Integumentary Function – Psoriasis

Instructions: Response must be at least 310 words written in current APA format with at least two academic references cited. References must be within the last five years. Response must extend, correct/refute, or add additional nuance.

Integumentary Function – Psoriasis

Psoriasis is a chronic skin disease that is characte by deficiencies in the normal cycle of the epidermal development that lead to epidermal hyperproliferation, altered growth of the skin, inflammation, and vascular

dysfunction (Peters, Weissman, & Gill, 2000).

There are several types of psoriasis lesion that individuals can experience, and each may differ in the way they respond to treatment (Peters, Weissman, & Gill, 2000). The different types of psoriasis includes: plaque psoriasis

which is the most common type, and is characterized by dry scalling patches, guttate psoriasis is characterized by drop-like dots that develops in individuals recovering from a streptococcal or viral infection, erythrodermic psoriasis

characterized by exfoliation of fine scales that covers large areas accompanied by severe itiching, and pain (Peters, Weissman, & Gill, 2000). Other types of psoriasis are pustular psoriasis characterized as pus-like blisters that are not

infectious with fluids that contains white blood cells. Nail psoriasis that is seen on toe and finger nails; inverse psoriasis that is characterized by smooth, inflamed lesions mostly in flexural areas of the body, such as the armpits. Psoriatic

arthritis is characterized by an inflammation, swelling, and joint destruction, and scalp psoriasis that is a plaque type lesion (Peters, Weissman, & Gill, 2000).

The onset of psoriasis can be sudden or steady, and many patient such as K.B. will experience remissions, and exacerbations. The most common triggers for psoriasis are bacterial or viral infections on any part of the skin, dry air

or skin, use of certain medications such as beta blockers, and lithium. Other triggers are skin injuries, such as cuts, and insect bites, too little or too much sunlight, and excessive alchohol intake (Dlugasch & Story, 2021).

           cure for psoriasis

Although there is no cure for psoriasis, there are treatment available that will improve the symptoms. There three main approaches to treatment including topical treatments, phototherapy, and systemtic medications. Topical

treatments includes corticosteriods is the topical agent that is mostly used in treating psoriasis, and is used to reduce inflammation, itching, and scaling of lesions (Peters, Weissman, & Gill, 2000). Other topical treatments include

vitamin D, anthralin, retinoids, calcinerin inhibitors, salicylic acid, coal tar, mositurizers, and dandruff shampoo (Dlugasch & Story, 2021). Phototherapy is used in the treatment of moderate forms of psoriais, these therapies are

administered in the form of sunlight, natural or artificial, broadband ultraviolent B phototherapy, photochemotherapy, and excimer laser (Dlugasch & Story, 2021). Oral or injectible forms of treatment are usually prescribed for

individuals with serve symptoms or those who are resisitant to other forms of treatment (Dlugasch & Story, 2021). These systemic theraputic agents are retinoids, methotrexate, cyclosporine, hydroxyurea, phosphodiesterease 4 inhibitor,

immunomodular drugs, and janus kinase inhibitors. These medications are used for a short time due the potential for individuals to experience serious side effects (Dlugasch & Story, 2021). In addition to the treatment modalitied

mentioned, stress management, and referral to a therapist to address the patients’ psychological needs is important. Recommendation for treatment in this case would include phototherapy, systemic therapy, and psychotherapy to address

K.B. emotional needs.

The medications used to treat psoriasis has severe adverse effects such as phototoxicity, nephrotoxicity bone marrow depression, and others, as a result. In addition, there is a high probability of these drugs to interact with other

medications that could result in a negative outcome; therefore it important to reconcile the medications that patient is taking (Peters, Weissman, & Gill, 2000).

Other clinical manifestations as mentioned above may include psoriatic arthritis that is characterized by joint pain, nail changes to include yellow-brown spots, dents on the nails, and separation from the base. An individual may

also experience symptoms of cardiovascular disease, inflammatory bowel disease, hypertension, and other autoimmune disorders as there is an increased risk associated with psoriasis that may be manifested as skin lesions (Dlugasch &

Story, 2021)

methods of developing theories

Instructions: Response must be at least 310 words written in current APA format with at least two academic references cited. References must be within the last five years. Response must extend, correct/refute, or add additional nuance.

