Northern Kentucky University

first question 

After doing the assigned reading and watching the videos do some research and discuss the resources available to help in your success here at Owens as related to what you just learned. What different kinds of resources are available to aid you in your success? Try to find one not already discussed by a classmate. Where is this resource located and how is it accessed? Is the resource a person, location, online, in-person, or something else? Do you need an appointment? Is this resource available to all students? Have you used this resource and what was your experience?  

 ULTIMATE Student’s GADGETS You Must Watch

http://www.youtube.com/watch?v=u8hYcvoJlC0 

Love technology? Gadgets to aid you in your success! 

please read this and watch this video and write a discussion  

second question  

After doing the assigned reading and watching the videos which strategies will aid you in successful decision making? Did you get new ideas from this material? What appealed to you? What will be challenging?       

CDM – Decision Making Model   

http://www.youtube.com/watch?v=XT0Awg-Fpxw 

Need to make a decision?? 

please read this and watch this video and write a discussion 

3- and please replay for this student 

 technology and information competency

I feel as though I use technology in my everyday life that I’m not really dependent on it. But I do need it for class and classwork just to get the things that require me to your technology. I believe I could live without a TV a tablet I don’t have much of a use for it because I find other things I enjoy more than using electronics. I know I spend a lot more time on technology now than I did over the summer because school was out. For most of my classes, I don’t really use technology as much because I mostly learn by being in the lab and using my hands to take things apart and put them back together and inspect things those things don’t really require technology.

and please replay for this student

technology and information competency

I feel as though I use technology in my everyday life that I’m not really dependent on it. But I do need it for class and classwork just to get the things that require me to your technology. I believe I could live without a TV a tablet I don’t have much of a use for it because I find other things I enjoy more than using electronics. I know I spend a lot more time on technology now than I did over the summer because school was out. For most of my classes, I don’t really use technology as much because I mostly learn by being in the lab and using my hands to take things apart and put them back together and inspect things those things don’t really require technology.


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Northern Kentucky University

http://http://www.youtube.com/watch?v=k75xnvi9QUo

www.youtube.com/watch?v=-v8aDo4dV3Q

1- watch these two videos and answer this question

After doing the assigned reading and watching the videos discuss the importance of diversity, making friendships, and connections as you progress through your course of study. Have you made a friend of an international student? Someone from a different background or perspective than you are from? Why is this important and what will you do now to ensure your success? How will you deal with different opinions and conflicts based upon what you just learned? write a small paragraph of 100 words ( discussion )

2- watch this video and answer this question

http://www.youtube.com/watch?v=a7BbEmwYSjI

After doing the assigned reading and watching the videos discuss your financial plan. How will you ensure your continued success? Is finishing each class you start part of this financial success? How will you balance work, life, and school-related to finances? What did you learn from the material that you will incorporate into what you are doing currently or that you found helpful? write a small paragraph of 100 words ( discussion ) and respond for this student

1- Diversity&relationships with others

I belive Diversity is one of the main things the world revolve around for example like race and ethnicity, culture. I’m a African America women that is what you would pick up from my physical appearance.You also have to be willing to learn basic awareness for cultural competence to learn the background and perspectives of others.But the is stereotypes of other races and cultural,like in the work field for the career path I choice they stereotypes is that its un normal for a women let alone a black women isn’t seen as normal and some what out of place.

2- Nick Bach

Diversity, making friendships, and making connects are all very important if you want to be sucessful. Without making connections and friendships the workplace will feel much more tense, and having a good relationship with coworkers can also improve productivity. Diversity is also very important in the workplace, and it is very important that workplaces are inclusive and accomidating for all of their employees, and will help ensure that everyone feels comfortable and has the equal treatment that they deserve.

3- Finance Discussion

I believe that I’m am really good and managing money but that doesn’t mean I have I don’t have some concerns and my finances that’s why I budget and plan out what I need to pay or save up for.At the moment I don’t have a job so what I do for money is a nonprofit work meaning I get paid that day after the job is done.I really think before I make decisions when it comes to money I honestly don’t need it I won’t buy it.I like to make a list every week to look over what I need to pay for and or buy like things for the house or things for my classes once that is sorted out I put what I want to save a side and then if my parents need anything else and then anything I might want to have it helps to sort out what need to be done then thing I may want because you should always try to treat your self.

