This reflection journal also allows students to outline what they have discovere

This reflection journal also allows students to outline what they have discovered about their professional practice, personal strengths and weaknesses, and additional resources that could be introduced in a given situation to influence optimal outcomes. Each week students should also explain how they met a course competency or course objective(s).
students should reflect on the personal knowledge and skills gained throughout the course. Journal entries should address one or more of the areas stated below. In the Topic 10 graded submission, each of the areas below should be addressed as part of the summary submission.
New practice approaches
Interprofessional collaboration
Health care delivery and clinical systems
Ethical considerations in health care
Practices of culturally sensitive care
Ensuring the integrity of human dignity in the care of all patients
Population health concerns
The role of technology in improving health care outcomes
Health policy
Leadership and economic models
Health disparities

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This assignment refers to the Histogram shown on the left that depicts the distr

This assignment refers to the Histogram shown on the left that depicts the distribution of a set of quiz scores. Q 1 requires application of learning from Module 9 combined with new learning from Module 10. Q’s 2-6 require your interpretation of the Histogram.
NOTE: You must answer ALL of the following questions to receive full points, and to have your attendance recorded for Week 10.
1. Based only on the level of measurement (NOIR Scale) of the quiz scores, would the appropriate branch of statistics to analyze the scores be parametric or non-parametric? Explain.
2. Is the distribution of the Quiz 1 scores normal or skewed? Explain.
3. If the distribution of quiz scores is skewed, is the direction of the skew positive or negative? Explain.
4. If quiz scores are normally distributed, would the appropriate branch of statistics used to analyze these data be parametric or non-parametric? Explain.
5. If distribution of quiz scores is skewed, would the appropriate branch of statistics used to analyze these data be parametric or non-parametric? Explain.
6. Provide a short summary statement of your Histogram findings. In other words, what is your overall interpretation of class performance on the quiz based on your analysis of the Histogram?
Please include : Jennifer R. Gray, S. K. (2021). THE PRACTICE OF NURSING RESEARCH. Appraisal, Synthesis, and Generation of Evidence. (9TH ed.). St Louis, Missouri: ELSEVIER. as one of the references

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Research, compose, and type a scholarly paper based on the scenario provided by

Research, compose, and type a scholarly paper based on the scenario provided by your faculty, and choose a
conclusion scenario to discuss within the body of your paper. Reflect on lessons learned in this class about
technology, privacy concerns, and legal and ethical issues and address each of these concepts in the paper. Consider
the consequences of such a scenario. Do not limit your review of the literature to the nursing discipline only because
other health professionals are using the technology, and you may need to apply critical thinking skills to its
applications in this scenario.
Scholarly Writing and APA Format • Paper submitted as a Microsoft Word document.
• Adheres to current APA formatting guidelines.
• Length is 4‐5 pages, excluding title and reference pages.
• Includes at least three (3) references that are:
• From recent (within the last 5 years) scholarly sources
• Cited in text appropriately
• Included on an APA formatted reference page
• Scholarly writing reflects:
• Accurate spelling
• Correct use of professional grammar
• Logical organization of thoughts (mechanics) less than 10% plagerisim (paper will be submited into Turnitin by the professor.

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Clare is brought to the ER after slashing her wrist with a razor. She had previo

Clare is brought to the ER after slashing her wrist with a razor. She had previously been in the ER for drug overdose and has history of addictions. She can be sarcastic, belittling and aggressive to those who try to care for her. She has a history of difficulty with interpersonal relationships at her job. Clare is diagnosed with borderline personality disorder. First, identify the defense mechanisms Clare is using, and second,d iscuss the various dialectical behavioral activities that can be utilzed with Clare. Body of work has to be pages not including reference page, apa7th edition citation scholarly and research citation

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End-of-life care becomes an issue at some point for elderly clients. Even with t

End-of-life care becomes an issue at some point for elderly clients. Even with the emergence of palliative care programs and hospice programs, most elderly people do not die in their own home as is their preference. What are the reasons for this trend? Discuss what you can do as a nurse to support your clients regarding end-of-life care in accordance with their wishes. Support your response with evidence-based literature.

