Pharmacotherapy For Cardiovascular Disorders

Despite the high mortality rates associated with cardiovascular disorders, improved treatment options do exist that can help address those risk factors that afflict the majority of the population today.

Photo Credit: Getty Images/Science Photo Library RF

As an advanced practice nurse, it is your responsibility to recommend appropriate treatment options for patients with cardiovascular disorders. To ensure the safety and effectiveness of drug therapy, advanced practice nurses must consider aspects that might influence pharmacokinetic and pharmacodynamic processes such as medical history, other drugs currently prescribed, and individual patient factors.

Reference: Murphy, S. L., Xu, J., Kochanek, K. D., & Arias, E. (2018). Mortality in the United States, 2017. Retrieved from

To Prepare
  • Review the Resources for this module and consider the impact of potential pharmacotherapeutics for cardiovascular disorders introduced in the media piece.
  • Review the case study assigned by your Instructor for this Assignment.
  • Select one the following factors: genetics, gender, ethnicity, age, or behavior factors.
  • Reflect on how the factor you selected might influence the patient’s pharmacokinetic and pharmacodynamic processes.
  • Consider how changes in the pharmacokinetic and pharmacodynamic processes might impact the patient’s recommended drug therapy.
  • Think about how you might improve the patient’s drug therapy plan based on the pharmacokinetic and pharmacodynamic changes. Reflect on whether you would modify the current drug treatment or provide an alternative treatment option for the patient.
By Day 7 of Week 2

Write a 2- to 3-page paper that addresses the following:

  • Explain how the factor you selected might influence the pharmacokinetic and pharmacodynamic processes in the patient from the case study you were assigned.
  • Describe how changes in the processes might impact the patient’s recommended drug therapy. Be specific and provide examples.
  • Explain how you might improve the patient’s drug therapy plan and explain why you would make these recommended improvements.


CASE STUDY 2: Patient HM has a history of atrial fibrillation and a transient ischemic attack (TIA). The patient has been diagnosed with type 2 diabetes, hypertension, hyperlipidemia, and ischemic heart disease.

Drugs currently prescribed include the following:

• Warfarin 5 mg po daily MWF and 2.5 mg daily T, TH, Sat, Sun

• Aspirin 81 mg po daily

• Metformin 1000 mg po bid

• Glyburide 10 mg po bid

• Atenolol 100 mg po daily

• Motrin 200 mg 1–3 tablets every 6 hours as needed for pain

please pay attention to the my case study above


Rosenthal, L. D., & Burchum, J. R. (2018). Lehne’s pharmacotherapeutics for advanced practice providers. St. Louis, MO: Elsevier.

  • Chapter 34, “Review of Hemodynamics” (pp. 335–340)
  • Chapter 35, “Diuretics” (pp. 341–349)
  • Chapter 36, “Drugs Acting on the Renin-Angiotensin-Aldosterone System” (pp. 351–362)
  • Chapter 37, “Calcium Channel Blockers” (pp. 363–369)
  • Chapter 38, “Vasodilators” (pp. 371–373)
  • Chapter 39, “Drugs for Hypertension” (pp. 375–388)
  • Chapter 40, “Drugs for Heart Failure” (pp. 389–402)
  • Chapter 41, “Antidysrhythmic Drugs” (pp. 403–418)
  • Chapter 42, “Prophylaxis of Atherosclerotic Cardiovascular Disease: Drugs That Help Normalize Cholesterol and Triglyceride Levels” (pp. 419–439)
  • Chapter 43, “Drugs for Angina Pectoris” (pp. 441–450)
  • Chapter 44, “Anticoagulant and Antiplatelet Drugs” (pp. 451–472)

4 references not more than 5years

zero plagiarism

Devry Nr508 Week 7 Quiz 2016


1. In Parkinson disease (PD), the basal ganglia influences the hypothalamic function to produce which grouping of clinical manifestations?

Inappropriate diaphoresis, orthostatic hypotension, constipation, and urinary retention

Asymmetric, regular, rhythmic tremors with slow alternating flexion and extension contractions

Involuntary contractions of skeletal muscles that impair active and passive movement

Bradykinesia of chewing, swallowing, and articulation

Question 2. Which is a characteristic of brainstem death?

Vegetative state



Locked-in syndrome

Question 3. With receptive dysphasia (fluent), the individual is able to

respond in writing, but not in speech.

speak back, but not comprehend speech.

comprehend speech, but not respond verbally.

respond verbally, but not comprehend speech.

Question 4. The body compensates to a rise in intracranial pressure by first displacing

cerebrospinal fluid (CSF).

arterial blood.

venous blood.

cerebral cells.

Question 5. Dementia is characterized by

deficits in attention and coherence of thought.

easy distractibility and poor concentration.

loss of recent and remote memory.

irritability, agitation, and restlessness.

Question 6. Which dyskinesia involves involuntary movements of the face, trunk, and extremities?





Question 7. Vomiting is associated with CNS injuries that compress which anatomic location(s)?

