Identifies 4 evidence-based articles & one evidence-based clinical practice guideline
Citation & uses APA 6th edition format for citation
Design/methods
Sample/setting
Major variables studied
Measurement
Data analysis
Results
Level of evidence/Application to project notes
Conduct a preliminary online search on the topic in Part 1 selected in the PICOT Question assignment above, using your PICOT question and keywords. ( see PICOT Paper attached ) Follow the instructions below to complete the assignment.
Assignment grid attached
1. Conduct your search to find the most representative evidence articles on your topic.
Use one of the databases listed or a comparable one: PubMed or CINAHL.
o Use various MeSH (Medical Subject Heading) terms and combinations of terms from your PICOT question.
o Examine the MeSH terms derived for this paper.
o Adjust your search strategy to include combinations of the most relevant three to four MeSH terms.
o save search strategies and searches.
o Restrict your searches to the most recent five years. Use four evidenced based articles and one evidence-based clinical practice guideline that can support a potential improvement project. Identify evidence that best addresses the focus of the topic for a potential improvement project.
2. Download and use the Evidence grid to format the second document.
3. Use the Evidence Grid to summarize a beginning synthesis.

Discussion: Evaluation & Management of HEENT Disorders
In clinical settings, head, eye, ear, nose, and throat (HEENT) disorders account for the majority of pediatric visits. With the prevalence of these disorders, you must be familiar with their signs and symptoms as well as evidence-based practices for assessment and treatment. Although many pediatric patients present with common HEENT disorders such as ear infections, allergies, and strep throat, some patients present with rare disorders requiring specialist care. In your role, making this distinction between when to treat and when to refer is essential. For this Discussion, examine the following case studies and consider potential diagnoses and management strategies.

Case Study 1:

HPI: A mother presents with her 2-year-old African American male child with complaints of ear pain and decreased sleep. Earlier this week, he had a runny nose and congestion with a mild cough that occurred mostly when lying down. His temperature is 100.7.
PE: Pt is walking around room, exploring in no acute distress.
HEENT: Mild nasal congestion, clear postnasal drainage, and lungs clear to auscultation. Ear exam reveals right tympanic membrane erythematous, translucent, in a neutral position, with no pus or fluid noted. Left tympanic membrane is full, reddish/orange in appearance, and opaque with pus.
Neck: Shotty anterior cervical adenopathy
Lungs: Clear to auscultation

To prepare:
• Review “Eye Disorders” and “Ear Disorders” in the Burns et al. text.
• Review the three case studies focusing on the case that is assigned to you. Analyze the patient information, including the parent’s perspective.
• Consider a differential diagnosis for the patient in the case study you selected. Think about the most likely diagnosis for the patient.
• Think about a treatment and management plan for the patient. Be sure to consider appropriate dosages for any recommended pharmacologic and/or non-pharmacologic treatments.
• Consider strategies for educating parents on the child’s disorder and reducing any concerns/fears presented in the case study.
By Day 3
Post an analysis of your assigned case by responding to the following:
o What additional questions will you ask?
 Has the case addressed the LOCATES mnemonic? If not, what else do you need to ask? What additional history will you need? (Think FMH, allergies, meds and so forth, that might be pertinent in arriving to your differential diagnoses).
o What additional examinations or diagnostic tests, if any will you conduct?
o What are your differential diagnoses? What historical and physical exam features support your rationales? Provide at least 3 differentials.
o What is your most likely diagnosis and why?
o How will you treat this child?
 Provide medication treatment and symptomatic care.
 Provide correct medication dosage. Use the knowledge you learned from this week’s and previous weeks’ readings as well as what you have learned from pharmacology to help you with this area.
o Patient Education, Health Promotion & Anticipatory guidance:
 Explain strategies for educating parents on their child’s disorder and reducing any concerns/fears presented in the case study.
 Include any socio-cultural barriers that might impact the treatment and management plans.
 Health Promotion:
 What immunizations should this child have had?
 Based on the child’s age, when is the next well visit?
 At the next well visit, what are the next set of immunizations?
 What additional anticipatory guidance should be provided today?

Explain how The Time Machine could be read as a story about the social stresses existing in England at the end of the 19th century.Explain how The Time Machine could be read as a story about the social stresses existing in England at the end of the 19th century.Explain how The Time Machine could be read as a story about the social stresses existing in England at the end of the 19th century.Explain how The Time Machine could be read as a story about the social stresses existing in England at the end of the 19th century.Explain how The Time Machine could be read as a story about the social stresses existing in England at the end of the 19th century.

Assignment 3b: Threats to the Global Environment Counterargument
The members of the United Nations are impressed by your presentation. The information you provided has led to productive debates. There are now questions about prioritizing the issues at hand. Some of the countries are challenging your recommendations and questioning your reasons for not including certain other issues they believe are priorities.
There are four remaining threats in the list of major global issues. Review the topics and reflect on two that you did not use in Assignment 3a. Defend your reasons for considering these topics to be less important than the issues you assessed in Assignment 3a.