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I need this paper to be at a master’s level. I need 6 sources – 2 peer-reviewed

I need this paper to be at a master’s level. I need 6 sources – 2 peer-reviewed (all sources must be within the last 5 years and reputable in the nursing field). It must be in APA 7 format. I need the paper to have an abstract, as well. The rubric containing additional information for the paper is attached below. I am also attaching a ppt with information from class to help get an idea.
Leadership styles to discuss: authoritarian, democratic, and laissez-faire.
Discuss prioritization of patients and delegation accordingly by the rubric.
Laissez-faireLaissez-faire

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Requirements: Content Criteria: Read the case study listed below. Refer to the r

Requirements:
Content Criteria:
Read the case study listed below.
Refer to the rubric for grading requirements.
Utilizing the Week 3 Case Study Template
(Links to an external site.)
, provide your responses to the case study questions listed below.
You must use at least one scholarly reference to provide pathophysiology statements. For this class, use of the textbook for pathophysiology statements is acceptable. You may also use an appropriate evidence-based journal.
You must use the current Clinical Practice Guideline (CPG) for the management and prevention of COPD (GOLD Criteria) to answer the classification of severity and treatment recommendation questions. The most current guideline may be found at the following web address: https://goldcopd.org/
(Links to an external site.)
. At the website, locate the current year’s CPG and download a personal copy for use. You may also use a medication administration reference such as Epocrates to provide medication names.
Proper APA format (in-text citations, reference page, spelling, English language, and grammar) must be used.
Case Study Scenario
Chief Complaint
A.C., is a 61-year old male with complaints of shortness of breath.
History of Present Illness
A.C. was seen in the emergency room 1 week ago for an acute onset of mid-sternal chest pain. The event was preceded with complaints of fatigue and increasing dyspnea for 3 months, for which he did not seek care. He was evaluated by cardiology and underwent a successful and uneventful angioplasty prior to discharge. Despite the intervention, the shortness of breath has not improved. Since starting cardiac rehabilitation, he feels that his breathlessness is worse. The cardiologist has requested that you, his primary care provider, evaluate him for further work-up. Prior to today, his last visit with your practice was 3 years ago when he was seen for acute bronchitis and smoking cessation counseling.
Past Medical History
Hypertension
Hyperlipidemia
Atherosclerotic coronary artery disease
Smoker
Family History
Father deceased of acute coronary syndrome at age 65
Mother deceased of breast cancer at age 58.
One sister, alive, who is a 5 year breast cancer survivor.
One son and one daughter with no significant medical history.
Social History
35 pack-year smoking history; he has cut down to one cigarette at bedtime following his cardiac intervention.
Denies alcohol or recreational drug use
Real estate agent
Allergies
No Known Drug Allergies
Medications
Rosuvastatin 20 mg once daily by mouth
Carvedilol 25 mg twice daily by mouth
Hydrochlorothiazide 12.5 mg once daily by mouth
Aspirin 81mg daily by mouth
Review of Systems
Constitutional: Denies fever, chills or weight loss. + Fatigue.
HEENT: Denies nasal congestion, rhinorrhea or sore throat.
Chest: + dyspnea with exertion. Denies productive cough or wheezing. + Dry, nonproductive cough in the AM.
Heart: Denies chest pain, chest pressure or palpitations.
Lymph: Denies lymph node swelling.
General Physical Exam
Constitutional: Alert and oriented male in no apparent distress.
Vital Signs: BP-120/84, T-97.9 F, P-62, RR-22, SaO2: 93%
Wt. 180 lbs., Ht. 5’9″
HEENT
Eyes: Pupils equal, round and reactive to light and accommodation, normal conjunctiva.
Ears: Tympanic membranes intact.
Nose: Bilateral nasal turbinates without redness or swelling. Nares patent.
Mouth: Oropharynx clear. No mouth lesions. Dentures well-fitting. Oral mucous membranes dry.
Neck/Lymph Nodes
Neck supple without JVD.
No lymphadenopathy, masses or carotid bruits.
Lungs
Bilateral breath sounds clear throughout lung fields. + Bilaterally wheezes noted with forced exhalation along with a prolonged expiratory phase. No intercostal retractions.
Heart
S1 and S2 regular rate and rhythm, no rubs or murmurs.
Integumentary System
Skin cool, pale and dry. Nail beds pink without clubbing.
Chest X-Ray
Lungs are hyper-inflated bilaterally with a flattened diaphragm. No effusions or infiltrates.
Spirometry
Predicted Pre-bronchodilator % Predicted Post-bronchodilator % Predicted Change
FVC (L)
5.64
5.23
93
5.77
102
9%
FEV1 (L)
4.57
2.92
64
3.01
66
2%
FEV1/FVC (%)
81
56
69
52
64
-5%
TLC
5.5
6.9
125
6.9
125
0%
Case Study Questions
Pathophysiology & Clinical Findings of the Disease
Are the spirometry results consistent with obstructive or restrictive pulmonary disease? What is the most likely pulmonary diagnosis for this patient?
Explain the pathophysiology associated with the chosen pulmonary disease.
Identify at least three subjective findings from the case which support the chosen diagnosis.
