1) Minimum 4 full pages and the template attached (Follow the 3 x 3 rule: minimum three paragraphs per part)

              Part 1: Minimum 4 pages

              Part 2: Complete the Teachin Work Proposal

Submit 1 document per part

2)¨******APA norms

          All paragraphs must be narrative and cited in the text- each paragraphs

          Bulleted responses are not accepted

          Dont write in the first person 

          Dont copy and pase the questions.

          Answer the question objectively, do not make introductions to your answers, answer it when you start the paragraph

         Submit 1 document per part

3)****************************** It will be verified by Turnitin (Identify the percentage of exact match of writing with any other resource on the internet and academic sources, including universities and data banks) 

********************************It will be verified by SafeAssign (Identify the percentage of similarity of writing with any other resource on the internet and academic sources, including universities and data banks)

4) Minimum 3 references per part not older than 5 years

5) Identify your answer with the numbers, according to the question.

Example:

Q 1. Nursing is XXXXX

Q 2. Health is XXXX

6) You must name the files according to the part you are answering: 

Example:

Part 1.doc 

Part 2.doc 

__________________________________________________________________________________

Part 1: 

 Written project that includes the following information as it applies to the problem, issue, suggestion, initiative, or educational need profiled in the capstone change proposal (See Files 1……. File 10)

1. Background

2. Clinical problem statement.

3 Purpose of the change proposal in relation to providing patient care in the changing health care system.

4. PICOT question ( You must create)

5. Literature search strategy employed.

6. Evaluation of the literature.

7. Applicable change or nursing theory utilized.

8. Proposed implementation plan with outcome measures.

9. Discussion of how evidence-based practice was used in creating the intervention plan.

10. Plan for evaluating the proposed nursing intervention.

11. Identification of potential barriers to plan implementation, and a discussion of how these could be overcome.

12. Appendix section, if tables, graphs, surveys, educational materials, etc. are created.

 Part 2:  Primary Prevention/Health Promotion 

The teaching plan proposal developed in this assignment will be used to develop your Community Teaching Plan.

 You are strongly encouraged to begin working on your presentation once you have received and submitted this proposal.

Select one of the following as the focus for the teaching plan:

1. *************Primary Prevention/Health Promotion*************
2. Secondary Prevention/Screenings for a Vulnerable Population
3. Bioterrorism/Disaster
4. Environmental Issues

Use the “Community Teaching Work Plan Proposal” (See File Teaching Work) resource to complete this assignment. This will help you organize your plan and create an outline for the written assignment

Please respond to the following write ups in about 8-10 sentnces with atleast 2 APA refrences 

Work 1 

Three ways in which the changes common to aging can be delayed

There are multiple statements about how sedentary lifestyles contribute to increased health problems throughout life, particularly when it comes to aging and the elderly. Routine physical exercise increases cardiac output and ventilation, which slows tissue changes associated with senescence by improving nutrition and oxygenation to the cells (Hubert & VanMeter, 2018). Weight bearing exercise helps to decrease risk for osteoporosis, and exercise can limit changes associated with aging to the cardiovascular system as well (Hubert & VanMeter, 2018). The immune system is also affected with aging, putting patients at higher risk for repeat inflammation or infection. Regular physical activity can also prevent immunosenescence and improve the effectiveness of the annual influenza vaccine without negative side effects that patients have the potential of occurring with prescription medications (Sellami et al., 2018).

Maintaining a healthy diet is another way that the common changes of aging can be delayed. Dietary intakes affects multiple body systems when it comes to aging. Too much dietary intake of fats and cholesterol puts patients at higher risk for atherosclerosis. The risk for atherosclerosis already increases with age due to the thickening of arteries (Hubert & VanMeter, 2018). Calcium, Vitamin C and Vitamin D are all associated with musculoskeletal health. These nutrients should be consumed throughout life to maintain a healthy system, but in the geriatric population it becomes important due to the risk of osteoporosis from the natural aging process that results in loss of calcium from the system (Hubert & VanMeter, 2018).