4– Nick Bach

My financial plan is to continue paying my monthly expenses while saving money, and to keep pointless spending at a minimum. I will insure success by keeping a log of all of my expenses, and base my spending around that each month. I balance work, life, and school finances by allocating adjusting work hours around how much I need for my expenses, while still giving me enough time to do my schoolwork. I found the tips about cutting out spending that is not necessary very helpful. I often pay for small things that I do not need, and that can start to add up.



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Northern Kentucky University

Assignment 2 Endocrine and Cardiovascular Systems

Ms. J.S., a 52 yo white female with two children (16 and 14 yo) presents with history of fatigue, weight gain and muscle weakness over past two years. She initially thought it was caused by work stress and busy family life but has also noticed that she bruises more easily than in the past. She also noted purple lines (stretch marks) that you identified as striae. All of the above symptoms have been getting worse. Blood pressure is 170/110, respirations 12/min and some ankle edema (non-pitting) was noted. The limbs seem relatively thin and the trunk thickened, especially between the upper shoulder blades. Diagnosis was made of Cushing disease/syndrome. How could you differentiate between the two? Elevated levels of cortisol has two effects of plasma leading to increased volume: 1) up-regulation of receptors for aldosterone and 2) an increased effectiveness of ADH (either by centrally increasing ADH release or peripherally by increasing the cellular responsiveness).

  • 1)What effects would these two changes (increased responsiveness to aldosterone and ADH) have on Na+, K+ and water levels in the plasma? (Endocrine Mod 3: MO2, MO3, CO2, CO3, CO4)
  • 2)Where does cortisol secretion occur, and thus is a potential site of an over-secreting tumor? How else could someone develop Cushing syndrome if not by a tumor in that area? (Endocrine Mod 3: MO1, MO2, MO3, CO1, CO2, CO3, CO4, CO5)
  • 3)What is the most common cause of Cushing syndrome in the United States? (Endocrine Mod 3: MO1, MO2, MO3, CO1, CO2, CO3, CO4, CO5)
  • 4)What measures above helped you determine that the stroke volume (considering the measures that factor into it) was reduced? (Cardiovascular Alterations Mod 5: MO7, MO9, MO10, MO12, MO17, CO2, CO3, CO4, CO5)
  • 5)Describe the mechanism of how digitalis (AKA Oubain) works at a molecular level to increase contractility (positive ionotrope)? Discuss the ion gradients, how they were created/maintained for a cell at resting membrane potential and the effects of this drug that lead to its action (rise in what ion and where) on muscle contraction. (Cardiovascular Structure and Function Mod4: MO2, MO6, MO7, MO9, MO11, CO1, CO2, CO3)
  • 6)Statins are commonly used to treat cardiovascular disease. Describe their effect and the mechanism of how that effect is brought about. Explain if men and women with similar cholesterol profiles are at similar risk for cardiovascular disease (i.e. are they equally predictive of cardiovascular risk for men and women). Supply a link to an article that supports your assertion and in a sentence or two, describe the “take home point(s)” of the article (Cardiovascular Structure and Function Mod 5: MO1, MO5, MO7, MO8, MO9 CO1, CO2, CO3)
  • 7)Supply one link/web address/citation to an article (different from above article) that describes differences in either gender or race in the treatment or assessment of risk for cardiovascular disease and a statement of how that information will affect your assessment/treatment of patients in practice.
  1. Adrenal tumors c. Infections
  2. Pituitary tumors d. Glucocorticoids prescribed by healthcare workers

