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  • [Solved] PHI acute care setting

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    **Assignment: Addressing a Breach of Protected Health Information (PHI) in an Acute Care Setting** **Level: DOES (Miller's Taxonomy)** **Objective:** The student will demonstrate the ability to apply their knowledge and skills in identifying, addressing, and mitigating a breach of Protected Health I…

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    Assignment Prompt & Instructions

    **Assignment: Addressing a Breach of Protected Health Information (PHI) in an Acute Care Setting**

    **Level: DOES (Miller's Taxonomy)**

    **Objective:**

    The student will demonstrate the ability to apply their knowledge and skills in identifying, addressing, and mitigating a breach of Protected Health Information (PHI) in an acute care setting by taking appropriate actions and ensuring compliance with legal, ethical, and organizational requirements.

    **Scenario:**

    You are a nurse manager in an acute care unit. A colleague inadvertently sent an email containing a patient’s discharge summary, including PHI, to the wrong recipient outside the healthcare organization. The recipient has acknowledged receiving the email but has not deleted it. The email contains the patient’s name, diagnosis, and treatment details.

    **Assignment:**

    Based on the scenario, perform the following tasks:

    1. **Immediate Response**
    – Demonstrate the steps to identify the breach and confirm the information shared.
    – Document the breach following organizational protocols.
    – Notify your immediate supervisor and the compliance or privacy officer as required.
    2. **Risk Assessment and Reporting**
    – Conduct a risk assessment using the organization’s breach assessment tool to determine the severity of the incident.
    – Complete an incident report, detailing the breach, the information disclosed, and the steps taken so far.
    3. **Mitigation and Containment**
    – Develop a communication plan to contact the unintended recipient, request the deletion of the email, and ensure no further dissemination of the information.
    – Coordinate with IT or other relevant departments to determine if additional technical measures are needed to secure sensitive information.
    4. **Communication with the Patient**
    – Prepare a written and verbal notification for the affected patient, as required by HIPAA regulations.
    – Role-play the patient notification conversation, ensuring transparency, empathy, and adherence to legal requirements.
    5. **Organizational Reporting and Follow-Up**
    – Identify which external entities, such as the Department of Health and Human Services (HHS), need to be notified about the breach and prepare the necessary documentation.
    – Develop an action plan to prevent future breaches, including staff training and updates to procedures.
    6. **Reflective Exercise**
    – Write a brief reflective summary analyzing your actions and decision-making process during the scenario. Include potential challenges, ethical considerations, and lessons learned.

    **Evaluation Criteria:**

    – **Accuracy and Completeness:** Correct identification of the breach and adherence to regulatory and organizational protocols.
    – **Communication Skills:** Effective and empathetic communication with the affected patient and colleagues.
    – **Critical Thinking:** Thorough risk assessment and mitigation planning.
    – **Professionalism:** Demonstrates accountability and commitment to protecting patient privacy.
    – **Reflective Practice:** Insightful analysis of actions and areas for improvement.

  • [Solved] 320

    ✓ Verified Academic Solution Available

    Executive Solution Overview

    **files (1)** – ## 320.txt **## 320.txt** Purpose of Assignment: It is important for nurses to reflect on experiences and new knowledge gained in order to promote professional growth. Course Competencies: Evaluate responses of communicable diseases in healthcare today. Debate current healthcare poli…

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    Assignment Prompt & Instructions

    **files (1)**

    – ## 320.txt

    **## 320.txt**

    Purpose of Assignment:
    It is important for nurses to reflect on experiences and new knowledge gained in order to promote professional growth.

    Course Competencies:
    Evaluate responses of communicable diseases in healthcare today.
    Debate current healthcare policy as it relates to nursing practice.
    Critique ethical issues in current nursing practice.
    Analyze cultural and social issues in the contemporary, professional nursing environment.
    Evaluate the use of information technology and patient data analyses in the current healthcare delivery system.
    Analyze current issues in healthcare.

    Instructions:
    Reflect on your development as a nursing professional and address the following in a 1-2 page paper:
    Describe how you achieved each of the course competencies.
    Provide at least one example of new knowledge gained related to each competency and explain how this new knowledge will impact your nursing practice

    **## 320.txt**

    Purpose of Assignment:
    It is important for nurses to reflect on experiences and new knowledge gained in order to promote professional growth.

    Course Competencies:
    Evaluate responses of communicable diseases in healthcare today.
    Debate current healthcare policy as it relates to nursing practice.
    Critique ethical issues in current nursing practice.
    Analyze cultural and social issues in the contemporary, professional nursing environment.
    Evaluate the use of information technology and patient data analyses in the current healthcare delivery system.
    Analyze current issues in healthcare.

    Instructions:
    Reflect on your development as a nursing professional and address the following in a 1-2 page paper:
    Describe how you achieved each of the course competencies.
    Provide at least one example of new knowledge gained related to each competency and explain how this new knowledge will impact your nursing practice

  • [Solved] Organizational Culture & Structure in Strategic Planning

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    Executive Solution Overview

    **files (2)** – ## OrganizationalCultureStructureinStrategicPlanning.docx – ## Rubric-OrganizationalCultureandStructureinStrategicPlanning.pdf **## OrganizationalCultureStructureinStrategicPlanning.docx** ## Organizational Culture & Structure in Strategic Planning **First Part** · Choose an existing…

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    Assignment Prompt & Instructions

    **files (2)**

    – ## OrganizationalCultureStructureinStrategicPlanning.docx

    – ## Rubric-OrganizationalCultureandStructureinStrategicPlanning.pdf

    **## OrganizationalCultureStructureinStrategicPlanning.docx**

    ## Organizational Culture & Structure in Strategic Planning

    **First Part**

    · Choose an
    existing health care organization that you can use as the basis for your analysis and business plan. When selecting the organization, ensure that it meets the following criteria:

    Organization may be for
    profit, non-profit, or community based.

    Information about the organization, including financial data, should be publicly available to ensure you can complete the required organizational analysis.

    Be sure that you have selected an organization,
    not a system. For example, Banner Health is a system not an organization, while Banner Desert Medical Center is an organization.

    **Second Part is Business Memo** Imagine you have been asked to communicate your findings about the organization to stakeholders. In a business memo to stakeholders (500-750 words), address the following:

    1. Describe the organizational culture.

    2. Discuss the implications of the culture on strategic planning.

    3. Explain the difference between operating activities and strategic initiatives.

    4. Communicate where the value is in the organization based on the structure.

    5. Identify areas of opportunity and explain where process changes would be seen or come from.

    6. Identify potential barriers to strategic planning and explain actions that could be taken to overcome the barriers.

    Please use sources and APA style writing

    2

    **## Rubric-OrganizationalCultureandStructureinStrategicPlanning.pdf**

    Organizational Culture and Structure in Strategic Planning – Rubric Total 60 points

    Criterion 1. Unsatisfactory 2. Insufficient 3. Approaching 4. Acceptable 5. Target

    Organizational Culture

    Organizational Culture

    0 points

    Description of organizational

    culture, is not included.

