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For Week 2 you will examine how patient factors may influence pharmacokinetic and pharmacodynamic processes of pharmacotherapeutics used in the treatment of cardiovascular disorders

For Week 2 you will examine how patient factors may influence pharmacokinetic and pharmacodynamic processes of pharmacotherapeutics used in the treatment of cardiovascular disorders For Week 2 you will examine how patient factors may influence pharmacokinetic and pharmacodynamic processes of pharmacotherapeutics used in the treatment of cardiovascular disorders.  You also explore ways to improve drug therapy plans for cardiovascular disorders based on patient factors and overall health needs. When writing your Week 2 Assignment, consider the following scenario: Patient AO has a history of obesity and has recently gained 9 pounds. The patient has been diagnosed with hypertension and hyperlipidemia. Drugs currently prescribed include the following: Atenolol 12.5 mg daily Doxazosin 8 mg daily Hydralazine 10 mg qid Sertraline 25 mg daily Simvastatin 80 mg daily Week 2: Cardiovascular System Alterations of the cardiovascular system can cause serious adverse events and may lead to death when not treated in a timely and safe manner. Unfortunately, many patients with cardiovascular disorders are unaware until complications appear. In clinical settings, patients often present with symptoms of several cardiovascular disorders, making it essential for you, as the advanced practice nurse, to be able to recognize these symptoms and recommend appropriate drug treatment options. This week, you examine the impact of patient factors that may lead to changes in pharmacokinetic and pharmacodynamic processes on patient drug therapy for cardiovascular disorders. You also explore ways to improve drug therapy plans for cardiovascular disorders based on patient factors and overall health needs. Learning Objectives Students will: Analyze the influence of patient factors on pharmacokinetic and pharmacodynamic processes Analyze the impact of changes in pharmacokinetic and pharmacodynamic processes on patient drug therapies Evaluate drug therapy plans for cardiovascular disorders Assignment: Pharmacotherapy for Cardiovascular Disorders …heart disease remains the No. 1 killer in America; nearly half of all Americans have high blood pressure, high cholesterol, or smoke—some of the leading risk factors for heart disease… —Murphy et al., 2018 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. 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 https://www.cdc.gov/nchs/products/databriefs/db328.htm 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. Pharmacotherapy for Cardiovascular Disorders – Sample Answer Cardiovascular disorders are among the chronic conditions that profoundly threaten human life. One of the most common cardiovascular conditions is hypertension. According to Arcangelo et al. (2017), about 70 million US citizens have hypertension. Other cardiovascular diseases affect more than 20% of the American population. The report shows that heart-related diseases are a threat to human life. The pharmacotherapy knowledge of cardiovascular conditions profoundly affects treatment therapies. Thus, nurses should have proper knowledge about factors affecting the pharmacokinetic and pharmacodynamic processes in their respective patients before prescribing the medication (Fongemie & Felix-Getzik, 2015). Therefore, this paper discusses the pharmacotherapy of cardiovascular diseases by looking at factors that influence pharmacodynamics and pharmacokinetic process, describe how the transformation might affect the drug therapy, and give an explanation on how the treatment can be improved. How Gender Might Influence Pharmacokinetic and Pharmacodynamic Processes Gender can determine how patients respond to various cardiovascular drugs. According to Rosenthal and Burchum (2018), medicine can be more reactive in women compared to men and vice versa. The following are examples of how gender determines drug response between men and women. Digoxin does not affect men in any way in terms of mortality. However, when women take the same dosage of the medication, their mortality rate may increase (Luepke et al., 2017). Another example is derived from the assigned case. When men take Atenolol 12.5 mg daily, they are likely to experience erectile dysfunction signs (Rosenthal & Burchum, 2018). In other words, they may have problems having sexual intercourse. However, women’s sexual function is not affected by the drug. Also, Hydralazine can cause erectile dysfunction in men. However, the medicine does not cause any sexual problems in women. Lastly, women react more to opioids compared to men, and thus they can be relieved from pain by fewer painkillers compared to men. Metabolism of drugs is also different in women and men Fongemie and Felix-Getzik (2015) report that enzyme expression is lower in men and higher in men. Impact of Changes in Process on The Patient’s Recommended Drug Therapy Gender can play a huge role in a patient’s recommended medication. For instance, when prescribing drugs that are metabolized by CYP2B6 enzyme, the nurse should increase the dosage in women and decrease dosage in men (Fongemie & Felix-Getzik, 2015). In this case,

Identify a quality improvement opportunity in your organization or practice. In a 1,250-1,500 word paper, describe the problem or issue and propose a quality improvement initiative based on evidence-based practice

