Res/3 Path

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Instructions: Respond by extending, refuting/correcting, or adding additional nuance. Response must be in current APA format, must be grammatically correct and must be at least 200 words.Clinical Manifestations of Acute Kidney InjuryThe possible types of Acute Kidney Injury as per M.r J.R clinical manifestation are perenal injury and intrinsic injury. In perenal injury, the kidney may normally be functioning, but renal perfusion linked to vomiting or diarrhea results in a decreased arterial filtration rate. Some symptoms of perenal injury include nausea, fatigue, and vomiting. And as from the presented case, M.r J.R has shown these symptoms. Besides, there are clinical manifestations of gastroenteritis and possible renal injury. These are possible signs of perenal injury type of Acute Kidney Injury.The intrinsic injury happens when there is injury to the kidney, resulting to loss in kidney function. A common type of intrinsic injury is acute tubular necrosis, with the usual cause such as nephrotoxic (toxic agents to the tubular cells) (Rahman,ÿShad & Smith,ÿ2012). Some of these toxic agents may include medicine. They are more severe when the patient has an existing condition that increases risk of having acute kidney disease. As from the presented case, M.r J.R has been using pain-relieving medicines such Pepto-Bismol, which can be harmful if overused with existing kidney disease. Toxic medicines may limit the normal homeostatic responses to volume depletion, thus resulting in the decline of renal functions. This type of acute kidney has symptoms such as nausea and fatigue, which were presented by M.r J.R. A clinical manifestation of possible renal injury is linked to this type of acute kidney injury.Risk FactorsThere are various risk factors for acute kidney injury. From the given case, Mr. J.R might have the following risk factors.Age: Mr. J.R is 73 years old, and people older than 65 years are susceptible to developing acute kidney injury; this is due to the functional deterioration of the kidney due to the aging process and a reduced renal reverse (American nurse, 2015).Sepsis: Sepsis can be a risk factor in Mr. J.R’s case, mainly because he has infections such as diarrhea and inflammatory response during this process can lead to the adaptive response of the tubular epithelial cells, which reduces functions of the cells to minimize energy demand, and can result in reduced kidney function.Toxic medications can also be a risk factor for kidney disease since they limit the normal homeostatic responses to volume depletion, resulting in the decline of renal functions.Complications On Hematologic System (Coagulopathy and Anemia) and the Pathophysiologic Mechanisms InvolvedIn this case, hematologic system functions will reduce significantly. This is because damaged kidneys generate fewer erythropoietin (EPO), a hormone responsible for indicating bone marrow to create red blood cells. With reduced EPO, the body will make fewer red blood cells signifying less oxygen is supplied to other body tissues. Besides, chronic kidney disease can lead to low levels of nutrients such as vitamin B12 and folate to make red blood cells (Nih.gov, 2014). The case of fewer red blood cells leads to anemia. Besides, chronic kidney disease can lead to venous thromboembolism, making it easier for the body to form blood clots; this is mainly seen with kidney problems causing welling or higher levels of proteins in the urine.Ms. P.C. Case Study QuestionsClinical Manifestations and Microscopic Examination of the Vaginal DischargeThe most possible diagnosis for Ms. P.C is a pelvic inflammatory disease. This disease mainly happens when sexually transmitted bacteria extends from the vagina and affects the uterus, fallopian tube, or ovaries. Ms. P.C has presented clinical manifestations such as abdominal pain, nausea, emesis, and vaginal discharge, which is thick, greenish-yellow