    11.7 points

    Description of organizational

    culture is incomplete and/or

    incorrect.

    13.5 points

    Description of organizational

    culture is included, but lacks

    explanation and supporting

    details.

    15.3 points

    Description of organizational

    culture , is complete and

    includes explanation and

    relevant supporting details.

    18 points

    Description of organizational

    culture is thorough and

    includes substantial

    explanation and relevant

    supporting details.

    Implications on Strategic

    Planning

    Implications on Strategic

    Planning

    0 points

    The implications of the

    culture on strategic planning,

    is not included.

    7.8 points

    The implications of the

    culture on strategic planning,

    is incomplete and/or

    incorrect.

    9 points

    The implications of the

    culture on strategic planning,

    is included, but lacks

    explanation and supporting

    details.

    10.2 points

    The implications of the

    culture on strategic planning,

    is complete and includes

    explanation and relevant

    supporting details.

    12 points

    The implications of the

    culture on strategic planning,

    is thorough and includes

    substantial explanation and

    relevant supporting details.

    Operating Activities and

    Strategic Initiatives

    Operating Activities and

    Strategic Initiatives

    0 points

    Explanation of the difference

    between operating activities

    and strategic initiatives is not

    included.

    3.9 points

    Explanation of the difference

    between operating activities

    and strategic initiatives is

    incomplete and/or incorrect.

    4.5 points

    Explanation of the difference

    between operating activities

    and strategic initiatives is

    included, but lacks

    explanation and supporting

    details.

    5.1 points

    Explanation of the difference

    between operating activities

    and strategic initiatives is

    complete and includes

    explanation and supporting

    details.

    6 points

    Explanation of the difference

    between operating activities

    and strategic initiatives is

    thorough and includes

    substantial explanation and

    supporting details.

    Value and Areas of

    Opportunity

    Value and Areas of

    Opportunity

    0 points

    Explanation of the value in

    the organization based on

    structure, including

    identification of

    opportunities and

    explanation of where process

    changes could be seen or

    come from, is not included.

    3.9 points

    Explanation of the value in

    the organization based on

    structure, including

    identification of

    opportunities and

    explanation of where process

    changes could be seen or

    come from, is incomplete

    and/or incorrect.

    4.5 points

    Explanation of the value in

    the organization based on

    structure, including

    identification of

    opportunities and

    explanation of where process

    changes could be seen or

    come from, is included, but

    lacks clarity and support.

    5.1 points

    Explanation of the value in

    the organization based on

    structure, including

    identification of

    opportunities and

    explanation of where process

    changes could be seen or

    come from, is complete,

    clear, and supported.

    6 points

    Explanation of the value in

    the organization based on

    structure, including

    identification of

    opportunities and

    explanation of where process

    changes could be seen or

    come from, is thorough,

    precise, and well supported.

    Barriers

    Barriers

    0 points

    Identification of potential

    barriers to strategic planning

    and explanation of actions

    that could be taken to

    overcome the barriers is not

    included.

    3.9 points

    Identification of potential

    barriers to strategic planning

    and explanation of actions

    that could be taken to

    overcome the barriers is

    incomplete and/or incorrect.

    4.5 points

    Identification of potential

    barriers to strategic planning

    and explanation of actions

    that could be taken to

    overcome the barriers is

    included, but lacks relevant

    supporting details.

    5.1 points

    Identification of potential

    barriers to strategic planning

    and explanation of actions

    that could be taken to

    overcome the barriers is

    complete and includes

    relevant supporting details.

    6 points

    Identification of potential

    barriers to strategic planning

    and explanation of actions

    that could be taken to

    overcome the barriers is

    thorough and includes

    substantial relevant

    supporting details.

    Thesis, Position, or Purpose

    Communicates reason for

    writing and demonstrates

    awareness of audience.

    0 points

    The thesis, position, or

    purpose is not discernible.

    No awareness of the

    appropriate audience is

    evident.

    1.95 points

    The thesis, position, or

    purpose is unfocused or

    confused. There is very little

    awareness of the intended

    audience.

    2.25 points

    The thesis, position, or

    purpose is discernable in

    most aspects, but is

    occasionally weak or unclear.

    There is limited awareness of

    the appropriate audience.

    2.55 points

    The thesis, position, or

    purpose is adequately

    presented. An awareness of

    the appropriate audience is

    demonstrated.

    3 points

    The thesis, position, or

    purpose is clearly

    communicated throughout

    and clearly directed to a

    specific audience.

    Development, Structure,

    and Conclusion

    Advances position or

    purpose throughout writing;

    conclusion aligns to and

    evolves from development.

    0 points

    No advancement of the

    thesis, position, or purpose is

    evident. Connections

    between paragraphs are

    missing or inappropriate. No

    conclusion is offered.

    1.95 points

    Writing lacks logical

    progression of the thesis,

    position, or purpose. Some

    organization is attempted,

    but ideas are disconnected.

    Conclusion is unclear and not

    supported by the overall

    development of the purpose.

    2.25 points

    Limited advancement of

    thesis, position, or purpose is

    discernable. There are

    inconsistencies in

    organization or the

    relationship of ideas.

    Conclusion is simplistic and

    not fully aligned to the

    development of the purpose.

    2.55 points

    The thesis, position, or

    purpose is advanced in most

    aspects. Ideas clearly build

    on each other. Conclusion

    aligns to the development of

    the purpose.

    3 points

    The thesis, position, or

    purpose is logically advanced

    throughout. The progression

    of ideas is coherent and

    unified. A clear and logical

    conclusion aligns to the

    development of the purpose.

    Mechanics of Writing 0 points 1.95 points 2.25 points 2.55 points 3 points
    © 2026. Grand Canyon University. All Rights Reserved.

    [https://www.gce.com/](https://www.gce.com/)

    [https://www.gce.com/](https://www.gce.com/)

    Criterion 1. Unsatisfactory 2. Insufficient 3. Approaching 4. Acceptable 5. Target

    Includes spelling,

    capitalization, punctuation,

    grammar, language use,

    sentence structure, etc.

    Errors in grammar or syntax

    are pervasive and impede

    meaning. Incorrect language

    choice or sentence structure

    errors are found throughout.

    Frequent and repetitive

    mechanical errors are

    present. Inconsistencies in

    language choice or sentence

    structure are recurrent.