As humans, we tend to respond to certain events within our environment by finding a way to explain how these events occurred. Our interpretations are based on how we formulate our ideas by establishing possible theories. Therefore, a theory can be explained as a set of ideas arranged in an orderly way to enable one to explain certain events and phenomena as observed. For instance, medical theories help medics to try to understand the causes and nature of health and diseases. So, theories enable us to understand, explain and make predictions about a certain event we have seen or encountered or concerning a given topic or subject matter.

There are various ways and methods of developing theories since the human mind is constantly seeking answers. They can be constructed using sentences that are based on the subject matter. Through our minds, we can come up with personal theories from events we have observed and by critically evaluating the event (Berente et al., 2019). Scientists on the other hand use scientific data and a variety of tests to develop and build their theories. These are new theories and they have to be well researched. Another way to develop a theory would involve relying upon previous established/published theories and using them as a guide of foundation for the new theory. By so doing, the theorist can add discoveries, integrate new concepts using different approaches, or modify the existing theory. From a simple hypothesis followed by appropriate research and a valid deduction, we can easily come up with a good theory.

Established theories

A good theory should depend on facts, values, and other theories. It is upon these 3 dependencies that theories are evaluated upon. Facts help support the theory and make it evidence-based. Many theorists rely on facts presented in research reports. Values include the data that is used to support the theory. It could be measurements or another figure that support the testability of the theory. Established theories provide support to new theories as evidence and support and if the old theories were true then chances are that the new theory will also be true. An example of a theory would be a business strategy created by a businessman to increase his sale and number of customers. Through research and information from others, his theory will be tested depending on the sales trajectory. Poor results from few customers would imply a poor theory.

The primary criteria to evaluate a theory is to falsify or test it. The result of the testing can either be the refutation or the collaboration of the theory. However, there is no specifically defined way to evaluate theories (Woodcock et al., 2021).   Due to the infinite number of repetitive tests required, theories are hard to prove. The Severity, the validity of tests, measures, and identification of all variables are other factors that prohibit proving theories. Values that are hard to disapproved and present testable predictions collaborated by the research are highly valued. Another method of evaluation would involve considering the accuracy and precision of the prediction of a theory. Prediction accuracy of around 80% would imply that the theorist has done a good job and has accounted for all variables and factors.

In conclusion, theories are important tools that help us analyze and interpret the events surrounding our lives.

Centers For Medicare & Medicaid Services (CMS)


According to the Centers for Medicare & Medicaid Services (CMS), quality measures rare represented in structured Health Quality Measure Format (HQMF) is a way that they can be interpreted by information systems like electronic health records (EHR). Electronic clinical quality measures (eCQMs) are tools used to measure and track quality of health care services. Eligible professionals, hospitals, and critical access hospitals generate information populated through the EHR. Measuring eCQMs help to ensure the safe effective, efficient, equitable, timely, and patient-centered care (Centers for Medicare & Medicaid Services [CMS], n.d.).

Several eCQM measures are monitored. Patient and family engagement, patient safety, care coordination, population/public health, efficient use of healthcare resources, and clinical process/effectiveness. There are many barriers to full meaningful use, however, many benefits have been identified. Baillieu et al., states when an organization is implementing eMeansures. And eCQM programs, the nurse informaticist may need to convince naysayers of the benefits that can be derived. Meaningful use of eMeasures. And eCQMs used by primary care providers facilitates quality improvement (QI), presents unnecessary acute care visits, improves patient outcomes. And promises to promote better continuity of care, especially for the underserved patient populations.

Another convincing argument is the fact there has been a positive association between practice size and meaningful use in both adult. And pediatric preventative care, suggesting successful implementation of clinical care and workflow that is supported by health IT contributes to reducing preventable chronic diseases. Understanding that advancements in health IT can improve patient outcomes by improving capacity for disease prevention, improve health promoting and chronic care management are compelling reasons to implement eMeasures and eCQMs (Baillieu et al., 2020).

history of hypertension

Mr. White is a 72-year-old man, with a history of hypertension, COPD and moderate dementia, who presents with 4 days of increased confusion, nighttime restlessness, visual hallucinations, and urinary incontinence. His physical exam is unremarkable except for tachypnea, a mildly enlarged prostate, inattentiveness, and a worsening of his MMSE score from a baseline of 18 to 12 today.


