NURS FPX 4000 Assessment - NURS FPX 4000 Assessment

Capella University, NURS-FPX4025, RN-TO-BSN

NURS FPX 4025 Assessment 4 Presenting Your PICO(T) Process Findings to Your Professional Peers

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NURS FPX 4025 Assessment 4 Presenting Your PICO(T) Process Findings to Your Professional Peers Student Name Capella University FPX4025 Professor’s Name Submission Date Sharing Your PICO(T) Process Results with Your Colleagues Good morning, my name is and I am going to present you with an evidence-based plan which will prove to be helpful to the patients with acute decompensated heart failure (ADHF) and particularly those who could be at risk of having an ischemic stroke during their hospitalization. The concept of evidence-based practice (EBP) is extremely important in the work of nurses since EBP involves the application of clinical skills, personal preferences of the patient, as well as the most relevant research findings, which results in better patient outcomes. The application of the PICOT model in this scenario is a big assist as it assists nurses in developing the appropriate questions about clinical practice. The aim of the given presentation is to elaborate on the diagnosis, formulate a PICOT question, locate the evidence concerning the topic in the academic literature, and outline key stages in EBP. Diagnosis According to the Outcomes, Risks, and Complications The ADHF is the extreme weakening of the power of the heart to convey sufficient portions of oxygenated blood in support of the metabolism of the organism. ADHF is linked to a large amount of fluid in the body, leading to congestion of the lungs and inadequate supply of blood to different body organs. According to a report by the Centers for Disease Control and Prevention (2024), almost 14.6% of deaths are caused by ADHF in adults aged 20 or older, resulting in 6.7 million adults with heart diseases in the United States. Shortness of breath, weakness, leg edema, and poor tolerance to physical activity are the most prevalent symptoms of ADHF. ADHF is characterized by high morbidity and mortality rates and is considered one of the most urgent clinical issues that hospitalized patients have. The presence of ADHF leads to long hospital stays, cardiac dysfunction, and low quality of life. The hemodynamic abnormalities, heart rhythm disorders including atrial fibrillation, clot formation, and end-organ perfusion dysfunction are some of the complications of ADHF (Milhem et al., 2025). One of the possible complications of ADHF, which is evident in practical situations, is ischemic stroke. It could also happen that the heart can develop blood clots, and the blood supply cannot reach the brain. Some of the complications that might arise as a result of ADHF include cardiogenic shock and respiratory failure as a result of pulmonary edema. Examples The problems of ADHF can be explained by a situation when a patient gets admitted to the hospital due to a case of congestive heart failure, and finds out that he is experiencing irregular heartbeats, which is known as atrial fibrillation. Atrial fibrillation complication also causes the accumulation of blood in the atrium of the heart. Thus, there is the possibility of the formation of blood clots. The clots of blood move to the brain, resulting in a stroke. Finally, the patient also acquires a neurological problem in the form of hemiplegia and aphasia. One more problem that can be identified with ADHF is evident when people experience fluid retention and decreased cardiac output, thereby resulting in hypoxemia due to pulmonary congestion. PCIO(T) Question In adult patients with acute decompensated heart failure (P), how does nurse-led early stroke risk assessment and prevention (I), compared to standard care with no risk assessment (C), influence the incidence of ischemic stroke (O) in the hospital (T)? PICOT Breakdown P (Population): adults with acute decompensated heart failure. I (Intervention): Preventive risk assessment and intervention in stroke at an early age. C (Comparison): Standard care in the absence of stroke risk assessment. O (Outcome): Affect the occurrence of ischemic stroke T (Time): In hospitalization (within 30 days) Alignment with PICOT Framework All the elements of the PICOT question apply to the particular clinical issue of ADHF. In relation to the first element, the population would be comprised of patients with ADHF who are at risk of developing thromboembolism. The intervention element entails the identification of the various risk factors that lead to stroke among patients. The comparisons would be between the status quo, where the risks have not been detected before the onset of stroke, and where the risk has been detected before the stroke has occurred. The outcome element would be geared towards ensuring that no ischemic stroke takes place as this could be lethal. Overview of Content of More Than Three Sources of Evidence Multiple quality scientific papers have been reviewed to identify the effectiveness of early risk assessment of ischemic stroke in ADHF patients. In their research, Iguchi et al. (2021) carried out an observational study among more than 4,000 patients and concluded that ischemic stroke is one of the main complications that occur during hospitalization for ADHF. The study found that BNP, atrial fibrillation, and acute coronary syndrome are significant predictors of the condition of a patient. Yamazaki et al. (2026), in their turn, have conducted an observational study involving over 5,000 participants. They came to the conclusion that ischemic stroke occurs the most in the first 30 days of hospitalization and the onset of the sickness. Also, the alterations of hemoglobin and the cardioembolic mechanism are the factors that are believed to raise the chance of having a stroke considerably. Ran et al. (2025) included 2,994 people and systematically reviewed and analyzed 11 clinical studies. The authors of this paper found NT-proBNP to be an excellent biomarker in assessing the patient’s outcome, including ischemic stroke. This article is extremely important because a number of sources are analyzed. Therefore, this research paper presents high-level evidence, and the role of biomarkers in assessing risks should be taken into account in medical practice. In Lucki et al. (2025), the study was an observational one that focused on the hospitalization outcomes of ADHF patients. The authors concluded that the more serious nature of the disease and long-term hospitalization are risk factors

