Describe a class in which you were a strategic learner in order to pass a test but did not come away from the class with a deep learning experience.
Originally posted 2018-04-01 21:46:34.
NR‐222 HEALTH AND WELLNESS REQUIRED UNIFORM ASSIGNMENT: HEALTH PROMOTION PROJECT PURPOSE To apply concepts you have learned about health promotion concepts and strategies, enhance your written communication skills, and demonstrate a beginning understanding of cultural competency.
COURSE OUTCOMES This assignment enables the student to meet the following course outcomes. CO #1 Discuss the professional nurse’s role in health promotion activities. (PO #1 & 2) CO #3 Discuss health promotion, illness prevention, health maintenance, health restoration, and rehabilitation in relation to the nurse’s role in working with various populations. (PO #1 & 2) CO #7 Identify health promotion strategies throughout the life span. (PO #1 & 2)
DUE DATE The Health Promotion Project (RUA) is due in Unit 5. However, refer to the Course Calendar for variations in campus requirements and details. The Late Assignment Policy applies to this assignment.
TOTAL POINTS POSSIBLE 100 Points REQUIREMENTS
1. Identify a health problem or need for health promotion for a particular stage in the life span of a population from a specific culture in your area (this might include age and gender population as well). Choose one of the Leading Health Indicators (LHI) priorities from Healthy People 2020 (see the Healthy People.gov 2020 Leading Health Indicators website link in the Assignment section for Unit 2 under “Web Links). Students in a cultural concentration will use that specific cultural focus to complete this assignment.
2. Research a topic related to health and wellness associated with one of the Healthy People 2020 topic areas. Students in a cultural concentration will use that specific cultural focus to complete this assignment.
3. Submit your topic to the instructor for approval at least 2 weeks prior to the assignment (during Unit 3) but earlier if desired. All topics must be approved.
4. You will develop an educational health promotion project addressing the population/culture in your area. For or example, if you are in the Hispanic concentration, your project might be educational interventions to address how food choices are related to the high rates of diabetes among Latinos; or, a community project that addresses the statistic that Hispanics experience new HIV infections at more than twice the rate of whites; or, finding opportunities to intervene with Puerto Ricans, a Hispanic subculture, who suffer asthma at twice the rate of the general population (2020 LHI Topic Three: Environmental Quality: (see the Healthy People.gov 2020 Leading Health Indicators website link in the Assignment section for Unit 2 under “Web Links).
5. General expectations All articles must be from nursing or scholarly journals and should include health promotion and wellness
content. Articles must be published within the last five (5) years. If you are unsure whether the article is appropriate, ask your instructor. You could lose significant points if the article is not from a scholarly source and/or appropriate to the topic.
Please ask questions if you need clarification.
NR‐222 HEALTH AND WELLNESS
NR222 RUA Health Promotion Project Guidelines.docx Revised 06/2016 psb 2
PREPARING THE ASSIGNMENT 1. Writing the Paper: You will explore the topic and explain the information in writing a 3‐4 page APA formatted
paper.
a. Select a minimum of three (3) scholarly nursing or research article (published within the last 5 years) related to your topic that include health promotion and wellness content. Students in a cultural concentration will select at least one article specifically related to the cultural focus for this assignment. You may need to evaluate several articles before you find appropriate selections. For more information on how to choose a scholarly article, open the “Course Resources” tab under the “Course Home” Menu to the left of your Learning Studio (eCollege) course page and open “What Is a Scholarly Source.”
b. Write a 3‐4 page paper (excluding the title and reference pages) using the following guidelines: Write brief introduction of the topic and describe why it is important to health promotion in the
specific cultural population in your area. Include a description of the topic and the targeted sub culture or population (include statistics). Explain how the project relates to the Healthy People 2020 topic area you have chosen. Summarize the articles; include key points or findings from the articles. Discuss how you used the information from the articles for your Health Promotion Project. Provide
specific examples. Describe the approach/approaches you developed to educate the target population about the topic.
Include specific ways to promote lifestyle changes within the specified population relative to your specific culture. The approach should be appropriate for your cultural concentration.
Write your conclusion and summary.
c. Your paper must follow APA format. Include a title page and a reference page. Use 12‐point Times New Roman font and include in‐text citations (use citations whenever paraphrasing, using statistics, or quoting from the article). Please refer to your APA manual as a guide for in‐text citations and sample reference pages.
d. Use TurnItIn in time to make any edits that might be necessary based on the Similarity Index prior to
submitting your paper to your instructor. Consult with your instructor about the acceptable Similarity Index for this paper.