Vestibular nuclei in the lower pons and medulla oblongata

Floor of the third ventricle

Vestibular nuclei in the midbrain


Question 8. Cognitive operations cannot occur without the _____ functioning.


medulla oblongata

reticular activating system

cingulate gyrus

Question 9. What are the initial clinical manifestations noted immediately after a spinal cord injury?

Headache, bradycardia, and elevated blood pressure

Confusion, irritability, and retrograde amnesia

Loss of deep tendon reflexes and flaccid paralysis

Hypertension, neurogenic shock, and tachycardia

Question 10. Which clinical manifestation is characteristic of cluster headaches?

Aura before the headache with photophobia and nausea and vomiting

Severe unilateral tearing, burning, or temporal pain

Gradual onset of bilateral pain with sensation of a tight band around the head

Throbbing headache with intermittent burning sensation

Question 11. A man who sustained a cervical spinal cord injury 2 days ago suddenly develops severe hypertension and bradycardia. He reports severe head pain and blurred vision. The most likely explanation for these clinical manifestations is that he is

experiencing acute anxiety.

developing spinal shock.

developing autonomic hyperreflexia.

experiencing parasympathetic areflexia.

Question 12. The most severe diffuse brain injury caused by rotational acceleration is most likely to be located in the

diencephalon to the brainstem.

medial portion of the brainstem.

entire brainstem.


Question 13. Which neurotransmitter is reduced in people with schizophrenia?


Gamma-aminobutyric acid (GABA)



Question 14. Which is a positive symptom of schizophrenia?

Blunted affect

Auditory hallucinations

Poverty of speech

Lack of social interaction

Question 15. Hypothalamic-pituitary-adrenal (HPA) system abnormalities exist in a large percentage of individuals with


major depression.


panic disorder.

Question 16. The life-threatening problems associated with myelomeningocele include

upward displacement of the cerebellum into the diencephalon.

motor and sensory lesions below the level of the myelomeningocele.

downward displacement of the cerebellum, brainstem, and fourth ventricle.

encephalitis causing generalized cerebral edema and hydrocephalus.

Question 17. The neural groove closes dorsally during the _____ week of gestational life.





Question 18. Anterior midline defects of neural tube closure cause developmental defects in the

brain and skull.

spinal cord.


peripheral nerves.

Question 19. Which statement is false regarding the pathophysiology of acute pancreatitis?

Pancreatic acinar cells metabolize ethanol, which generates toxic metabolites.

Injury to the pancreatic acinar cells permits leakage of pancreatic enzymes that digest pancreatic tissue.

Acute pancreatitis is an autoimmune disease in which IgG coats the pancreatic acinar cells so they are destroyed by the pancreatic enzymes.

When gallstones are present, bile flows into the pancreas, contributing to attacks.

Question 20. The desire to eat is stimulated by

agouti-related protein (AgRP).

alpha-melanocyte–stimulating hormone (?-MSH).

cocaine- and amphetamine-regulated transcript (CART).

peptide YY (PYY).

Question 21. The most common manifestation of portal hypertension induced splenomegaly is





Question 22. Incomplete fusion of the nasomedial or intermaxillary process during the fourth week of embryonic development causes

cleft palate.

sinus dysfunction.

cleft lip.

esophageal malformation.

Question 23. At 2 or 3 weeks of age, an infant who has been fed well and gained weight begins to vomit for no apparent reason. The vomiting has gradually become more forceful. These symptoms may be indicative of which disorder?

Esophageal atresia

Congenital aganglionic megacolon

Pyloric stenosis


Question 24. Hepatitis _____ in children is primarily associated with blood transfusions.





Question 25. Meconium _____ is an intestinal obstruction caused by meconium formed in utero that is abnormally sticky and adheres firmly to the mucosa of the small intestine.








HSA 515 Assignment 1

Click the link above to submit your assignment.

Students, please view the “Submit a Clickable Rubric Assignment” in the Student Center.
Instructors, training on how to grade is within the Instructor Center.

Assignment 1: Legal Aspects of U.S. Health Care System Administration
Due Week 4 and worth 100 points

Prevailing wisdom reinforces the fact that working in U.S. health care administration in the 21st Century requires knowledge of the various aspects of health laws as they apply to dealing with medical professionals. Further, because U.S. health care administrators have to potentially interact with many levels of professionals beyond the medical profession, it is prudent that they are aware of any federal, state, and local laws that may be applicable to their organizations. Thus, their conduct is also subject to the letter of the law. They must evaluate the quality of their professional interactions and be mindful of the implications and ramifications of their decisions.

You are employed as a top health administrator at the hypothetical Well Care Hospital in Happy Town. When you were hired, your pre-employment screening involved background checks into any violation of hospital medical misconduct during the last five (5) years. The results showed that you were in good standing with the hospital administration community. During the past year, you had to undergo training in personnel conduct, as well as in inter-employee conduct with medical staff, nurses, technologists, etc. During the past six (6) months, the hospital has been under scrutiny for breach of medical compliance.

