Obesity and the Relationship of the Leptin Receptor

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Obesity and the Relationship of the Leptin Receptor

Instructions

*Abstract
*Introduction- 1) hook 2) background info 3)problem statement 4) research question 5)
hypothesis 6) thesis statement
*Literature review (minimum of 6 article, APA)
*Method – 1) meta analysis 2) provides step by step process of the research 3) tools used during
the research 4) how the tools were handled 5) 3rd person; passive voice; past tense
*Results – 1) no interpretation (only present results) 2) narration paragraph 3)tables 4) past tense
*Discussion
*Limitations & Implications
*Conclusion
*Reference (min 10, APA)

Ethical Issues in the Health Care System

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Ethical Issues in the Health Care System

Details

What are the ethical issues that have been raised in the health care system in other countries
with the emergence of the Coronavirus outbreak? Explain the ethical issue, principals, theories if
any to justify your answer? There are many online sources you can use for this argument? Your
sources and arguments should be different from each other. This should be individual answers
and don’t work in groups.
Instructions:
1- Write it in your own words? No plagiarism
2- Post your own initial answer 500 words

Evidence-Based Practice Change Process

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Purpose

The purpose of this assignment is: To apply a change process using the ACE Star Model of Knowledge Transformation and a systematic review after identifying a clinical topic of concern and related nursing practice issue. The information from the ‘Illustration’ part of our lessons in Weeks 1-6 will mentor you through  this process. Your change process is to be set up as a pilot project.
Course Outcomes
This assignment enables the student to meet the following course outcomes:
CO2: Proposes leadership and collaboration strategies for use with consumers and other
healthcare providers in managing care and/or delegating responsibilities for health promotion,
illness prevention, health restoration and maintenance, and rehabilitative activities. (PO#2)
CO8: Selects evidence for best practices when planning professional nursing care involving
systems, processes, and devices for individuals, families, aggregates and communities. (PO#8)
Points
The assignment is worth 225 points.

Directions
Please do not use any of the Nurse Daniel information for your own topic, nursing intervention, or
change project. Nurse Daniel serves as an example only to illustrate the change process.
Please review the infographic as way to guide you in getting started with your assignment:

Developing an Assignment with Integrity (Links to an external site.)
A short tutorial with tips for completing this assignment may be viewed below or by reading the
transcript (Links to an external site.).
EBP Change Process (form)
Download the EBP Change Process form (Links to an external site.) during Week 1.
The use of this specific form is REQUIRED and is due at the end of Week 6.
A short tutorial with tips for completing this assignment may be viewed in the short video above.
Identify a clinical topic and related nursing practice issue you think needs to be changed.
Locate a systematic review on your topic from the CCN Library databases. Be sure this involves
nursing actions.
Work through each step of the ACE Star Model as outlined on the assignment form (Star Points
1-5: Discovery, Summary, Translation, Implementation, and Evaluation). Respond to the
instructions provided on the form.
Follow the activities and thinking of Nurse Daniel in Weeks 1-6 in the ‘Illustration’ part of each
lesson. He will be working through a clinical topic and nursing practice issue to demonstrate a
change (ACE Star Model and systematic review).
Work on a portion of the process each week, as the illustration unfolds.
Please reach out to your instructor for feedback or assistance with your PICOT question as needed.
Required and Additional Background Reading in Weeks 1 and 2 under Readings is available for
more information on the ACE Star Model and the use of systematic reviews.
Please cite any references (in APA format) of your systematic review or other scholarly
document (optional) as needed. Paraphrasing information, rather than quoting, is expected. No
quotes for this assignment please!
For questions about this assignment, please contact your instructor.
Use the grading rubric as a final way to check that all components of the form have been
completed. The rubric is the tool your instructor will use to assess your content.
Reminder
Before preparing your assignment, please review this “Crediting Sources Made Simple (Links to
an external site.)” resource. This tool is intended to help you understand scholarly writing, APA,
referencing, and crediting. Please reach out to your instructor with any questions as you prepare
your assignment.
**Academic Integrity**

College of Nursing values honesty and integrity. All students should be aware of the
Academic Integrity policy and follow it in all discussions and assignments.