Capella University, NURS-FPX4025, RN-TO-BSN

NURS FPX 4025 Assessment 3 Using the PICO(T) Process

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NURS FPX 4025 Assessment 3 Using the PICO(T) Process Student Name Capella University NURS FPX 4025 Professor’s name Submission Date Using the PICO(T) Process The acute decompensated heart failure (ADHF) is one of the most problematic cardiovascular issues due to its rapid progression, during which the amount of accumulated fluid, cardiac output, and the ability to supply tissues sufficiency increase. The issue in question is a healthcare emergency that has a high morbidity and mortality. Hence, evidence-based practice (EBP) can be used for the treatment of ADHF since EBP enables specialists to merge the experience of the health care provider, preferences of the patient, and empirical data (Ghorpade & Salvi, 2024). EBP tools are numerous, but PICO(T) is the most potent tool. This approach is based on population, intervention, comparison, outcomes, and time. By using PICO(T), clinicians will have the ability to generate pertinent questions, conduct a literature review, and make a decision regarding the treatment actions. Using the PICO(T) model to address the problem of ADHF will assist nurses in preventing such complications as ischemic stroke. ADHF Acute decompensated heart failure is said to be a potentially fatal complication as they do not produce enough output of the heart that, in turn, is incapable of supplying the body with the necessary oxygen in the form of tissue perfusion, resulting in systemic and pulmonary edema. Shortness of breath, exhaustion, fluid overload, and inability to maintain good physical performance are some of the common symptoms that are experienced in ADHF. More so, ADHF today needs emergency medical care since it is highly likely to be put into the hospital. The untreated ADHF is associated with numerous health issues, including prolonged hospitalization, frequent hospitalization, low quality of life, and mortality (Milhem et al., 2025). In addition, ischemic stroke is among the numerous diseases that are regularly observed with ADHF. This can be attributed to the fact that ADHF is surrounded by such hemodynamic changes as stagnation of blood, hypercoagulability, and inadequate cerebral perfusion. The impacts of ADHF and the risks associated with the complexities of ADHF are tremendous to certain population segments. The elderly, underprivileged individuals, and those with no easy access to healthcare services are more likely to be affected by ADHF and its complications. For example, the poor can face issues such as delayed diagnosis and treatment of their conditions, as well as poor prevention techniques, such as anticoagulation treatment (Milhem et al., 2025). Such disparities might be the reasons why individuals have bigger opportunities of experiencing complications, including strokes. Secondly, minority groups are usually confronted with various issues when they receive appropriate medical attention. Formulating a PICOT Question The clinical question should be developed during the EBP practice as it will help the professionals to determine the most effective interventions in improving patient outcomes. Regarding ADHF patients, the most significant problem that arises in this group of patients when dealing with complications encountered during hospitalization is an escalation in the risk of ischemic stroke, which is associated with serious outcomes, including morbidity, mortality, and disabilities. Using PICOT to generate the clinical question can be helpful since it offers valuable guidelines for creating the right question (Jahanshahlou et al., 2024). The clinical question formulated using this process involves aspects of the problem that need to be solved, the population of patients, the intervention used, the comparative intervention, desirable outcomes, and time. As for the issue in question, it may be worthwhile for nurses to focus on early risk assessments of stroke among ADHF patients in order to prevent stroke. Based on this, it is clear that nurses will be very important in effecting the suggested interventions. PICOT-Formatted Research Question In adult patients with acute decompensated heart failure (P), compared to standard care with no risk assessment (C), how does nurse-led early stroke risk assessment and prevention (I) versus standard care (C) influence the incidence of ischemic stroke (O) in the course of hospitalization (T)? PICOT Breakdown · Population: Non-communicable, acutely decompensated heart failure in adult patients. · I (Intervention): EPS (Early stroke risk assessment and prevention) · C (Comparison): Standard care: no stroke risk assessment. · O (Outcome): Have an impact on the prevalence of ischemic stroke. · T (Time): In hospital (in 30 days) The Effect of the PICOT Approach on the ADHF Management Evidence-based practice will necessitate the use of the PICOT model, and through it, the healthcare professionals will be in a position to test various interventions in order to give the patients sufficient treatment. When it comes to the treatment of ADHF, it is rather clear that early detection of the risk of stroke along with adequate response is required. Assessing the risks of strokes, nurses and other medical workers will be empowered to identify risky patients and make the right recommendations related to their care (Milhem et al., 2025). For instance, monitoring of at-risk patients and administration of anticoagulants in case it is needed will be the two steps that should be undertaken. Evaluation of the risks of stroke can be regarded as the most prominent difference between evidence-based practice and standard practice. Eventually, through the PICOT model, health care professionals will be in a position to enhance the outcomes of the patients. Search of the Literature Noting Search Engines, Key Words, and Factors of Credibility The literature was extensively searched with the help of scholarly sources that can be used in this PICOT question. The databases like PubMed, CINAHL, Google Scholar, and ScienceDirect were used. The selected databases have been used due to their credibility of information since they consist of only evidence-based and peer-reviewed information regarding health care. Some of the keywords that will be used during the search procedure are: acute decompensated heart failure, risk of ischemic stroke, stroke prevention in heart failure patients, BNP monitoring, and complications of heart failure. To make sure that valuable evidence is presented, the search procedure included certain filters such that all sources whose content has not been reviewed by peer reviewers or was published