Identify a quality improvement opportunity in your organization or practice. In a 1,250-1,500 word paper, describe the problem Assignment Identify a quality improvement opportunity in your organization or practice. In a 1,250-1,500 word paper, describe the problem or issue and propose a quality improvement initiative based on evidence-based practice. Apply “The Road to Evidence-Based Practice” process, illustrated in Chapter 4 of your textbook, to create your proposal. Include the following: Provide an overview of the problem and the setting in which the problem or issue occurs. Explain why a quality improvement initiative is needed in this area and the expected outcome. Discuss how the results of previous research demonstrate support for the quality improvement initiative and its projected outcomes. Include a minimum of three peer-reviewed sources published within the last 5 years, not included in the course materials or textbook, that establish evidence in support of the quality improvement proposed. Discuss steps necessary to implement the quality improvement initiative. Provide evidence and rationale to support your answer. Explain how the quality improvement initiative will be evaluated to determine whether there was improvement. Support your explanation by identifying the variables, hypothesis test, and statistical test that you would need to prove that the quality improvement initiative succeeded. While APA style is not required for the body of this assignment, solid academic writing is expected, and documentation of sources should be presented using APA formatting guidelines, which can be found in the APA Style Guide, located in the Student Success Center. This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion. You are required to submit this assignment to LopesWrite. Refer to the LopesWrite Technical Support articles for assistance. Quality Improvement Proposal – Sample Answer In 2016, Johns Hopkins (2017) released the findings of a study in which it found that medical errors claim the lives of more than 250,000 Americans yearly. Compared to other leading causes of mortality in the U.S., medical errors come second, just before the respiratory illnesses. The Institute of Medicine (IOM) recognizes these errors as a threat to the healthcare system, and this is why some of its recommendations emphasize on building hospitals’ capacity to prevent and address these errors. From a clinical point of view, medical errors encompass various forms of mistakes that clinicians and patients commit, either knowingly or unknowingly. Some examples include misdiagnosis, administering wrong medications, and transfusing blood to the wrong patient. Errors due to the administration of medication affect a significant number of American patients. To minimize the incidences of these mistakes including their impact, hospitals require Quality Improvement (QI) programs. It is important to present a proposal for such a program, emphasizing its importance, and implementation and evaluation processes. An Overview of the Problem Including the Setting In Which It Occurs The problem occurs in outpatient setting, and it involves the lack of precaution and health literacy, and absence of adequate clinician-patient communication, leading to wrong medication and missing doses. This issue is prevalent in the selected setting primarily because of the illegible handwriting during the doctor’s prescription, causing pharmacists to misread the prescription. Additionally, the absence of support staff and high workload are contributing to cases of medical errors. The responsibilities that come with handling multiple patient cases at once can be overwhelming, resulting to burnout. According to Kwon et al. (2021), physicians who experience burnout are more likely to commit medical errors, compared to those experiencing burnout. Lack of patient counseling is also a contributory factor for the quality issue because lack of patient’s awareness regarding the importance of adherence, tends to cause poor adherence. Furthermore, this problem is occurring in outpatient due to the use of some drugs with similar names. The Reason Why a Quality Improvement Initiative Is Required In the Setting Including Expected Outcome Cases of medication administration errors have various implications for patients and for clinicians, and if not addressed, they can have serious impact on the wellbeing of patients, and dent the image of practitioners. These errors put patients at risk of injuries or even death because prescribing certain medications to some patients can cause them to develop kidney complications. If a patient is suffering from a chronic kidney disorder, for instance, administering nephrotoxic medication may cause the condition to worsen. If one mistakenly uses atenolol to treat COPD, still, the patient may experience adverse complications because beta-blockers are known to worsen the condition. Recently, the Medicare program has been penalizing providers for failing to meet the required quality standards. Therefore, there is need to ensure the providers deliver the required quality in the selected setting. Thus, the implementation of the QI will lead to decline in cases of patient injuries and deaths due to medication administration errors, by more than 50%. How the Results of Previous Research Demonstrate Support for the Quality Improvement Initiative and Outcomes Some of the available evidence lends support to the proposed QI including the projected outcomes. According to the cross-sectional study carried out by Wondmieneh et al. (2020), for instance, the absence of guidelines for guiding the administration of the medication, and inadequate training of the clinical staff were responsible of incidences of medication errors. For their part, Petejova and colleagues (2019) investigate the effect of nephrotoxic, and from their analysis, it is evident that that the drug can cause renal failure. Current evidence also supports the relationship between counseling and adherence. Taibanguay et al. (2019), using a randomized-controlled trial to examine this relationship, found that educating patients had a significant chance of improving adherence. Since lack of adherence is one of the main factors that lead to medication errors, the findings by Taibanguay et al. (2019) support the projected outcomes. Steps Necessary to implement the Quality Improvement Initiative (Include Rationale and Evidence) The Road to Evidence-Based Practice process provides the framework that can help guide the implementation of the QI initiative. The first step will involve carrying out an assessment to determine the

What happens to the nurse when role stress or strain becomes too overwhelming? What happens to patient care? How is this related to possible ethic and legal issues?

What happens to the nurse when role stress or strain becomes too overwhelming? Assignment: Role Strain and Burnout in Nursing Write a 1000-1500 word essay addressing each of the following points/questions. Be sure to completely answer all the questions for each bullet point. There should be three main sections, one for each bullet below. Separate each section in your paper with a clear heading that allows your professor to know which bullet you are addressing in that section of your paper. Support your ideas with at least three (3) sources using citations in your essay. Make sure to cite using the APA writing style for the essay. The cover page and reference page in correct APA do not count towards the minimum word amount. Review the rubric criteria for this assignment. What happens to the nurse when role stress or strain becomes too overwhelming? What happens to patient care? How is this related to possible ethic and legal issues? Discuss how nurses can manage or reduce role stress and role strain. Explain two issues that lead to nurse burnout and discuss a solution for each issue. Think of an experience in your nursing profession where you either felt strain or burnout and how you overcame this event. (Since this is personal experience, you can use first person narration for this portion of your essay.) Assignment Expectations: Length: 1000-1500 words; answers must thoroughly address the questions in a clear, concise manner. Structure: Include a title page and reference page in APA format. These do not count towards the minimum word count for this assignment. Your essay must include an introduction and a conclusion. References: Use appropriate APA style in-text citations and references for all resources utilized to answer the questions. A minimum of three (3) scholarly sources are required. Rubric: This assignment uses a rubric for scoring. Please review it as part of your assignment preparation and again prior to submission to ensure you have addressed its criteria at the highest level. Format: Save your assignment as a Microsoft Word document (.doc or .docx) or a PDF document (.pdf) File name: Name your saved file according to your first initial, last name, and the assignment number (for example, “RHall Assignment 1.docx”) Read American Association of Colleges of Nursing (AACN). (2018). Nursing faculty shortage. American Association of Colleges of Nursing (AACN). (2018). About the nursing shortage. Carte, N. S., & Williams, C. (2017). Role strain among male RNs in the critical care setting: Perceptions of an unfriendly workplace. Intensive & Critical Care Nursing, 43, 81-86. Iel Marciano de, M. F., & de Almeida, R. J. (2016). Occupational stress at work in nursing in brazil: An integrative review. Revista Brasileira Em Promocao Da Saude, 29(3), 447-454. Johnston, D. W., Jones, M. C., Charles, K., Mccann, S. K., & Mckee, L. (2013). Stress in nurses: Stress-related affect and its determinants examined over the nursing day. Annals of Behavioral Medicine, 45(3), 348-56. Role Strain and Burnout in Nursing – Sample Expert Answer Nurse burnout is the physical, emotional, and mental exhaustion that is caused by some occupational elements of the nurse. When a parent is working, they have to combine the role of family and work, and since each of these have associated problems, they often result to burnout. It is common for individuals to get stressed at work, but when it happens subsequently for long periods of time and they tend to get used to it, there is emotional exhaustion (Fida, Laschinger, & Leiter, 2018). The work program of most nurses and nurse students is intense and often has elements of burnouts. However, there are several solutions to this burnout, and these solutions are aimed at reducing the amount of work-related stress for consistent periods of time. Whereas it is common to assume that nurse burnout is one of the defining characteristics of the nursing profession, application of some of the solutions to the problem can help in resolving most of the burnout cases and preventing others from occurring. Effects of Overwhelming Role Stress Effects on Patient Care Nurse burnout has numerous adverse effects on patient care. One of the direct effects of nurse burnout is that providers have to cut off the hours they spend on practice, or enter early retirement. Given the fact that there is still a shortage of nurses, it is evident that a further reduction of practice hours or introduction of early retirement for nurses has the first direct effect as lowering the nurse patient ratio (White et al., 2019). Despite this fact, most therapists give the first recommendation to patients who experience burnout as taking nonclinical jobs. Leaving the clinical workforce not only leads to the strain of nurses, and yet the same energy is not used in recruiting new nurses. Relation to possible Ethic and Legal Issues One of the leading causes of mental and emotional burnout is when providers are overwhelmed with ethical decisions that affect patients. Moral distress situations often make the nurses feel that they are not able to perform work according to the professional values and practice. Breakdowns of communication and introduction of organizational structures and hierarchies is one of the ways of solving some of these ethical issues. However, it should be understood that a change in institutional policies, which were designed using evidence-based practice could only lead to worse outcomes on ethics (Woodhead, Northrop, & Edelstein, 2016). For example, when nurses are allowed to withhold patient care in a facility until their assistant returns to work from a venture that is not work-related, it is only likely that an even larger ethical issue could emerge from the situation. How Nurses can Reduce Role Stress and Role Strain The only sure way of reducing role stress and role strain among nurses is assessing the root cause of the problem and addressing it permanently. In most of the cases, however, nurse leaders have superficial solutions to the problem, such as giving the affected nurse a one week break from work. This means that when the nurse comes back and faces the same