Nursing/ Medicine Research Article Critique

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Nursing/ Medicine Research Article Critique

A research critique demonstrates your ability to critically evaluate an investigative study. For this
assignment, choose an original or primary research study related to nursing or medicine. The
purpose of this assignment is to review a research study in-depth and to decide whether or not it
is a valid research study that can be used in practice. It is your written evaluation of the study,
not just a summary of the study.
The body of your paper should follow APA Style guidelines, and it should 4–6 pages doublespaced plus a cover page and reference list. The full article must be attached to the critique for Note: Because submission of the article is part of the assignment requirements and is necessary
for grading, any assignment submitted without the accompanying article will be considered
incomplete. An incomplete assignment will be initially assigned a zero. The student has the
opportunity to submit the article to complete the assignment. However, if it is submitted after the
due date and time, the late penalty will apply. After five days, submissions will not be accepted,
as per University policy, and the grade will remain a zero.
Articles used for one assignment cannot be used for the other assignments. (Students should
find new research articles for each assignment.)
The selected articles should be original research studies. Review articles, concept analysis,
meta-analysis, meta-synthesis, integrative review, and systemic review should not be used.
Mixed-methods studies should not be used.
Your critique should include the following:
Research Problem/Purpose
Describe the problem as it is presented in the study.
State the purpose of the research.
Have the investigators placed the study problem within the context of existing nursing or
healthcare knowledge?
Will the study solve a problem relevant to nursing?
Review of the Literature (may be part of the author’s introduction or conclusion)

Identify the concepts explored in the literature review.
Are the references current in relation to the publication date of the study? If not, what are the
possible reasons for using older sources?
Theoretical Framework
Do the authors identify their overall assumptions or a theoretical framework for the study? Are
these assumptions appropriate for the study?
Does the research draw only on nursing theory, or does it draw on theory from other disciplines?
If a formal theory is not identified, suggest one (preferably a nursing theory) that might be
suitable for the study. Various nursing theories can be found at http://www.nursingtheory.org/theories-and-models/
Variables/Hypotheses/Questions/Assumptions
What is the research question or the hypothesis? Is it clearly stated or implied?
What are the independent and dependent variables in the hypothesis or research question?
Are the variables clearly defined so that the reader understands the researchers’ interpretation of
the variables?
Is the dependent variable concrete and measurable?
Methodology
What type of design (quantitative, qualitative) was used in this study?

Was inductive or deductive reasoning used in this study?
State the sample size and study population, sampling method, and study setting.
Did the investigator choose a probability or non-probability sample?
Describe how the independent variable was tested or surveyed in the study.
Describe how the dependent variable was measured.
Discuss the reliability and the validity (quantitative) or the credibility (qualitative) of the
measurement tools.
How were ethical considerations addressed? What ethical considerations were necessary for this
type of study?
Data Analysis
What data analysis method was used?
How were the results in the study presented to the reader?
Discuss at least one (1) finding from the authors’ results and relate it to the dependent variable of
the study.
Summary/Conclusions, Implications, and Recommendations
What are strengths and limitations of the study other than those stated by the authors?
Can the researcher generalize the findings to other populations? Explain.
What is the significance of the findings and conclusions for you in your personal nursing

Neurological and Musculoskeletal Disorders (Vignette Questions and Answers)

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Vignette Student Response Questions and Answers

Vignette 25: Fibromyalgia (FM)

A 34-year-old Caucasian female presents to the clinic with a chief complaint of widespread pain in her joints and muscles. She states that her skin seems sensitive and sometimes it hurts to be touched. She has had extreme fatigue for the past 4 months. She admits to being depressed and it unable to sleep well. She has had to drop out of her gardening club due to pain. She says that bright lights and loud noises really bother her. Past medical history noncontributory. Social history is significant for her divorce from her husband 14 months ago. She is the mother of 2 small children and works as an administrative assistant as the local insurance company. Physical exam remarkable for tender points over her posterior supraspinatus muscles, occiput, trapezius, gluteal area, and sacroiliac joints bilaterally. The APRN tells the patient that she most likely has fibromyalgia, based on her physical exam.