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DIRECTIONS AND ASSIGNMENT CRITERIA
Assignment Criteria
Points % Description
Articles and Turn It In Submission
5
5%
A minimum of three (3) scholarly articles is used as sources. Articles meet criteria of being from scholarly journals and include health
promotion and wellness content. Students will select at least one article specifically related to the cultural focus for this assignment.
Submitted paper to TurnItIn; Necessary/Appropriate revisions made based on originality report.
Introduction and Conclusion
15
15%
Establish the purpose of the paper Create an effective conclusion that identifies the main ideas and major support
points from the body of your report. Minor details are left out.
Relate Topic to Target
Population
25
25%
Description of topic and targeted cultural population. Relationship to the Healthy People 2020 topic area. Statistics to support the significance of the topic.
Summary of Articles
20
20%
Summary of articles include: Key points and findings of the article. Discussion of how information from the articles is used in your Health Promotion
Project (give specific examples).
Health Promotion Project
Discussion
25
25%
Description of approaches to educate the target cultural population about the topic
Specify a culturally sensitive approach to promote lifestyle changes within the specified population.
APA Style and Format
10
10%
APA Style (Writing) Correct use of Standard English grammar and sentence structure. No spelling or typographical errors. Organized around required components. Information flows in a logical sequence that is easy for the audience to follow.
APA Format
All information taken from another source, even if summarized, must be cited and listed on the Reference page using (APA 6th ed.)
Document setup: Title and Reference pages; Margins; Spacing; Use of Headers Citations in the text and reference page.
Total 100 100
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GRADING RUBRIC
NR222 RUA Health Promotion Project Guidelines.docx Revised 06/2016 psb 4
Assignment Criteria
Outstanding or Highest Level Very Good or High Level of Competent or Satisfactory Poor, Failing or of Performance Performance Level of Performance Unsatisfactory Level of
Performance A (92–100%) B (84–91%) C (76–83%) F (0–75%)
Articles and Turn It In Submission
5
A minimum of three (3) scholarly articles are used as sources. Articles meets criteria of being from scholarly journals, includes health promotion and wellness content,
and are current (published within the past 5 years). At least one article is related to your chosen cultural group. TurnItIn is used prior to submitting paper to instructor for grading. Necessary/Appropriate revisions made
based on originality report. Note: This criterion is “all or nothing.” If you meet all of the criteria for the article and use TurnItIn, you will earn
5 points. 5 points
Article does not meet all criteria. Or TurnItIn is not used.
0 points
Introduction and Conclusion
15
Introduction establishes the purpose of the paper and stimulates the reader’s interest. AND The main ideas and major support points from the body of the paper are presented in the conclusion.
14‐15 points
Introduction establishes the purpose of the paper. AND The main ideas and major support points from the body of the paper are presented in the conclusion.
13 points
The introduction and conclusion provide very general information related to the topic of the paper.
12 points
The introduction and/or conclusion are vague, does not relate to the topic, and/or not evident.
0‐11 points
Relate Topic to Target Population
25
Thoroughly covers all required elements; Demonstrates excellent understanding of health promotion concepts and applied them consistently. Required elements are: Description of topic and target cultural population.
Relationship to the Healthy People 2020 topic area.
Generally covers all required elements; Demonstrates general/basic understanding of health promotion concepts and applied them consistently. Required elements are: Description of topic and target cultural population.
Relationship to the Healthy People 2020 topic area.
Generally covers all required elements; Demonstrates limited understanding of health promotion concepts and/or did not apply the concepts consistently. Required elements are: Description of topic and target cultural population.
Relationship to the Healthy People 2020 topic area.
Missing some of the required elements; Demonstrates very limited understanding of health promotion concepts and/or did not apply the concepts consistently or inappropriately. Required elements are: Description of topic and target cultural population.
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NR‐222HEALTH AND WELLNESS
Statistics to support the
significance of the topic.
23‐25 points
Statistics to support the significance of the topic.
21‐22 points
Statistics to support the significance of the topic.
19‐20 points
Relationship to the Healthy People 2020 topic area.
Statistics to support the significance of the topic.
0‐18 points
Summary of Articles
20
Summary of articles includes: All key points and findings from the articles.