Note: You may create and / or make all necessary assumptions needed for the completion of this assignment.

Write a three to four (3-4) page paper in which you:

  1. Articulate your position as the top administrator concerned about the importance of professional conduct within the health care setting. Justify your position.
  2. Ascertain the major ramifications of having professional staff compromise the boundaries of ethics and medical conduct.
  3. Analyze the four (4) elements required of a plaintiff to prove medical negligence.
  4. Discuss the overarching duties of the health care governing board in mitigating the effects of medical non-compliance, as they apply to the rules of practice set forth in the Well Care Hospital governing board’s manifesto.
  5. Use at least five (5) quality academic resources in this assignment. Note: Wikipedia and other Websites do not quality as academic resources.

Your assignment must follow these formatting requirements:

  • Be typed, double spaced, using Times New Roman font (size 12), with one-inch margins on all sides; citations and references must follow APA or school-specific format. Check with your professor for any additional instructions.
  • Include a cover page containing the title of the assignment, the student’s name, the professor’s name, the course title, and the date. The cover page and the reference page are not included in the required assignment page length.

The specific course learning outcomes associated with this assignment are:

  • Describe the sources of law in America, the relative legal procedure, and the related court system.
  • Examine the various applications of the law within the health care system.
  • Use technology and information resources to research issues in health care policy, law, and ethics.
  • Write clearly and concisely about health care policy, law, and ethics using proper writing mechanics.


I have two articles

and I want you to write the summary for each one hafe page and I want both today.



first article


Second article



Will Gilead Follow The Pfizer Game Plan For Sales Growth?

John LaMattina

February 9, 2016


Back in 1989 Pfizer was a mid-tier pharmaceutical company with total revenues of $5.1 billion. Pfizer PFE +0.79% had come off a decade of modest growth, but internally the company was very optimistic. This optimism was fueled by the rapid launch of what was termed inside of Pfizer as the “big 5”: Norvasc, Zoloft, Zithromax, Diflucan, and Cardura. In 1996, Pfizer launched Viagra and signed a co-marketing agreement with Warner-Lambert for Lipitor. The cumulative effect of these products was tremendous and literally transformed Pfizer into a major global corporation. By 1999, Pfizer revenues were almost $27 billion. In the 1990s, Pfizer split four times, with a single share in 1989 becoming 18 shares at the end of the decade. It was indeed heady times.


But such growth poses long-term challenges. As shareholders demand continued growth on the order of 10% annually, the internal R&D pipeline is challenged to keep up. It is not as if one can grow R&D and expect an immediate return. Early research investments, particularly back then, would not flower for another 15 years. Thus, to meet its goals of being the world’s top pharmaceutical company, Pfizer turned to growth through external acquisitions. With the rapid growth in Lipitor sales, Pfizer merged with Warner-Lambert to gain exclusive access to this drug–a drug whose sales would peak at $12.9 billion. But the Lipitor growth exacerbated the situation; it was hard enough to grow a pipeline which could keep up with the sales growth that Pfizer was achieving. Eventually, Lipitor would lose its patent. How do you replace a nearly $13 billion drug, a drug that by itself had greater sales than most companies? Well, as most know by now, Pfizer went the acquisition route with Pharmacia (2003), Wyeth (2009), Hospira HSP +% (2015), and now Allergan AGN +2.16%.


Is history about to repeat? The growth of Gilead has been even more spectacular. Gilead revenues in 2005 were $2.0 billion. But in 2015, thanks to the launch of its landmark cures for hepatitis C, Sovaldi and Harvoni, Gilead sales were roughly $32 billion. Gilead is now a top ten pharmaceutical company. Yet it is highly unlikely that its internal R&D pipeline has the assets needed to drive the type of growth that Gilead has provided over the last decade. If that wasn’t hard enough, Gilead has competition in the hepatitis C space not just from AbbVie ABBV +0.77% but also now with Merck’s recently approved Zepatier. Given that Merck has priced its drug at a steep 33% discount to Gilead’s drugs, there will be even more pressure on growing revenues.


So, what will Gilead do to inspire shareholder confidence for future growth? Would it consider the “Pfizer script?” Pfizer has certainly laid out the game plan for dealing with such a situation. Furthermore, given the drop in the value of biotech stocks in the last few months, a number of companies may prove to be attractively priced. Will Gilead be willing to undergo the kind of acquisition it needs to continue its remarkable growth? Is there a company out there with the type of blockbuster that Gilead would need to acquire to meet its goals? But, if it starts down this road, will it be able to stop? Pfizer couldn’t.


(The author is the former head of Global Pfizer R&D.)

Discussion 1: Socio-Emotional Development

Cultural behaviors and practices vary dramatically around the globe, though no one practice is more effective than the other. These cultural behaviors and practices not only enrich the lives of children but also impact child development, group dynamics, and all aspects related to thinking (e.g., decision making). Thus, all domains of psychology—affective, behavioral, and cognition are impacted by culture.