Many people worry about their cognitive status when they age. In my family, every woman on the paternal side for the last three generations has died with some type of cognitive impairment related to aging, most commonly Alzheimer’s- which makes this topic all the more interesting for me. Social interaction and cognitive activities that involve problem solving like puzzles, reading, and card games, reduce senescence in the central nervous system (Hubert & VanMeter, 2018). In one study that looked at social interaction among elderly community residents, positive correlations were made between maintaining social interaction and preventing cognitive decline. The study also found that maintaining healthy relationships by going out and making time for leisure activities by using the recreation center prevented cognitive decline as well (Kimura et al., 2017)

Patient example for labs and diagnostic tests

Mrs. C.T., a 78 year old woman, states that she is having hip and knee pain after a fall that she had a week ago. She states she lives alone in her apartment on the ground floor and only leaves to go to church, the grocery store, and to get a haircut. Her hobbies include sitting at the table watching the birds and knitting. She is on a fixed income and usually eats canned meats and vegetables.
Bone density scans show that her bone density is low. X-Ray shows fractures of the long bones of one of her legs. Her bones appear porous and brittle. Mrs. C.T. would benefit from dietary of calcium, Vitamins A and C to strengthen her bones, and regular weight bearing exercise to prevent complications of osteoporosis.

Results of new knowledge that impact plan of care

Teaching patients how to modify their dietary intakes based on age and risk factors is important to preserve their health status and help to delay some of the negative changes of aging. Many aging people are unaware of the diet changes that need to be made for a healthy lifestyle. Teaching this to patients is primary and secondary prevention for cardiovascular diseases (Kolarzyk et al., 2018). Teaching patients about how to maintain an active lifestyle is important as well to reduce many health problems related to more sedentary activity. Encouragement of geriatric patients to go to the recreational center to engage in physical activity and social interaction would address many of the aging protective needs of this population.

Work 2

Major physiological changes associated with decreased sex hormones release to the body

Men

The purpose of this discussion will be to address the physiological changes seen in the aged related to the decreased secretion of sex hormones in the body. The major sex hormone testosterone peaks in early adulthood for men with a drop of about 1 % each year after age 30, changes are generally seen later in life and function does not completely end (Hubert & VanMeter, 2018). Aging has been described as a mild chronic proinflammatory process (Frungieri et al., 2018). Untreated inflammation from trauma, infections agents or medications of the male sex organs can lead to infertility, benign prostatic hyperplasia (BPH), and elevated prostate-specific antigen (PSA) (Frungieri et al., 2018). Older men are at risk for prostate cancer due to chronic inflammation, cyclooxygenase 2 (COX2) a key enzyme of prostaglandins is excessively produced (Frungieri et al., 2018). Treatments to decrease risk for development of inflammatory process include nonsteroidal anti-inflammatory drugs for example aspirin, soy and green tea (Frungieri et al., 2018). 

Women
The major sex hormonal changes occur in women around age 50, the ovaries stop producing estrogen and progesterone causing the anterior pituitary gland to raise the serum levels follicle-stimulating hormone (FSH) and luteinizing hormone (LH); ovulation begin to cease, the menses terminate with dropping estrogen and progesterone levels (Hubert & VanMeter, 2018). Older women experience thinning of vaginal mucosa, loss of elasticity, decreased glandular vaginal and cervical secretions causing inflammation, and dyspareunia (Hubert & VanMeter, 2018). Despite these findings, women appear to be immune privileged, they often respond to different vaccines with stronger humoral response offering greater protection overall (Giefing-Kröll et al., 2015). Unfortunately, as the protective effects of estrogen cease, so do the protective immunological benefits, postmenopausal women have fewer total lymphocytes, mostly B and CD4, T lymphocytes (Giefing-Kröll et al., 2015). Treatments to help boost immune system include hormone replacement therapy (HRT), estrogen, increased B-lymphocytes and decreased pro-inflammatory cytokine production (Giefing-Kröll et al., 2015).

Patient example for labs and diagnostic tests, give an injection

Mr. B.B age 55 had a PSA 4ng/m/L. Upon exam reviewed results and discussed causes and options. Since Mr. B.B has no family history is a European man and therefore he has lower risk. A urine was sent, and it came back abnormal with bacteria greater than 10,000. He will be treated with an oral antibiotic Amoxicillin for 7 days for this urinary tract infection.
Mrs. AW age 53 has been feeling weaker over the last few weeks, no cough, shortness of breath or chest pain noted. Appetite intact no recent weight loss to note, vitals all stable. After further evaluation patient states she stopped taking her HRT and did not think that would cause her to feel so bad. She will resume meds ASAP. Mrs. AW agreed to also receive a shingles vaccine today, given to her left deltoid.