Question 1 of 2:

What are the underlying causes of fibromyalgia? 

<Type your response here>

 

Question 2 of 2:

The APRN tells the patient that the tender points are no longer used to diagnose FM. She suggests that the patient takes the Widespread Pain Index (WPI) and the Symptom Severity Inventory (SSI). The patient asks the APRN what these tests are for. What is the APRN’s best answer?

<Type your response here>

 

Neurological and Musculoskeletal Disorders (Vignette Questions and Answers)

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Vignette Student Response Questions and Answers

Vignette 24: Osteoarthritis (OA)

A 57-year-old male construction worker comes to the clinic with a chief complaint of pain in his right hip. The pain has progressively gotten worse over the last 2 months and he has been having trouble sleeping. There is little pain in the morning, but he is a bit stiff. The pain increases as the day wears on.  has taken acetaminophen without any relief but states that the ibuprofen does work a little bit. He is anxious since the hip pain has limited his ability to work and he is afraid that his boss will fire him if he cannot perform his usual duties. There is no history of past trauma or infection in the joint. Past medical history noncontributory. Social history without history of alcohol, tobacco, or illicit drug use. Physical exam remarkable for decreased range of motion of the right hip. BMI 34 kg/m2. Radiographs in the office demonstrated asymmetrical joint space narrowing of the right hip with osteophyte formation. Several areas of the hip showed bone-on-bone contact with loss of the articular cartilage. The APRN tells the patient he has osteoarthritis (OA) and refers the patient to an orthopedist for evaluation of his need for a total hip replacement.

Question:

Describe how osteoarthritis develops and forms and distinguish primary osteoarthritis from secondary arthritis.   

<Type your response here>

 

Neurological and Musculoskeletal Disorders (Vignette Questions and Answers)

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Vignette Student Response Questions and Answers

Vignette 23: Cerebral Artery Vascular Accident (CVA)

An 83-year-old man presents with a history of atrial fibrillation (AF), hypertension, and diabetes. His daughter, who accompanied the patient, states that yesterday the patient had a period when he could not speak or understand words, and that approximately 4 weeks prior he staggered against a wall and was unable to stand unaided because of weakness in his legs. She states that both instances lasted approximately a half-hour. She was unable to persuade her father to go to the emergency room either time. Today he suffered another episode of right sided weakness, dysarthria, and difficulty with speech. Past medical history: Hypertension for 15 years, well controlled; diabetes for the past 10 years, and hyperlipidemia. Medications: Diltiazem CD 300 mg daily; lisinopril 40 mg daily; metformin 500 mg twice daily; aspirin 81 mg daily and atorvastatin 20 mg po qhs.

Social history: reported former smoker with 40 pack year history. Alcohol -drinks one beer a day. Denies any other substance abuse. Review of systems: Denies dyspnea, dizziness, or syncope; complains that he cannot move or feel his right arm or leg. Difficulty with speech.

Physical exam: Vitals: height = 70 inches; weight = 185 pounds; body mass index = 26.5; BP = 134/82 mm Hg; heart rate = 88 bpm at rest, irregularly irregular pattern.

HEENT remarkable for expressive aphasia, eyes with contralateral homonymous hemianopsia.

No loss of sensation but unable to voluntarily move right arm or leg.

The patient was diagnosed with a right middle cerebral artery vascular accident (CVA) secondary to atrial fibrillation (AF)

Question:

How does atrial fibrillation contribute to the development of a CVA? 