For this Discussion, you will explore the impact of culture from birth to adolescent’s socio-emotional development. You also will examine cultural practices in childhood development and the impact on adult outcomes.

To Prepare:

  • Different cultural practices in childhood might relate to outcomes in adulthood. Consider one of the following aspects that you have experienced or you may know of an experience for this Discussion:
    • child rearing practices
    • discipline
    • attachment
    • co-sleeping
    • emotional management
    • peers and play
  • This week’s Learning Resources provide you with different sources related to different cultural practices in childhood. From your readings, select a different culture other than your own to complete this Discussion post.

By Day 3

Post an explanation of how the cultural practice you personally experienced or that you know of an experience from a socio-emotional development perspective is similar to or is different from the practice you read about in your Learning Resources. Further explain how different cultural practices in childhood regarding this practice might lead to different or similar outcomes in adulthood.

(Note: No one practice is typically more effective than the other, however, there are some practices that are quite different, and scholars debate if there are indeed some practices which are harmful, unhealthy, or even unsafe.)

Note: Be sure to support your postings and responses with specific references to the Learning Resources and identify current relevant literature to support your work.

Final Med

The discussion assignment provides a forum for discussing relevant topics for this week based on the course competencies covered.

Post your initial response to the Discussion Area by the due date assigned.  To support your work, use your course text readings and also use outside sources. As with all assignments, cite your sources and provide references in APA format.

Start reviewing and responding to the postings of your classmates as early in the week as possible. Respond to at least two of your classmates. Participate in the discussion by providing a point of view with a rationale, challenging an aspect of the discussion, or indicating a relationship between two or more lines of reasoning in the discussion. Complete your participation for this assignment by the due date assigned.


You have two very ill patients this week, and each of them presents a very complicated case. First, you have a patient with an ongoing problem that has resisted diagnosis. He was enroute to an evaluation with a neurologist, but on the way to the hospital suddenly fell into a coma (a state of involuntary unconsciousness due to illness or injury) and had to be brought in to your medical facility by ambulance.

You will use at least 10 medical terms to describe this patient, and to refer to the original underlying problem the patient had in the first place. Use the nervous system medical word elements chart and the medical, surgical, and diagnostic terms chart on from your textbook to get you started on the medical terms you will need. You can include specific drugs used in neurological disease as you list at least 3 tests and procedures used. 

Your second patient this week is also quite ill and is presenting a number of problems. This patient is diabetic, and also has another Endocrine System disorder (of your choice). Consult the endocrine medical word elements chart as you develop medical terms—include at least 10 that would be appropriate in this case. You should consult  medical, surgical, and diagnostic procedures in your textbook as you select at least 3 tests and procedures for this patient. .

Nursing Research And Evidence Based Practice With Picot Question

Today is week 1 day 2.  I need discussion question by Weds.  The picot question in this discussion question will be the question for the paper.  So I need discussion question complete and the 3 part paper.


Discussion: Nursing Research and Evidence-Based Practice


In your practice as a nurse, you may use procedures and methods that did not necessarily originate in evidence, but instead were derived from informal and unwritten conventions, traditions, and observations. While these techniques may have merit, practices are constantly being updated and contradicted by information from scholarly research studies and professional guidelines. This new information serves as “evidence” for revising practices to improve outcomes across health care.


Based on this evidence, you can formulate a question. In this Discussion, you consider the use of evidence-based practice in your own organization and formulate a question that you will need to answer for your portfolio project. This is called a PICOT question. You will also investigate strategies for overcoming barriers to implementing evidence-based practice (EBP).


To prepare:                                                         


  • Consider a recent clinical experience in which you were providing care for a patient.
  • Determine the extent to which the care that you provided was based on evidence and research findings or supported only by your organization’s standard procedures. How do you know if the tasks were based on research?
  • What questions have you thought about in a particular area of care such as a procedure or policy?
  • Review Chapter 2, pages 31–34 on “Asking Well worded Clinical Questions” in Polit & Beck and consult the resource from the Walden Student Center for Success: Clinical Question Anatomy & examples of PICOT questions (found in this week’s Learning Resources). Formulate your background questions and PICOT question.
  • Reflect on the barriers that might inhibit the implementation of evidence-based practice in your clinical environment.
  • Review the article “Adopting Evidence-Based Practice in Clinical Decision Making” in this week’s Learning Resources. Select one of the barriers described that is evident in your organization and formulate a plan for overcoming this barrier.


By Day 3


Post an evaluation of the use, or lack thereof, of EBP in a recent clinical experience. Identify which aspects of the care delivered, if any, were based on evidence and provide your rationale. List your background questions and PICOT question about this nursing topic. Critique how the policies, procedures, and culture in your organization may hinder or support the adoption of evidence-based practices. Identify the barrier you selected from the article and explain how this barrier could be overcome within your organization.




Course Project: Part 1—Identifying a Researchable Problem


One of the most challenging aspects of EBP is to actually identify the answerable question.