in color, and very smelly; these are all symptoms of pelvic inflammatory disease (Higuera,ÿ2019). Besides, the positive high white blood cells count in her microscopic examination of the vaginal discharge is a positive sign for pelvic inflammatory disease.Microorganism InvolvedThe microorganism involved is bacteria. Greenish-yellow in color, smelly vaginal discharge, and abnormal white blood cells, as seen in the case of Ms. P.C, are signs of bacterial infection (Higuera,ÿ2019). This bacteria travels from vagina to womb or fallopian tubes, causing an infection. Several types of bacteria can cause pelvic inflammatory disease; however, the common types are gonorrhea or chlamydia infections. They are mainly acquired during unprotected sex (Higuera,ÿ2019). Besides, someone can get bacteria when they gets into the reproductive region when the usual barrier, which is formed by the cervix, is disrupted; this happens mostly during menstruation (Mayo clinic, 2019). As from the Ms. P.C case, she admits to having unprotected sex once in a while, and her LMP also ended three days ago. These can be one of the causes of the bacteria.Criteria to Recommend HospitalizationTreatment of pelvic inflammatory disease is essential since it helps relieve acute symptoms, exterminate the current infection, or minimize the disease’s long-term effect. This as well helps in the reduction of the transmission of the infection to a sexual partner. A patient can be urgently admitted to the hospital if they have severe symptoms such as the ones shown by Ms. P.C., such as nausea and vomiting. Another factor is when the patient has signs of pelvic peritonitis.The criteria I will use to recommend hospitalization to Ms. P.C include administering antibiotics. The first treatment line is to prescribe antibiotics immediately to Ms. P.C after receiving the lab test. The recommended antibiotics are penicillin, cefoxitin, metronidazole, ceftriaxone, and doxycycline (Das, Ronda & Trent, 2016). They help in stopping the growth of the bacteria or kills it. The patient should then be checked after three days of taking the antibiotics to monitor and ensure the treatment is working. It is also imperative to advise the patient to continue taking the antibiotics to finish the dose even if the condition improves. If the oral antibiotics do not work or in the cases of severe symptoms, the patient will continue in the hospital, where the intravenous medication will be recommended (Das, Ronda & Trent, 2016). Surgery can also be considered when the patient shows signs of scarring on the fallopian tubes. One or both of the fallopian tubes can be removed. Treating Ms. P.C’s sexual partner will also be recommended to avoid the bacteria’s reinfection. While out of the hospital, Ms. P.C will be advised to refrain from any sexual activities until the treatment is completed.ReferencesRahman,ÿM., Shad,ÿF., & Smith,ÿM. (2012). Acute kidney injury: A guide to diagnosis and management.ÿAmerican Family Physician,ÿ86(7), 631-639.American nurse. (2015, July 13).ÿAmerican nurse: The official Journal of the American Nurses Association (ANA). American Nurse.ÿhttps://www.myamericannurse.com/acute-kidney-injury/Das, B. B., Ronda, J., & Trent, M. (2016). Pelvic inflammatory disease: improving awareness, prevention, and treatment.ÿInfection and Drug Resistance,ÿ9, 191?197. https://doi.org/10.2147/IDR.S91260Higuera,ÿV. (2019).ÿPelvic inflammatory disease (PID). Healthline.ÿhttps://www.healthline.com/health/pelvic-inflammatory-disease-pid#risksMayo clinic. (2019, October 18).ÿIron deficiency anemia – Diagnosis and treatment – Mayo Clinic. Mayo Clinic – Mayo Clinic.ÿhttps://www.mayoclinic.org/diseases-conditions/iron-deficiency-anemia/diagnosis-treatment/drc-20355040Nih.gov. (2014, July 16).ÿAnemia in chronic kidney disease. National Institute of Diabetes and Digestive and Kidney Diseases.https://www.niddk.nih.gov/health-information/kidney-disease/anemiaÿ(Links to an external site.)