Mr. M.S., an overweight, 55 yo white male presents to your clinic with chest pains. He has a history of hypertension, alcohol use and does not restrict his diet. He is currently taking nitroglycerin tablets as needed for angina. This pain is worse and is not controlled by nitroglycerin. The pain is radiating down his left arm. The pain in the chest feels like pressure or heartburn. You hear inspiratory rales, consistent with pulmonary edema. His blood pressure is 100/75. He begins to have difficulty breathing, especially when lying down. EKG and serum enzymes suggest a left ventricular wall myocardial infarction. Cardiac catheterization reveals a pulmonary wedge pressure of 30 mm Hg (normal, 5 mm Hg) and two-dimensional echocardiography measured an ejection fraction of 0.35 (normal, 0.55). In the Coronary ICU, he was treated with thrombolytic agents (tPA), digitalis (a positive inotropic agent) and furosemide (Lasix, a loop diuretic)

Rubric for Assignment 2 on Endocrine and Cardiovascular Systems

  • 1)Student described a correct effect (retention, loss) by stimulation of ADH or Aldosterone on each (Na+, K+ and water) as it relates to plasma (3 pts)
  • 2)Student correctly lists the site (specific organ) of cortisol production (1pt) and describes a credible alternative source of cortisol or analogue capable of leading to Cushing Syndrome (1pt)
  • 3) Correctly chose the best answer (2pts)
  • 4)Student lists a measure that indicates reduced stroke volume in the case scenario (1pt) Student lists additional measure(s) that indicates reduced stroke volume in the case scenario (1pt) Student correctly explains why a measure indicates reduced stroke volume in the case scenario (1pt) Student correctly explains why additional measure(s) indicates reduced stroke volume in the case scenario (1pt)
  • 5)Identifies the correct ion pump/ATPase as a main factor in creating and maintaining the ionic membrane gradients found in a cell at rest and being directly inhibited by Digitalis (2pts) Identifies the correct, different, pump (exchanger) as a main factor in creating altered ion levels within the cell leading to the contractility changes (as a result of the first pump being affected) (2pts)
  • 6)Student correctly lists the effect on blood (and it’s mechanism for achieving that effect) that is a large part of its cardiovascular benefit (2pts)
  • 7)Supplied a link or web address or citation to an article (different from above article, 1pt) that described important differences in either race or gender when assessing the risk for cardiovascular disease

Correctly identifies the rise in this ion intracellularly as the reason for the increased contractility (2pts)

Student identifies if there is a gender difference (2pt) when interpreting blood lipid levels and supplies a valid citation or link (1pt) supporting that statement with a brief “take home point” summary of findings of the article (3pts)

Included a statement of the importance of the findings in the assessment/treatment of future patients (2pts)


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Northern Kentucky University

Overview VT of Matrix Assignment: 

This  assignment will require you to take the PICO, 5 research articles and place them in a table for analysis.  You will critique each article and identify the most important parts of the research, analysis, and findings.

Then  you will summarize the articles by grading the research, and identifying gaps in the literature as well as possible interventions (see grading rubric and examples).

This will serve as the foundation for the work you will do in the Project/Practicum courses. As you work with your preceptor and finalize your capstone project, you will continue to build on this material.  This assignment will be graded within 3-4 days of due date, with feedback provided once all grading has been completed. 

This assignment enables the learners to meet Course SLO #1, 2, 3, 4  

Instructions:

Identify your PICO or research question of interest

Gather 5 research articles on your topic: be sure to save them and submit them along with the matrix;  please make sure they are PDF documents. Do not use clinical guidelines or Cochran Reviews, abstracts, or  poster presentations.  You can search for research only by indicating “research” when you do an advanced search.  If you can’t answer a lot of the questions, it is probably not a research article. 

Review sample matrices and summaries

Use matrix table- one for each article and critique the parts of the article using the rubric

Be sure to identify the evaluation tool used to grade the evidence such as (See below for grading the evidence tools)

Identify where there are issues with the articles and what gaps were not addressed with the research; be prepared this may change the way you look at your topic or may result in a slightly different direction for your area of interest. This is ok- that is what you want to accomplish with this assignment. It will really assist you as you move forward with your project.

For this assignment you will turn in the matrix tables, summary, references and pdf copies of your 5 articles. 

