, 2021). Pharmacodynamics, simply put means what a drug does to the body, “is the study of the biochemical, physiologic, and molecular effects of pharmaceuticals on the body” (Farined, 2021).
            The patient case I will be discussing and analyzing is a 60-year-old male with a past medical history of diabetes, hypertension, alcohol abuse, and hyperlipidemia who presented to the emergency department for acute kidney injury while he was at home working in his garage. The patient was admitted to the neurology/Med-Surg unit where I work. The patient suddenly became light-headed, with right arm weakness, numbness in his right hand, and blurry vision. A stroke code was activated, and the patient was immediately taken for a CT scan to rule out hemorrhagic stroke, consent was obtained by the neurology doctor for possible Tissue plasminogen activator (TPA) administration. My unit is part of the inpatient stroke team, and TPA was immediately started on the patient post-CT scan. Tissue plasminogen activator (TPA) is a drug of choice when an ischemic stroke is of concern because the pharmacodynamics of TPA works by dissolving blood clots that are blocking the blood flow to the brain (National Institute of Neurological Disorders and Stroke, 2022). With the start of the TPA medication, as one of the stroke team champions, I was assigned to closely monitor and assess the patient for any neurological changes as well as any changes in his vital signs until the patient was taken to the intensive care unit. Without realizing it I was evaluating the pharmacodynamics and pharmacokinetics of the TPA administered.
Factors that may have influenced the pharmacokinetic and pharmacodynamic processes of the patient would be his age, health, sex, other medical conditions such as hypertension, diabetes, hyperlipidemia, etc., and genetic makeup. Also, additional considerations would be considered, If the patient is taking any over-the-counter medication, such as vitamins and/or supplements, as these could potentially have negative side effects on his prescribed medications. Fortunately, the patient declines the use of any of these medications.
Based on the patient’s unique medical and social history, contributing variables, and the medical plan of care, it was decided to intensively monitor the patient throughout his hospital stay for any neurological abnormalities brought on by the TPA administration.
Due to the stroke, I would advise him to continue his prescribed long-term anticoagulant. However, before choosing which anticoagulant to administer to the patient, I would want to speak with the patient and go over the advantages and disadvantages of the various types of anticoagulants that are available. I would make sure the patient understands the reasons why the medication is prescribed before making any recommendations. Furthermore, it is crucial to inform him about the anticoagulant signs and symptoms of bleeding he should watch out for. According to Rosenthal and Burchum (2021), monitoring is a critical component of medicine administration, After the patient leaves the hospital, I would encourage him to follow up with an assigned neurologist and his primary care physician for close monitoring and to make sure he comes back for any scan that might be required.
References
 Farined, A. (2021). Dose-response relationships. https://www.merckmanuals.com/professional/clinicalpharmacology/pharmacodynamics/dose-response-relationships
National Institute of Neurological Disorders and Stroke. (2022). Tissue plasminogen activator for acute ischemic stroke (alteplase, activase®). https://www.ninds.nih.gov/aboutninds/impact/ninds-contributions-approved-therapies/tissue-plasminogen-activator-acuteischemic-stroke-alteplase-activase
 Rosenthal, L. D., & Burchum, J. R. (2021). Lehne’s pharmacotherapeutics for advanced practice nurses and physician assistants (2nd ed.) St. Louis, MO: Elsevier.