    Occasional mechanical errors

    are present. Language choice

    is generally appropriate.

    Varied sentence structure is

    attempted.

    Few mechanical errors are

    present. Suitable language

    choice and sentence

    structure are used.

    No mechanical errors are

    present. Appropriate

    language choice and

    sentence structure are used

    throughout.

    Format/Documentation

    Uses appropriate style, such

    as APA, MLA, etc., for college,

    subject, and level;

    documents sources using

    citations, footnotes,

    references, bibliography, etc.,

    appropriate to assignment

    and discipline.

    0 points

    Appropriate format is not

    used. No documentation of

    sources is provided.

    1.95 points

    Appropriate format is

    attempted, but some

    elements are missing.

    Frequent errors in

    documentation of sources

    are evident.

    2.25 points

    Appropriate format and

    documentation are used,

    although there are some

    obvious errors.

    2.55 points

    Appropriate format and

    documentation are used with

    only minor errors.

    3 points

    No errors in formatting or

    documentation are present.

    © 2026. Grand Canyon University. All Rights Reserved.

    [https://www.gce.com/](https://www.gce.com/)

    [https://www.gce.com/](https://www.gce.com/)

    **## Rubric-OrganizationalCultureandStructureinStrategicPlanning.pdf**

    Organizational Culture and Structure in Strategic Planning – Rubric Total 60 points

    Criterion 1. Unsatisfactory 2. Insufficient 3. Approaching 4. Acceptable 5. Target

    Organizational Culture

    Organizational Culture

    0 points

    Description of organizational

    culture, is not included.

    11.7 points

    Description of organizational

    culture is incomplete and/or

    incorrect.

    13.5 points

    Description of organizational

    culture is included, but lacks

    explanation and supporting

    details.

    15.3 points

    Description of organizational

    culture , is complete and

    includes explanation and

    relevant supporting details.

    18 points

    Description of organizational

    culture is thorough and

    includes substantial

    explanation and relevant

    supporting details.

    Implications on Strategic

    Planning

    Implications on Strategic

    Planning

    0 points

    The implications of the

    culture on strategic planning,

    is not included.

    7.8 points

    The implications of the

    culture on strategic planning,

    is incomplete and/or

    incorrect.

    9 points

    The implications of the

    culture on strategic planning,

    is included, but lacks

    explanation and supporting

    details.

    10.2 points

    The implications of the

    culture on strategic planning,

    is complete and includes

    explanation and relevant

    supporting details.

    12 points

    The implications of the

    culture on strategic planning,

    is thorough and includes

    substantial explanation and

    relevant supporting details.

    Operating Activities and

    Strategic Initiatives

    Operating Activities and

    Strategic Initiatives

    0 points

    Explanation of the difference

    between operating activities

    and strategic initiatives is not

    included.

    3.9 points

    Explanation of the difference

    between operating activities

    and strategic initiatives is

    incomplete and/or incorrect.

    4.5 points

    Explanation of the difference

    between operating activities

    and strategic initiatives is

    included, but lacks

    explanation and supporting

    details.

    5.1 points

    Explanation of the difference

    between operating activities

    and strategic initiatives is

    complete and includes

    explanation and supporting

    details.

    6 points

    Explanation of the difference

    between operating activities

    and strategic initiatives is

    thorough and includes

    substantial explanation and

    supporting details.

    Value and Areas of

    Opportunity

    Value and Areas of

    Opportunity

    0 points

    Explanation of the value in

    the organization based on

    structure, including

    identification of

    opportunities and

    explanation of where process

    changes could be seen or

    come from, is not included.

    3.9 points

    Explanation of the value in

    the organization based on

    structure, including

    identification of

    opportunities and

    explanation of where process

    changes could be seen or

    come from, is incomplete

    and/or incorrect.

    4.5 points

    Explanation of the value in

    the organization based on

    structure, including

    identification of

    opportunities and

    explanation of where process

    changes could be seen or

    come from, is included, but

    lacks clarity and support.

    5.1 points

    Explanation of the value in

    the organization based on

    structure, including

    identification of

    opportunities and

    explanation of where process

    changes could be seen or

    come from, is complete,

    clear, and supported.

    6 points

    Explanation of the value in

    the organization based on

    structure, including

    identification of

    opportunities and

    explanation of where process

    changes could be seen or

    come from, is thorough,

    precise, and well supported.

    Barriers

    Barriers

    0 points

    Identification of potential

    barriers to strategic planning

    and explanation of actions

    that could be taken to

    overcome the barriers is not

    included.

    3.9 points

    Identification of potential

    barriers to strategic planning

    and explanation of actions

    that could be taken to

    overcome the barriers is

    incomplete and/or incorrect.

    4.5 points

    Identification of potential

    barriers to strategic planning

    and explanation of actions

    that could be taken to

    overcome the barriers is

    included, but lacks relevant

    supporting details.

    5.1 points

    Identification of potential

    barriers to strategic planning

    and explanation of actions

    that could be taken to

    overcome the barriers is

    complete and includes

    relevant supporting details.

    6 points

    Identification of potential

    barriers to strategic planning

    and explanation of actions

    that could be taken to

    overcome the barriers is

    thorough and includes

    substantial relevant

    supporting details.

    Thesis, Position, or Purpose

    Communicates reason for

    writing and demonstrates

    awareness of audience.

    0 points

    The thesis, position, or

    purpose is not discernible.

    No awareness of the

    appropriate audience is

    evident.

    1.95 points

    The thesis, position, or

    purpose is unfocused or

    confused. There is very little

    awareness of the intended

    audience.

    2.25 points

    The thesis, position, or

    purpose is discernable in

    most aspects, but is

    occasionally weak or unclear.

    There is limited awareness of

    the appropriate audience.

    2.55 points

    The thesis, position, or

    purpose is adequately

    presented. An awareness of

    the appropriate audience is

    demonstrated.

    3 points

    The thesis, position, or

    purpose is clearly

    communicated throughout

    and clearly directed to a

    specific audience.

    Development, Structure,

    and Conclusion

    Advances position or

    purpose throughout writing;

    conclusion aligns to and

    evolves from development.

    0 points

    No advancement of the

    thesis, position, or purpose is

    evident. Connections

    between paragraphs are

    missing or inappropriate. No

    conclusion is offered.

    1.95 points

    Writing lacks logical

    progression of the thesis,

    position, or purpose. Some

    organization is attempted,

    but ideas are disconnected.

    Conclusion is unclear and not

    supported by the overall

    development of the purpose.

    2.25 points

    Limited advancement of

    thesis, position, or purpose is

    discernable. There are

    inconsistencies in

    organization or the

    relationship of ideas.