Comprehensive discussion of how information from the articles is used in the Health Promotion Project with several specific examples provided.
19‐20 points
Most key points and findings from the articles are included.
Discussion of how information from the articles is used in the Health Promotion Project included with specific examples provided.
17‐18 points
Some key points and findings of the article are missing.
Limited discussion of how information from the articles is used in the Health Promotion Project. Examples included, but very general/not specific.
16 points
Little understanding of the key points of the articles demonstrated.
OR Discussion of how information from the article could be used in your Health Promotion Project not included.
0–15 points
Health Promotion Project Discussion
25
Thoroughly covers all required elements; Demonstrates excellent understanding of health promotion strategies and applied them consistently. Required elements are: Description of approaches to educate the target population about the topic
Specific ways to promote lifestyle changes within the specified population.
23‐25 points
Generally covers all required elements; Demonstrates general/basic understanding of health promotion strategies and applied them consistently. Required elements are: Description of approaches to educate the target population about the topic
Specific ways to promote lifestyle changes within the specified population.
21‐22 points
Generally covers all required elements; Demonstrates limited understanding of health promotion strategies and/or did not apply the concepts consistently. Required elements are: Description of approaches to educate the target population about the topic
Specific ways to promote lifestyle changes within the specified population.
19‐20 points
Missing some of the required elements; Demonstrates very limited understanding of health promotion strategies and/or did not apply the concepts consistently or inappropriately. Required elements are: Description of approaches to educate the target population about the topic
Specific ways to promote lifestyle changes within the specified population.
0‐18 points
APA Style
and Format
APA Style (Writing) Correct use of Standard English grammar, paragraph, and sentence structure.
No spelling or typographical errors.
APA Style (Writing) One to three minor errors in use of Standard English grammar, paragraph, and sentence structure.
APA Style (Writing) One major error or more than four minor errors in use of Standard English grammar, paragraph, and sentence structure.
APA Style (Writing) Language needs development. More than four spelling and/or grammar errors.
Poorly organized thoughts & concepts.
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NR‐222HEALTH AND WELLNESS
10
Paper is clearly organized around required components.
Information flows in a logical sequence that is easy for the audience to follow.
APA Format All information taken from another source, even if summarized, must be cited and listed on the Reference page using. All elements of each reference included in the correct order.
Document setup includes title and reference pages in correct APA format.
Correct/Appropriate use of margins, spacing, and headers.
Citation of sources included in the body of the paper using correct APA format
Sources cited correctly on the reference page
10 points
One to two spelling or typographical errors.
Paper is organized; one required component not clearly identified.
APA Format All information taken from another source, even if summarized, must be cited and listed on the reference page. All elements of each reference on the reference page included. Some elements not in the correct order.
Document setup includes title and reference page, with 1‐2 errors in APA format.
Use of margins, spacing, and headers has 1 to 2 errors.
One source cited in the paper not included on the references list OR one source listed on the Reference page not cited in the paper.
9 points
Three to four spelling or typographical errors.
Paper is organized; one required component not clearly identified.
APA Format All information taken from another source, even if summarized, must be cited. Format for citations not correct. Some references on the reference page have elements missing.
Document setup includes title and reference page. Three or more errors in APA format of the title page.
Use of margins, spacing, and headers has 3‐4 errors.
Two sources cited in the paper not included on the references list OR two or more sources listed on the Reference page not cited in the paper.
8 points
APA Format All information taken from another source, even if summarized, must be cited. Lacks proper citations and/or does not reference sources. Document setup includes title and reference page. Three or more errors in APA format of the title page.
Use of margins, spacing, and headers has more than 4 errors.
Three or more sources cited in the paper not included on the references list OR three or more sources listed on the Reference page not cited in the paper.
0‐7 points
Total Points Possible = 100 points
Originally posted 2018-04-01 21:45:03.
Reflect on the various settings in which family nurse practitioners are able to work. Currently in primary care, specifically community health centers, there is a significant need to hire more advanced practice nurses to meet the care needs of patients in both rural and urban populations. Read the article attached below and examine what role does the Community Nursing Practice Model have in achieving better access, care delivery and outcomes to patients living in underserved communities. Identify 1 (one) MSN Essential most correlates to this discussion related to community nursing practice.
Nurse Practitioners in Community Health Settings Today.pdf
I have also attached additional information pertaining to community health from the Center for Disease Control (CDC).