—Karen Sue Davies


Formulating a question that targets the goal of your research is a challenging but essential task. The question plays a crucial role in all other aspects of the research, including the determination of the research design and theoretical perspective to be applied, which data will be collected, and which tools will be used for analysis. It is therefore essential to take the time to ensure that the research question addresses what you actually want to study. Doing so will increase your likelihood of obtaining meaningful results.


In this first component of the Course Project, you formulate questions to address a particular nursing issue or problem. You use the PICOT model—patient/population, intervention/issue, comparison, and outcome—outlined in the Learning Resources to design your questions.


To prepare:


  • Review the article, “Formulating the Evidence Based Practice Question: A Review of the Frameworks,” found in the Learning Resources for this week. Focus on the PICOT model for guiding the development of research questions.
  • Review the section beginning on page 75 of the course text, titled, “Developing and Refining Research Problems” in the course text, which focuses on analyzing the feasibility of a research problem.
  • Reflect on an issue or problem that you have noticed in your nursing practice. Consider the significance of this issue or problem.
  • Generate at least five questions that relate to the issue which you have identified. Use the criteria in your course text to select one question that would be most appropriate in terms of significance, feasibility, and interest. Be prepared to explain your rationale.
  • Formulate a preliminary PICO question—one that is answerable—based on your analysis. What are the PICO variables (patient/population, intervention/issue, comparison, and outcome) for this question?


Note: Not all of these variables may be appropriate to every question. Be sure to analyze which are and are not relevant to your specific question.


  • Using the PICOT variables that you determined for your question, develop a list of at least 10 keywords that could be used when conducting a literature search to investigate current research pertaining to the question.


To complete:


Write a 3- to 4-page paper that includes the following:


  • A summary of your area of interest, an identification of the problem that you have selected, and an explanation of the significance of this problem for nursing practice
  • The 5 questions you have generated and a description of how you analyzed them for feasibility
  • Your preliminary PICOT question and a description of each PICOT variable relevant to your question
  • At least 10 possible keywords that could be used when conducting a literature search for your PICOT question and a rationale for your selections


By Day 7


Submit your Project. It will also be a component of your Portfolio Assignment for this course, which is due by Day 7 of Week 10.




Davies, K. S. (2011). Formulating the evidence based practice question: A review of the frameworks. Evidence Based Library and Information Practice, 6(2), 75–80. Retrieved from


2nd part


Course Project: Part 2—Literature Review


This is a continuation of the Course Project presented in Week 2. Before you begin, review the Course Project Overview document located in the Week 2 Resources area.


The literature review is a critical piece in the research process because it helps a researcher determine what is currently known about a topic and identify gaps or further questions. Conducting a thorough literature review can be a time-consuming process, but the effort helps establish the foundation for everything that will follow. For this part of your Course Project, you will conduct a brief literature review to find information on the question you developed in Week 2. This will provide you with experience in searching databases and identifying applicable resources.


To prepare:


  • Review the information in Chapter 5 of the course text, focusing on the steps for conducting a literature review and for compiling your findings.
  • Using the question you selected in your Week 2 Project (Part 1 of the Course Project), locate 5 or more full-text research articles that are relevant to your PICOT question. Include at least 1 systematic review and 1 integrative review if possible. Use the search tools and techniques mentioned in your readings this week to enhance the comprehensiveness and objectivity of your review. You may gather these articles from any appropriate source, but make sure at least 3 of these articles are available as full-text versions through Walden Library’s databases.
  • Read through the articles carefully. Eliminate studies that are not appropriate and add others to your list as needed. Although you may include more, you are expected to include a minimum of five articles. Complete a literature review summary table using the Literature Review Summary Table Template located in this week’s Learning Resources.
  • Prepare to summarize and synthesize the literature using the information on writing a literature review found in Chapter 5 of the course text.


To complete:


Write a 3- to 4-page literature review that includes the following:


  • A synthesis of what the studies reveal about the current state of knowledge on the question that you developed
    • Point out inconsistencies and contradictions in the literature and offer possible explanations for inconsistencies.
  • Preliminary conclusions on whether the evidence provides strong support for a change in practice or whether further research is needed to adequately address your inquiry
  • Your literature review summary table with all references formatted in correct APA style


Note: Certain aspects of conducting a standard review of literature have not yet been covered in this course. Therefore, while you are invited to critically examine any aspect of the studies (e.g., a study’s design, appropriateness of the theoretic framework, data sampling methods), your conclusion should be considered preliminary. Bear in mind that five studies are typically not enough to reflect the full range of knowledge on a particular question and you are not expected to be familiar enough with research methodology to conduct a comprehensive evaluation of all aspects of the studies.


By Day 7 of Week 5


This part of the Course Project is due. It will also be a component in your Portfolio Assignment in this course, which is due by Day 7 of Week 10.


3rd part


Course Project: Part 3—Translating Evidence Into Practice


In Part 3 of the Course Project, you consider how the evidence you gathered during Part 2 can be translated into nursing practice.