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Student answer 2 pharm

Score an A in this assignment. Get an original solution.  
Description of the patient case: 
The patient is a 26-year-old Male, who presented to our ER for worsening right elbow bursitis. The patient was seen in the ER 2 days prior for the same issue, underwent a drainage procedure with documented removal of only 1cc, and was started on PO Keflex. Fluid was also sent for culture. Since the last time in the ER, the patient reported worsening pain and spreading redness around the elbow. The patient also reported some intermittent numbness and tingling in the fingers of the right hand.  The patient decided to come back in due to concerns about a possible worsening infection.  The patient denied any fevers/chills or other systemic symptoms.  The patient denied tobacco or alcohol use. 
Factors that might have influenced the pharmacokinetic and pharmacodynamic processes of the patient
The patient was not responding to the trial of oral antibiotics.  Keflex 500mg PO QID instructed to take one tablet by mouth four times a day for 5 days.  Once inpatient, the patient was started on IV vancomycin.  Following the initial dose of Vancomycin 1.5gm IV loading dose, he had a mild vancomycin infusion reaction with a pruritic rash on the abdomen that resolved with PO Benadryl dose.  Following doses of vancomycin were tolerated better with Benadryl pre-treatment and slowing infusion rate.
One factor to consider in this case was the rate of the IV infusion.  “Red Man Syndrome” is used to describe the adverse effect of vancomycin infusion.  This anaphylactoid reaction is caused by vancomycin degranulation of mast cells and basophils resulting in histamine release independent of IgE (Rivera & Ryan, 2022).  Another factor that may be worth noting is gender.  According to Alvarez-Arango et al. (2021), White patients were found more likely to experience Red Man Syndrome than non-White patients.  Red Man Syndrome was also identified as more likely to affect male rather than female patients (Alvarez-Arango et al., 2021).  
A personalized plan of care
According to Rosenthal & Burchum (2021), one patient may experience adverse effects from a medication, while others may not.  Asking the patient to report symptoms during and after the initiation of medication can help with identifying adverse reactions and implementing a plan to treat symptoms.  In assessing the risk-to-benefit ratio of medication, one must consider the severity of the side effects (Rosenthal & Burchum, 2021).  In this case, vancomycin 1gm IV q12hrs (15mg/kg dosing) was continued.  The infusion rate was extended to 120 minutes.  The patient was also pretreated with Benadryl 50mg by mouth to prevent infusion reaction.
                                                                                                       References:
Alvarez-Arango, S., Michelle, O. S., Sequist, T. D., & Burk, C. M. (2021). Vancomycin infusion reaction — moving beyond “Red man syndrome”. The New England Journal of Medicine, 384(14), 1283-1286. doi:https://doi.org/10.1056/NEJMp2031891
Rivera, C. G., & Ryan, K. L. (2022). Call to Pharmacists: End Use of “Red Man Syndrome.” Annals of Pharmacotherapy, 56(1), 102–103. https://doi.org/10.1177/10600280211021417
Rosenthal, L. D., & Burchum, J. R. (2021). Lehne’s pharmacotherapeutics for advanced practice nurses and physician assistants (2nd ed.) St. Louis, MO: Elsevier.

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Psychopathology

Score an A in this assignment. Get an original solution.   
:  Factors That Influence the Development of Psychopathology
In many realms of medicine, objective diagnoses can be made: A clavicula is broken.  An infection is present. TSH levels meet the diagnostic criteria for hypothyroidism. Psychiatry, on the other hand, deals with psychological phenomena and behaviors. Can these, too, be “defined objectively and by scientific criteria (Gergen, 1985), or are they social constructions?” (Sadock et al., 2015).
Thanks to myriad advances during recent decades, we know that psychopathology is caused by many interacting factors. Theoretical and clinical contributions to the field have come from the neural sciences, genetics, psychology, and social-cultural sciences. How do these factors impact the expression, classification, diagnosis, and prevalence of psychopathology, and why might it be important for a nurse practitioner to take a multidimensional, integrative approach?
To Prepare:

Review      this week’s Learning Resources, considering the many interacting factors      that contribute to the development of psychopathology.
Consider      how the theoretical perspective on psychopathology impacts the work of the      PMHNP.

Main Assignment
Explain the biological (genetic and neuroscientific); psychological (behavioral and cognitive processes, emotional, developmental); and social, cultural, and interpersonal factors that influence the development of psychopathology.
Learning Resources
adock, B. J., Sadock, V. A., & Ruiz, P. (2015). Kaplan & Sadock’s synopsis of psychiatry (11th ed.). Wolters Kluwer.

Chapter      1, Neural Sciences
Chapter      2, Contributions of the Psychosocial Sciences
Chapter      3, Contributions of the Sociocultural Sciences
Chapter      4, Theories of Personality and Psychopathology
Chapter      31.17c, Child Psychiatry: Other Conditions: Identity Problem 

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