Mr. White’s presentation is most consistent with an acute delirium (acute change in cognition, perceptual derangement, waxing and waning consciousness, and inattention).

1. What is the most likely diagnosis to frequently cause acute delirium in patients with dementia?

2. What additional testing should you consider if any?

3. What are treatment options to consider with this patient?

What does evidence- based practice (EBP) mean?


What does evidence- based practice (EBP) mean? Why is it important to nursing? How does your own work environment use EPB and what strategies you can use to implement EBP into nursing practice? This week you will need to think about and analyze a specific situation that has occurred in your work setting and the impact critical thinking had on that specific situation.

Learning Outcomes

After completing this module, you will be able to:

  • Compare and contrast creative strategies to implement research evidence into nursing practice.
  • Analyze a critical incident in the workplace using a critical thinking tool or model of your choice.

Reading & Resources 

Read Chapters 5 & 8 In Rubenfeld, M. G., & Scheffer, B.K. (2015). Critical thinking TACTICS for nurses: Achieving the IOM competencies (3rd ed.). Sudbury, MA: Jones and Bartlet

Discussion 4

Discuss strategies that you can use to encourage and support implementing evidence- based practice and use of nursing outcome indicators in your current work environment to improve nursing practice and ultimately high quality, safe patient care?

Please support your initial discussion and opinions with at least two citations from the assigned readings, or peer-reviewed professional nursing literature.

See the Nursing Syllabus Standards & Policies Document for Discussion Participation Guidelines & Grading Criteria.

influence patient education has in health care using the experiences of a patient

on the influence patient education has in health care using the experiences of a patient. Interview a friend or family member about that person’s experiences with the health care system. You may develop your own list of questions.

Suggested interview questions:

  1. Did a patient education representative give you instructions on how to care for yourself after your illness or operation?
  2. Did a health care professional, pharmacist, nurse, doctor, or elder counselor advise you on your medication, diet, or exercise?
  3. Who assisted you at home after your illness or operation?
  4. Do you know of any assistance services, i.e., food, transportation, medication, that would help you stay in your home as you get older?

epic poetry about your life

1. Two Summaries

Read “Penelope’s Agnoia” and “Herakles, Odysseus, and the Bow,” then write a summary of that article, no more than ½ page in length, which explains the article’s main claim and the arguments it uses to support that claim. You can earn up to ten points of credit for the first article you summarize, and up to five additional points if you submit a summary for the other article as well.

2. One poem

Write 20-40 lines of epic poetry about your life.  How you make it poetry is up to you; you may want to use rhyme, meter or other formal devices.  How you make it “epic” is also up to you, but you can apply some of the things you’ve learned in lecture and section to make what you write more like the Odyssey.  Like Odysseus, you should not feel bound by a strict respect for the truth.

aplastic anemia

Response #1 Respond to one of your peers in your discussion group. Identify the additional workup that is needed to rule in or rule out these differential diagnoses. What clinical signs/symptoms would you expect to see with these two differential diagnoses ?

Peer response


According to McCance and Huether (2018), “anemia is a reduction in the total circulating red cell mass or a decrease in the quality or quantity of hemoglobin.” Anemias commonly result from acute or chronic blood loss, impaired erythrocyte production, increased erythrocyte destruction, or a combination of these factors. The main physiologic manifestation of anemia is a reduced oxygen-carrying capacity of the blood resulting in hypoxemia. Symptoms of anemia vary, depending on the body’s ability to compensate for reduced oxygen-carrying capacity.

Anemia that is mild and develops gradually is usually easier to compensate and may cause problems for the individual only during physical exertion. As the reduction in the number of red blood cells (RBCs) continues, symptoms become more pronounced and alterations of specific organs and compensatory effects become more apparent. There are several ways to classify anemias. They can be categorized as blood loss, inherited genetic effects, acquired genetic effects and nutritional deficiencies (McCance & Huether, 2018).