Capella University, NURS-FPX4025, RN-TO-BSN

NURS FPX 4025 Assessment 2 Applying an EBP Model

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NURS FPX 4025 Assessment 2 Applying an EBP Model Student Name Capella University NURS-FPX4025 Professor’s Name Submission Date Applying an EBP Model Sickle cell disease (SCD) is a hereditary blood disorder that causes the red blood cells to stiffen into a sickle shape. This leads to obstruction in the blood vessels, pain crisis, organ damage, and a drop in the quality of life (QOL) (D’Costa et al., 2023). Children such as a 10-year-old with a pain crisis require holistic and lifetime care. Evidence-based practice (EBP) in nursing is an effort to improve patient safety and care. This takes into account evidence, practitioner and patient values/preferences in order to realize the intended results. The paper discusses the Johns Hopkins Nursing Evidence-Based Practice (JHNEBP) model to resolve problems in the SCD child’s care and enhance his pain control experience. Description of the Diagnosis and Associated Issue Sickle cell anemia is a long-lasting condition that is commonly experienced by children. Pain (pain crises) has been noted to be a common symptom of the disease in childhood, with multiple hospital visits and requiring a multidisciplinary team for their management (Jain et al., 2026). A problem with SCD is that there is a gap between the development of the disease and symptoms and complications (pain crisis). In addition, care can be influenced by problems with the coordination of services and access to health services, including transportation problems, lack of knowledge and skills in health care providers. These affect the quality of life and complications. It is here that an EBP approach can assist, where care can be provided in a different way compared to the typical care approach and not based on the best available evidence. Without the availability and consistency of using evidence-based approaches, there’s a potential for a delay in timely pain and supportive care interventions. The EBP model assists health care practitioners in planning care, avoiding delays in care, and enhancing quality and outcomes with the top and current evidence at their fingertips (Connor, 2023). This means that an EBP model will need to be adopted to aid in alleviating these problems and health outcomes in children with SCD. Selection of the Evidence-Based Practice Model The Johns Hopkins Nursing Evidence-Based Practice (JHNEBP) model was chosen for this discussion as it is an easy way to integrate and use to support decision-making (Bissett et al., 2025). This model is divided into three general steps: Practice Question (P), Evidence (E), and Translation (T). The model provides a framework that nurses can use to recognize evidence problems, seek evidence, and transform practice to utilize evidence. The JHNEBP model is suitable to tackle issues related to sickle cell disease as it is practice-focused. It assists nurses in forming practice questions and finding and utilizing evidence. It also results in better patient outcomes and the added advantages of standardisation and uniformity of nursing care (Gaber et al., 2025). The simplicity of the models enables them to be used in complicated issues, including delays in the treatment and care of SCD kids. Description of the Evidence-Based Practice Model Steps The JHNEBP model’s first step is the Practice Question (P), and it starts with recognising a problem and developing an evidence question. This may be achieved by taking into account Population (P), Intervention (I), Comparison (C), Outcome (O), and Time (T) factors (PICOT). Again, with regard to sickle cell disease, the practice question is to coordinate care and expedite treatment for pain in children. The second step is Evidence (E), as nurses apply evidence by searching for studies and analysing the validity and applicability of the studies. The nurses search credible databases (for example, PubMed, CINAHL, and Google Scholar) for peer-reviewed evidence in the area. And the nurses also critique the evidence for validity, reliability, and strength to ensure that the evidence used to guide our practice is reliable. The third step is Transformation (T), or putting the evidence into our practice. This is when we introduce strategies to facilitate change, such as improved communication between health care providers, education of the patient, and removing these barriers to treatment (Ainslie et al., 2024). These strategies are tested to assess the impact it has on the patient. Steps are important as they outline the strategic approach of the model by using best practices in health care. Application of the Evidence-Based Practice Model to the Issue A particular issue impacted by using the JHNEBP model was the delayed treatment and lack of coordination of care in the case of childhood sickle cell disease. In the Practice Question phase, a PICOT question was developed: What is the effect of enhanced care on the prevention and treatment of pain crises, and on patient outcomes in kids who suffer from sickle cell disease compared to usual care? This question was applied in searching for literature. In the Evidence phase, peer-reviewed literature from the past 5 years was identified using search engines PubMed, CINAHL, and Google Scholar. We conducted a search based on the following terms: Sickle cell disease, children, childhood, pain crisis, coordination of care, and barriers to care. Articles we have chosen were based on the research findings within the past few years, with results in children and barriers to care. We identified barriers to care, with few studies focused on children, and problems getting the full text of certain studies. We had the opportunity to search a couple of studies. At the Translation stage, we formulated care improvement strategies based on the data in the research. These strategies involve communication with the health care team and families, support services like transport services, and protocol use to manage pain (Baker et al., 2024). The goals of these strategies are to reduce delays in care as well as enhance treatment. Analysis of Evidence The first one – Schlenz et al. (2025) – is a qualitative study that explains the impediments and enablers of care in children with sickle cell disease. The research is credible, since it appears in a peer-reviewed journal and