Due to a fall from a second story townhouse, Jimmy sustained a fractured left femur and a mild head injury. Jimmy is 10 years old. He was reaching for a ball that had gotten lodged into the gutter over the small balcony of his parent’s bedroom

Due to a fall from a second story townhouse, Jimmy sustained a fractured left femur and a mild head injury. Jimmy is 10 years old. He was reaching for a ball that had Due to a fall from a second story townhouse, Jimmy sustained a fractured left femur and a mild head injury Due to a fall from a second story townhouse, Jimmy sustained a fractured left femur and a mild head injury. Jimmy is 10 years old. He was reaching for a ball that had gotten lodged into the gutter over the small balcony of his parent’s bedroom. Due to a fall from a second story townhouse, Jimmy sustained a fractured left femur and a mild head injury. Jimmy is 10 years old. He was reaching for a ball that had gotten lodged into the gutter over the small balcony of his parent’s bedroom. He thought if he stood on the railing and reached with the badminton racket he could get it. Currently he is 2 days postoperative from repair of the left femur. He is being transferred out of the pediatric ICU where the Neurologist has stated he is stable but needs continued neuro checks q2 hours. He has a full left leg cast. The Foley catheter is to be replaced today, or he can attempt to roll onto a bedpan if needed. Please list the systems that are affected by this boy’s injuries. List the nursing interventions now that he is on your nursing unit. Start a list of nursing diagnosis match the system you are presenting. Systems Affected By The Boy’s Injuries – Sample Answer Due to a fall from a second-story townhouse, Jimmy experienced a series of injuries, and currently, three systems are affected. One of the systems is the nervous system affected by mild head injuries sustained after the fall. The nurse needs to look out for complications involving this system, such as concussion and pain. Another system is the skeletal system which was affected due to the fracture of the left femur. Nurses should look out for the risk of falling, especially if the patient can get up independently.  The third system is the urinary tract system which is affected due to the insertion of the catheter. Nurses should look out for hospital-acquired infections that might occur if proper hygiene is not observed. Nursing Intervention And Diagnosis For Each System Nervous System Mild Head Injuries After the neurologist observed Jimmy, he was considered to be stable but should still be under observation. Some of the symptoms to look out for the mild head injuries include changes in behavior, restlessness, headache, nausea, vomiting, pupillary changes, and seizures (Oyesanya et al. 2018). If some of the symptoms are observed, there should be an MRI to understand further brain tissue changes and an electroencephalogram to detect any seizure activity. The care plan should be non-surgical, mainly focusing on drug therapy. Skeletal System The nurse diagnosis is the risk of fall caused by the left femur fracture. Some of the risk factors include loss of muscle integrity, weakness, and the ability of the patient to get up without assistance. The primary care plan includes maintaining limb rest as indicated and ensuring sufficient support of joints, significantly above and below the fracture site (Hommel et al. 2012). Moreover, a catheter will be placed to reduce the need for movement. Urinary System There is a risk of hospital-acquired urinary tract infection as the patient already has a catheter and is being replaced (Saint et al. 2016). It is vital to maintain high levels of hygiene to prevent any urinary tract infection. References Hommel, A., Kock, M. L., Persson, J., & Werntoft, E. (2012). The Patient’s view of nursing care after hip fracture. International Scholarly Research Notices, 2012. Oyesanya, T. O., Bowers, B. J., Royer, H. R., & Turkstra, L. S. (2018). Nurses’ concerns about caring for patients with acute and chronic traumatic brain injury. Journal of clinical nursing, 27(7-8), 1408-1419. Saint, S., Greene, M. T., Krein, S. L., Rogers, M. A., Ratz, D., Fowler, K. E., … & Fakih, M. G. (2016). A program to prevent catheter-associated urinary tract infection in acute care. New England Journal of Medicine, 374(22), 2111-2119. Place your order now for a similar assignment and get fast, cheap and best quality work written by our expert level  assignment writers.