 
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Cardiovascular Discussion

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Discussion All Topics Below:Define apical impulse and describe its normal location, size and duration. Describe which abnormal conditions may affect the the apical impulse and explain why.Explain the mechanism producing normal first and second heart sounds.Explain the position of the valves during the cardiac cycle is diastole, isometric contraction, systole and isometric relaxation.Define preload and afterload.Each student must post a substantial post with a minimum of 250 words (3 paragraphs) (introduction, body and conclusion) ÿAll posts and replies must contain at least (2) professional references, one may be the course textbook, properly cited in the current APA format.

 
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Family Support Assessment

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Family Support AssessmentCase management is useful in a variety of settings.ÿ You will be using the nursing process to conduct an in-home assessment in Sentinel City?ÿto develop a plan of care for a family.ÿ The process of collecting, analyzing, and synthesizing data from a variety of sources can help the nurse to gain an understanding of family strengths, values, and needs related to physical and social determinants of health to promote the health and well-being of the family unit.Complete the Family Support & Home Assessment virtual simulation activity which can be found by clicking Enter Virtual Simulation.Once you enter Sentinel HospitalClick BEGINYou?ll enter the lobby and be led to the hospital mapClicking SKIP will take you directly to mapSelect Location: Family Services Or SIMPath Competencies: Collaboration for Improving OutcomesOnce you are in the room, the Family Support Assessment Form will be available.ÿ Complete the Family Support Assessment Form by asking the client predetermined questions.ÿ When the form is completed, click Submit.ÿ Develop a Family Support Care Plan to address the needs of this family using your institutions? care plan template or useÿthis care plan template.Include a properly formatted community health nursing diagnosis that addresses either preschool age children, single mothers, or pregnant women.Increased risk of (disability, disease, etc.) among (community or population) related to (disability, disease, etc.) as demonstrated in or by (health status indicator, or etiological/causal statement).Example: Increased risk of obesity among school-age children related to lack of safe outdoor play areas for children as demonstrated by elevated BMI rates.Reading and ResourcesChapter 16 pages 297-316, Chapter 23 pages 395-404, Chapter 20 pages 367-375, Chapter 26 pages 439-447 in Fundamentals of Case Management Practice.Reviewÿclinical guidelines of the AHRQClinical Guidelines and RecommendationsEvidence-based research provides the basis for sound clinical practice guidelines and recommendations. The datab…Additional Instructions:All submissions should have a title page and reference page.Utilize a minimum of two scholarly resources.Adhere to grammar, spelling and punctuation criteria.Adhere to APA compliance guidelines.Adhere to the chosen Submission Option for Delivery of Activity guidelines.Submission Options:Choose One:Instructions:Paper4 to 6-page paper. Include title and reference pages.

 
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Case Study: Mr. M.