    Conclusion is simplistic and

    not fully aligned to the

    development of the purpose.

    2.55 points

    The thesis, position, or

    purpose is advanced in most

    aspects. Ideas clearly build

    on each other. Conclusion

    aligns to the development of

    the purpose.

    3 points

    The thesis, position, or

    purpose is logically advanced

    throughout. The progression

    of ideas is coherent and

    unified. A clear and logical

    conclusion aligns to the

    development of the purpose.

    Mechanics of Writing 0 points 1.95 points 2.25 points 2.55 points 3 points
    © 2026. Grand Canyon University. All Rights Reserved.

    [https://www.gce.com/](https://www.gce.com/)

    [https://www.gce.com/](https://www.gce.com/)

    Criterion 1. Unsatisfactory 2. Insufficient 3. Approaching 4. Acceptable 5. Target

    Includes spelling,

    capitalization, punctuation,

    grammar, language use,

    sentence structure, etc.

    Errors in grammar or syntax

    are pervasive and impede

    meaning. Incorrect language

    choice or sentence structure

    errors are found throughout.

    Frequent and repetitive

    mechanical errors are

    present. Inconsistencies in

    language choice or sentence

    structure are recurrent.

    Occasional mechanical errors

    are present. Language choice

    is generally appropriate.

    Varied sentence structure is

    attempted.

    Few mechanical errors are

    present. Suitable language

    choice and sentence

    structure are used.

    No mechanical errors are

    present. Appropriate

    language choice and

    sentence structure are used

    throughout.

    Format/Documentation

    Uses appropriate style, such

    as APA, MLA, etc., for college,

    subject, and level;

    documents sources using

    citations, footnotes,

    references, bibliography, etc.,

    appropriate to assignment

    and discipline.

    0 points

    Appropriate format is not

    used. No documentation of

    sources is provided.

    1.95 points

    Appropriate format is

    attempted, but some

    elements are missing.

    Frequent errors in

    documentation of sources

    are evident.

    2.25 points

    Appropriate format and

    documentation are used,

    although there are some

    obvious errors.

    2.55 points

    Appropriate format and

    documentation are used with

    only minor errors.

    3 points

    No errors in formatting or

    documentation are present.

    © 2026. Grand Canyon University. All Rights Reserved.

    [https://www.gce.com/](https://www.gce.com/)

    [https://www.gce.com/](https://www.gce.com/)

    **## OrganizationalCultureStructureinStrategicPlanning.docx**

    ## Organizational Culture & Structure in Strategic Planning

    **First Part**

    · Choose an
    existing health care organization that you can use as the basis for your analysis and business plan. When selecting the organization, ensure that it meets the following criteria:

    Organization may be for
    profit, non-profit, or community based.

    Information about the organization, including financial data, should be publicly available to ensure you can complete the required organizational analysis.

    Be sure that you have selected an organization,
    not a system. For example, Banner Health is a system not an organization, while Banner Desert Medical Center is an organization.

    **Second Part is Business Memo** Imagine you have been asked to communicate your findings about the organization to stakeholders. In a business memo to stakeholders (500-750 words), address the following:

    1. Describe the organizational culture.

    2. Discuss the implications of the culture on strategic planning.

    3. Explain the difference between operating activities and strategic initiatives.

    4. Communicate where the value is in the organization based on the structure.

    5. Identify areas of opportunity and explain where process changes would be seen or come from.

    6. Identify potential barriers to strategic planning and explain actions that could be taken to overcome the barriers.

    Please use sources and APA style writing

    2

    **## Rubric-OrganizationalCultureandStructureinStrategicPlanning.pdf**

    Organizational Culture and Structure in Strategic Planning – Rubric Total 60 points

    Criterion 1. Unsatisfactory 2. Insufficient 3. Approaching 4. Acceptable 5. Target

    Organizational Culture

    Organizational Culture

    0 points

    Description of organizational

    culture, is not included.

    11.7 points

    Description of organizational

    culture is incomplete and/or

    incorrect.

    13.5 points

    Description of organizational

    culture is included, but lacks

    explanation and supporting

    details.

    15.3 points

    Description of organizational

    culture , is complete and

    includes explanation and

    relevant supporting details.

    18 points

    Description of organizational

    culture is thorough and

    includes substantial

    explanation and relevant

    supporting details.

    Implications on Strategic

    Planning

    Implications on Strategic

    Planning

    0 points

    The implications of the

    culture on strategic planning,

    is not included.

    7.8 points

    The implications of the

    culture on strategic planning,

    is incomplete and/or

    incorrect.

    9 points

    The implications of the

    culture on strategic planning,

    is included, but lacks

    explanation and supporting

    details.

    10.2 points

    The implications of the

    culture on strategic planning,

    is complete and includes

    explanation and relevant

    supporting details.

    12 points

    The implications of the

    culture on strategic planning,

    is thorough and includes

    substantial explanation and

    relevant supporting details.

    Operating Activities and

    Strategic Initiatives

    Operating Activities and

    Strategic Initiatives

    0 points

    Explanation of the difference

    between operating activities

    and strategic initiatives is not

    included.

    3.9 points

    Explanation of the difference

    between operating activities

    and strategic initiatives is

    incomplete and/or incorrect.

    4.5 points

    Explanation of the difference

    between operating activities

    and strategic initiatives is

    included, but lacks

    explanation and supporting

    details.

    5.1 points

    Explanation of the difference

    between operating activities

    and strategic initiatives is

    complete and includes

    explanation and supporting

    details.

    6 points

    Explanation of the difference

    between operating activities

    and strategic initiatives is

    thorough and includes

    substantial explanation and

    supporting details.

    Value and Areas of

    Opportunity

    Value and Areas of

    Opportunity

    0 points

    Explanation of the value in

    the organization based on

    structure, including

    identification of

    opportunities and

    explanation of where process

    changes could be seen or

    come from, is not included.

    3.9 points

    Explanation of the value in

    the organization based on

    structure, including

    identification of

    opportunities and

    explanation of where process

    changes could be seen or

    come from, is incomplete

    and/or incorrect.

    4.5 points

    Explanation of the value in

    the organization based on

    structure, including

    identification of

    opportunities and

    explanation of where process

    changes could be seen or

    come from, is included, but

    lacks clarity and support.

    5.1 points

    Explanation of the value in

    the organization based on

    structure, including

    identification of

    opportunities and

    explanation of where process

    changes could be seen or

    come from, is complete,

    clear, and supported.

    6 points

    Explanation of the value in

    the organization based on

    structure, including

    identification of

    opportunities and

    explanation of where process

    changes could be seen or

    come from, is thorough,

    precise, and well supported.

