Nurse practitioner education you learned about the importance of evidence-based practice

In a previous learning activity, and throughout your nurse practitioner education you learned about the importance of evidence-based practice clinical practice guidelines
For this journal, you will construct clinical reasoning skills to evaluate, plan, and implement care in 3 scenarios.
• Acute injury or illness. Choose one.
o Ankle sprain
o Acute low back pain
o Pityriasis rosea
o Skin Abscess
• Wellness. Choose one:
o Adult wellness exam
o Annual Medicare wellness exam
o Prenatal visit
• Chronic condition management visit. Choose one.
o Acne
o Psoriasis
o Osteoarthritis
o Rheumatoid arthritis
INSTRUCTIONS
A. Choose one condition in each category for a total of 3 cases to present.
B. For each case, include an applicable clinical practice guideline to form the evaluation and management plan of care and briefly describe why each guideline is appropriate. Include the patient's gender, age, and cultural aspects as related to your patient in each case, as well as the physical findings.
C. Next, complete a care management plan based on your knowledge of the condition and the guideline for each case. Include the following:
1. Guideline title
2. Medication/s- (with Dose and Sig details as in a script)
3. Non-medication treatments
4. Implementation of diagnostic testing if needed or your plan if no improvement
5. Culturally competent patient education considerations
6. Referrals if needed or if no improvement
7. Follow up

# 2 assignment,
Differentiate State Regulatory Restrictions on NP Practice
NPs have a scope of practice regulated by state laws, boards of nursing, boards of medicine, and reimbursement that may differ depending on your location. There are several sources of restrictions to NP practice, such as state laws and federal regulations which include who may prescribe controlled substances and which substances NPs can prescribe, as well as the various reimbursement payers which may have limits. It is essential that the NP be fully informed of what they are allowed to do by law (state and federal) or by other regulatory organizations.
These regulations vary widely from state to state and continue to rapidly change. They may also vary by facility policy. Consequences of practicing outside your scope of practice may include work-related discipline, fines, suspension or revocation of your license, a civil lawsuit, or even criminal charges.
There are three major regulatory practice models for NPs: supervisory, collaborative, and independent. In this journal assignment:
• Define each model.
• Identify three states: one with each different model.
• Compare the three state models, using the following details:
1. collaborative agreement required
2. direct versus indirect supervision description
3. practice hours or wait period to full practice
4. review of documentation
5. prescribing restrictions, if any
6. NP payor reimbursement per each state/model
• Include other unique requirements noted.

Applicable Clinical Practice Guideline: The American College of Physicians (ACP) clinical practice guideline for the treatment of acute low back pain is appropriate here because it advocates for a conservative, non-pharmacological approach as the first line of treatment. This guideline is evidence-based and aligns with the patient's preference to avoid medication initially, while still providing effective care.

Care Management Plan:

Guideline Title: American College of Physicians (ACP) "Noninvasive Treatments for Acute, Subacute, and Chronic Low Back Pain"

Medication/s: Due to patient preference and guideline recommendation, no medication is prescribed initially. If pain does not improve, consider a short course of an NSAID.

Non-medication treatments: Recommend remaining active, but with caution, to avoid further injury. Educate on heat therapy for pain relief and back-strengthening exercises. Refer for physical therapy.

Diagnostic testing: No imaging (X-ray, MRI) is needed at this time as there are no "red flag" symptoms (e.g., fever, saddle anesthesia, severe or progressive neurologic deficits). Plan if no improvement: If pain worsens or radiates after 2-4 weeks, consider an MRI to rule out a herniated disc.

Culturally competent patient education: Acknowledge his cultural beliefs about pain tolerance. Frame non-medication options like physical therapy and exercise as ways to build "strength" and resilience, aligning with his values. Provide educational materials in Spanish.

Referrals: Immediate referral to physical therapy for a personalized exercise and strengthening plan.

Follow-up: Schedule a follow-up appointment in 2 weeks to reassess pain and functional status.

Case 2: Adult Wellness Exam

A 30-year-old female, a professional of Asian descent, presents for her annual wellness exam. She reports no specific health concerns but is interested in preventative health and maintaining a healthy lifestyle. She is a vegetarian and active, but has a family history of hypertension and diabetes.

Sample Answer

Journal Assignment 1: Clinical Reasoning in Patient Care Scenarios

Case 1: Acute Low Back Pain

A 45-year-old male, a construction worker of Hispanic descent, presents to the clinic with acute low back pain following a work-related activity two days ago. He describes the pain as a constant, dull ache in his lower back, rated as 6/10, with occasional sharp pangs upon movement. He has no radiating pain down his legs, no numbness, or weakness. The patient is hesitant about taking medication due to cultural beliefs about "being strong enough" to handle pain.

Nurse practitioner education you learned about the importance of evidence-based practice

Sample Answer

Journal Assignment 1: Clinical Reasoning in Patient Care Scenarios

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