Capella University, NURS-FPX4025, RN-TO-BSN

NURS FPX 4025 Assessment 1 Analyzing a Research Paper

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NURS FPX 4025 Assessment 1 Analyzing a Research Paper Student Name Capella University NURS-FPX4025 Professor’s Name Submission Date Analyzing a Research Paper Criteria Analysis Type of Study This is a qualitative descriptive study because it conducts semi-structured interviews with parents of children who have sickle cell disease, and then describes their experiences using content analysis. Using the Johns Hopkins Nursing Evidence-Based Practice (JHNEBP) model, this study has a Level VI rating on the evidence pyramid. That means it is almost on the bottom of the pyramid (and Level I is the top and Level VII the bottom). It is Level VI because it doesn’t involve experiments, control groups, or statistical tests, nor does it include scientific measurements. This is still valuable, despite its placement at Level VI, because it informs us of the problems people face and how to make health care more patient-centered. Credibility Peer-reviewed journal. NIH-funded. IRB approved. Conducted by healthcare researchers. Importance of Diagnosis Focuses on sickle cell disease in children. Identifies barriers and facilitators to care. Application to Patient (Jamie) Applies to Jamie’s pain crisis. Highlights care barriers (access, delays) and supports better care coordination and education. Sickle cell disease (SCD) is a genetic condition causing red blood cells to be in a sickle shape and affecting the mobility of the blood cells. This leads to complications that cause pain, organ damage, and loss of quality of life. It is an early childhood disease diagnosed early on, and the child should undergo specialist care to avoid complications in later life. Children with SCD need tailored care, as this allows children to have a better quality of life and reduces complications (Schieve et al., 2022). This assignment will elaborate on one of the journal articles on barriers and facilitators of holistic care in children with sickle cell disease, to treat a 10-year-old boy, Jamie Hampton, with SCD pain. Abstract of the Research Article Our chosen article is Barriers and facilitators to paediatric sickle cell care: a qualitative descriptive study, Schlenz et al (2025), a qualitative descriptive study that provides the barriers and facilitators to holistic care of children with sickle cell disease. The authors analysed data from semi-structured interviews of 27 parents of sickle cell children. The Conceptual Framework of the Access to Care Model was used to do a directed content analysis. Such qualitative studies provide a detailed account of what it is like as a patient or a carer to go through an issue; they can be helpful in determining access barriers. Qualitative research isn’t as rigorous as quantitative research, but it does provide you with some knowledge of the problem, and you can learn from this to better care. The study provides Level VI evidence, which is especially helpful in patient experience and enhancing patient-centered care, albeit being lower on the hierarchy of evidence. Article Credibility It is a plausible article for a few reasons. First, because they have published their article in a peer-reviewed journal about the topic, Pediatric Blood & Cancer. First, since it is a study sponsored by NIH, and thus a measure of the quality of the study (Schlenz et al., 2025). Two, it has been endorsed by the Institutional Review Board (IRB). The authors of the study have published other studies on pediatrics or hematology. In addition, the research contains information on various locations, thereby rendering the study genuine. Significant Results of the Research This paper has brought out the fact that there were a number of factors that supported and hindered sickle cell care. This was by way of positive parent-provider relations, support, and education. This led to greater health care satisfaction and engagement (Schlenz et al., 2025). The support and support services (e.g., appointments, transport). There were problems, the study found. The lack of knowledge of health care providers, waiting times, and appointments was the issue in the health system. The individual issues were transportation, money, no-show (failure to attend), and employment/studying opportunities (Sang et al 2025). These may have an influence on health and health care. The most prevalent power outage in health care was in public transport. Relevance to Sickle Cell Disease The work is also relevant in coming up with innovative solutions to tackle sickle cell disease since sickle cell disease needs to be handled on a long-term and comprehensive basis. The disease symptoms and signs without effective treatment are pain, complications, and hospitalizations. The identified children with SCD have various quality of life (QoL) needs and complications, which necessitate a variety of health care services (Schlenz et al 2015). They underscored the health care barriers and facilitators to enhance the quality of life of SCD. Application to Patient The presented study can be used in the case of the crisis of sickle cell disease in a 10-year-old child of Jamie Hampton. Jamie has pain crises that require treatment. Jamie may face delays and difficulty coordinating and getting care. He might have problems getting to appointments. The experiment demonstrates ways to enhance care. These are communication, education, and coordination. He has nurses who are looking after him. They can make sure that he is free of pain, educate, and coordinate (Ge et al, 2023). Therefore, with education, removing barriers, and offering enablers, we can enhance the care and experience of Jamie. Application to Practice This study can provide us with an idea. This can assist in empowering health care providers, including nurses, so as to overcome the health barriers. That is, parents will be assisted in transportation and well-informed and supported in their healthcare journey. Health-care professionals can also be more humble and practice cultural humility to care for the patient by being reflective of the patient or family (Hernandez et al., 2021). Barriers and facilitators will ensure that the health-care system can offer the most efficient health and well-being to the child with sickle cell disease. Conclusion The article looks at the barriers and facilitators of health care for sickle cell diseases. This points to the significance of proper health care,

Capella University, NURS-FPX4015, RN-TO-BSN

NURS FPX 4015 Assessment 5 Head-to-Toe Assessment on a Volunteer Presentation

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NURS FPX 4015 Assessment 5 Head-to-Toe Assessment on a Volunteer Presentation Student Name Capella University NURS-FPX4015 Professor Name Submission Date Head-to-Toe Assessment on a Volunteer Presentation Hello, everyone! Immaculate Durvil is my name and I will perform a head-to-toe examination of my patient, Ms. Aiyana Tehanata today. During this evaluation, I will monitor the overall appearance, check her vital signs, perform focused physical examination, and examine her neurological, cardiovascular, respiratory, and musculoskeletal systems. I will also explain my process of doing every component of the assessment in order to be comprehensive and precise. The demonstration relies on the health status of Ms. Tehanata and its impact on her overall care plan, which deals with the short-term and long-term health requirements. Comprehensive and Professional Assessment I started the overall examination of Ms. Aiyana Tehanata and talked about the reason behind the examination and her medical history, including her chief complaint, which is tingling in her feet. I also insisted on the role of communication during the process to make her feel at ease and collaborate. I began by general assessment to note her overall look with alertness and demeanor and whether she was experiencing distress or not. I then did a physical examination, specifically looking at the color and texture of the skin including any edema or other abnormalities of her extremities. I proceeded to the cardiovascular assessment, which involved hearing heart sounds, where S1 and S2 were normal without any murmur, gallops, and rubs. I proceeded to have an examination of the 4 th intercostal space where I identified the presence of stenotic turbulence. The above finding indicates that there are potential vascular abnormalities that could be explored (Selvaraj et al., 2022). The vital signs were taken, with temperature (98.4degF), heart rate (75 bpm), blood pressure (130/72 mmHg), and SpO2 (98%), which were normal. The respiratory examination was also accompanied by the fact that the lungs were clear and clear in the five lobes of the lungs, which was a sign that the lungs were free of respiratory distress or abnormalities. Next, I proceeded to the genitourinary examination and the abdominal examination, which were both free of distress and abnormalities. Her stomach was tender, non-tender, and stool was normal. I would then examine the musculoskeletal system to determine whether a person has joint pain, stiffness or restricted movements. I detected complete movement in all the extremities, and no external swelling or pain in joints. The neuro-assessment also involved a rudimentary ocular nerve appraisal, where Ms. Tehanata was attentive and oriented, as well as had intact cranial nerves. She was tested using the Snellen chart, and the outcome was 20/30 in the right eye and 20/40 in the left one, which is compatible with her reported problems in focusing. The next examination was the peripheral vascular system. I inspected both legs of the fibula to determine whether it is swollen, or altered in skin color or whether it has an ulcer. Symmetrical and palpable pulses in lower extremities were +2 bilaterally, and Capillary refill was less than 3 seconds. A single 10-point monofilament examination revealed reduced sensation in both feet, specifically 1, 2, 3, and 6 on the right foot, 4, 5, 6, and 9 on the left foot, which may be a sign of a possible neurological problem, such as peripheral neuropathy. In the process of the assessment, I shared the results with Ms. Tehanata and clarified to her the importance of her symptoms regarding the possibilities of diabetes and peripheral neuropathy. I also talked about the following steps of additional diagnostic tests and treatment, and made sure she had the idea of the consequences of her current health condition. Discussion of Diagnosis and Findings Following the examination, I told Ms. Tehanata that she had the signs of peripheral neuropathy, which is one of the common complications usually observed in persons with diabetes or hypertension. One of the main findings that can be used to diagnose this diagnosis is reduced sensation in both feet that is reflected by the 10-point monofilament test (Parveen et al., 2025). These findings suggest that she may have nerve damage in the lower extremities which may be secondary to long term hyperglycemia or vascular problems. I highlighted that peripheral neuropathy is a severe disease, and unattended to, it may cause other complications like ulcers, infection and even amputations. I told her that the elevated level of blood sugar might be causing the damaging of the nervous system, and managing her blood sugar levels is the only way to avoid the amplification of the situation. This observation suggests that, possibly, stricter management of her diabetes and an assessment of her medications, including Metformin and Gabapentin, is needed to make her treatment plan optimal (Dave et al., 2025). The vascular sufficiency may be compromised as caused by constriction of her blood vessels that appears in her cardiovascular examination with stenotic turbulence in the 4th intercostal space. This might be a root cause of the numbness in her feet. I promised her that I would be watching her heart and her circulatory system very closely and would take into consideration other diagnostic procedures to determine the vascular health. Finally, I addressed the topic of the need to have regular follow-up visits and tight blood glucose control. Reduced sensation exposes Ms. Tehanata to more risks of injuries, wounds, and infections that can remain undetected because her feet have impaired sensation (Baig et al., 2022). I focused on the importance of good feet care, frequent checking of her blood sugar levels and lifestyle changes (eating healthy and exercising). These measures are critical in ensuring that there is no more damage to the nerve and that her quality of life is enhanced. Understanding of Pharmacological Needs As the assessment and evaluation show, Gabapentin is prescribed to Ms. Tehanata to control peripheral neuropathy and reduce tingling in her feet. Gabapentin acts by decreasing nerve activity related to nerve-related pain and enhancing her general comfort by balancing her nerve activity that is related to the abnormal