Results of new knowledge that impact plan of care

The aging process is full of surprises for both men and women. Men, despite decreasing testosterone, testes shrinkage, and decreased sperm production, men can still father a child, if their spouse is still of childbearing age (Hubert & VanMeter, 2018). Women get to enjoy the effects and protective nature of all the hormones until after menopause and then the real party begins with hot flashes, severe mood swings, sweating, insomnia, visual changes and headaches (Hubert & VanMeter, 2018). Both pts would need good education regarding current plan treatment and a 1-month follow-up care to maintain optimal health.

Write a Tri- fold educational brochure . Brochure must: have a unique title, student name and an introduction be typed in 12 Calibri or times roman fonts be arranged in an orderly sequenced manner that is meaningful to readers be neatly printed and presented in color. 

Prepare a client information brochure on nursing interventions necessary to meet the needs of the older adult with Presbycusis

 e: Topic 4 DQ 2

In their report of code of ethics (2015), the American Nurses Association defines accountability as taking self-responsibility for our actions. As nurses, we have a great responsibility to patients, peers, and ourselves all the time. Nurses that hold an RN licensed are accountable and obligated to maintain the highest ethics, transparency, and morals when caring for patients. The Nursing Practice Act and the law mandate and outlines nursing practice responsibilities. The scope of regulations in the California Nursing Practice Act clarifies nursing practice (NPA sec. 2527-2542). Nursing practice is a privilege that needs honesty, dignity, and appreciation. Nurses must be knowledgeable of updated policies and protocols of patient care, empathetic to patients and their families, flexible, and most importantly, truthful. Patients trust nurses with their lives.

We are humans and make mistakes, no doubt about that. But not taking the responsibility and correct or improve our practice is not only unethical but criminal. The one example in my nursing practice that I will never forget was a new grad. I dropped a pill on the floor and quickly picked it up; no one saw it, only me; I was in a hurry since I had more things to do. I could have given that medication, no one knew I dropped it, but for a second, I thought that if I could be dishonest with myself, how can I expect to be honest with others. I have never forgotten that experience. I threw it away and went to get a new one. Honesty, respect, and accountability define us not only as nurses but as human beings.

Working at the bedside can become overwhelming, and the more we do it, the better we develop a way of improving time management. Therefore, w a new policy is not welcomed since nurses must get used to a new practice. However, these changes are not to make us nurses angry or make us work harder. New Evidenced-based practice policies are created to help the patient heal or prevent them from getting sicker, so being flexible and understanding new guidelines and how they benefit the patient is another way of taking self-accountability. Healthcare facilities have the responsibility to educate and promote accountability. According to (Sherman, 2019), nurses develop a practice and mindset that prevents them from following new EBP; her article explains how nurses may refuse to follow new policies when they feel their approach is appropriate and can be, that does not mean it is a professional way of practicing and that is why EBP policies and procedures are in place. Flexibility to adapt and understand changes is part of the nursing practice and an obligation; not following the facility of practice’s policies and procedures is a crime.

                                                                       References

American Nurses Association (2015) Code of ethics for nurses with interpretive statements (second ed) ANA, page41. https://www.nursingworld.org/practice-policy/nursing-excellence/ethics-code-of-ethics-for-nurses/

Sherman, R. O., & Cohn, T. M. (2019). Promoting professional accountability and ownership: Nursing leaders set the tone for a culture of professional responsibility. American Nurse Today, 14(2), 24–26.

California Nursing Practice Act (n.d.) regulations of nursing practice. https://leginfo.legislature.ca.gov

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Simply respond to the writer(student) post above supporting positively using 200-300 words APA format with references.  

Discuss why you have decided to complete your BSN at this time, and the concerns you have about completing your baccalaureate degree. Based on the readings in the course materials, what strategies can you implement to be a successful student?

Below please find the course materials:

7 Habits of Highly Effective Nursing Students

Sep 23, 2015 | Blog, Nursing Students

Nursing school is challenging, whether you’re a new student or a seasoned professional in an RN to BSN, or RN to MSN program. Between the volume of material to cover, the hours of studying to understand it all and learning to care for patients, nursing students have to work hard to stay on top of it all.