Katie is an 8 year old Caucasian female who is brought to your office today by her mother & father. They report that they were referred to you by their primary care provider after seeking her advice because Katie’s teacher suggested that she may have ADHD.

Katie is an 8 year old Caucasian female who is brought to your office today by her mother Not only do children and adults have different presentations for ADHD, but males and females may also have vastly different clinical presentations. Different people may also respond to medication therapies differently. For example, some ADHD medications may cause children to experience stomach pain, while others can be highly addictive for adults. In your role, as a psychiatric nurse practitioner, you must perform careful assessments and weigh the risks and benefits of medication therapies for patients across the life span. For this Assignment, you consider how you might assess and treat patients presenting with ADHD. To prepare for this Assignment: Review this week’s Learning Resources, including the Medication Resources indicated for this week. Reflect on the psychopharmacologic treatments you might recommend for the assessment and treatment of patients with ADHD. Examine Case Study A Young Caucasian Girl with ADHD. You will be asked to make three decisions concerning the medication to prescribe to this patient. Be sure to consider factors that might impact the patient’s pharmacokinetic and pharmacodynamic processes. CASE STUDY BACKGROUND Katie is an 8 year old Caucasian female who is brought to your office today by her mother & father. They report that they were referred to you by their primary care provider after seeking her advice because Katie’s teacher suggested that she may have ADHD. Katie’s parents reported that their PCP felt that she should be evaluated by psychiatry to determine whether or not she has this condition. The parents give you a copy of a form titled “Conner’s Teacher Rating Scale-Revised”. This scale was filled out by Katie’s teacher and sent home to the parents so that they could share it with their family primary care provider. According to the scoring provided by her teacher, Katie is inattentive, easily distracted, forgets things she already learned, is poor in spelling, reading, and arithmetic. Her attention span is short, and she is noted to only pay attention to things she is interested in. The teacher opined that she lacks interest in school work and is easily distracted. Katie is also noted to start things but never finish them, and seldom follows through on instructions and fails to finish her school work. Katie’s parents actively deny that Katie has ADHD. “She would be running around like a wild person if she had ADHD” reports her mother. “She is never defiant or has temper outburst” adds her father. SUBJECTIVE Katie reports that she doesn’t know what the “big deal” is. She states that school is “OK”- her favorite subjects are “art” and “recess.” She states that she finds her other subjects boring, and sometimes hard because she feels “lost”. She admits that her mind does wander during class to things that she thinks of as more fun. “Sometimes” Katie reports “I will just be thinking about nothing and the teacher will call my name and I don’t know what they were talking about.” Katie reports that her home life is just fine. She reports that she loves her parents and that they are very good and kind to her. Denies any abuse, denies bullying at school. Offers no other concerns at this time. MENTAL STATUS EXAM The client is an 8 year old Caucasian female who appears appropriately developed for her age. Her speech is clear, coherent, and logical. She is appropriately oriented to person, place, time, and event. She is dressed appropriately for the weather and time of year. She demonstrates no noteworthy mannerisms, gestures, or tics. Self-reported mood is euthymic. Affect is bright. Katie denies visual or auditory hallucinations, no delusional or paranoid thought processes readily appreciated. Attention and concentration are grossly intact based on Katie’s attending to the clinical interview and her ability to count backwards from 100 by serial 2’s and 5’s. Insight and judgment appear age appropriate. Katie denies any suicidal or homicidal ideation. Diagnosis: Attention deficit hyperactivity disorder, predominantly inattentive presentation RESOURCES § Conners, C. K., Sitarenios, G., Parker, J. D. A., & Epstein, J. N. (1998). Revision and restandardization of the Conners’ Teacher Rating Scale (CTRS-R): Factors, structure, reliability, and criterion validity. Journal of Abnormal Child Psychology, 26, 279-291. At each decision point, you should evaluate all options before selecting your decision and moving throughout the exercise. Before you make your decision, make sure that you have researched each option and that you evaluate the decision that you will select. Be sure to research each option using the primary literature. Introduction to the case (1 page) Briefly explain and summarize the case for this Assignment. Be sure to include the specific patient factors that may impact your decision making when prescribing medication for this patient. Decision #1 (1 page) Which decision did you select? Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature. Why did you not select the other two options provided in the exercise? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature. What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources (including the primary literature). Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples. Decision #2 (1 page) Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature. Why did you not select the other two options provided in the exercise? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature. What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources (including the primary literature). Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples. Decision #3 (1 page) Why did you select this decision? Be specific and support

Post a description of how you might evaluate a patient who presents with back pain. Then, describe potential red flags and warning signs of drug abuse. Explain the ethical implications of prescribing narcotics for chronic back pain.