Capella University, NURS-FPX4015, RN-TO-BSN

NURS FPX 4015 Assessment 4 Caring for Special Population Teaching Presentation

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NURS FPX 4015 Assessment 4 Caring for Special Population Teaching Presentation Student Name Capella University NURS FPX 4015 A4 Professor’s Name Submission Date Caring for Special Population Teaching Presentation Slide 1 Hi, my name is……., Today I’m going to speak about special populations, homeless/housing insecure populations. Slide 2 The care of culturally competent nursing care is still essential for delivering appropriate health care solutions to homeless and housing-insecure individuals. Homelessness affects individuals’ health care access, leading to higher prevalence of chronic diseases, mental health problems, and infectious diseases (Sleet & Francescutti, 2021). Nurses have the opportunity to address health disparities by utilizing evidence-based patient-centered strategies that center on trust and providing accessible, compassionate care. In this presentation, we will explore homeless healthcare needs, their inequitable treatment, and cultural needs, and will showcase some helpful nursing practices for the delivery of fair and effective healthcare. Slide 3 Population Group and Their Healthcare Needs Homelessness and housing insecurity are made up of a diverse population of people with mental illness, financial problems, families, and veterans. People experiencing homelessness can be defined as those who do not have a fixed, regular nighttime residence while staying in a shelter, transitional housing, or in a car, a bus or train, an abandoned building, or a public building or place, such as a hospital or mental health facility (Sleet & Francescutti, 2021). Housing insecurity is a term used to describe people who are at risk of becoming homeless due to financial issues, moving frequently, or living too close together. The constant switching of housing from shelters to other insecure environments negatively impacts access to care and exacerbates acute and chronic health issues. Slide 4 Because of their lack of coverage, homeless people often suffer from chronic health problems, such as high blood pressure, diabetes, and respiratory diseases. Non-compliance with drugs and medication and harsh weather conditions are combined with poor nutrition, which hastens the progression of the disease (Mejia-Lancheros et al., 2020). Diabetic ketoacidosis (DKA), peripheral neuropathy, and lower extremity amputation are some examples of complications of uncontrolled diabetes, while stroke and heart failure are some examples of complications of uncontrolled Hypertension. Environmental pollution, smoking, and exposure to repeated cold weather worsen chronic obstructive pulmonary disease (COPD), leading to increased hospital admissions and premature death. Shelter overcrowding increases homeless persons’ vulnerability to infectious diseases due to insufficient sanitation. Homeless individuals suffer more from tuberculosis, hepatitis, and COVID-19 infection than other people, resulting in higher death rates (Tsai & Wilson, 2020). Homeless individuals are often affected by depression, anxiety, post-traumatic stress disorder (PTSD), and substance abuse disorders. Homeless people have been less likely to use medical services because of their experience of trauma, abuse, and systemic neglect. Integrated prevention programs and early detection with person-centered coordinated services are needed to address the healthcare needs of this population. Slide 5 Culturally Sensitive Nursing Strategies To provide culturally competent nursing care to homeless people, it is necessary to know about the unique challenges and cultural experiences of these individuals. Trauma-informed care is beneficial for equitable care delivery as it allows healthcare providers to be more aware of how past trauma can impact patient behaviors and medical service engagement. Trauma-informed care practices create safe environments that are open for patients, as well as active listening techniques and experiences validation (Barry et al., 2023). Nurses should not use stigmatizing language as they assess patients’ barriers to care, such as issues of medication storage and survival being more important than health management. Creating trust and showing empathy between nurse and patient is a practice that increases patients’ involvement in their treatments. Medication access and management are a substantial challenge for homeless people due to financial, cognitive, and storage issues. To advocate for the use of long-acting medications, nurses will support monthly injectable antipsychotics in individuals with schizophrenia, and extended release antihypertensive in those with unstable living conditions (Adams et al., 2020). Healthcare providers who make medications easier to take and do not require refrigeration, and simplify medication regimens, enhance treatment adherence. Properly educated patients can become active players in their healthcare management during periods of instability if they are informed of and educated about the various treatment options and ways of risk reduction. Street medicine services are useful strategies to improve healthcare services for homeless people when they are mobile, moving between multiple locations. Those living in homelessness prefer to avoid traditional health care settings due to adverse experiences, extended wait times, and challenges with transportation (Gutman et al., 2024). Mobile health units deliver health care services at encampments, drop-in centers, and shelters, where individuals receive services focused on chronic disease management, wound care, and substance use counseling in addition to preventive services. Boston Health Care for the Homeless program has been a successful model whose primary care is delivered in community-based settings, resulting in better health outcomes (Koh et al., 2020). Healthcare models that offer flexibility in appointment times, such as walk-in clinics and same-day appointments, offer medical care convenience for individuals who experience homelessness by meeting ongoing medical care needs. Slide 6 Physical Assessment Findings Physical evaluations must be conducted since people who are homeless are more likely to delay health care until their condition is serious. Nurses should examine for skin infections, wounds, frostbite, and foot problems that are caused by long hours of walking and possibly wearing inappropriate footwear. A patient’s overall health needs can be understood by assessing their dehydration and malnutrition. Mental health assessments are equally critical because homeless people often have depression, PTSD, a nd substance use disorders that can compromise their capacity to take care of themselves and follow instructions (Adams et al., 2020). No judgement builds trust between healthcare providers and patients, resulting in disclosure of health concerns. Wound care, hydration, and mental health referrals are key activities that nurses conduct in health care settings as they perform physical and mental health screenings that will have a positive impact on chronic disease outcomes. Slide 7 Diversity within the Special Population Group