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Case Study: Mr. M.It is necessary for an RN-BSN-prepared nurse to demonstrate an enhanced understanding of the pathophysiological processes of disease, the clinical manifestations and treatment protocols, and how they affect clients across the life span.Evaluate the Health History and Medical Information for Mr. M., presented below.Based on this information, formulate a conclusion based on your evaluation, and complete the Critical Thinking Essay assignment, as instructed below.Health History and Medical InformationHealth HistoryMr. M., a 70-year-old male, has been living at the assisted living facility where you work. He has no know allergies. He is a nonsmoker and does not use alcohol. Limited physical activity related to difficulty ambulating and unsteady gait. Medical history includes hypertension controlled with ACE inhibitors, hypercholesterolemia, status post appendectomy, and tibial fracture status postsurgical repair with no obvious signs of complications. Current medications include Lisinopril 20mg daily, Lipitor 40mg daily, Ambien 10mg PRN, Xanax 0.5 mg PRN, and ibuprofen 400mg PRN.Case ScenarioOver the past 2 months, Mr. M. seems to be deteriorating quickly. He is having trouble recalling the names of his family members, remembering his room number, and even repeating what he has just read. He is becoming agitated and aggressive quickly. He appears to be afraid and fearful when he gets aggressive. He has been found wandering at night and will frequently become lost, needing help to get back to his room. Mr. M has become dependent with many ADLs, whereas a few months ago he was fully able to dress, bathe, and feed himself. The assisted living facility is concerned with his rapid decline and has decided to order testing.Objective DataTemperature: 37.1 degrees CBP 123/78 HR 93 RR 22 Pox 99%Denies painHeight: 69.5 inches; Weight 87 kgLaboratory ResultsWBC: 19.2 (1,000/uL)Lymphocytes 6700 (cells/uL)CT Head shows no changes since previous scanUrinalysis positive for moderate amount of leukocytes and cloudyProtein: 7.1 g/dL; AST: 32 U/L; ALT 29 U/LCritical Thinking EssayIn 750-1,000 words, critically evaluate Mr. M.’s situation. Include the following:Describe the clinical manifestations present in Mr. M.Based on the information presented in the case scenario, discuss what primary and secondary medical diagnoses should be considered for Mr. M. Explain why these should be considered and what data is provided for support.When performing your nursing assessment, discuss what abnormalities would you expect to find and why.Describe the physical, psychological, and emotional effects Mr. M.’s current health status may have on him. Discuss the impact it can have on his family.Discuss what interventions can be put into place to support Mr. M. and his family.Given Mr. M.’s current condition, discuss at least four actual or potential problems he faces. Provide rationale for each.You are required to cite to a minimum of two sources to complete this assignment. Sources must be published within the last 5 years and appropriate for the assignment criteria and relevant to nursing practice.Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.You are required to submit this assignment to LopesWrite. Refer to the LopesWrite Technical Support articles for assistance.RUBRICAttempt Start Date: 23-Sep-2019 at 12:00:00 AMDue Date: 29-Sep-2019 at 11:59:59 PMMaximum Points: 120.0Case Study: Mr. M.No of Criteria: 11 Achievement Levels: 5CriteriaAchievement LevelsDescriptionPercentageUnsatisfactory0.00 %Less Than Satisfactory75.00 %Satisfactory79.00 %Good89.00 %Excellent100.00 %Content80.0     Clinical Manifestations of Mr. M.10.0Clinical manifestations are omitted.Clinical manifestations are partially presented. There are major omissions and inaccuracies.Clinical manifestations are summarized. An overview of the general symptoms is presented. Some findings are incomplete.Subjective and objective clinical manifestations are described. Overall, the clinical manifestations are accurate and reflect observed and perceived signs and symptoms.Subjective and objective clinical manifestations are detailed. The clinical manifestations are accurate and clearly report the observed and perceived signs and symptoms.Diagnoses and Secondary Diagnoses10.0A discussion on what primary and secondary medical diagnoses should be considered for Mr. M. is omitted; or, medical diagnoses presented are inaccurate.A partial discussion on what primary and secondary medical diagnoses should be considered for Mr. M. is presented. There are major inaccuracies. Rationale and evidence for the diagnoses are lacking.A general discussion on what primary and secondary medical diagnoses should be considered for Mr. M. is presented. There are some inaccuracies. A summary provides some rationale and evidence to explain why the diagnoses are relevant.A discussion on what primary and secondary medical diagnoses should be considered for Mr. M. is presented. General rationale and relevant data are used to explain why the diagnoses should be considered. There are minor inaccuracies.A detailed discussion on what primary and secondary medical diagnoses should be considered for Mr. M. is presented. Strong rationale and reliable data are used to explain why the diagnoses are relevant and should be considered.Explanation of Expected Abnormalities During Nursing Assessment15.0A discussion of what abnormalities a nurse would expect to find during a nursing assessment is omitted; or, the expected findings are not relevant for the patient or his health status.An incomplete summary of some abnormalities a nurse would expect to find during a nursing assessment is presented. There are inaccuracies. No rationale or evidence is provided for support.A general discussion on the abnormalities a nurse would expect to find during a nursing assessment is presented. There are minor inaccuracies. Some rationale or evidence is provided for support.A discussion of abnormalities a nurse would expect to find during a nursing assessment is presented. General rationale and evidence are provided for support.A thorough discussion of abnormalities a nurse would expect to find during