Post a description of how you might evaluate a patient who presents with back pain. Then, describe potential red flags and warning signs of drug abuse. Explain the ethical implications of prescribing narcotics for chronic back pain. Discussion: Chronic Back Pain Patients frequently present with complaints of pain such as chronic back pain. They often seek medical care with the intent of receiving drugs to manage the pain. Typically, for this type of pain, narcotic drugs are often prescribed. This can pose challenges for you as the advanced practice nurse prescribing the drugs. While there is a process for evaluating back pain, it can be difficult to assess the intensity of a patient’s pain because pain is a subjective experience. Only the person experiencing the pain truly knows whether there is a need for drug treatments. This makes it important for you, as the prescriber, to watch for red flags and warning signs of abuse. In this Discussion, you explore the ethical implications of prescribing narcotics to patients with chronic back pain. To prepare: Review this week’s media presentation on evaluating back pain, as well as Chapter 15 of the Buttaro et al. text in the Learning Resources. Reflect on the evaluation process for a patient with a history of back pain. Consider how you might evaluate a patient that presents with back pain. Think about potential red flags and warning signs of drug abuse. Reflect on the ethical implications of prescribing narcotics for chronic back pain. Think about what you would prescribe and why. By Day 3 Post a description of how you might evaluate a patient who presents with back pain. Then, describe potential red flags and warning signs of drug abuse. Explain the ethical implications of prescribing narcotics for chronic back pain. Finally, explain what you would prescribe for patients and why. Chronic Back Pain – Sample Answer Evaluating a Patient with Chronic Back Pain An advanced practice nurse should evaluate patients who present with back pain accurately before prescribing them medications, such as narcotics. An APN can evaluate a patient with back pain using the following methods. Patel and Kinsella (2017) note that one of the methods of evaluating backpain is physical examination. The nurse should physically examine the patient to determine whether they suffer from back pain. From the physical exam, a nurse group the patient into the following four categories.The categories include low back pain that is non-specific, back pain related to spinal stenosis or radiculopathy, back pain from a non-spinal source, and back pain linked to another cause of the spinal problem. Patel and Kinsella (2017) also note that the condition can be evaluated using computed tomography (CT) and magnetic resonance imaging (MRI). Signs of Drug Abuse APNs are responsible for identifying the signs of drug abuse in prescribing patients with medications. According to Geise and Powers (2020), physical warning signs and red flags of drug abuse include red eyes, tremors, dilated pupils, impaired physical coordination, rapid speech, lethargy during the day, and slowed speech. The psychological warning signs of drug abuse the nurse should look at include anxiety, confusion, insomnia, depression, forgetfulness, excessive mood swings, illogical thinking, and memory loss. The APN should also analyze the patient’s behavior for warning signs of drug abuse. These signs include erratic behavior, defensiveness or anger about drug abuse-related topics, poor social interaction, legal issues, poor judgment personality changes, violence, use of sleeping r headache drugs, and financial issues (Geise & Power, 2020). The nurse can also collect observations from friends and family. For instance, if the family reports that the patient has chronic relationship challenges, then the nurse should treat this information as a warning sign of drug abuse. The Ethical Implications of Prescribing Narcotics The first ethical implication of prescribing narcotic drugs to patients with chronic back pain is beneficence. According to Smeltzer et al. (2017), an APN should prescribe the narcotic drugs to patients after a prover and careful evaluation of the drugs’ impact in the patients. In other words, this consideration ensures that APNs prescribe narcotic medications that are more beneficial to the patient. Another consideration is non-maleficence. This ethical consideration ensures that an APN considers other safe alternatives before deciding to prescribe narcotics as pain medication. Autonomy is another ethical consideration that has implications on the prescription of narcotic medication (2017). This consideration was designed to ensure that nurses allow patients to decide whether to take narcotics or not. In other words, the consideration forces the nurses to respect the wishes of their patients. Treatment of Back Pain I would not prescribe narcotics as drugs to relieve back pain because Coluzzi et al. (2019) note that medications with opioids, such as hydrocodone and oxycodone do not work well for severe and chronic pain. On that note, I can prescribe nonsteroidal anti-inflammatory drugs (NSAIDs). These over-the-counter medications can help relieve acute back pain. However, if the OTCs have no worked, I would prescribe Baclofen (Coluzzi et al., 2019). This drug is a muscle reluctant and can relieve pain by relaxing the muscles on the back. References Coluzzi, F., Polati, E., Freo, U., & Grilli, M. (2019). Tapentadol: an effective option for the treatment of back pain. Journal of pain research, 12, 1521. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6526923/ Geise, R., & Powers, M. F. (2020). Roles of Pharmacy Technicians in Preventing Prescription Drug Abuse. Journal of Pharmacy Technology, 8755122520939640. https://doi.org/10.1177%2F8755122520939640 Patel, D. R., & Kinsella, E. (2017). Evaluation and management of lower back pain in young athletes. Translational pediatrics, 6(3), 225. doi: 10.21037/tp.2017.06.01 Smeltzer, K. E., Desai, G. J., & Johnson, B. (2017). Ethical Considerations in Prescribing or Withholding Opioids for Chronic Pain. Osteopathic Family Physician, 9(3). https://doi.org/-639-1-10-20170503.pdf Place your order now for a similar assignment and get fast, cheap and best quality work written by our expert level  assignment writers.Use Coupon: NEW30 to Get 30% OFF Your First Order Nurses’ Role in Pain Assessment and Management As healthcare professionals, nurses play an essential role in assessing and managing patients’ pain. Pain is one of the most common symptoms

Create a 10-12-slide PowerPoint health promotion, with speaker notes, that outlines a teaching plan. For the presentation of your PowerPoint, use Loom to create a voice over or a video. Include an additional slide for the Loom link