Capella University, NURS-FPX4015, RN-TO-BSN

NURS FPX 4015 Assessment 3 Mental Health Diagnosis Concept Map

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NURS FPX 4015 Assessment 3 Mental Health Diagnosis Concept Map Student Name Capella University NURS FPX 4015 Professor Name Submission Date Mental Health Diagnosis Concept Map References Bandelow, B. (2020). Current and novel psychopharmacological drugs for anxiety disorders. Advances in Experimental Medicine and Biology, 1191, 347–365. https://doi.org/10.1007/978-981-32-9705-0_19 Bains, N., & Abdijadid, S. (2020, July 10). Major depressive disorder. Europepmc.org. https://europepmc.org/article/nbk/nbk559078 Chand, S. P., Arif, H., & Kutlenios, R. M. (2023, July 17). Depression (Nursing). Nih.gov; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/sites/books/NBK568733/ Huang, X.-J., Ma, H.-Y., Wang, X.-M., Zhong, J., Sheng, D.-F., & Xu, M.-Z. (2022). Equating the PHQ-9 and GAD-7 to the HADS depression and anxiety subscales in patients with major depressive disorder. Journal of Affective Disorders, 311, 327–335. https://doi.org/10.1016/j.jad.2022.05.079 Walter, H. J., Abright, A. R., Bukstein, O. G., Diamond, J., Keable, H., Ripperger-Suhler, J., & Rockhill, C. (2022). Clinical practice guideline for the assessment and treatment of children and adolescents with major and persistent depressive disorders. Journal of the American Academy of Child & Adolescent Psychiatry, 62(5), 479–502. https://doi.org/10.1016/j.jaac.2022.10.001