Identify at least three objective findings from the case which support the chosen diagnosis.
Management of the Disease
*Utilize the required Clinical Practice Guideline (CPG) to support your treatment recommendations.
Classify the patient’s disease severity. Is this considered stable or unstable?
Identify two (2) “Evidence A” recommended medication classes for the treatment of this condition and provide an example (drug name) for each.
Describe the mechanism of action for each of the medication classes identified above.
Identify two (2) “Evidence A” recommended non-pharmacological treatment options for this patient.
Category Points % Description
Pathophysiology & Clinical Findings of the Disease
45
45%
The student:
Identifies the correct spirometry pattern and likely diagnosis.
Explains the pathophysiology associated with the chosen disorder.
Supports the pathophysiology statement with at least one appropriate, scholarly reference (textbook is acceptable for pathophysiology statements only).
Identifies at least three subjective findings from the case.
Identifies at least three objective findings from the case.
(5 Required Elements)
Management of the Disease
45
45%
The student:
Utilizes the required Clinical Practice Guideline (CPG) to support the chosen treatment recommendations.
Correctly classifies the disease severity and states whether or not the disease is stable or unstable.
Identifies two (2)“Evidence A” recommendedmedicationclassesfor the treatment of the condition and provides an example (drug name) for each.
Identifies two (2) “Evidence A” recommended non-pharmacological treatment options for the condition.
(4 Required Elements)
90
90%
Total CONTENT Points= 90 pts
Assignment Format
Category
Points
%
Description
Organization, spelling, grammar & APA format
10
10%
The student:
Uses the week 3case study template for case study responses.
Provides correct in-text citations for responses which match the reference page.
Has minimal spelling, grammar & APA format errors.
100
100%
Total FORMAT Points= 10 pts
ASSIGNMENT TOTAL=100 points
Week 3 Respiratory Case Study
Criteria Ratings Pts
This criterion is linked to a Learning Outcome
Pathophysiology & Clinical Findings of the Disease
The student:
– Identifies the correct spirometry pattern and likely diagnosis.
– Explains the pathophysiology associated with the chosen disorder.
– Supports the pathophysiology statement with at least one appropriate, scholarly reference (textbook is acceptable for pathophysiology statements only).
– Identifies at least three subjective findings from the case.
– Identifies at least three objective findings from the case.
(5 Required Elements)
45 pts
All 5 required elements are present.
41 pts
1 required element is missing.
37 pts
2 required elements are missing
23 pts
3-4 required elements are missing.
0 pts
All 5 required elements are missing.
45 pts
This criterion is linked to a Learning Outcome
Management of the Disease
The student:
– Utilizes the required Clinical Practice Guideline (CPG) to support the chosen treatment recommendations.
– Correctly classifies the disease severity and states whether or not the disease is stable or unstable.
– Identifies two (2) “Evidence A” recommended medication classes for the treatment of the condition and provides an example (drug name) for each.
– Identifies two (2) “Evidence A” recommended non-pharmacological treatment options for the condition.
(4 Required Elements)
45 pts
All 4 elements are present
41 pts
1 required element is missing
37 pts
2 required elements are missing
23 pts
3 required elements are missing
0 pts
All 4 required elements are missing
45 pts
This criterion is linked to a Learning Outcome
Organization, spelling, grammar & APA format
The student:
Uses the week 3 case study template for case study responses.
Provides correct in-text citations for responses which match the reference page.
Has minimal spelling, grammar & APA format errors.
10 pts
Case study template is used for responses AND In-text citations are correct which match the reference page AND There are 0-2 errors in spelling, grammar or APA format.
9 pts
Case study template is used for responses AND In-text citations are correct which match the reference page AND There are 3-5 errors in spelling, grammar or APA format.
8 pts
Case study template is used for responses AND In-text citations are correct which match the reference page AND There are 6-8 errors in spelling, grammar or APA format.
5 pts
Case study template is not used for responses OR In-text citations are incorrect or do not match the reference page AND There are 0-5 errors in spelling, grammar or APA format.
0 pts
Case study template is not used for responses AND/OR In-text citations are incorrect or do not match the reference page AND There are 6 or more errors in spelling, grammar or APA format.
10 pts
This criterion is linked to a Learning Outcome
Late penalty deductions
Students are expected to submit assignments by the time they are due. Assignments submitted after the due date and time will receive a deduction of 10% of the total points possible for that assignment for each day the assignment is late. Assignments will be accepted, with penalty as described, up to a maximum of three days late, after which point a zero will be recorded for the assignment. Quizzes and discussions are not considered assignments and are not part of the late assignment policy.
0 pts
Manual Deductions