NA – Energy sources Civil war
Globalization NA – Poor health of entire populations
NA – Lack of educational opportunities Cultural taboos
Inappropriate uses of technology NA – Climate change

1. Choose two of these four threats and write one paragraph on each threat stating why each is less a priority to the health of the global environment than the four you assessed in Assignment 3a.
2. Support your argument with at least three scholarly sources for each threat chosen (a total of at least 6 sources) that can be used to support your position that these two threats are less a priority than the four threats which you chose to assess in assignment 3a.
3. Each counterargument should include:
• An opening statement describing the threat; Three (3) points that offer evidence which supports your position that these threats are less a priority than the four threats that you assessed in Assignment 3a.
1. Please cite at least three scholarly sources in your argument.
2. For a brief list of resources for this assignment, please see the end of the course guide.
This course requires use of new Strayer Writing Standards (SWS). The format is different than other Strayer University courses. Please take a moment to review the SWS documentation for details. (Note: You will be prompted to enter your Blackboard login credentials to view these standards.)
The specific course learning outcomes associated with this assignment are:
• Examine the factors that account for why the growth in the world’s population can negatively affect globally

In 2–3 pages:

Create a work plan listing the tasks that will need to be completed to meet the system’s requirements.
Create a Gantt chart that is based on the details of your work plan. You may use any drawing/presentation/project management tool with which you are familiar and to which you have access. Should you decide to try project management software for this assignment, free options are available for download (such as Open Workbench at http://open-workbench.en.softonic.com/ or OpenProj at http://sourceforge.net/projects/openproj/)
Justify your choices for the work plan and Gantt chart, explaining how your choices meet the requirements of the system.
Cite your sources according to APA guidelines.

In a 3- to 4-page paper, address the following:

Discuss how continuous feedback provided by effective performance-management programs encourages and assists employees.
Describe how feedback helps to enhance the performance appraisal process that leads to improvement, promotions, or terminations.
Evaluate how human resources development programs that address the unique needs of some employees can be implemented to increase goodwill, attract, and retain quality employees.
Incorporate two scholarly HRM sources on how HRM professionals can use feedback systems to enhance employee performance.In a 3- to 4-page paper, address the following:

Discuss how continuous feedback provided by effective performance-management programs encourages and assists employees.
Describe how feedback helps to enhance the performance appraisal process that leads to improvement, promotions, or terminations.
Evaluate how human resources development programs that address the unique needs of some employees can be implemented to increase goodwill, attract, and retain quality employees.
Incorporate two scholarly HRM sources on how HRM professionals can use feedback systems to enhance employee performance.

The paper must answer the following two questions in two page long.
1. Would the Integral project yield financial returns? Discuss the potential scenarios both in the short run through tangible and the intangible benefits of this sustainable development project, as well as long run tangible and/or intangible benefits.

2. How should Esquel prepare itself for the risks from this project? What kind of hurdles could they face as they engage more deeply in this sustainability venture and effort? The paper must answer the following two questions in two page long.
1. Would the Integral project yield financial returns? Discuss the potential scenarios both in the short run through tangible and the intangible benefits of this sustainable development project, as well as long run tangible and/or intangible benefits.

2. How should Esquel prepare itself for the risks from this project? What kind of hurdles could they face as they engage more deeply in this sustainability venture and effort?

Discussion: Interprofessional Collaborative Practice and Advanced Practice Nurses
Interprofessional practice requires that health care practitioners recognize that patient outcomes are better when there is a collaborative team approach in addressing patient health issues. Also, there are barriers to interprofessional practice that must be addressed among health care practitioners. The Interprofessional Education Collaborative (IPEC) is an initiative including multiple professions designed to advance interprofessional education so that students entering health care professions are able to view collaboration as the norm and seek collaborative relationships with other providers (IPEC, 2011).

This week your Discussion will focus on interprofessional practice. This Discussion is an opportunity for you to examine your perspective and experiences with interprofessional collaborative practice and to apply your knowledge to managing patient care.

To prepare:
Identify a professional nursing organization and review their position on interprofessional practice
Review the following case study:
Case Study:

Ms. Tuckerno has been diagnosed with multiple sclerosis (MS). The patient receives care at an internal medicine clinic. Her internist is not in the office today and she is being treated by the nurse practitioner. The patient is on two medications for her MS, three different blood pressure medications, one medication for thyroid disease, one diabetic pill daily, insulin injections twice a day, she uses medical cannabis, and uses eye drops for glaucoma. Upon assessing the patient, the nurse practitioner (NP) decides her treatment plan should be adjusted. The NP discontinues some of the patient’s meds and discontinues medical cannabis. She orders the patient to follow up in two weeks.

The patient returns and is seen by her internist. The internist speaks with the patient and reviews her medical chart. The internist states to the patient, “I am dissatisfied with the care you received from the nurse practitioner.” The internist places the patient back on originally prescribed medications and medical cannabis.

By Day 3
Post an explanation of your understanding of interprofessional practice. Also, explain the position on interprofessional practice for a professional nursing organization that you are a member of or of which you plan to become a member. Then, explain what you think is the best collaborative approach to manage Ms. Tuckerno’s care.