Capella University, NURS-FPX4015, RN-TO-BSN

NURS FPX 4015 Assessment 2 Enhancing Holistic Nursing Care with the 3Ps

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NURS FPX 4015 Assessment 2 Enhancing Holistic Nursing Care with the 3Ps Student Name Capella University NURS FPX 4015 Instructor Name Due Date Enhancing Holistic Nursing Care with the 3Ps The 3Ps (pathophysiology, pharmacology, and physical assessment) are part of enhancing holistic nursing care. The three-point combination of disease process, medication management, and patient appraisal provides nurses with the most complete information about the disease process (Sapna et al., 2023). By gaining knowledge in these areas, nurses can, however, provide care that is patient-centered and addresses the complexities of physical, psychological, and social health. It aids in getting better patient outcomes and overall health. This evaluation seeks to showcase their role in enhancing patient outcomes and well-being. Holistic Nursing Care and Its Benefits Holistic nursing care is patient-centered care that considers the whole person- mind, body, spirit, and emotions rather than physical ailments when caring for the patient. A compassionate, personalized approach to care and treatment combines conventional treatment with complementary approaches. Holistic nursing can be defined as a healing-whole-person provider (Kwame & Petrucka, 2021). This approach helps to build a meaningful nurse-patient relationship and takes into account the emotional, cultural, and lifestyle factors. Holistic care for patients does not focus on treating symptoms but rather the root causes, thus creating overall wellness. This will improve patient satisfaction as individuals feel heard, appreciated, and will have high trust in the care providers (Kwame & Petrucka, 2021). Cultural and personal preferences are considered in treatment plans, and stress and anxiety are minimized with mindfulness and emotional support, leading to better health. Nurses also reap great advantages from holistic treatment. Deeper connections with patients increase job satisfaction, and practicing self-care helps to stave off burnout and emotional fatigue (Kwame & Petrucka, 2021). Holistic nursing extends beyond clinical skills to alternative therapies to enhance clinical skills and foster a positive work culture based on teamwork and empathy. The positive impact of holistic care has been well documented in numerous research studies and has been shown to reduce readmission rates, improve patient outcomes, and increase the quality of life for patients and healthcare providers. According to Hovde et al. (2023), holistic methods such as music therapy, guided imagery, and therapeutic touch can make a huge difference in decreasing the anxiety level, pain level, and stress of the patient, leading to improved healing and satisfaction. Additionally, nurses who practice holistic self-care techniques have less burnout and a higher level of job engagement (Williams et al., 2022). The results highlight the importance of the role of holistic nursing in creating a better, caring, sustainable health care system Pathophysiology and Its Role in Nursing Practice Pathophysiology is the study of changes in the functions of the body at the molecular, cellular, or organ level that occur due to trauma or illness, causing pain or damage. Nurses can use it to gain insight into the mechanisms of the disease, and to be able to provide better care, both for the symptoms and the mechanism. The recognition of the progression of a disease can enable a nurse to anticipate the potential complications and intervene in a timely manner and to help educate patients on how to effectively manage a disease (Peate, 2022). A nurse with a knowledge of pathophysiology can see beyond symptoms and can see what impact symptoms have on the whole person physically, emotionally, and mentally. For example, those suffering from diabetes mellitus are insulin-resistant and may also have problems with glucose metabolism, which is known to lead to neuropathy, kidney disease, and cardiovascular issues. Knowing these links helps the nurses develop a comprehensive care plan that includes lifestyle changes, counseling, and prevention. The pathophysiology also aids in clinical decision-making. In a condition such as heart failure, nurses’ understanding of the role of fluid retention as well as decreased cardiac output can help them observe early signs of deterioration in the heart failure condition, alter the plan of care, and educate the patient about self-care strategies (Peate, 2022). Further, the knowledge of the inflammatory response of the body during an infection enables the nurse to evaluate the pattern of the fever, to give the necessary treatment, and to assist with good immune function. Incorporating the pathophysiology in a comprehensive educational program for holistic nursing care enables nurses to take on physical, psychological, and social care for patients, which helps enhance patient outcomes and encourages a more holistic approach to healthcare. Pharmacology and Its Role in Nursing Practice Pharmacology is a subject that gives nurses the necessary information on medications such as mechanism of action, therapeutic effects, and possible side effects. With this understanding, nurses can choose the best medications to use, know how to administer them safely, and keep a check on how the patients respond to these medications. Nurses play a key role in helping to prevent medication errors by taking the time to review factors such as dosages, drug interactions, and contraindications before prescribing a medication. The need for nurses to assess how all the factors – medications included – interact with a patient’s overall heal rather than simply following prescriptions to administer medications (Ernstmeyer & Christman, 2023). For instance, a patient with hypertension who is using beta blockers will need to be monitored for adverse effects such as dizziness and fatigue while also factoring in lifestyle changes, such as diet and exercise. In mental health care, knowing what these medications do to the neurotransmitter levels can help nurses help patients who may be affected by the side effects of a medications such as mood changes or drowsiness. As a part of Pharmacology, the psychological and social aspects as well as the physical aspects are of interest. Emotional readiness for self-administering medication and/or social support for self-administering medication may impact patient education surrounding medication use for chronic conditions such as insulin use for diabetes. Similarly, balancing effective pain management and avoiding dependency is a challenge in pain management, and nurses will need to provide reassurance and alternative coping mechanisms (Vaismoradi et al., 2024).

Capella University, NURS-FPX4015, RN-TO-BSN

NURS FPX 4015 Assessment 1 Comprehensive Head-to-Toe Assessment Transcript

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NURS FPX 4015 Assessment 1 Comprehensive Head-to-Toe Assessment Transcript Student Name Capella University NURS-FPX4015 Professor Name Submission Date Marco Mancini – Physical Assessment Transcript Nurse: Well, good morning, Mr. Mancini. My name is Shazia. Today I will be doing your head to toe physical examination. I know you have been experiencing certain sleeping problems and anxiety. Would it be alright to go ahead with the assessment before we start? Client: Yes, that’s fine. Nurse (professional demeanor): You are welcome. During the exam, be able to inform me that you are not comfortable or have to rest. We shall start with measuring your vital signs. [Vital Signs – Objective] Temperature:6°F Heart Rate: 82 bpm, regular rhythm Respiratory Rate: 16 breaths/min, unlabored Blood Pressure: 148/92 mmHg O2 Saturation: 98% on room air Height: 5’10” Weight: 175 lbs BMI:1 (normal range) Note: Elevated BP is consistent with known hypertension diagnosis. General Appearance Mr. Mancini is of the correct age, dressed and groomed well. He maintains good eye contact and appears slightly nervous. His speech is clear though there are times that he stops speaking when talking on emotionally sensitive issues. Nurse: I can notice that you are tense. You are feeling good–you are very open. Neurological & Cognitive Status Level of Consciousness: Alert and oriented ×4 (person, place, time, situation) Cognition: Mild impairment in concentration in responding to emotionally evoking questions. Memory: Intact short- and long-term recall. Cranial Nerves II–XII: Grossly intact (CN VII facial symmetry observed during conversation; CN II gross visual acuity normal). Nurse: Are you able to count backwards by sevens starting with 100? Client: 93… 86… 79… umm… 72… Note: Processing slowed, however, proper effort and accuracy were observed. Head, Eyes, Ears, Nose, Throat (HEENT) Head: Normocephalic, atraumatic Eyes: PERRLA, no nystagmus Ears: Tympanic membranes clear bilaterally Nose: Mucosa pink, no congestion Mouth/Throat: Moist mucous membranes, no lesions, teeth intact. Skin Color: Normal for ethnicity Temperature: Warm, dry Turgor: Good elasticity Lesions: No rashes, ulcers, or abnormal findings Psychomotor activity: No apparent self-harm, scarring. Cardiovascular Heart sounds: S1 and S2 audible, no murmurs Rate & rhythm: Regular Peripheral pulses: 2+ bilaterally Capillary refill: <2 seconds Respiratory Breath sounds: Clear to auscultation bilaterally Respiratory effort: Non-labored, even pattern Chest expansion: Symmetrical Gastrointestinal Abdomen: Flat, soft, non-tender Bowel sounds: Present in all four quadrants No hepatosplenomegaly Reports no recent nausea, vomiting, or changes in appetite Genitourinary Subjective only as per outpatient exam protocol. Denies dysuria, hematuria, or frequency Denies sexual dysfunction No history of STIs reported Musculoskeletal Gait: Steady ROM: Full range in upper/lower extremities Muscle strength: 5/5 bilaterally No joint swelling or tenderness Psychiatric/Mental Health Observations Mood: “Some days I feel guilty… I get scared easily.” Affect: Constricted but appropriate Thought processes: Logical and goal-directed Insight/Judgment: Fair Suicidal ideation: Denies current or past SI/HI Sleep: Problems in sleeping because of nightmares and flashbacks. Coping mechanisms: Avoidance (e.g., violence in media), isolation Nurse: I am glad you told me, Marco. Understanding how these memories affect your everyday life is important. You are not the only one and we are to assist in your recovery process. Plan of Care – Immediate Follow-Up Continue lisinopril for hypertension Citalopram 20 mg for depression/anxiety Prazosin 1 mg qHS for nightmares Closing Statement Assess for orthostatic hypotension related to medication interactions Refer for individual psychotherapy (CBT) Educate the patient about PTSD, medication side effects, and suicide prevention resources. Arrange follow-up with Psychiatric NP in three weeks Nurse: Thank you again, Marco. Today you are open, and this will assist us in constructing a robust care plan. You are improving, and you will not stop collaborating with us in order to achieve your recovery. We will follow up with you in a week and three weeks to have a therapy session and medication follow-up, respectively.