Key definitions:

Level of evidence:  the process used to evaluate the level of evidence of your articles- such as Jones Hopkins,  Cincinnati Children’s evaluation etc,

Evaluation tool: use the method and describe how you arrived at the scoring or knowing that the article included all content it needed to- such as CASP; 

Instrument: What type of instrument or tool was used in the article?  This could be  a depression screening tool, Nurse satisfaction tool etc.  Describe the instrument- how many questions, reliability- consistency with test-retest, Cronbach Alpha, inter-rater reliablity; validity with content validity, face validity 

Files: 

Use this form for your assignment: Article Matrix and Analysis Revised 10.2020-1.docx

Rubric: DNP 816 Rubric for Matrix and Summary 10.2020 Final v2.docx

Sample 1 Matrix_dnp816. Fall 2020 with permission.docx

Sample 2 DNP 816 Matrix Fall 2020 with permission.docx

Links to critical appraisal tools to evaluate research quality:

Joanna Briggs Institute (joannabriggs.org) Joanna Briggs Institute (Links to an external site.)  (Links to an external site.)

CASP checklists (Links to an external site.)

Mixed Method appraisal checklist McGill:  (Links to an external site.)

Cincinnati Children’s Hospital Medical Center Legend tools- very helpful (Links to an external site.)

Johns Hopkins EBP Models and Tools  (Links to an external site.)


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Northern Kentucky University

Based on chapter 1 in the textbook:

Part 1What Constitutes A Social Problem?

Part 2 — Identify any problem that you consider a social problem and explain why it is a social problem. (Based on your understanding of chapter 1)

In order to view your classmate’s responses to this CTQ/Discussion Broad Topics, you must first respond to the CTQ/DB Topic yourself. Students must create a thread “first” in order to view other threads in this forum. If your first post is not your own response to the CTQ, 8 points will be deducted.


(Sometimes students will view classmates’ responses first and then post an initial response to the DB. [This behavior is not acceptable in this class]. You must prepare yourself to respond to the CTQ by reading the supplemental reader, textbook, or by viewing any available supplemental materials), and then post your own thoughts}

EXERCISE: Overt and Covert Racism

Racism comes in many forms. It is structured within institutions, both through the people acting on behalf of the institutions and in the institutional regulations and organizational policies. Overt racism, which is clearly unfair, is easier to see than covert racism, which hides and can seem small or unimportant to those unaffected. For this exercise, pick an institution. It can be schools, prisons, media, healthcare, police, housing, or any other of your choosing. Think specifically about the type of institution and make two lists. The first list is things the institution might do that would be overtly racist. The second list is things the institution might do that would be covertly racist. Try to come up with at least four examples of each.

For example, in a high school, a Black student finding a noose in his locker would be overt racism, and Black students being told not to gather behind the cafeteria at lunch so the administration can keep an eye on them, even though white students also gather behind the cafeteria at lunch, would be covert racism.


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Assignment 3 Pulmonary and Renal Systems

Ms. MC is a 59 yo woman with long history of smoking 1 – 1.5 packs/day (20+ years) but is no longer smoking. She notices that she fatigues quickly, is often short of breath, coughs frequently and has ankle swelling. She has trouble sleeping but noted some improvement with extra pillows. You note an increase in anteroposterior chest diameter, prolonged expiratory phase with wheezing. She also has cyanosis of nailbeds with moderate pitting edema bilaterally. Lab tests reveal Hgb is high normal, PaO2 is low at 48 mmHg, O2 saturation is at 80%, PCO2 is significantly elevated (70 mmHg) and HCO3– is also elevated above normal (35 mEq/L). Your diagnosis is a combination of chronic bronchitis and emphysema (COPD). Pulmonary function tests revealed a decrease in Vital Capacity and Expiratory Flow Rate combined with an increase in both Residual Capacity and Functional Residual Capacity. These types of tests could also reveal other conditions, such as asthma, as well as guide treatment to prevent significant attacks.