    Barriers

    Barriers

    0 points

    Identification of potential

    barriers to strategic planning

    and explanation of actions

    that could be taken to

    overcome the barriers is not

    included.

    3.9 points

    Identification of potential

    barriers to strategic planning

    and explanation of actions

    that could be taken to

    overcome the barriers is

    incomplete and/or incorrect.

    4.5 points

    Identification of potential

    barriers to strategic planning

    and explanation of actions

    that could be taken to

    overcome the barriers is

    included, but lacks relevant

    supporting details.

    5.1 points

    Identification of potential

    barriers to strategic planning

    and explanation of actions

    that could be taken to

    overcome the barriers is

    complete and includes

    relevant supporting details.

    6 points

    Identification of potential

    barriers to strategic planning

    and explanation of actions

    that could be taken to

    overcome the barriers is

    thorough and includes

    substantial relevant

    supporting details.

    Thesis, Position, or Purpose

    Communicates reason for

    writing and demonstrates

    awareness of audience.

    0 points

    The thesis, position, or

    purpose is not discernible.

    No awareness of the

    appropriate audience is

    evident.

    1.95 points

    The thesis, position, or

    purpose is unfocused or

    confused. There is very little

    awareness of the intended

    audience.

    2.25 points

    The thesis, position, or

    purpose is discernable in

    most aspects, but is

    occasionally weak or unclear.

    There is limited awareness of

    the appropriate audience.

    2.55 points

    The thesis, position, or

    purpose is adequately

    presented. An awareness of

    the appropriate audience is

    demonstrated.

    3 points

    The thesis, position, or

    purpose is clearly

    communicated throughout

    and clearly directed to a

    specific audience.

    Development, Structure,

    and Conclusion

    Advances position or

    purpose throughout writing;

    conclusion aligns to and

    evolves from development.

    0 points

    No advancement of the

    thesis, position, or purpose is

    evident. Connections

    between paragraphs are

    missing or inappropriate. No

    conclusion is offered.

    1.95 points

    Writing lacks logical

    progression of the thesis,

    position, or purpose. Some

    organization is attempted,

    but ideas are disconnected.

    Conclusion is unclear and not

    supported by the overall

    development of the purpose.

    2.25 points

    Limited advancement of

    thesis, position, or purpose is

    discernable. There are

    inconsistencies in

    organization or the

    relationship of ideas.

    Conclusion is simplistic and

    not fully aligned to the

    development of the purpose.

    2.55 points

    The thesis, position, or

    purpose is advanced in most

    aspects. Ideas clearly build

    on each other. Conclusion

    aligns to the development of

    the purpose.

    3 points

    The thesis, position, or

    purpose is logically advanced

    throughout. The progression

    of ideas is coherent and

    unified. A clear and logical

    conclusion aligns to the

    development of the purpose.

    Mechanics of Writing 0 points 1.95 points 2.25 points 2.55 points 3 points
    © 2026. Grand Canyon University. All Rights Reserved.

    [https://www.gce.com/](https://www.gce.com/)

    [https://www.gce.com/](https://www.gce.com/)

    Criterion 1. Unsatisfactory 2. Insufficient 3. Approaching 4. Acceptable 5. Target

    Includes spelling,

    capitalization, punctuation,

    grammar, language use,

    sentence structure, etc.

    Errors in grammar or syntax

    are pervasive and impede

    meaning. Incorrect language

    choice or sentence structure

    errors are found throughout.

    Frequent and repetitive

    mechanical errors are

    present. Inconsistencies in

    language choice or sentence

    structure are recurrent.

    Occasional mechanical errors

    are present. Language choice

    is generally appropriate.

    Varied sentence structure is

    attempted.

    Few mechanical errors are

    present. Suitable language

    choice and sentence

    structure are used.

    No mechanical errors are

    present. Appropriate

    language choice and

    sentence structure are used

    throughout.

    Format/Documentation

    Uses appropriate style, such

    as APA, MLA, etc., for college,

    subject, and level;

    documents sources using

    citations, footnotes,

    references, bibliography, etc.,

    appropriate to assignment

    and discipline.

    0 points

    Appropriate format is not

    used. No documentation of

    sources is provided.

    1.95 points

    Appropriate format is

    attempted, but some

    elements are missing.

    Frequent errors in

    documentation of sources

    are evident.

    2.25 points

    Appropriate format and

    documentation are used,

    although there are some

    obvious errors.

    2.55 points

    Appropriate format and

    documentation are used with

    only minor errors.

    3 points

    No errors in formatting or

    documentation are present.

    © 2026. Grand Canyon University. All Rights Reserved.

    [https://www.gce.com/](https://www.gce.com/)

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    **## OrganizationalCultureStructureinStrategicPlanning.docx**

    ## Organizational Culture & Structure in Strategic Planning

    **First Part**

    · Choose an
    existing health care organization that you can use as the basis for your analysis and business plan. When selecting the organization, ensure that it meets the following criteria:

    Organization may be for
    profit, non-profit, or community based.

    Information about the organization, including financial data, should be publicly available to ensure you can complete the required organizational analysis.

    Be sure that you have selected an organization,
    not a system. For example, Banner Health is a system not an organization, while Banner Desert Medical Center is an organization.

    **Second Part is Business Memo** Imagine you have been asked to communicate your findings about the organization to stakeholders. In a business memo to stakeholders (500-750 words), address the following:

    1. Describe the organizational culture.

    2. Discuss the implications of the culture on strategic planning.

    3. Explain the difference between operating activities and strategic initiatives.

    4. Communicate where the value is in the organization based on the structure.

    5. Identify areas of opportunity and explain where process changes would be seen or come from.

    6. Identify potential barriers to strategic planning and explain actions that could be taken to overcome the barriers.

    Please use sources and APA style writing

    2

    **## Rubric-OrganizationalCultureandStructureinStrategicPlanning.pdf**

    Organizational Culture and Structure in Strategic Planning – Rubric Total 60 points

    Criterion 1. Unsatisfactory 2. Insufficient 3. Approaching 4. Acceptable 5. Target

    Organizational Culture

    Organizational Culture

    0 points

    Description of organizational

    culture, is not included.

    11.7 points

    Description of organizational

    culture is incomplete and/or

    incorrect.

    13.5 points

    Description of organizational

    culture is included, but lacks

    explanation and supporting

    details.

    15.3 points

    Description of organizational

    culture , is complete and

    includes explanation and

    relevant supporting details.

    18 points

    Description of organizational

    culture is thorough and

    includes substantial

    explanation and relevant

    supporting details.