<Type your response here>

 

Neurological and Musculoskeletal Disorders (Vignette Questions and Answers)

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Neurological and Musculoskeletal Disorders (Vignette Questions and Answers)

Vignette Student Response Questions and Answers

Vignette 22: Traumatic Brain Injuries (TBIs)

A 22-year-old male was an unrestrained front seat passenger of a car traveling at 50 miles per hour. The driver swerved to avoid hitting a deer that darted in front of the car and hit a tree. EMS on the scene noted a stellate fracture of the windshield on the passenger side. The patient was non-responsive at the at the scene when the paramedics arrived, and his pupils were unequal with the left pupil larger and sluggish to react to light. He was placed in a hard-cervical collar per protocol and log rolled onto a long backboard. He was breathing spontaneously at the scene, but pulse oximetry in the EMS unit revealed a SaO2 of 78% on room air. He was intubated at the scene for airway protection and transported to a Level 1 trauma center. Glasgow Coma Scale=3

After a full trauma work up, the patient was diagnosed with an isolated traumatic brain injury with acute subdural hematoma secondary to coup-contrecoup mechanism of injury. He was emergently taken to the operating room for craniotomy after which he was taken to the Intensive Care Unit (ICU) for close monitoring. He had an intracranial bolt for measurements of his intracranial pressure (ICP).

Question 1 of 2:

Explain the differences between primary and secondary traumatic brain injuries (TBIs)? 

<Type your response here>

 

Question 2 of 2:

The APRN is called by the ICU staff because the patient’s ICP has risen to 22 mmHg. The APRN recognizes the urgent need to lower the ICP. The APRN institutes measures to decrease the ICP and increase the cerebral perfusion pressure (CPP). What are the factors that determine CPP?

<Type your response here>

Neurological and Musculoskeletal Disorders (Vignette Questions and Answers)

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Vignette Student Response Questions and Answers

Vignette 21: Spinal Cord Injury (SCI)

A 22-year-old male was an unrestrained front seat passenger of a car traveling at 50 miles per hour. The driver swerved to avoid hitting a deer that darted in front of the car and hit a tree. The patient was ejected from the vehicle. He was awake and alert at the scene when the paramedics arrived, and his pupils were equal and reactive to light. He was placed in a hard-cervical collar per protocol and log rolled onto a long backboard. He was breathing spontaneously at the scene, but pulse oximetry in the EMS unit revealed a SaO2 of 88% on room air. He was placed on 100% oxygen via non-rebreather mask and was taken to a Level I trauma center with the following vital signs:

Vital signs: BP 90/50, Pulse 48 and regular, Respirations 24 and shallow with some use of accessory muscles, temp 95.2 F rectally. He was awake and answering questions appropriately but says he cannot feel his arms or legs. Glasgow Coma Scale 14. His skin was warm and dry with minor abrasions noted on his arms. According to family members, past medical history noncontributory and social history reveals only occasional alcohol use and no tobacco or vaping history. Full work up in the ED revealed a fracture-dislocation of C4 with assumed complete tetraplegia (formerly called quadriplegia). No other injuries noted He was given several liters of IV fluid, but his blood pressure remained low.

Question 1 of 2:

Explain the differences between primary and secondary spinal cord injury (SCI)? 

<Type your response here>

Question 2 of 2:

What is spinal shock and how it is different from neurogenic shock? 

<Type your response here>

Neurological and Musculoskeletal Disorders (Vignette Questions and Answers)

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Neurological and Musculoskeletal Disorders (Vignette Questions and Answers)

Vignette 20: Alzheimer’s Disease (AD)

A 67-year-old male presents to the clinic along with his family with a chief complaint of having problems with his short-term memory. His family had dismissed these problems and attributed them to the aging process. Over time they have noticed changes in his behavior, along with increased confusion and difficulty completing basic tasks. He got lost driving home from the bowling alley and had to be brought home by the police department. He is worried that he may have Alzheimer’s Disease (AD). Past medical and social history positive for a minor cerebral vascular accident when he was 50 years old but without any residual motor or sensory defects. No history of alcohol or tobacco use. Current medication is clopidogrel 75 mg po qd.  Neurological testing confirms the diagnosis of AD.

Question:

What is Alzheimer’s Disease and how does amyloid beta factor into the development and progression of the disease? 

<Type your response here>