  • 1.What changes occurred in her airways that led to obstruction and increased airway resistance? (Hint: View it in two parts: 1) the airway changes and 2) the alveolar tissue changes relating to elasticity and compliance). (Pulmonary System MO2,3,5,7,8,23,26)
  • 2.How does acidosis, such as caused by ketones or CO2 retention, alter the delivery of oxygen to the tissues? (Pulmonary System MO2,5,9,11,12,16)
  • 3.What is a V/Q ratio and how does it affect oxygenation of blood in health and disease? In late stages of COPD, such as seen above, how is V/Q altered (Hint, see fig. 27-17) (Pulmonary System MO5,6,9,10)
  • 4.Why does she have ankle edema? What role does the lung play in hydrostatic pressure changes seen here? What is the effect pulmonary artery pressure and resultant changes to the right side of the heart? (Pulmonary System MO9,13,14,18,25,30

Five years after being treated for hypercortisolism by you, Ms. J.S. returns with complaint of weight gain (she had lost weight after last visit led to removal of an anterior pituitary tumor that was promoting excessive ACTH release). Her blood pressure had improved as after the 5 year ago visit, but has been rising over the past three years. Stress at work has been worse and her diet suffered as a result. Current blood pressure is 175/110 and you note an abdominal bruit upon examination. This leads you to check plasma renin levels, which came back 10ng/mL per hr (normal is 0.9-3.3ng/mL per hr). A differential renal vein renin test was ordered and showed a difference of 1.6 (normal is 1). *NB. The renal vein renin test is no longer used as less expensive and less invasive tests, such as duplex ultrasonography and computed tomographic angiography are now available. I am using this test in this context as a thought provoking, though now outdated, exercise. The test results were consistent with renal artery stenosis, which an arteriogram confirmed was 85% blocked. An angioplasty is scheduled and her blood pressure should to return to normal after the procedure.

  • 5.The turbulent blood flow through the renal artery, narrowed due to atherosclerosis, led to the sound detected upon examination. Why did the differential renal vein renin test show an increase in the blocked renal artery side secretion of renin, yet a drop in renin levels on the other (normal) side? (Renal MO3,4,26)
  • 6.What actions (list 4) of renin lead to increased blood pressure? (Endocrine MO1-4; Cardiovascular MO13; Renal MO6)
  • 7.What medications are available to treat someone who had a genetic predisposition to higher than average renin production (or incomplete/unsuccessful repair of the renal artery stenosis), and thus prevent the adverse effects of high blood pressure? Describe why you feel this is an appropriate treatment (i.e. focusing treatment on the derangement as closely as possible). (Endocrine MO1-4; Cardiovascular MO13; Renal MO6)
  • Rubric: Assignment 3 Pulmonary and Renal
    Systems Rubric

  • 1) Two parts: Correctly answered what changes
    occurred in the airways (2pts) and correctly answered how the alveoli changed
    in terms of compliance/elasticity (2pts)
  • 2) Fully discussed the effect of a drop in pH (2pts)
    on oxygen binding to hemoglobin.
  • 3) Correctly described the change in V/Q ratio in
    Ms. MC’s case (3pts)
  • 4) Correctly described the cause of the peripheral
    edema in regards to lung tissue/alveoli (2pt), alveolar surface area changes (2pt),
    changes in oxygen diffusion and effect on pulmonary artery pressure. Correctly
    discusses the effect long-term on the right side of the heart and its ability
    to match input with output of blood efficiently (2pt)
  • 5) Correctly described why and how renin secretion
    was different on the affected (narrowed) versus unaffected side (2pts)
  • 6)Correctly described 4 actions of renin that can
    contribute to an increase in blood pressure (directly or indirectly) (4pts)
    7) Correctly listed two different medications (not
    two of the same family i.e. naproxen is similar to ibuprofen in that both block
    prostaglandin synthesis but steroids have a different mode of action) to treat
    the problem in blood pressure created by the renal vessel blockage (2pts). Correctly gave a rational and reasonable
    discussion of why this treatment was appropriate and matched/treated the root
    of the problem. (2pts)


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