a nursing assessment is presented. Strong rationale and evidence are provided for support.Effects of Health Status on Physical, Psychological, and Emotional Aspects of Patient and Family15.0The effects of the health status on the physical, psychological, and emotional aspects of the patent, and the impact the health status has on the family, are omitted.The effects of the health status on the physical, psychological, and emotional aspects of the patient, and the impact the health status has on the family, are partially summarized. The effects presented are questionable, and support for the discussion is not provided.The effects of the health status on the physical, psychological, and emotional aspects of the patient, and the impact the health status has on the family, are summarized. Overall, the described effects on the patient and impact to the family are relevant. Some support for the discussion is provided.A discussion of the effects of the health status on the physical, psychological, and emotional aspects of the patient, and the impact the health status has on the family, is presented. Support for the discussion is provided.A thorough discussion of the effects of the health status on the physical, psychological, and emotional aspects of the patient, and the impact the health status has on the family, is presented. Strong support for the discussion is provided.Interventions for Support15.0Interventions that can be put into place to support Mr. M. and his family are omitted.Some interventions that can be put into place to support Mr. M. and his family are partially presented. More information is required.Some interventions that can be put into place to support Mr. M. and his family are summarized. There are minor inaccuracies.Key interventions that can be put into place to support Mr. M. and his family are discussed. Some detail is needed for clarity.All relevant interventions that can be put into place to support Mr. M. and his family are thoroughly discussed.Actual or Potential Problems Based on Condition15.0Fewer than three actual or potential problems faced by the patient are presented. The problems posed are not relevant to his condition.Three actual or potential problems faced by the patient are partially presented. It is unclear how some of the posed problems are relevant to his condition. There are inaccuracies.At least four actual or potential problems faced by the patient are summarized. The posed problems are generally relevant to his condition. There are minor inaccuracies. Some information or rationale is needed.Four or more actual or potential problems faced by the patient are discussed. The posed problems are relevant to his condition. Rationale provided generally supports the discussion.Four or more actual or potential problems faced by the patient are thoroughly discussed. The posed problems are clearly related to his condition. Strong rationale is provided and supports the discussion.Organization, Effectiveness, and Format20.0     Thesis Development and Purpose5.0Paper lacks any discernible overall purpose or organizing claim.Thesis is insufficiently developed or vague. Purpose is not clear.Thesis is apparent and appropriate to purpose.Thesis is clear and forecasts the development of the paper. Thesis is descriptive and reflective of the arguments and appropriate to the purpose.Thesis is comprehensive and contains the essence of the paper. Thesis statement makes the purpose of the paper clear.Argument Logic and Construction5.0Statement of purpose is not justified by the conclusion. The conclusion does not support the claim made. Argument is incoherent and uses noncredible sources.Sufficient justification of claims is lacking. Argument lacks consistent unity. There are obvious flaws in the logic. Some sources have questionable credibility.Argument is orderly but may have a few inconsistencies. The argument presents minimal justification of claims. Argument logically, but not thoroughly, supports the purpose. Sources used are credible. Introduction and conclusion bracket the thesis.Argument shows logical progression. Techniques of argumentation are evident. There is a smooth progression of claims from introduction to conclusion. Most sources are authoritative.Clear and convincing argument presents a persuasive claim in a distinctive and compelling manner. All sources are authoritative.Mechanics of Writing (includes spelling, punctuation, grammar, language use)5.0Surface errors are pervasive enough that they impede communication of meaning. Inappropriate word choice or sentence construction is used.Frequent and repetitive mechanical errors distract the reader. Inconsistencies in language choice (register), sentence structure, or word choice are present.Some mechanical errors or typos are present, but they are not overly distracting to the reader. Correct sentence structure and audience-appropriate language are used.Prose is largely free of mechanical errors, although a few may be present. A variety of sentence structures and effective figures of speech are used.Writer is clearly in command of standard, written, academic English.Paper Format (use of appropriate style for the major and assignment)2.0Template is not used appropriately, or documentation format is rarely followed correctly.Appropriate template is used, but some elements are missing or mistaken. A lack of control with formatting is apparent.Appropriate template is used. Formatting is correct, although some minor errors may be present.Appropriate template is fully used. There are virtually no errors in formatting style.All format elements are correct.Documentation of Sources (citations, footnotes, references, bibliography, etc., as appropriate to assignment and style)3.0Sources are not documented.Documentation of sources is inconsistent or incorrect, as appropriate to assignment and style, with numerous formatting errors.Sources are documented, as appropriate to assignment and style, although some formatting errors may be present.Sources are documented, as appropriate to assignment and style, and format is mostly correct.Sources are completely and correctly documented, as appropriate to assignment and style, and format is free of error.Total Percentage  100