    Implications on Strategic

    Planning

    Implications on Strategic

    Planning

    0 points

    The implications of the

    culture on strategic planning,

    is not included.

    7.8 points

    The implications of the

    culture on strategic planning,

    is incomplete and/or

    incorrect.

    9 points

    The implications of the

    culture on strategic planning,

    is included, but lacks

    explanation and supporting

    details.

    10.2 points

    The implications of the

    culture on strategic planning,

    is complete and includes

    explanation and relevant

    supporting details.

    12 points

    The implications of the

    culture on strategic planning,

    is thorough and includes

    substantial explanation and

    relevant supporting details.

    Operating Activities and

    Strategic Initiatives

    Operating Activities and

    Strategic Initiatives

    0 points

    Explanation of the difference

    between operating activities

    and strategic initiatives is not

    included.

    3.9 points

    Explanation of the difference

    between operating activities

    and strategic initiatives is

    incomplete and/or incorrect.

    4.5 points

    Explanation of the difference

    between operating activities

    and strategic initiatives is

    included, but lacks

    explanation and supporting

    details.

    5.1 points

    Explanation of the difference

    between operating activities

    and strategic initiatives is

    complete and includes

    explanation and supporting

    details.

    6 points

    Explanation of the difference

    between operating activities

    and strategic initiatives is

    thorough and includes

    substantial explanation and

    supporting details.

    Value and Areas of

    Opportunity

    Value and Areas of

    Opportunity

    0 points

    Explanation of the value in

    the organization based on

    structure, including

    identification of

    opportunities and

    explanation of where process

    changes could be seen or

    come from, is not included.

    3.9 points

    Explanation of the value in

    the organization based on

    structure, including

    identification of

    opportunities and

    explanation of where process

    changes could be seen or

    come from, is incomplete

    and/or incorrect.

    4.5 points

    Explanation of the value in

    the organization based on

    structure, including

    identification of

    opportunities and

    explanation of where process

    changes could be seen or

    come from, is included, but

    lacks clarity and support.

    5.1 points

    Explanation of the value in

    the organization based on

    structure, including

    identification of

    opportunities and

    explanation of where process

    changes could be seen or

    come from, is complete,

    clear, and supported.

    6 points

    Explanation of the value in

    the organization based on

    structure, including

    identification of

    opportunities and

    explanation of where process

    changes could be seen or

    come from, is thorough,

    precise, and well supported.

    Barriers

    Barriers

    0 points

    Identification of potential

    barriers to strategic planning

    and explanation of actions

    that could be taken to

    overcome the barriers is not

    included.

    3.9 points

    Identification of potential

    barriers to strategic planning

    and explanation of actions

    that could be taken to

    overcome the barriers is

    incomplete and/or incorrect.

    4.5 points

    Identification of potential

    barriers to strategic planning

    and explanation of actions

    that could be taken to

    overcome the barriers is

    included, but lacks relevant

    supporting details.

    5.1 points

    Identification of potential

    barriers to strategic planning

    and explanation of actions

    that could be taken to

    overcome the barriers is

    complete and includes

    relevant supporting details.

    6 points

    Identification of potential

    barriers to strategic planning

    and explanation of actions

    that could be taken to

    overcome the barriers is

    thorough and includes

    substantial relevant

    supporting details.

    Thesis, Position, or Purpose

    Communicates reason for

    writing and demonstrates

    awareness of audience.

    0 points

    The thesis, position, or

    purpose is not discernible.

    No awareness of the

    appropriate audience is

    evident.

    1.95 points

    The thesis, position, or

    purpose is unfocused or

    confused. There is very little

    awareness of the intended

    audience.

    2.25 points

    The thesis, position, or

    purpose is discernable in

    most aspects, but is

    occasionally weak or unclear.

    There is limited awareness of

    the appropriate audience.

    2.55 points

    The thesis, position, or

    purpose is adequately

    presented. An awareness of

    the appropriate audience is

    demonstrated.

    3 points

    The thesis, position, or

    purpose is clearly

    communicated throughout

    and clearly directed to a

    specific audience.

    Development, Structure,

    and Conclusion

    Advances position or

    purpose throughout writing;

    conclusion aligns to and

    evolves from development.

    0 points

    No advancement of the

    thesis, position, or purpose is

    evident. Connections

    between paragraphs are

    missing or inappropriate. No

    conclusion is offered.

    1.95 points

    Writing lacks logical

    progression of the thesis,

    position, or purpose. Some

    organization is attempted,

    but ideas are disconnected.

    Conclusion is unclear and not

    supported by the overall

    development of the purpose.

    2.25 points

    Limited advancement of

    thesis, position, or purpose is

    discernable. There are

    inconsistencies in

    organization or the

    relationship of ideas.

    Conclusion is simplistic and

    not fully aligned to the

    development of the purpose.

    2.55 points

    The thesis, position, or

    purpose is advanced in most

    aspects. Ideas clearly build

    on each other. Conclusion

    aligns to the development of

    the purpose.

    3 points

    The thesis, position, or

    purpose is logically advanced

    throughout. The progression

    of ideas is coherent and

    unified. A clear and logical

    conclusion aligns to the

    development of the purpose.

    Mechanics of Writing 0 points 1.95 points 2.25 points 2.55 points 3 points
    © 2026. Grand Canyon University. All Rights Reserved.

    [https://www.gce.com/](https://www.gce.com/)

    [https://www.gce.com/](https://www.gce.com/)

    Criterion 1. Unsatisfactory 2. Insufficient 3. Approaching 4. Acceptable 5. Target

    Includes spelling,

    capitalization, punctuation,

    grammar, language use,

    sentence structure, etc.

    Errors in grammar or syntax

    are pervasive and impede

    meaning. Incorrect language

    choice or sentence structure

    errors are found throughout.

    Frequent and repetitive

    mechanical errors are

    present. Inconsistencies in

    language choice or sentence

    structure are recurrent.

    Occasional mechanical errors

    are present. Language choice

    is generally appropriate.

    Varied sentence structure is

    attempted.

    Few mechanical errors are

    present. Suitable language

    choice and sentence

    structure are used.

    No mechanical errors are

    present. Appropriate

    language choice and

    sentence structure are used

    throughout.

    Format/Documentation

    Uses appropriate style, such

    as APA, MLA, etc., for college,

    subject, and level;

    documents sources using

    citations, footnotes,

    references, bibliography, etc.,

    appropriate to assignment

    and discipline.

    0 points

    Appropriate format is not

    used. No documentation of

    sources is provided.

    1.95 points

    Appropriate format is

    attempted, but some

    elements are missing.

    Frequent errors in

    documentation of sources

    are evident.