Create a 10-12-slide PowerPoint health promotion, with speaker notes, that outlines a teaching plan. The growth, development, and learned behaviors that occur during the first year of infancy have a direct effect on the individual throughout a lifetime. For this assignment, research an environmental factor that poses a threat to the health or safety of infants and develop a health promotion that can be presented to parents and caregivers. Create a 10-12-slide PowerPoint health promotion, with speaker notes, that outlines a teaching plan. For the presentation of your PowerPoint, use Loom to create a voice over or a video. Include an additional slide for the Loom link at the beginning, and an additional slide for references at the end. In developing your PowerPoint, take into consideration the health care literacy level of your target audience, as well as the demographic of the caregiver/patient (socioeconomic level, language, culture, and any other relevant characteristic of the caregiver) for which the presentation is tailored. Include the following in your presentation: Describe the selected environmental factor. Explain how the environmental factor you selected can potentially affect the health or safety of infants. Create a health promotion plan that can be presented to parents and caregivers to address the environmental factor and improve the overall health and well-being of infants. Offer recommendations on accident prevention and safety promotion as they relate to the selected environmental factor and the health or safety of infants. Offer examples, interventions, and suggestions from evidence-based research. At least three scholarly sources are required. Two of the three sources must be peer-reviewed and no more than 5 years old. Provide readers with four resources:  two community resources, one national resource, and one web-based resource. Include a brief description and contact information for each resource. You are required to cite a minimum of three peer-reviewed sources to complete this assignment. Sources must be published within the last 5 years, appropriate for the assignment criteria, and relevant to nursing practice. Refer to the resource, “Creating Effective PowerPoint Presentations,” located in the Student Success Center, for additional guidance on completing this assignment in the appropriate style. Refer to the resource, “Loom,” located in the Student Success Center, for additional guidance on recording your presentation. While APA style is not required for the body of this assignment, solid academic writing is expected, and documentation of sources should be presented using APA formatting guidelines, which can be found in the APA Style Guide, located in the Student Success Center. This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion. You are required to submit this assignment to LopesWrite. A link to the LopesWrite technical support articles is located in Class Resources if you need assistance. Environmental Factors and Health Promotion Presentation: Accident Prevention and Safety Promotion for Parents and Caregivers of Infants Carbon monoxide poisoning is a condition that occurs when an individual breaths carbon monoxide for an extended period of time.  It is a condition that can be fatal in adults and even more likely to lead to fatality in infants (Fruchtman et al., 2020). Therefore, carbon monoxide poisoning is usually treated as an emergency as soon as it is diagnosed/identified. Carbon monoxide gas is colorless and odorless making it very difficult to detect and that is what makes it very lethal. Carbon monoxide poisoning occurs when the gas remain unvented outside a closed environment. Some of the potential sources of carbon monoxide gas within the home setting includes any appliances that uses coal, oil, gas, or wood, for example a cooking stove, an oven, clothes dryers to list a few (McKenzie et al., 2017). The breathing rate of infants is more than that of adults. This makes them to be more susceptible to carbon monoxide poisoning. Likewise, the negative impact of the condition is worse in infants that it is in adults, given the fragile nature of the body organs which are still developing (Fruchtman et al., 2020). Due to the buildup of carbon monoxide in the child body, vital organs like the brain and heart end up being deprived of the much needed oxygen, which ay end up leading to permanent damage and in severe cases even death. In some cases, the impacts are felt weeks later in targeted body systems like the neurological system leading to a condition known as the delayed neurologic syndrome (Sonmez et al., 2018). The health promotion plan will have seven major steps, the first being collection of data. The data on the prevalence and impact of carbon monoxide poisoning and how it occurs will assist in creating a suitable plan to counter the issue. The next step is setting goals and objectives. The health promotion goals need to be SMART. The third step of the plan is evaluation of best practices. The best practices need to be based on evidence-based data (Fisher et al., 2016).  After evaluation and listing of best practices, a review of the required resources is then performed to assess the viability of the different methods to implement in the health promotion. The fifth step is selection of the best intervention from a list of best practices, based on the availability of resources and ease of implementation. The sixth step is implementing the health promotion. For the Implementation  to be successful; it will be important to collaborate with other stakeholders. The final step is monitoring and evaluating the impact of the health promotion. One of the simplest ways to avoid carbon monoxide poisoning is by ensuring that the house is well ventilated. This will mean that the air circulation is optimum reducing the likelihood of CO poisoning. Another recommendation is to install a CO detector that sounds of an alarm in case the CO levels within the room is above the normal levels (McKenzie et al., 2017). However, it is important to ensure that the system is well maintained with batteries replaced every now and then.  It is also recommended that

Explore the National Institute of Nursing Research (NINR) website: http://www.ninr.nih.gov/ Review its publication Bringing science to life: NINR strategic plan (2011, p. 7) to identify the current priorities for nursing research

Explore the National Institute of Nursing Research (NINR) website: http://www.ninr.nih.gov/ Module 8 Assignment Each response to a task below should be 500-1000 words. All responses should be combined into a single document for submission. APA formatting required. Tasks: 1. Explore the National Institute of Nursing Research (NINR) website: http://www.ninr.nih.gov/ Review its publication Bringing science to life: NINR strategic plan (2011, p. 7) to identify the current priorities for nursing research. Do you agree with the priorities or would you recommend addition or elimination of some of the priorities? What effect do the nursing research priorities have on nursing researchers? 2. What criteria must be met in order to consider a practice, evidence-based? Provide examples. Explain the role quality plays in evidence-based practice. 3. Based on the information you learned to this point, write a research proposal that relates to the topics you chose for a previous assignment. Be sure to include the following information in your proposal: Hypothesis Theory Design model Method Anticipated results Potential Dissemination Avenues Current Nursing Research Priorities – Sample Answer Part One The evidence-based practice has become the normal standard in the nursing profession. However, the need for nursing researchers to analyze data, design researches, and report the outcome has become a significant activity. According to Hopia and Heikkilä (2020), nursing research should be made one of the visions for nursing professionals in a move to improve nursing practice and patient care. Thus, nursing professionals should enroll in advanced nursing research courses so that they can gain vital knowledge in nursing research practice. Nursing scholars bring a holistic concept to researching families, communities, and individuals. The nursing research priorities are vital because they reflect the nurses’ commitment to improving health services and the improvement of quality care and patient outcome. The National Institute of Nursing Research (NINR) argues that research is one of the ways to develop a technical foundation in nursing practice. The institution also reports that nursing research can be used to develop knowledge in preventive disability and disease, manage and eliminate signs of conditions, and improve patient care. The organization highlighted priorities nurses should meet in their research. I agree with the priorities based on the be below importance. The first priority is “enhancing health promotion and disease prevention.” This priority means that nurses should conduct studies that main to improving health promotion and decrease the prevalence of diseases. This priority is so vital to nursing practice in that it motivates nurses to work towards improving health by developing strategies and medical therapies to reduce reports about diseases. Through this priority, nurses can develop vaccines and create health promotion programs to improve their style. Currently, the work requires nurses’ expertise on how to prevent the spread of the Covic- 19 viruses. The nurses should conduct studies to determine how to reduce the spread of the disease and how to treat it. The second priority is “improving palliative and end-of-life care.” P eople who are about to die have the right to die in peace, surrounded by people who love him or her (Al-Yateem et al., 2019). Nurses can improve end-of-life care through research. Research can be done to develop an EBP care strategy that can be used to improve dying patients’ satisfaction. The researches can also help nurses overcome the ethical issues related to end-of-life care. The third priority is “enhancing innovation in science and practice.” Technology can be used to improve patients’ experiences in healthcare institutions. Nurses should also research on how technologies can be applied in nursing. Some of the working technologies include electronic health records (HER), smart beds, and websites. These technologies have helped nursing firms improve data management. Nursing research should also focus on “developing the next generation of nurse scientists.” Researches should be conducted on how the next generation of nurse scientists can be designed (Wolf, 2019). Lastly, nurses should focus on improving the quality of patients’ lives by researching ways on how to manage symptoms of chronic and acute health problems. The priorities can improve job satisfaction because they can be used to answer the majority of nursing issues. Management of nurse staff should also be added to the five priorities. Part 2 Evidence-based practice is a nursing practice that is based on well-structured nursing research. EBP has improved the healthcare system in that it has helped nurses use evidence-based treatments in providing care to patients. Also, nursing leaders have used perspectives to develop and apply strategies that aim at improving workers’ satisfaction in the nursing industry. EBP has helped nurses, and other healthcare professionals develop many treatments that have been used in improving population health (Woo et al., 2017). For instance, through EBP, nurses and other healthcare professionals have been able to get the treatment for Ebola. Also, vaccination against cervical cancer was developed based on EBPs. This part of the assignment discusses the characteristics of EBPs and also analyzes the role of quality on EBPs. Characteristics of EBP The first characteristic of EBP is that is must have been developed by clinical experts. When talking about clinical expertise, one should look at the individual’s experience, educational level, and clinical skills. According to Al-Yateem et al. (2019), clinicians with vast skills in clinical practice can provide better EBP treatments compared to people who have fewer skills because they know what to do at every level. The individual who has developed the practice should also have experience in the issue. For instance, when a clinician does research about management, he or she should have proper knowledge about management. The person’s educational level is also vital in EBP. The practice must be developed by a well-trained person. The second characteristic that EBP practice should meet patient expectations and values. In other words, the practice should be able to improve patient satisfaction. For instance, the medication should be able to treat and cure a patient’s illness so that it can be considered evidence-based. Also, a vaccine can be evidence-based when it prevents certain diseases from affecting the children. The last characteristic is that the practice should have been developed through a sound methodology. The methodology is the research strategies used to conduct a study; for a practice to characterized