One differential diagnosis that this patient could possibly have is iron deficiency anemia. Fifty percent of anemia is related to iron deficiency and is also highly associated with pregnancy (Khani et al., 2021). Iron is essential for the production of hemoglobin. The depletion of iron stores may result from blood loss, decreased intake or impaired absorption. According to Khani et al. (2021), “iron deficiency anemia reduces the capacity of red blood cells delivering oxygen to the tissues of the body, with clinical symptoms such as conjunctival pallor, shortness of breath, dizziness, and weakness.”

         aplastic anemia

Another differential diagnosis could be aplastic anemia. Aplastic anemia is a condition that occurs when your body stops producing enough new blood cells. The condition leaves you fatigued and more prone to uncontrollable bleeding. It can occur suddenly at any age, or it can come on slowly and worsen over time.

According to Shen et al. (2021), “the exact etiology is not clear, which may be related to chemical poisons, viral infection, lack of immunity, and other factors.” Clinical manifestations are “low proliferation of bone marrow hematopoietic cells and peripheral blood pancytopenia, which are mainly anemia, hemorrhage, and infection (Shen et al., 2021). Treatments for aplastic anemia might include medications, blood transfusions or a stem cell transplant, also known as a bone marrow transplant.


Khani Jeihooni, A., Hoshyar, S., Afzali Harsini, P., & Rakhshani, T. (2021). The effect of nutrition education based on PRECEDE model on iron deficiency  anemia among female students. BMC Women’s Health, 21(1), 1–9.

McCance K., L., & Huether, S., E. (2018). Pathophysiology: The biologic basis for disease in adults and children (8th ed.). Elsevier.

Shen, W., Liu, X., & Zhou, A. (2021). Analysis of continuous nursing intervention on aplastic anemia patients based on the “Information-motivation-            behavioral skills model.” Evidence-Based Complementary & Alternative Medicine (ECAM), 1–7.

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the relationship between self-concept, physical fitness, and health habits in school-aged children

 the relationship between self-concept, physical fitness, and health habits in school-aged children

Question 1

For data collection to be valid, what must occur?

The tool must be accurate all of the time.

The tool must measure what it is supposed to measure.

The tool must be unbiased.

The tool must be thorough.

Question 2

Which research design would be used to determine the relationship between self-concept, physical fitness, and health habits in school-aged children?

Applied research design

Nonexperimental design 

Experimental design

Pretest and posttest design 

Question 3

The clinical nurse leader (CNL) is a recently proposed role. The responsibilities of the person in this role include which of the following?

Provide daily care to a specific subset of patients with similar needs.

Oversee and manage care delivery in specific settings.

Manage and streamline operations in multiple nursing units.

Replace the outdated CNS role.

Question 4

Which of the following is an example of a research question based on a clinical problem?

Relationship between hours of bright light and irritability of preterm infants

patient’s pharmacokinetic and pharmacodynamic processes

For this Discussion, you reflect on a case from your past clinical experiences and consider how a patient’s pharmacokinetic and pharmacodynamic processes may alter his or her response to a drug.

To Prepare
  • Review the Resources for this module and consider the principles of pharmacokinetics and pharmacodynamics.
  • Reflect on your experiences, observations, and/or clinical practices from the last 5 years and think about how pharmacokinetic and pharmacodynamic factors altered his or her anticipated response to a drug.
  • Consider factors that might have influenced the patient’s pharmacokinetic and pharmacodynamic processes, such as genetics (including pharmacogenetics), gender, ethnicity, age, behavior, and/or possible pathophysiological changes due to disease.
  • Think about a personalized plan of care based on these influencing factors and patient history in your case study.
By Day 3 of Week 1

Post a description of the patient case from your experiences, observations, and/or clinical practice from the last 5 years. Then, describe factors that might have influenced pharmacokinetic and pharmacodynamic processes of the patient you identified. Finally, explain details of the personalized plan of care that you would develop based on influencing factors and patient history in your case. Be specific and provide examples.

By Day 6 of Week 1

Read a selection of your colleagues’ responses and respond to at least two of your colleagues on two different days by suggesting additional patient factors that might have interfered with the pharmacokinetic and pharmacodynamic processes of the patients they described. In addition, suggest how the personalized plan of care might change if the age of the patient were different and/or if the patient had a comorbid condition, such as renal failure, heart failure, or liver failure.

Note: For this Discussion, you are required to complete your initial post before you will be able to view and respond to your colleagues’ postings. Begin by clicking on the “Post to Discussion Question” link, and then select “Create Thread” to complete your initial post. Remember, once you click on Submit, you cannot delete or edit your own posts, and you cannot post anonymously. Please check your post carefully before clicking on Submit!