CDC Community Health Improvement Navigator:
https://www.cdc.gov/chinav/
Originally posted 2018-04-01 21:43:29.
Please use APA Format. Use this medication
Acupril 40 mg daily
capoten 300 mg daily
altace 10 mg daily
Chief complaint: medication refill ” I ran out of medicines”
HPI: E.D a 65-year-old AA male presents to the clinic for prescription refills. The patient also indicates that she has noticed shortness of breath which started about 4 months ago. The SOB gets worse with exertion, especially when she is walking fast and it is resolved when he is resting. He reports that she is also bothered by shortness of breath that wakes her up intermittently during her sleep. His symptoms of shortness of breath resolve after sitting upright on 3 pillows. He also has lower leg edema pitting 1+ which started 2 weeks ago. He also indicates that she often feels light headed at times with intermittent syncope episodes while going up a flight stairs, but it resolves after sitting down to rest. He has not tried any over the counter medications at home.
He never filled her prescriptions that he received at her checkup 6 months ago, she did not think it was important.
PMH:
Primary Hypertension
Previous history of MI 1 year ago
Surgeries:
1 year ago-Left Anterior Descending (LAD) cardiac stent placement
Allergies: Penicillin
Vaccination History:
He receives an annual flu shot. Last flu shot was this year
Has not had a Td in over 10 years
Has not had the herpes zoster vaccine
Social history:
High school graduate, married and no children. He drinks one 4-ounce glass of red wine daily. He is a former smoker that stopped 3 years ago.
Family history:
Both parents are alive. Father has history of MI and valvular heart disease; mother alive and cardiac history is unknown. He has one brother who is alive and has history of MI 5 years ago at age 52.
ROS:
Constitutional: Lightheaded and faint with exertion.
Respiratory: Shortness of breath with exertion. + Orthopnea
Cardiovascular: + 2 pitting leg edema for 3 weeks.
Psychiatric: Pt sated not taking medications for 6 months – “ran out and did not get refills”
Physical examination:
Vital Signs
Height: 5 feet 1 inches Weight: 163 pounds BMI: 31 obesity, BP 157/87 T 98.0 po P 110 R 22, non-labored
HEENT: Normocephalic/Atraumatic, Bilateral cataracts; PERRL, EOMI; No teeth loss seen. Gums no redness.
NECK: Neck supple, no palpable masses, no lymphadenopathy, no thyroid enlargement.
LUNGS: + Mild Crackles on inspiratory phase no clearing with cough. Equal breath sounds. Symmetrical respiration. No respiratory distress.
HEART: Normal S1 with S2 during expiration. An S4 is noted at the apex; + systolic murmur noted at the right upper sternal border without radiation to the carotids. Pulses are 2+ in upper extremities and 2+ in pedal pulses bilaterally. 2+ pitting edema to her knees noted bilaterally
ABDOMEN: No abdominal distention. Nontender. Bowel sounds + x 4 quadrants. No organomegaly. Normal contour; No palpable masses.
GENITOURINARY: No CVA tenderness bilaterally. GU exam deferred.
MUSCULOSKELETAL: + Heberden’s nodes at the DIP joints, hands. + Crepitus, bilateral knees. Slow gait but steady. No Kyphosis.
PSYCH: Normal affect. Cooperative.
SKIN: No rashes. + Dry skin. Skin intact.
Labs:: Hgb 13.2, Hct 38%, K+ 4.0, Na+137, Cholesterol 225, Triglycerides 187, HDL 37, LDL 190, TSH 3.7, glucose 98
A:
Primary Diagnosis:
Congestive Heart Failure (CHF) (150.9)
Secondary Diagnoses:
Primary Hypertension (I10)
Obesity (E66):
Osteoarthritis (OA) (715.90)
Differential Diagnosis:
Peripheral Vascular Disease (PVD) (173.9)
P:
Medications:
Tylenol 650 mg PO Q4 hours as needed for arthritis pain
Labs: UA; Brain natriuretic peptide (BNP); LFTs and TSH.
12-lead EKG, Chest X-ray; Initial 2D echo with Doppler; Ankle-brachial index
Referrals: may refer based on lab results
Follow up: return to office in 2 weeks
Additional lab results:
Echo results 1 week ago: Left ventricular EJ Fraction decreased to 30 %
BNP – no available
Questions: As an NP student, need to determine the medications for CHF/ASCVD
According to the ACC/AHA Guidelines, what medications should this patient be prescribed? Does he need medication given his history of MI? Write her complete prescriptions using the prescription writing format.