 
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pressure point therapies

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How can you incorporateÿpressure point therapies into nursing practice for pain management.ÿGive examples.

 
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Research related to how company utilizes information

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The purpose of this assignment is to conduct research related to how a specific company utilizes information related to consumer behavior, product mix or service processes, and pricing to create marketing plans that will meet business needs including their specified marketing objectives.Review:Review the following topic materials.Topic 3: “Consumer Purchasing Decisions”Topic 4: “What Is a Product?” “What Is a Service,” and “Service Delivery”Topic 5: “Pricing and Breakeven Analysis”Part 1:Continuing in the role of a marketing professional who has been tasked with completing a marketing plan for a client, refer back to the research you completed in the Topic 2 Part 1: Research as a starting point for the assignment. Conduct additional research related to consumer behavior, the company’s specific product or service, and the company pricing strategy, and use it to complete the “Marketing Plan Analysis and Presentation: Part 2 ? Research Template.”Part 2:Create a 15-20 slide PowerPoint presentation that summarizes your marketing plan analysis based upon the research you have conducted. Slides should address each of the key areas listed below and should include speaker notes that explain how the company could have used what it learned about consumer behavior, product or service, and pricing to help it develop a marketing plan in order to meet the company marketing objectives and business needs. Include a slide at the end of the presentation to cite your research sources.Company Background:Company name, vision, and mission.Company marketing objectives.Consumer Behavior:Describe the customer segments and target markets.Describe characteristics of the target markets that will affect product/service and pricing decisions.Describe how the company differentiates its product and positions its brand.Describe a consumer buying behavior model for this company and brand.Product or Service:Describe the product mix.Describe the product lines.Describe the service processes.Discuss physical evidence of service, service scape, and ambiance.Discuss the roles of company employees in service delivery.Price:Define the company’s pricing objectives and discuss whether the objectives are profit- or sales-oriented.Provide example of current company pricing strategies.Describe pricing tactics (discounts, etc.) that are used to drive short-term demand.General Requirements:Refer to the resource, “Creating Effective PowerPoint Presentations,” located in the Student Success Center, for additional guidance on completing this assignment in the appropriate style.Submit the “Marketing Plan Analysis and Presentation: Part 2 ? Research Template” and PowerPoint presentation with speaker notes.While APA style is not required for the body of this assignment, solid academic writing is expected, and documentation of sources should be presented using APA formatting guidelines, which can be found in the APA Style Guide, located in the Student Success Center.This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.You are not required to submit this assignment to LopesWrite.Benchmark InformationThis benchmark assignment assesses the following programmatic competencies:BS Accounting; BS Business Administration; BS Business Analytics; BS Business Information Systems; BS Business Management; BS Entrepreneurial Studies; BS Finance; BS Finance and Economics; BS Hospitality Management; BS Marketing and Advertising; BS Sports Management; BS Supply Chain and Logistics Management2.1: Demonstrate appropriate research strategies for acquiring information necessary to meet specific business needs.