Post a description of the focus of your scenario. Describe the data that could be used and how the data might be collected and accessed. What knowledge might be derived from that data?

Post a description of the focus of your scenario. Describe the data that could be used and how the data might be collected and accessed. In the modern era, there are few professions that do not to some extent rely on data. Stockbrokers rely on market data to advise clients on financial matters. Meteorologists rely on weather data to forecast weather conditions, while realtors rely on data to advise on the purchase and sale of property. In these and other cases, data not only helps solve problems, but adds to the practitioner’s and the discipline’s body of knowledge. Of course, the nursing profession also relies heavily on data. The field of nursing informatics aims to make sure nurses have access to the appropriate date to solve healthcare problems, make decisions in the interest of patients, and add to knowledge. In this Discussion, you will consider a scenario that would benefit from access to data and how such access could facilitate both problem-solving and knowledge formation. To Prepare: Reflect on the concepts of informatics and knowledge work as presented in the Resources. Consider a hypothetical scenario based on your own healthcare practice or organization that would require or benefit from the access/collection and application of data. Your scenario may involve a patient, staff, or management problem or gap. By Day 3 of Week 1 Post a description of the focus of your scenario. Describe the data that could be used and how the data might be collected and accessed. What knowledge might be derived from that data? How would a nurse leader use clinical reasoning and judgment in the formation of knowledge from this experience? The Application of Data to Problem-Solving – Sample Answer The Application of Data to Problem-Solving In today’s data-driven world, nursing has embraced informatics and knowledge work to improve patient outcomes, enhance workflow efficiency, and address systemic challenges in healthcare (Singh et al., 2023). The ability to access, collect, and analyze data is integral to identifying problems, implementing evidence-based interventions, and fostering innovation within nursing practice. This paper examines a hypothetical scenario in which data is used to address medication administration errors in a medical-surgical unit. Scenario: Reducing Medication Administration Errors Medication administration errors are a significant concern in healthcare, posing risks to patient safety and leading to adverse outcomes. In a hypothetical 21-bed medical-surgical unit with an average daily census of 18 patients, the unit has observed an increase in medication errors over three months. These errors range from incorrect dosages to missed medications, with patterns suggesting that certain shifts, staff members, or high-acuity patient loads may contribute to the problem. Addressing this issue requires a systematic, data-driven approach to identify root causes and implement effective solutions. Data Collection and Access The data for this scenario would include detailed medication error reports, staff documentation habits, patient acuity levels, and workflow patterns during medication administration. Data could be collected through incident reporting systems, electronic health records (EHRs), and real-time observational studies of staff during medication rounds (Awad et al., 2021). Access to such data would allow nurse leaders to identify patterns in errors, such as whether they occur more frequently during specific shifts, with particular medications, or under certain conditions like high patient acuity. Analyzing this data could highlight critical gaps, such as insufficient staff training on new medications or inefficient workflows that lead to errors. Knowledge Derived from Data The knowledge derived from this data would include evidence-based strategies to mitigate risks, such as redesigning workflows, introducing double-check systems, or leveraging barcode medication administration (BCMA) technology (Albeshri et al., 2024). For example, data might reveal that errors are more frequent during evening shifts due to reduced staffing, prompting the implementation of additional resources during high-risk hours. Patterns in error types, such as dosage miscalculations, could guide tailored educational initiatives for staff. This process not only enhances patient safety but also builds a culture of continuous improvement and accountability within the unit. Role of Nurse Leaders in Knowledge Formation Nurse leaders play a critical role in transforming raw data into actionable knowledge. Using clinical reasoning and judgment, they synthesize data with their expertise and understanding of the clinical environment to prioritize interventions. For example, a nurse leader may identify that errors during evening shifts are due to lower staffing levels and advocate for additional resources during those hours (Albeshri et al., 2024). They also evaluate the effectiveness of interventions by comparing pre- and post-intervention data, refining strategies as necessary to ensure sustained improvements. Implications for Problem-Solving and Knowledge Development The application of data to solve problems like medication administration errors demonstrates how informatics can bridge the gap between practice and knowledge. Nurse leaders can identify trends, implement evidence-based interventions, and evaluate outcomes. This iterative process contributes to the body of nursing knowledge, providing insights that can be shared across the organization or disseminated through professional networks to inform broader practice improvements (Albeshri et al., 2024). Conclusion The use of data in addressing medication administration errors highlights the essential role of nursing informatics and knowledge work in modern healthcare. By leveraging data from various sources, nurse leaders can identify root causes, implement targeted interventions, and create a culture of safety and accountability. Clinical reasoning and judgment are integral to transforming data into actionable knowledge, ensuring that interventions are evidence-based and aligned with organizational goals. References Albeshri, S. M., Alharbi, R. A., zakria Alhawsa, H., Bilal, A. M., Alowaydhi, B. Y., Alzahrani, O. M., … & Alfadly, W. N. (2024). The Role of Nursing in Reducing Medical Errors: Best Practices and Systemic Solutions. Journal of Ecohumanism, 3(7), 4613-4622. https://doi.org/10.62754/joe.v3i7.4574 Awad, A., Trenfield, S. J., Pollard, T. D., Ong, J. J., Elbadawi, M., McCoubrey, L. E., … & Basit, A. W. (2021). Connected healthcare: Improving patient care using digital health technologies. Advanced Drug Delivery Reviews, 178, 113958. https://doi.org/10.1016/j.addr.2021.113958 McGonigle, D., & Mastrian, K. G. (2022). Nursing informatics and the foundation of knowledge (5th ed.). Jones & Bartlett Learning. Singh, A., Co-Reyes, J. D., Agarwal, R., Anand, A., Patil, P., Garcia, X., … & Fiedel, N. (2023). Beyond