Capella University, NURS-FPX4055, RN-TO-BSN

NURS FPX 4055 Assessment 4 Health Promotion Plan Presentation

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NURS FPX 4055 Assessment 4 Health Promotion Plan Presentation Student Name NURS-FPX4055 Capella University Professor Name Submission Date Slide: 1 I am called _ and this is a presentation on the Prevention and Management of Hypertension in the elderly population of Greensboro, Guilford County, North Carolina. They will learn about screening for blood pressure, community resources, risk factors for hypertension, checking blood pressure, eating healthily and lowering sodium, exercise and following medication. Slide: 2 Health Promotion Plan Presentation This is a feasible health promotion plan that can help in educating the Greensboro older adults on how to prevent and control hypertension. This session will sensitise the people to the problem of hypertension and complications of hypertension and make them think of changing their health through healthy behaviours and making it a priority to manage themselves. Capability perseverance education can improve the knowledge and maintenance of individuals’ healthier being with hypertension (Kalu et al., 2023). The participants will be taught the value of checking blood pressure, eating well, managing sodium intake, physical activities, taking their prescribed medications and regular visits to the health care facilities. Hypertension management barriers such as transportation, financial, cultural, and health literacy barriers will also be included in the plan. The general objective is to boost self-esteem and confidence among the participants in their power to monitor and control BP and utilise community resources. Slide 3: Scenario Alexander James, 52, a community member, will be representative of an adult at risk for problems related to hypertension for the educational session. The lack of physical activity, unhealthy eating habits and lack of visits to health care providers are factors that limit the extent of healthy lifestyle behaviour in Alexander. He is aware that, exceeding to uncontrolled, high blood pressure is a big trouble to him, but he needs to find a solution to incorporate high blood pressure into his already busy life. During the session, Alexander will be educated on the risk factors of hypertension and learn to measure a blood pressure reading, nutrition and healthier food choices and will develop a health action plan for his 30-day session. In addition, obstacles to his following the recommendations will be addressed, which might be monetary, travel, cultural and health-literacy issues that he might encounter. Slide: 4 Evaluation of Educational Session Outcomes and Health Goals Evaluation to assess level of knowledge, skill and confidence towards hypertension management will be made through the educational session. The awareness regarding the risk factors, complications, awareness of hypertension and prevention of hypertension would be assessed as a pre and post enquiry session. The participants will also be conversant with lifestyle changes along with the 30-day plan of action. This will be demonstrated to ascertain the possibility of beneficial influence of structured health education in hypertension-self-management and health behaviour (Adzitey et al., 2026). They will be evaluated on how they use the information in a blood pressure monitoring demonstration /teach back session. The feedback that participants will give will indicate whether there exist some non-comfortable blocks within the session which should be mitigated with an additional demonstration or 1:1 addressing. These methods will be used to ascertain whether health goals that were agreed upon during the session were met and what to improve to be better in future health goals sessions. Slide: 5 SMART Goal 1: To create awareness about hypertension and its risk factors There is also the need to enhance the hypertension awareness levels of participants, its causes, complications and risk factors – this will be the first SMART (Specific, Measurable, Achievable, Relevant, and Time-bound) objective. Specifically, the participants will be informed about the effects of hypertension among the aged people, and the necessity of regular blood pressure measurements. The objective is quantifiable because, at the end of the session, the percentage of participants getting the post-session questions right will be quantified, and this will be used as a measure of improved knowledge; A percentage cutoff of 85 or higher will be used. Can be done through visual presentation, educational handouts, discussion and Q & A activity. Greater knowledge is applicable since it might encourage participants to embrace risk factors and existing screening and care. The results indicate that patient education interventions have the potential to increase hypertension awareness and habits to control it (Kalam et al., 2025). The evaluation of progress will be done at the end of the session and after 30 days. Slide: 6 SMART Goal 2: Promote healthy lifestyle behaviors The second SMART goal is to encourage participants to seek healthy behaviours that can lead to the prevention and/or treatment of hypertension. There will be practical tips taught to participants regarding the necessity of exercise, changes in diet, intake of food with lower sodium content, intake of medications and regular blood pressure check-ups. A measurable goal is that at least 80% of the participants who attend the workshop will clarify which life changes are to be made and that a personal action plan has been worked out for the last 30 days. The older adult will be able to achieve and attain the goal through the use of handouts, visual presentation and discussion of community resources. The behaviours that are described are pertinent as they are crucial to decreasing the risk of cardiovascular events and because they contribute to blood pressure control. Lifestyle modification is a part of the prevention and treatment of hypertension, as evidenced by research (Elmakki 2024). The 30 days will be spent reviewing progress, which will be done in terms of action plans and follow-up discussions with participants. Slide: 7 SMART Goal 3: To build confidence in the use of community resources The third SMART goal is to boost participants’ confidence around self-monitoring their blood pressure and community resources available to them. The participants will be able to know how to take a blood pressure reading and to identify at least 2 resources that will assist in healthcare, medications, nutrition, transportation or other needs. At least 90% of the participants will demonstrate or

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