 
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Rodger concept

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Post a response to the following question in the discussion forum, and respond to one of your classmate?s postings for this question. Your initial response and responses to others should be at least 150 words. Respond to your classmate?s requests for feedback. In addition, follow the guidelines provided in the Grading Rubric for Online Discussions-500 Level.Using Rodger?s evolutionary method for concept analysis, analyze Robson and Troutman-Jordan’s (2014) concept analysis on cognitive reframing https://wilkes.idm.oclc.org/login?url=search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=103905950 .Please use the link.1.ÿRodger?s Process of Concept DevelopmentBeth Rodgers first published her evolutionary method for concept analysis in 1989. According to Rodgers, concept analysis is necessary because concepts are dynamic, “fuzzy”, and context dependent, and possess some pragmatic utility purpose. Because phenomena, needs, and goals change, concepts must be continually refined and variations introduced to achieve a clearer and more useful meaning.Rodgers examined two viewpoints or schools of thought regarding concept development, and showed that the methods of each differ significantly. Rodgers termed these methods “essentialism” and “evolutionary” viewpoints. In her work, she contrasted the essentialist method of concept development as exemplified by Wilson and Walker and Avant with concept development using the evolutionary method.The evolutionary method of concept development is a concurrent task approach. In it, the tasks may be occurring simultaneously, rather than a sequence of specific steps that are completed before going to the next step. There are several activities involved in the evolutionary method of concept development.Primary Activities in Rodger?s Process of Concept Analysis:Identify the concept and associated terms.Select an appropriate realm (a setting or a sample) for data collection.Collect data to identify the attributes of the concept and the contextual basis of the concept (i.e. interdisciplinary, sociocultural, and temporal variations).Analyze the data regarding the characteristics of the concept.Identify the exemplar of the concept, if appropriate.Identify hypotheses and implications for further development.Rodgers defined many terms and explained the process of concept analysis using the evolutionary view. The goal of the concept analysis, to an extent, is to determine how the researcherÿidentifies the concept of interest, terms, and expressions selected.The goal of the analysis also influencesÿselection of the setting and sampleÿfor data collection. For instance, the setting may be a library and the sample might be literature. The sampling might be time-oriented, such as literature from the previous five years. Whatever the case may be, the researcher?s goal is to develop a rigorous design consistent with the purpose of the analysis. The selection of literature from related disciplines may include those that typically use the concept. An exhaustive review includes all the indexed literature using the concept, and may be limited by a time frame, such as several years.A sample across each discipline over time is obtained by employing a randomized process. Inÿcollecting and managing data,ÿa discovery approach is preferred. The focus of the data analysis is on identifying the attributes, antecedents, and consequences and related concepts or surrogate terms. The attributes located by this means constitute a “real definition as opposed to a nominal or dictionary definition” (Rogers, 2006, p. 92).Rodgers definesÿsurrogate termsÿas ways of expressing the concept other than by the term of interest. She distinguishes between surrogate terms andÿrelated conceptsÿby illustrating the surrogate terms are different words that express the concept, whereas “related concepts are part of a network that provide a background” and “lend significance to the concept of interest” (Rodgers, 2006, p. 92).Identifying an exemplarÿfrom the literature, field observation, or interview provides a clear example of the concept. Examples of real cases are preferred over constructed cases. The goal is to illustrate the characteristics of the concept in relevant contexts to enhance the clarity and effective application of the concept.Interpreting the resultsÿinvolves gaining insight on the current status of the concept and generating implications for inquiry based on this status and identified gaps. Interpreting the results may involve interdisciplinary comparison, temporal comparison, and assessment of the social context within which the concept analysis was conducted.Identifying implicationsÿfor further development and formal inquiry may be the result. The results of the analysis may direct further inquiry rather than giving the final answer on the meaning of the concept. The implications of this form of research-based concept analysis may yield questions for future research, or hypotheses may be extracted from the findings. The major outcome of the evolutionary method of concept analysis is the generation of questions for further research rather than the static definition of the concept.2.ÿConcept Analysis ExemplarThe following is an outline delineating the steps of a concept analysis using Rodger?s Evolutionary Method:A.ÿÿÿÿIdentify the concept and associated terms.Concept: Chronic pain (non-cancerous pain in adults)Associated terms: Chronic pain, persistent pain, intractable pain, and continuous pain.B.ÿÿÿÿSelect an appropriate realm (setting) for data collection.The realm for this study was nursing, psychology, and neurophysiology professional journal publications between the years 1979 and 2009. Included were case studies, qualitative and quantitative studies, review articles, and meta-analyses.C.ÿÿÿIdentify the attributes of the concept and the contextual basis of the concept.Attributesÿof chronic pain: their primary dimensions (physical, behavioral, and psychological).Physical dimension is characterized by quantity, intensity (Level or severity), neurological transmission, and anatomic patterns of chronic pain.Behavioral dimension is characterized by expressive, movement, and functional behaviors.Psychological dimension is characterized by affective an evaluative components.D.ÿÿÿSpecify the characteristics of the concept.Characteristics of chronic pain include:Relative language (i.e. “ache”) and modifiers (i.e. “annoying” or “dull”).Behaviors-ÿexpressive behaviors (moaning and use of pain words); movement behaviors (grimacing, massaging, protective movements, rhythmic movements); functional behaviors (use of socially defined sick role behaviors such as decreased mobility, inactivity, and bed rest)Time dimension- include onset and frequency or rhythm of pain episodesAntecedents-ÿNo specific physical or psychological characteristics were noted that were antecedents or chronic pain. Although trauma sometimes precedes chronic pain, trauma is not necessary or sufficient to cause chronic pain. Chronic pain may be related to alterations in the production and regulation of cortisol, serotonin, and endogenous opioids and in the synthesis and release of sensory neuropeptides.Consequences-ÿTwo themes: living with chronic pain results in alterations of psychological life patterns including depression, anger, anxiety, grief, hopelessness and helplessness; social pattern alterations may result in isolation and loneliness; there may be loss of work, and consequently, loss of insurance and money to pay for medical expenses; andÿcoping with chronic pain- effective coping- decreases the adverse effects of chronic pain by reducing stress and thereby reducing pain intensity. Strategies include distraction, meditation, positive thinking, counseling, and use of alternative treatments (i.e. acupuncture, massage, herbal medications, meditation and imagery).E.ÿIdentify an exemplar of the concept.Chronic pain is a subjective, multidimensional, bio/psycho/social syndrome that can be recognized by physical, psychological, and behavioral patterns. Chronic pain results in physical, psychological, and social alternatives of function to varying degrees. There is no known purpose and there is no single explanation of the symptoms.F.ÿIdentify hypotheses and implications for development.Research is needed to understand the relationship between intensity, quality and duration of pain and central nervous system function.Research is needed to explore body-brain-mind interactions in the development, persistence, and consequences of chronic pain.Research is needed to identify the subjective symptoms that may differentiate chronic pain from acute pain. If early symptoms can be identified, studies can be conducted to determine interventions that may stop the development of chronic pain (Breen, 2000, pp. 24, 48-59).