Originally posted 2018-04-01 21:42:17.
Responses to Colleagues Templates (There are two)
Response to Colleagues Template One
Two Colleagues Five Additional Ideas for Each Colleague
APA References
Response to Colleagues Template Two
One Colleague Response
Design Thinking Process Observations
APA References
Read a selection of your colleagues’ postings.
Respond to your colleagues by doing the following:
1 day ago
Patricia Heffron
RE: Discussion – Week 5
Workspace observations
Description of One Particular Problem
The workspace I use the majority of the time is in my basement. It is comfortable with good lighting. I have access to everything I would need, including my computer for research and any other school needs. The most comforting aspect is that my dogs are near me. The one aspect that can be difficult at times, especially when I am not completely focused, is my television and my phone. These things can be distracting as I may pick up my phone and call someone or play a game. I may also turn a show on or watch a movie if I am not completely motivated to complete my task.
Innovative Ideas List From Phase 2
To resolve my problem of distraction while doing work, I will look into these solutions:
By thinking through what is needed to help reduce distraction, I realized that many things could help. When getting down to the real problem, I am able to better realize the focus of the solutions. After seeing what I need to solve my problem, the above are the solutions that I think will help the most. I will now be able to test them to see what works best for my situation and hopefully I will be successful in having fewer distractions while completing my work (Brown, 2008).
APA References
Brown, T. (2008, June). Design thinking.Harvard business review, 86(6), 84-92.
1 day ago
John Ezomo
RE: Discussion – Week 5
Phase 1: Inspiration
What about the working space is already optimized or ideal?
I have the liberty to put on or off the lights, work desk, sense of security, ample area to work, and computer
Why do these things work well?
The music playing in the background of my working space works well for me while working.
What about the workspace could be improved?
Organization of mess up in the room should be enhanced.
Are there problems or difficulties that you repeatedly experience?
Unstable internet connection
What behaviors, functions, and interactions that take place in your workspace seem interesting or notable?
The interaction that takes place in my workspace is my family. My parents and siblings always check on me and when am worn out they motivate me. They dance with me to the beats of the music to distract me from my tedious work. They bring me food and drinks when I don’t get out of my workspace.
Problematic aspect
My greatest problem is the internet connection. At times the connection is strong but very weak at some periods. It is a big deterrent to my studies because I rely on it while watching online lectures. It has always disappointed me because I have to check the internet connection devices if they are in place and refresh the browser. I have missed several lectures due to internet failures. The providers have checked but they can’t figure out the problem.
Phase 2: ideation
Purchase a modern router
Move the working place closer to the router
Advance the internet package
Look for another internet provider
Place a Wi-Fi amplifier
Place two new routers, so that if one fails you use the other one
Contact a variety flo-tech
Put off all inactive devices
Change the location of the router
Seek internet specialist’s advice
References
Blumenthal D, &Tavenner M. (2010). The “meaningful use†regulation for electronic health records. N Engl J Med.
Brown, T. (2008). Design thinking. Harvard Business Review, 86(6), 84–92. Retrieved from https://searchebscohostcom.ezp.waldenulibrary.org/login.aspx?direct=true&db=bth&AN=32108052&site=ehost-live&scope=site
Brown, B., & Scott, A. D. (2011). How P&G tripled its innovation success rate. Harvard Business Review, 89(6), 64– 72.
Gerd, W. (2012). Introduction to design thinking. Retrieved from https://experience.sap.com/skillup/intoductionto-design- thinking/
Tim, B.&Barry K. (2019). Change by design: design thinking transforms organizations and inspires innovation. Harper Business.
he affordable care act, also known as Obama care was moved into place 8 years ago in March 2018. This was passed into law to help the United States citizens receive health care coverage at an affordable price. The main goal of the affordable care act was to have many more citizens covered by health care and meet their medical needs. One of the key points of the affordable care act was to allow easy access for the people to compare prices online, and know they were not going to be rejected for having pre-existing conditions.
Some of the key points of Obama care include: bringing down health care premiums, provides free preventative care, provides access to insurance for the uninsured Americans who suffer from pre-existing conditions, Extends coverage for young adults, prohibits from coverage rejection of children due to pre-existing conditions, improves care for older adults after being discharged from the hospital, and increases access to services at home and in the community.