    2.25 points

    Appropriate format and

    documentation are used,

    although there are some

    obvious errors.

    2.55 points

    Appropriate format and

    documentation are used with

    only minor errors.

    3 points

    No errors in formatting or

    documentation are present.

    © 2026. Grand Canyon University. All Rights Reserved.

    [https://www.gce.com/](https://www.gce.com/)

    [https://www.gce.com/](https://www.gce.com/)

  • [Solved] ED

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    [>Anatomy homework help](https://www.sweetstudy.com/fields/biology-anatomy) – [\ \ 20260320_235214.jpg](https://www.sweetstudy.com/files/20260320-235214-jpg "20260320_235214.jpg")

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    [>Anatomy homework help](https://www.sweetstudy.com/fields/biology-anatomy)

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  • [Solved] Discussion 5

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    In-depth study guidance and analytical solution covering Discussion 5.

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  • [Solved] Post discussion

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    – Pull your state of practice prescribing regulations for the APN and provide a _**detailed summary of state requirements**_. Be sure to include prescribing responsibilities and continuing education requirements. Include the following in your response, – Submit a copy of your state practice act rega…

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    – Pull your state of practice prescribing regulations for the APN and provide a _**detailed summary of state requirements**_. Be sure to include prescribing responsibilities and continuing education requirements. Include the following in your response,

    – Submit a copy of your state practice act regarding prescribing.
    – Discuss the components of the practice act related to prescribing for the APRN in your chosen state of practice.
    – Identify specifics related to state of practice prescriptive authority.
    – How do the regulations support advocating for structures, policies, and processes that promote a culture of safety and prevent risks and injury.
    – Discuss state specific continuing education requirements for prescriptive authority.
    – How can you use the website and resources for process improvement, to inform change, or to create policy recommendation.

  • [Solved] week 3 response 2

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    see attachment 2 paragraph response add or put your opinion towards this response **files (1)** – ## week3response2.pdf **## week3response2.pdf** Case Scenario 2 Reese is a 2 year old who comes to the clinic because her parents have noted her left eye deviates nasally more than the right. Her parent…

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    Assignment Prompt & Instructions

    see attachment

    2 paragraph response

    add or put your opinion towards this response

    **files (1)**

    – ## week3response2.pdf

    **## week3response2.pdf**

    Case Scenario 2

    Reese is a 2 year old who comes to the clinic because her parents have noted her left
    eye deviates nasally more than the right. Her parents have noted Reese squints and tilts
    her head often and seems to have decreased visual acuity from her left eye. They are
    concerned about her vision.

    Reese has findings that are concerning for strabismus, probably esotropia. The child is at
    risk for amblyopia if intervention is not pursued quickly.

    Relevant Questions
    I would ask the parents about onset, progression, and exacerbating factors. I would want
    to know how long ago they noticed the deviation in his eye and if it is present all the
    time. Do they notice if it gets worse when he becomes tired or is sick? Also, I would ask
    if they have noticed it seeming to get worse since they first noticed it.

    I would inquire if Reese has demonstrated behaviors such as rubbing his eyes, closing
    one eye to see, or difficulty tracking items. Questions regarding Reese’s birth history,
    such as if he was premature or had any birth complications, would be pertinent. Asking
    about any neurologic history would be important as well. Family history of strabismus,
    amblyopia, or having to wear corrective lenses at a young age would be helpful to know,
    as there can be a genetic component to many eye conditions. Last, I would ask if there
    were any red flag symptoms, such as acute onset, headache, or vomiting, to assess for
    possible serious neurologic issues (Burns et al., 2022).

    Exam to Perform

    The exam should include testing visual acuity and performing a complete eye exam.
    Testing visual acuity can be done with picture charts or by simply observing fixation and
    tracking of objects. Testing eye alignment with the corneal light reflex, also known as the
    Hirschberg test, is important. Asymmetrical light reflection indicates strabismus.
    However, the cover-uncover test would be the best test to perform to confirm this
    diagnosis. By covering each eye in succession, a manifest deviation, or tropia, can be
    identified. An alternate cover test can be performed to identify latent deviations, or
    phorias.

    Assessment of extraocular movements would be prudent to evaluate cranial nerves II
    through VI. A red reflex exam should be performed in children to rule out cataracts or
    retinoblastoma. Additionally, referral for cycloplegic refraction should be sent to a

    pediatric ophthalmologist (American Academy of Ophthalmology [AAO], 2023).

    Management

    Pediatric ophthalmology should be contacted, and Reese should be seen as soon as
    possible. Although not always necessary, children that are treated early for their crossed
    eyes have less risk for long-term complications. Refractive errors are typically treated
    first with glasses. If amblyopia is also present, occlusion of the good eye can force use of
    the amblyopic eye. Atropine drops can also be used to blur vision in the good eye. Vision
    therapy may also help these eyes work together. Some patients may need surgery to
    correct the eye muscle alignment. Parents should be educated that the sooner the
    condition is treated, the better the outcomes will be, and vision loss can be prevented
    (AAO, 2023).

    Potential Complications if Left Untreated

    The biggest complication of leaving Reese’s condition untreated is amblyopia. The brain
    will suppress the image seen by the weaker eye resulting in loss of vision in that eye.
    Loss of binocular vision will also occur, affecting depth perception. Over time, the
    crossed eyes may become permanent. Other problems due to impaired vision can arise
    such as delays in motor skills, difficulty coordinating, and social issues (Burns et al.,
    2022).

    **## week3response2.pdf**

    Case Scenario 2

    Reese is a 2 year old who comes to the clinic because her parents have noted her left
    eye deviates nasally more than the right. Her parents have noted Reese squints and tilts
    her head often and seems to have decreased visual acuity from her left eye. They are
    concerned about her vision.

    Reese has findings that are concerning for strabismus, probably esotropia. The child is at
    risk for amblyopia if intervention is not pursued quickly.

    Relevant Questions
    I would ask the parents about onset, progression, and exacerbating factors. I would want
    to know how long ago they noticed the deviation in his eye and if it is present all the
    time. Do they notice if it gets worse when he becomes tired or is sick? Also, I would ask
    if they have noticed it seeming to get worse since they first noticed it.

    I would inquire if Reese has demonstrated behaviors such as rubbing his eyes, closing
    one eye to see, or difficulty tracking items. Questions regarding Reese’s birth history,
    such as if he was premature or had any birth complications, would be pertinent. Asking
    about any neurologic history would be important as well. Family history of strabismus,
    amblyopia, or having to wear corrective lenses at a young age would be helpful to know,
    as there can be a genetic component to many eye conditions. Last, I would ask if there
    were any red flag symptoms, such as acute onset, headache, or vomiting, to assess for
    possible serious neurologic issues (Burns et al., 2022).