 
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Health History Assignment Description: Interview your first Digital Standardized Patient, Tina Jones, document her comprehensive health history, and complete post-exam activities. Students spe

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Assignment Description: Interview your first Digital Standardized Patient, Tina Jones, document her comprehensive health history, and complete post-exam activities. Students spend, on average, two and a half hours on this assignment.

 
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An Ethical Dilemma and Case Study

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Review the Ethical Dilemma beginning on page 309 and answer the questions at the end of the case. Each question should be answered with one to two paragraphs. Each paragraph should contain three to five complex sentences.A. ÿDescribe the difficulties in ethical leadership at Stacy?s farm.What type of conflict management style does Doug have?B. Are there more constructive ways for him to handle conflicts with employees?C. Describe the alternatives Stacy has answering that candidates question and the advantages and disadvantages of each.2. Write your answers to the following questions about Case 16, ?Ethical Leadership at Cardinal IG: The Foundation of a Culture of Diversity,? Your answers should total one to two paragraphs for each question. Each paragraph should contain three to five complex sentences.a. ÿDescribe David Pinder?s background. What influence did his background have on his leadership style?b. How has David Pinder embraced ethical leadership to create an ethical culture at Cardinal?c. How has Cardinal?s principles and values shaped the ethical behavior of employees?d. How has Cardinal empowered its employees to practice responsible and accountable leadership?e. ÿWhat lessons can be learned from Cardinal?

 
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Metaparadigm grid

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I have a metaparadigm grid that is due Saturday morning for my theory class. I have attached the assignment requirement, template, reading material, lastly, an example grid. Please be sure this is in APA format. Also only to use the example as a guide. If youre interested in completing this, let me know. Thanks!

 
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