Now that you have located available research on your PICOT question, you will examine what the research indicates about nursing practices. Connecting research evidence and findings to actual decisions and tasks that nurses complete in their daily practice is essentially what evidence-based practice is all about. This final component of the Course Project asks you to translate the evidence and data from your literature review into authentic practices that can be adopted to improve health care outcomes. In addition, you will also consider possible methods and strategies for disseminating evidence-based practices to your colleagues and to the broader health care field.


To prepare:


  • Consider Parts 1 and 2 of your Course Project. How does the research address your PICOT question?
  • With your PICOT question in mind, identify at least one nursing practice that is supported by the evidence in two or more of the articles from your literature review. Consider what the evidence indicates about how this practice contributes to better outcomes.
  • Explore possible consequences of failing to adopt the evidence-based practice that you identified.
  • Consider how you would disseminate information about this evidence-based practice throughout your organization or practice setting. How would you communicate the importance of the practice?


To complete:


In a 3- to 4-page paper:


  • Restate your PICOT question and its significance to nursing practice.
  • Summarize the findings from the articles you selected for your literature review. Describe at least one nursing practice that is supported by the evidence in the articles. Justify your response with specific references to at least 2 of the articles.
  • Explain how the evidence-based practice that you identified contributes to better outcomes. In addition, identify potential negative outcomes that could result from failing to use the evidence-based practice.
  • Outline the strategy for disseminating the evidence-based practice that you identified throughout your practice setting. Explain how you would communicate the importance of the practice to your colleagues. Describe how you would move from disseminating the information to implementing the evidence-based practice within your organization. How would you address concerns and opposition to the change in practice?


By Day 7 of Week 10


This part of the Course Project is due. It should be combined with the other two components of the Course Project and turned in as your Portfolio Assignment for this course.


Note: In addition, include a 1-page summary of your project.


For this final iteration, you will need to:


  • Submit your paper to Grammarly and SafeAssign through the Walden Writing Center. Based on the Grammarly and SafeAssign reports, revise your paper as necessary.
  • Reminder: The School of Nursing requires that all papers submitted include a title page, introduction, summary, and references. The School of Nursing Sample Paper provided at the Walden Writing Center provides an example of those required elements (available from the Walden University website found in this week’s Learning Resources). All papers submitted must use this formatting.

Biology Lab Experiment Report

  • 10 pages report about this experiment 



Does protein level affect the metabolic rate of zebrafish?


dietary ingredients, nutrients as well as anti-nutritional factors are important factors that affect its growth and development.  However, there is lack of proper nutritional control due to absence of standardized reference diet (Boyle 5354).  Moreover, many epidemiological studies indicate that several prenatal and peri-natal dies are important in the growth and development of Zebra fish (Danio rerio) (Siccardi et al 23).   In order to provide standardized dietary framework, there is need for the provision of specific dietary and nutritional standard to improve the growth and development of Zebra fish (Danio rerio).  Thus, the need for investigating the growth and metabolic rate of Zebra fish (Danio rerio) when fed with different commercial diets.


How can protein affect the metabolic rate?

Does the oxygen level in the water indicate the metabolic rate?




Zebra fish (Danio rerio) is a small shoaling fish and it belongs to the minnow family of Cyprinadae and order cypriniformes. Due to its unique characteristics, the Zebra fish (Danio rerio) is mostly used as a vertebrae model organism in scientific research. It has regenerative qualities and has been modified by various researchers to produce several transgenic strains. It has been used in various medical research studies and findings including those dealing with the prevention of cancer, cardio-vascular conditions as well as investigation of the immune systems and other drug discovery systems

Furthermore, due to their omnivores qualities, they are have been used in environmental monitoring activities in order to prevent water pollution by estrogen (Howard 1173).   Based on previous literatures and research studies investigating their growth and metabolic rate, it is evident that the Zebra fish (Danio rerio) are imperative in studying the development, genetics as well as the human disease conditions (Williams et al 153).



HYPOTHESES: Protein will increase the metabolic rate.

GOALS: To test the metabolic rate after using 6 different protein level in commercial diet by measuring the oxygen level



I will use 6 commercial diet with different level of protein and the same level of fat and fibers

Group 1

Name protein Fat Fiber
Nutrafin Max Flake Food 44% 5% 2%
Tetra Pond Koi Vibrance 31% 5% 2%


Group 2


Name Protein Fat Fiber
TetraMin Tropical Flakes 38% 6% 6%
HBH Algae Grazers 28% 6% 6%



Name Protein Fat Fiber
New Life Spectrum Premium 48% 5% 4%
Dainichi Veggie Deluxe 28% 5% 4%


I will use 3 tanks each tank have 2 male Zebra Fish. (Find the different between male and female metabolic rate) (Why did I choose male??)