The good news is that it is possible to do a great job in nursing school and still have time for family, friends and fun. Making these seven habits a part of your life can make you a more effective – and successful – nursing student, no matter what stage you’re in.

Habit 1: Manage Your Time

There’s a reason this is the first habit to master: it’s the most important! Balancing classes, studying, work, family obligations and a personal life takes some serious planning.

Break each day into blocks of time and then decide what’s the most important thing for each block. For example, you know you need time to sleep. Will you manage to get eight hours every day? Or should you plan for seven? Proper sleep is the foundation for a healthy, stress-free nursing school experience, so don’t skimp on it.

Schoolwork is the next important chunk for nursing school students. Tests, papers, and important assignments all require a certain amount of study time. Plan ahead and block out sufficient study time every day. Try not to let it get away from you.

Working nurses who are studying for a BSN or MSN need to become experts at balancing school, studying and their shifts, often while caring for family members.

That’s where strict scheduling helps.

Enlist your family to keep a master calendar so everyone knows when you’re working, going to class and studying. And be sure to schedule some free time for the things you like to do, whether it’s working out, reading, listening to music or spending time with your family. That balance will help you get through the rigors of nursing school.

Habit 2: Study Smart

Some people can cram for a test and make it work. But in nursing, you really have to understand the material and how to apply it in real-world situations. You’ll be using your reasoning skills to apply the right choices to different conditions, and not choosing between answers “A” or “B” on a test. That’s why you need to study smart. Try these ideas to make your study time work more effectively for you:

• Study effectively. Don’t spend four hours on something that should really take two. Try dividing a four-hour study block into four, one-hour study segments, and space them out a bit. You’ll probably comprehend the material much better and finish faster.
• Avoid distractions. When you sit down to study, put away any books, materials and devices that you don’t need. Avoid the temptation to check your texts or social media.
• Review classwork ahead of time. Read through text before you get to class.
• Practice. When you finish a section of reading, run through some practice test questions. See if you can answer them without your notes.
• Give yourself enough time. Most students underestimate the amount of time it will take to finish an assignment, study or write a paper. Be realistic.

Habit 3: Ask for Help

This is a tough one! For most of us, asking for help seems like a sign of weakness or failure, but it’s not. Seek out someone who’s been in your nursing shoes, and can offer advice or just listen. They’ll help you get through the difficult spots.

Habit 4: Focus

Now more than ever, nursing students are multi-tasking. It’s so easy to get distracted by a message or alert, and get way off track. The fact is that almost no one is good at multi-tasking. So try to focus on one thing at a time. Eliminate distractions by organizing your study space, and turn off your phone, TV and music. When you focus on studying, you’ll finish faster, leaving more time for catching up on social media and your favorite shows.

Habit 5: Make Realistic Goals

Keep it real, and you’ll be much more successful in reaching your goals. Sure, it would be great to study for eight hours over the weekend, but is it really possible? Can you aim for four and make that happen? How about setting daily goals like covering one major section and one smaller chapter? You’ll feel better about yourself when you make and reach smaller goals along the way to the big goal – your BSN or MSN degree.

Habit 6: Be Proactive

Planning ahead and staying on top of your assignments will save you lots of time, and prevent a rush to complete everything right before the end of the term. Also, take the initiative to ask questions of your instructors. Find out early about their standards and preferences, and you’ll complete assignments right the first time.

Habit 7: Reward Yourself

With all the challenges of nursing school, it’s not easy to do your best over the long haul. You will probably get tired of studying when you’d rather be spending time with your family or friends. That’s when it’s time to set a goal and reward yourself when you reach it. Getting into the habit of motivating yourself, controlling your behavior and doing something nice for yourself will take you far, both in nursing school and in your career.

These 7 Habits Can Make Nursing School Better

Creating good habits can make nursing school much easier, no matter how challenging it can be. Managing your time, being proactive, rewarding yourself, studying smart, focusing and asking for help will keep you happy and healthy while you earn that degree. Also, consider online nursing programs, which are designed for working professionals, and allow you to attend classes as your schedule permits.