In this Assignment you will practice this type of leadership by advocating for a healthcare program. Equally as important, you will advocate for a collaborative role of the nurse in the design and implementation of this program.

In this Assignment you will practice this type of leadership by advocating for a healthcare Much like honeyguide birds and honey badgers, nurses and health professionals from other specialty areas can—and should—collaborate to design effective programs. Nurses bring specialties to the table that make them natural partners to professionals with different specialties. When nurses take the requisite leadership in becoming involved throughout the healthcare system, these partnerships can better design and deliver highly effective programs that meet objectives. In this Assignment you will practice this type of leadership by advocating for a healthcare program. Equally as important, you will advocate for a collaborative role of the nurse in the design and implementation of this program. To do this, assume you are preparing to be interviewed by a professional organization/publication regarding your thoughts on the role of the nurse in the design and implementation of new healthcare programs. To Prepare: Review the Resources and reflect on your thinking regarding the role of the nurse in the design and implementation of new healthcare programs. Select a healthcare program within your practice and consider the design and implementation of this program. Reflect on advocacy efforts and the role of the nurse in relation to healthcare program design and implementation. The Assignment: (2–3 pages) In a 2- to 3-page paper create an interview transcript of your responses to the following interview questions: Tell us about a healthcare program, within your practice. What are the costs and projected outcomes of this program? Who is your target population? What is the role of the nurse in providing input for the design of this healthcare program? Can you provide examples? What is your role as an advocate for your target population for this healthcare program? Do you have input into design decisions? How else do you impact design? What is the role of the nurse in healthcare program implementation? How does this role vary between design and implementation of healthcare programs? Can you provide examples? Who are the members of a healthcare team that you believe are most needed to implement a program? Can you explain why? Expert Answer and Explanation Advocating for the Nursing Role in Program Design and Implementation The behavior that a person adopts determines their risk of developing an illness because habits like habitual drinking of alcohol are associated with higher risk of disorders such as cancer of the throat. Similarly, the risk of lung cancer is significantly among habitual smokers. When it comes to the prevention of complications of tobacco smoking, the nurse role comes into play considering that they sensitize the public, creating awareness about the dangers of smoking (Devi et al., 2020). Interviewer: Tell us about a healthcare program, within your practice. What are the costs and the projected outcomes of this program? Interviewee: I have had the opportunity of working on a Nicotine Replacement Therapy (NRT) program which involved putting smokers on treatment regimen that included a nicotine lozenge to reduce the urge to smoke. The goal was to lower the number of cigarettes the target population smoked while managing the smokers’ withdrawal symptoms. This program also sought to prevent those who smoked from developing various forms of illnesses ranging from the pneumonia to the mouth cancer which are some of the conditions that are prevalent among smokers. The adoption of this kind of program is associated with positive health outcomes such as fewer incidences of health issues that result because of smoking (Cartujano-Barrera et al., 2020). The U.S. requires $5,065 billion to manage tobacco use problem because $179 goes into treating one patient using the nicotine therapy. With a population of over 28 million smokers, the country stands a chance of saving on costs associated with smoking which caused the U.S. to lose $600 billion. Interviewer: Who is your target population? Interviewee: The program targets adult habitual smokers, male and female, who smoker more than five cigarettes a day. The target population is also drawn from various ethnic, cultural and racial backgrounds with focus on examining how they respond to the recommended therapy. This may shade light on whether one’s demographic background affects the NRT treatment outcomes (Cartujano-Barrera et al., 2020). Interviewer: What is the role of the nurse in providing input for the design of this healthcare program? Can you provide examples? Interviewee: When it comes to designing the healthcare program, the nurse’s role becomes crucial because they provide meaningful input that supports the development of the design of the program. Given their experience, they may recommend ideas that can help support the design of a more effective program. If they noticed adverse health events that occurred while using the NRT, for instance, the nurse may share this information with those tasked with crafting the program (Bakker et al., 2023). For their part, the designers may design the program in a way that they account for the needs of those who may experience side effects. Interviewer: What is your role as an advocate for your target population for this healthcare program? Do you have input into design decisions? How else do you impact design? Interviewee: My approach to advocating for patients involves bringing the health impact of the smoking to the attention of the political representatives so that they undertake the necessary measures to tackle the issue. For instance, they may respond by passing tougher laws that ban the promotion of the tobacco products (Hébert et al., 2021). In addition, I sensitize smokers and their families, informing them how they can access the NRT services. Although I am not involved in providing input decisions, I would improve the design by providing feedback that can enhance implementation of the future NRT programs. Interviewer: What is the role of the nurse in healthcare program implementation? How does this role vary between design and implementation of healthcare programs? Can you provide examples? Interviewee: When it comes to the implementation of the program, the nurse follows the plan, executing the tasks captured in the plan. They also note down the