I will measure the oxygen level by using

Salifert Oxygen Test Kit  

Quick and accurate test for dissolved oxygen content. Proper oxygen concentration is vital for aquarium inhabitants and the overall health of the aquarium environment. The Salifert Oxygen Profi Test allows extremely fast, professional measurement of dissolved oxygen. Maintaining proper oxygen levels is especially important in marine aquariums because of the low solubility of oxygen in saltwater. The Salifert Oxygen Test Kit is a “must-have” test kit for hobbyists with sophisticated aquarium devices such as calcium reactors, CO2 systems, or ozonizers, where regular monitoring of oxygen level is crucial. 50 tests. Use for freshwater or marine aquariums.


This is mainly because when the oxygen level decrease that means Fish are using more oxygen to increase their metabolic rate. Previous research studies and findings also indicate that some of the methods used in measuring the metabolic rate of animals include the double labeled water (DLW) and heart rate methods (HRM). The best method is the DLW since it is cheaper and provides best procedures to determine the standard errors in estimating oxygen consumption. However, the heart rate method is more accurate and provides reliable calibrations. In measuring the rate of metabolic rate of Zebra fish (Danio rerio) various commercial diets



A light:dark photoperiod of 12:12 h was provided by indirect fluorescent lighting. Temperature was monitored daily using a thermometer (Fisher Scientific, Pittsburgh, PA). Ammonia-nitrogen, NO2-N, and pH were monitored weekly using an aquarium pharmaceuticals test kit (Aquarium Pharmaceuticals, Chalfon, PA). Each tank contained one cylindrical plastic mesh cage (0.25 m height by 0.09 m diameter) covered with nylon mesh (Fashion Knee Hi; American Corporation, Henderson, NC). Temperature was maintained at 28°C (±0.5°C), pH ranged between 8.0 and 8.4, and ammonia-nitrogen and NO2-N remained below visual detection limits.

Identify the theoretical orientation you have selected to use.

The problem-solving model was first laid out by Helen Perlman. Her seminal 1957 book, Social Casework: A Problem-Solving Process, described the problem-solving model and the 4Ps. Since then, other scholars and practitioners have expanded the problem-solving model and problem-solving therapy. At the heart of problem-solving model and problem-solving therapy is helping clients identify the problem and the goal, generating options, evaluating the options, and then implementing the plan.

Because models are blueprints and are not necessarily theories, it is common to use a model and then identify a theory to drive the conceptualization of the client’s problem, assessment, and interventions. Take, for example, the article by Westefeld and Heckman-Stone (2003). Note how the authors use a problem-solving model as the blueprint in identifying the steps when working with clients who have experienced sexual assault. On top of the problem-solving model, the authors employed crisis theory, as this theory applies to the trauma of going through sexual assault. Observe how, starting on page 229, the authors incorporated crisis theory to their problem-solving model.

In this Final Case Assignment, using the same case study that you chose in Week 2, you will use the problem-solving model AND a theory from the host of different theoretical orientations you have used for the case study.

You will prepare a PowerPoint presentation consisting of 11 to 12 slides.

To prepare:

  • Review and focus on the case study that you chose in      Week 2. (Jake Levy Case Study)
  • Review the problem-solving model, focusing on the five      steps of the problem-solving model formulated by D’Zurilla on page 388 in      the textbook.
  • In addition, review this article listed in the Learning      Resources: Westefeld, J. S., & Heckman-Stone, C. (2003). The      integrated problem-solving model of crisis intervention: Overview and      application. The Counseling Psychologist, 31(2), 221–239.

presenting your PowerPoint presentation that addresses the following:

  • Identify the theoretical orientation you have selected      to use.
  • Describe how you would assess the problem orientation      of the client in your selected case study (i.e., how the client perceives      the problem). Remember to keep the theoretical orientation in mind      in this assessment stage.
  • Discuss the problem definition and formulation based on      the theoretical orientation you have selected.
  • Identify and describe two solutions from all the      solutions possible. Remember, some of these solutions should stem from the      theoretical orientation you are utilizing.
  • Describe how you would implement the solution. Remember      to keep the theoretical orientation in mind.
  • Describe the extent to which the client is able to      mobilize the solutions for change.
  • Discuss how you would evaluate whether the outcome is      achieved or not. Remember to keep the theoretical orientation in      mind.
  • Evaluate how well the problem-solving model can be used      for short-term treatment of this client.
  • Evaluate one merit and one limitation of using the      problem-solving model for this case.

Your 11- to 12-slide PowerPoint presentation should follow these guidelines:

  • Each slide should be written using bullet points,      meaning no long paragraphs of written text should be in the slides.
  • Include a brief narration of less than 30 seconds for      each slide (i.e., the narration takes the place of any written paragraphs,      while the bullet points provide context and cues for the audience to      follow along).

Be sure to:

  • Identify and correctly reference the case study you      have chosen.
  • Use literature to support your claims.
  • Use APA formatting and style.
  • Include the reference list on the last slide.


As you have learned in Modules 1 and 2, prokaryotes share many common features that differentiate them from eukaryotes, such as:

Lack of nuclear membrane, unicellularity, division by binary-fission and generally small size.