The nurse’s roles is to educate their patients and ensure that they receive the appropriate care they require. Enforce the need for preventative measures and diagnostic testing. Also inform the patient’s about their bill of rights, such as they are entitled to have full knowledge about anything that involves their care to make an informed decision. For example, recommending and emphasizing the importance of having an annual A1C for a patient who is pre-diabetic.
Comment 2
The Affordable Care Act (ACA) offers numerous positive changes in the course of the reforms of health care. There are some crucial elements about the public and community health such as an ability to get preventative services like mammograms or colonoscopies without copays, secondary insurance or deductibles. Strengthens community health center through the allocation of new funding for the expansion as well as constructing community health centers. Insurance organizations may no longer rescind services if the health care claim is made or even deny coverage to under 19 years children with a pre-existing condition (Rawal, 2016). Now patients may appeal insurance organization decisions as well as the federal grants developed to assist the state set up independent offices which can assist the patients navigate the private health insurance system.
These programs help patients to appeal or file a complaint, get an education regarding their rights as well as responsibilities in individual or group health plans insurance policies as well as enroll in health coverage. The ACA also expands the insurance coverage which impacts how clinical services are offered in public health departments. For instance, the agencies of governmental public health providing clinical services can transfer some cases to private sectors like routine childhood vaccinations. The ACA increased health care providers payment in the rural communities as most of them are underserved since they find it challenging to attract as well as retain medical professionals. Public health service may reach many people through developing programs and services like maternal child health program, home visiting as well as making available specialized behavioral health services to the general population. In the healthcare industry, the ACA is the most significant as it covers every aspect of healthcare including women and children health, mental health, care for most needy people professionals in the country as well as care for seniors. ACA has mandated many important health benefits including; emergency services, maternity/newborn care, addiction treatment, rehabilitation services and devices, pediatric services, outpatient care, hospitalization, mental health services, prescription drugs and preventative services (Rawal, 2016).
Nurses have a role in implementing the ACA law. In the United State, American Academy of Nursing and other Nursing organization have supported the effort of health care system reforms strongly. Nurses are expected to be active in patient care and participating in forums where there is a debate for policy discussion and decision making. Nurses should be involved in health care reforms at the state-wide level, the community as well as individual level (D.R., 2017). Nurses need ACA information to enable them to educate their patients concerning ACA law provisions as well as explain the benefits of it so that they may access both health services as well as insurance coverage.
Originally posted 2018-04-01 21:29:51.
APA format MSN degree 2 pages long with 3 references 2 from walden university library Due Saturday March 23, 2018 6pm EST
Neurological Disorders
Neurological disorders affect people of all ages, every day, and everywhere in the world. Our senses stem from the neurological system, the ability to taste, smell, hear, see, and touch are the main five senses. When one of these senses is affected our body reacts to it, however there are other senses affected such as the vestibular system that tells our body where we are spatially in the universe and proprioception that helps us gage strength, and ability to do the things we do firmly, or gently. This paper will discuss migraine headaches, share how behaviors can influence the headache and affect medications for headaches, share drug treatments, measures that can decrease symptoms, and organizations available that can help give information to patients affected by the disorder.
Pathophysiology of Migraine Headaches
Headaches are common disorders of the neurological system, but they can also signal underlying disease such as tumors, meningitis, or even brain bleeds per Huether and McCance (2017). They further share migraines can last four to 72 hours and a patient must have two documented episodes of criteria such as unilateral head pain, pain that worsens with activity, and the pain must be moderate to severe in nature. Patients must also have one of these criteria such as nausea, vomiting, photophobia, or phonophobia. Migraines can be with or without perceived auras that affect the visual, sensory, or motor pathways. (Huether and McCance, 2017) They further share the trigeminal vascular system is related to migraine pain, through the release of calcitonin gene-related peptide (CGRP), and that migraines have clinical phases such as a premonitory phase where the patient may be tired, irritable, or have a stiff neck. Migraine auras can accompany just before the migraine and can be visual,sensory, or motor. Headache phase such as throbbing pain, on one side but can spread to the whole head, cause fatigue, nausea, vomiting, dizziness and the recovery phase where the patient can experience continued fatigue, irritability or depression. Migraines are wose than general headaches or tension headaches in that the symptoms are worse, last longer, and prevent the patient from doing anything besides heading to a darkened, quiet, room. When migraines become chronic, they are quite debilitating and can require medications to treat them, next we will look at treatments for migraines.