    Exam to Perform

    The exam should include testing visual acuity and performing a complete eye exam.
    Testing visual acuity can be done with picture charts or by simply observing fixation and
    tracking of objects. Testing eye alignment with the corneal light reflex, also known as the
    Hirschberg test, is important. Asymmetrical light reflection indicates strabismus.
    However, the cover-uncover test would be the best test to perform to confirm this
    diagnosis. By covering each eye in succession, a manifest deviation, or tropia, can be
    identified. An alternate cover test can be performed to identify latent deviations, or
    phorias.

    Assessment of extraocular movements would be prudent to evaluate cranial nerves II
    through VI. A red reflex exam should be performed in children to rule out cataracts or
    retinoblastoma. Additionally, referral for cycloplegic refraction should be sent to a

    pediatric ophthalmologist (American Academy of Ophthalmology [AAO], 2023).

    Management

    Pediatric ophthalmology should be contacted, and Reese should be seen as soon as
    possible. Although not always necessary, children that are treated early for their crossed
    eyes have less risk for long-term complications. Refractive errors are typically treated
    first with glasses. If amblyopia is also present, occlusion of the good eye can force use of
    the amblyopic eye. Atropine drops can also be used to blur vision in the good eye. Vision
    therapy may also help these eyes work together. Some patients may need surgery to
    correct the eye muscle alignment. Parents should be educated that the sooner the
    condition is treated, the better the outcomes will be, and vision loss can be prevented
    (AAO, 2023).

    Potential Complications if Left Untreated

    The biggest complication of leaving Reese’s condition untreated is amblyopia. The brain
    will suppress the image seen by the weaker eye resulting in loss of vision in that eye.
    Loss of binocular vision will also occur, affecting depth perception. Over time, the
    crossed eyes may become permanent. Other problems due to impaired vision can arise
    such as delays in motor skills, difficulty coordinating, and social issues (Burns et al.,
    2022).

  • [Solved] week 3 response 1

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    see attachment 2 paragraphs response, to either add or give your view **files (1)** – ## week3response1.pdf **## week3response1.pdf** Case Scenario 4: Tony 3-year-old who is brought to the clinic by his parents for right ear pain and a fever of 101 for the past 2 days. His mother says he was coughin…

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    Assignment Prompt & Instructions

    see attachment

    2 paragraphs response, to either add or give your view

    **files (1)**

    – ## week3response1.pdf

    **## week3response1.pdf**

    Case Scenario 4: Tony

    3-year-old who is brought to the clinic by his parents for right ear pain and a fever of
    101 for the past 2 days. His mother says he was coughing and had a runny nose 5 days
    earlier. On exam, he has a bulging TM. He attends daycare. His past history is significant
    for Type I Penicillin allergy, and he is up to date on his immunizations. He weighs 33
    pounds.

    What physical exam components should the APRN perform?

    Ear exam with an otoscope in addition to supporting signs and symptoms, is sufficient
    for the diagnosis of Acute Otitis Media (Danishyar & Ashurst, 2023). According to the
    AAP guidelines, Tony has evidence of bulging of the tympanic membrane with new
    onset of ear pain, fever, and respiratory tract symptoms, which correlate with the
    diagnosis of AOM (AAP, 2013).

    How should the APRN manage Tony?

    The goal of treatment is to control pain and treat the infectious process with antibiotics.

    Pain: Ibuprofen 10mg/kg every 6-8 hours, maximum of 40mg/kg/day.

    For Tony, give 5ml (100mg/5ml formulation) every 6-8 hours

    Abx: Penicillin is first line for AOM but due to his IgE-mediated reaction, an alternative is
    Azithromycin 10mg/kg on the first day, then 5mg/kg on days 2-5, maximum 500mg/day
    1 and maximum 250mg for days 2-5 (UpToDate, 2025).

    For Tony, give 5ml (100mg/5ml formulation) on day one and 2.5ml on days 2-5.

    What education should the APRN provide to Tony's parents?

    Parents should be informed about the pathophysiology of AOM, which commonly occurs
    after URI and in children due to their anatomy. Children have horizontal ear canals that
    inhibit proper drainage of fluid, unlike adults.

    Parents should be educated on the importance of hand hygiene, PCV13 and influenza
    vaccines for the prevention of upper respiratory tract infections and the avoidance of
    tobacco smoke exposure. Important to take medication as prescribed for the entire

    course, choosing a licensed day care facility, and follow up if symptoms do not resolve or
    worsen (Maaks et al., 2019).

    **## week3response1.pdf**

    Case Scenario 4: Tony

    3-year-old who is brought to the clinic by his parents for right ear pain and a fever of
    101 for the past 2 days. His mother says he was coughing and had a runny nose 5 days
    earlier. On exam, he has a bulging TM. He attends daycare. His past history is significant
    for Type I Penicillin allergy, and he is up to date on his immunizations. He weighs 33
    pounds.

    What physical exam components should the APRN perform?

    Ear exam with an otoscope in addition to supporting signs and symptoms, is sufficient
    for the diagnosis of Acute Otitis Media (Danishyar & Ashurst, 2023). According to the
    AAP guidelines, Tony has evidence of bulging of the tympanic membrane with new
    onset of ear pain, fever, and respiratory tract symptoms, which correlate with the
    diagnosis of AOM (AAP, 2013).

    How should the APRN manage Tony?

    The goal of treatment is to control pain and treat the infectious process with antibiotics.

    Pain: Ibuprofen 10mg/kg every 6-8 hours, maximum of 40mg/kg/day.

    For Tony, give 5ml (100mg/5ml formulation) every 6-8 hours

    Abx: Penicillin is first line for AOM but due to his IgE-mediated reaction, an alternative is
    Azithromycin 10mg/kg on the first day, then 5mg/kg on days 2-5, maximum 500mg/day
    1 and maximum 250mg for days 2-5 (UpToDate, 2025).

    For Tony, give 5ml (100mg/5ml formulation) on day one and 2.5ml on days 2-5.

    What education should the APRN provide to Tony's parents?

    Parents should be informed about the pathophysiology of AOM, which commonly occurs
    after URI and in children due to their anatomy. Children have horizontal ear canals that
    inhibit proper drainage of fluid, unlike adults.

    Parents should be educated on the importance of hand hygiene, PCV13 and influenza
    vaccines for the prevention of upper respiratory tract infections and the avoidance of
    tobacco smoke exposure. Important to take medication as prescribed for the entire

    course, choosing a licensed day care facility, and follow up if symptoms do not resolve or
    worsen (Maaks et al., 2019).

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