As introduced on the Home page of Module 3, various species differ and can be classified into taxonomic groups based on several characteristics. One characteristic commonly used to differentiate an organism as belonging to one species or another is the potential for the individuals to reproduce sexually and produce viable offspring. However, this characteristic cannot be applied to prokaryotes, and so their identification and classification is often determined based on:

  • Phylogeny: All bacteria stem from a common ancestor and diversified since, consequently possess different levels of evolutionary relatedness
  • Metabolism: Different bacteria may have different metabolic abilities
  • Environment: Different bacteria thrive in different environments, such as high/low temperature and salt
  • Morphology: There are many structural differences between bacteria, such as cell shape, Gram stain (number of lipid bilayers) or bilayer composition
  • Pathogenicity: Some bacteria are pathogenic to plants or animals

All microbial metabolisms can be arranged according to three principles:

1. How the organism obtains carbon for synthesizing cell mass:

  • autotrophic – carbon is obtained from carbon dioxide (CO2)
  • heterotrophic – carbon is obtained from organic compounds
  • mixotrophic – carbon is obtained from both organic compounds and by fixing carbon dioxide

2. How the organism obtains reducing equivalents used either in energy conservation or in biosynthetic reactions:

  • lithotrophic– reducing equivalents are obtained from inorganic compounds
  • organotrophic – reducing equivalents are obtained from organic compounds

3. How the organism obtains energy for living and growing:

  • chemotrophic – energy is obtained from external chemical compounds
  • phototrophic – energy is obtained from light

In practice, these terms are almost freely combined. Typical examples are as follows:

  • chemolithoautotrophs obtain energy from the oxidation of inorganic compounds and carbon from the fixation of carbon dioxide. ie: Nitrifying bacteria
  • photolithoautotrophs obtain energy from light and carbon from the fixation of carbon dioxide, using reducing equivalents from inorganic compounds.

For example: Cyanobacteria are photosynthetic autotrophs. Cyanobacteria split water, H2O, molecules and use the electrons to reduce carbon in photosynthesis. Water is the electron donor.  However, Chlorobiaceae and Chromatiaceae are also photosynthetic autotrophs, but they use hydrogen sulfide H2S as the electron donor, or reducing equivalent donor.

  • chemolithoheterotrophs obtain energy from the oxidation of inorganic compounds, but cannot fix carbon dioxide (CO2).
  • chemoorganoheterotrophs obtain energy, carbon, and reducing equivalents for biosynthetic reactions by breaking apart organic compounds (made by photoautotrophs). Examples: most bacteria, e. g. Escherichia coli, Bacillus spp., Actinobacteria
  • photoorganoheterotrophs obtain energy from light, carbon and reducing equivalents for biosynthetic reactions from organic compounds. Some species are strictly heterotrophic, many others can also fix carbon dioxide and are mixotrophic. Examples: RhodobacterRhodopseudomonasRhodospirillumRhodomicrobiumRhodocyclusHeliobacteriumChloroflexus (alternatively to photolithoautotrophy with hydrogen)

For this SLP assignment, you will continue to analyze the paper by Urakawa et al. (2012) by considering the characteristics that allow us to classify the prokaryotic organisms in this study as belonging to different Domains. You will use the website:

UC Berkeley’s virtual exhibit hall and resource on taxonomy and phylogeny, to complete this assignment.

SLP Assignment

Review your definitions of Archaea and ammonia-oxidizing bacteria from Module 1. Begin at, webpage titled “Welcome to the Phylogeny Wing. Select the link “Phylogeny of Life” within the first of the “four ways to get started.” You will an overview of the relationship between DNA and the Three Domains of Life. Use this page to begin the research necessary to address these topics in a 3-4 page paper:

  1. What general characteristics determine whether a prokaryote belongs to the Archaea or Bacteria domain?
  2. Define DNA and RNA. What role do DNA and RNA play in this determination?
  3. What role does the metabolism play in classifying Nitrosococcus oceani and Nitrosopumilus maritimus as Archaea or Bacteria?
  4. Do either of these organisms normally thrive in an environment where crude oil is abundant?  What other microbes live in this type of environment?

SLP Assignment Expectations

The Session Long Project consists of an integrative project emphasizing the personalized application of each module’s concepts. For Modules 1–5, students are required to engage in an original integrative project reflecting their comprehensive knowledge of and ability to apply the course materials. Each component of the SLP will be graded on a modular basis.

Your essay is considered a scholarly work. You will be provided with many scholarly references to begin each assignment.  For any additional research you are required to do to complete your assignment, please use scholarly references such as a peer reviewed journal article or a government sponsored or university sponsored website. As you read through your sources, take notes from your sources and then write your paper in your own words, describing what you have learned from your research. Direct quotes should be limited and must be designated by quotation marks. Paraphrased ideas must give credit to the original author, for example (Murray, 2014). Direct copying from “homework help” websites will not receive credit.

When you write your essay, please organize your paper to include an introduction (overview of the assignment), body with subtitles (reflecting the requirements of the assignment), and a summary (develop connections between the required topics).