Migraine Treatments
First line treatment in migraines is the salicylates and nonsteroidal anti-inflammatory (NSAIDs) for mild to moderate migraines, with triptan type medications as first line for moderate to severe migraines. (Arcangelo, Peterson, Wilbur, and Reinhold, 2017) They further share second line treatment as over the counter caffeine compounds such as Excedrin when the salicylates and NSAIDS have not worked. If the migraine is severe the recommendation is to add Ergot derivative medications along with an antiemetic if triptan medications are not effective. Finally, is the third line medication treatments when all the above fail Butalbital or other opioids are recommended. Selecting treatment and trying medications can take months to find a combination that works and it is important to let the patient know this and assess if the patient is trying alternative or complimentary medicine practices along with medical science in the treatment of migraines as their can be drug interactions. Most of the medications used in migraine treatment require assessment of the cardiac status prior to use, and are not recommended during pregnancy. Several are affected by CYP3A4 pathways and therefore should not be used with inhibitors in that drug pathway. If a patient fails one triptan type drug another is tried as different medications can work better for some patients than others, the Butalbital and opioids are only used when all else fails due to addictability and the need to taper dosing prior to stopping these types of medications.
Behaviors Affecting Migraines and Migraine Medications
Patient behaviors can have an effect on migraines, too much sleep, too little sleep, alcohol, foods such as chocolate, and tyramine agents like red wine, stress, medications like vasodilators, hormones. Pretty much it seems life in general can be a trigger for some such as lower socioeconomical status, caffeine, smoking, and even loud noises, strong odors, weather, skipping meals, obesity. (Arcangelo, Peterson, Wilbur, and Reinhold, 2017) Often times we get busy with life and forget to slow down and take care of ourselves properly, it seems life is focused on getting ahead, or trying to fit into society rather than the health components that make life more enjoyable, and overall less costly. If one takes care of ones self, there is less expense for medical care and medication in general. Having patients keep a journal of their headaches can lead to triggers that are specific to that patient and this can help head off migraines but also help with finding medications to use specific to that patients condition. Educating on smoking and alcohol cessation, or adjusting diet if known triggers are found can help decrease symptoms and episodes of migraines.
Organizations are available to offer advice and support for patients that suffer with migraines such as the United States Headache Consortium, the Migraines.org which discusses facts and myths of migraines. Coalition for headache and migraine patients or CHAMP is a foundation to discuss migraines, find a cure and support patients and families dealing with chronic migraines.
Summary
While migraines are a disorder, and are neurologically related they can take time to diagnose, treat, and find triggers or behaviors that can affect the onset, duration, and occurrence of migraines. Working with patients to fully assess the type of headache, when it occurs, where it occurs, how long it lasts, how often it occurs, what worsens or alleviates it if anything, what kind of pain it brings such as stabbing, or throbbing, what medications or treaments they have already tried, and how it affects the patients life in that are they able to do anything when the migraine occurs. These are all questions as advanced practice nurses that will help guide diagnosis and treatment for migraine sufferers.
References
Arcangelo, V. P., Peterson, A. M., Wilbur, V. & Reinhold, J. A. (Eds.). (2017). Pharmacotherapeutics for advanced practice: A practical approach (4th ed.). Ambler, PA: Lippincott Williams & Wilkins.
Huether, S. E., & McCance, K. L. (2017). Understanding pathophysiology (6th ed.). St. Louis, MO: Mosby.
Originally posted 2018-04-01 21:14:40.
Annotated Bibliography
2-part assignment
Select 2 scholarly research and practice based articles related to nursing theory and dated within the past 10 years, 2008 until current. Do not select a non-practice based article. Then analyze the articles, be sure to address the following for each selected article:
PART 1: Complete for each of the selected articles
Summarize purpose of the article/research study
Description of theoretical concepts identified in article
Description of how are concepts measured in article
Describe implications of findings in support of the theory
PART 2: Complete only once, after addressing the above questions for both articles separately.
Write a 1 paragraph description (minimum 300 words) analyzing how the selected theory can be used in advanced nursing practice. Be specific, including what outcomes (for patient as well as the nurse practitioner) you might expect.
APA Style 6th edition
Originally posted 2018-04-01 21:13:13.