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Peer Responses: Due: Monday, Length: A minimum of 150 words per post, not includ

Peer Responses:
Due: Monday,
Length: A minimum of 150 words per post, not including references
Citations: At least one high-level scholarly reference in APA per post from within the last 5 years
Peer Post:
Questions / Answer And Explanations
What concerns do you have about her current regimen, and what alternatives will you discuss and offer? What other screenings might you apply? What are your own ethical standards on this case that you might consider in addition to legal standards?
Concerns about Patient ML current regimen
The patient asked to refill her meds for 6 months, prescription drug addiction is so common. It’s not that they don’t believe in you or that they believe you’re a drug addict. If they prescribe controlled substances to persons who abuse them or sell them to others, they risk losing their medical license and facing criminal charges
alternatives:
Let the patient sign a pain management agreement form or contract
pill counting
other screenings that I can apply
random drug testing
This condition is frequently included in the contract since doctors want to make sure that the patient aren’t misusing the medications. They also want to make sure the patient is the only one who’s taking the drug. As a result, they test you at random and then determine how much drug is in the patient’s system.
Pill counting on a regular basis can be a valuable method for ensuring medication adherence and reducing diversion, such as selling, sharing, or giving away prescriptions.
my own ethical standards on this case it is the health care worker’s role to collaborate with the patient to better understand the symptoms and underlying causes. A healthcare worker must educate the patient on the problem and potential intervention choices, just as they must with any illness, while carefully weighing the risks and benefits of each approach. A treatment plan is created by the patient and the provider together.
Step-by-step explanation
Provide a sample of an appropriate pain contract that would suit this patient and address her specific safety concerns (cite it and attach the actual contract you found – you do not have to make your own – there are plenty online)
Patient Pain Medication Agreement And Consent

Click to access patient_pain_agreement_english.pdf


Include your steps to ensure safe prescribing. Include the registry you will search prior to any prescribing; name the CA registry and if you are in a different state, you should name that registry also.
Step 1. Evaluate and define the patient’s issue clearly.
Step 2. Determine the therapeutic goal.
Step 3. Choose the Correct Drug Therapy
Step 4. Start therapy with the right information and nonpharmacologic treatments in mind.
Step 5. Provide information, instructions, and cautionary statements.
Step 6. Evaluate Therapy Regularly
Step 7. When prescribing, keep the cost of the drug in mind.
Step 8. Prescription Errors Can Be Reduced by Using Computers and Other Tools
Controlled Substance Utilization Review and Evaluation System (CURES) and Controlled Substance Prescriptions
If you were to keep her current list, what are the laws surrounding refills and the amounts you are allowed to dispense with the schedule II and III medications in the state of CA? In your own state?
Section 11164 of the Health and Safety Code
The prescription must be signed and dated in ink by the prescriber, and it must include the prescriber’s address and phone number, as well as the name of the ultimate user or research subject, or other contact information as determined by the Secretary of the United States Department of Health and Human Services; refill information and other information as determined by the Secretary of the United States Department of Health and Human Services. as well as the prohibited substance’s name, quantity, strength, and usage instructions.
Which medications on her list may you call into the pharmacy and which would you need a written script or electronic order? What are some elements required to include on the prescription form (paper or electronic signature) for the scheduled medications?
All of her medicines are prescription drugs (Losartan, Gabapentin, Atorvastatin, Diazepam, Norco)
Date of issue
Patient’s name and address
Clinician name, address, DEA number
Drug name
Drug strength
Dosage form
Quantity prescribed
Directions for use
Number of refills
Signature of prescriber
After you prescribe, how, when, and where would you (or your staff) go about making a report of your scheduled prescription in the state registry so that other prescribers and pharmacies could be aware?
Pharmacists and direct dispensers must disclose information on all Schedule II-IV restricted substances supplied within seven days of the dispensation.
After that, the data is entered into CURES.
The system currently provides prescription detail for an individual patient’s prescription records (Patient Activity Report, or PAR) to authorized prescribers and dispensers who have registered on the system, which includes the patient’s name, date of birth, and address; drug name, form, strength, quantity, dispensing pharmacy name, and license number;
DEA prescribes the certificate number, the prescriber’s name, the prescription number, the refill number, and the date of dispense are all included. This information can be used by a physician for a variety of purposes, including detecting a patient who may be a “doctor shopper,” evaluating medications supplied to the patient that was prescribed by other doctors and providing a complete picture of Scheduled pharmaceuticals dispensed to a patient.
In restricted states, APRN prescribers must follow a standardized procedure or protocol for furnishing schedule II and III controlled substances with a patient-specific approach. Please outline the minimum required components of a protocol. You may outline this in bullet form. Alternatively, you may find an appropriate protocol, clinical guideline, or standardized procedure from a literature search and attach it in lieu of outlining your own protocol.

Click to access pain-guidelines.pdf


References
Guide to the Laws Governing the Practice of Medicine by …
https://www.mbc.ca.gov › Download › Documents

Click to access pain-guidelines.pdf


Newsletter – Spring 2019 – Medical Board of California – CA.gov
https://www.mbc.ca.gov › Download › Newsletters

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Peer Responses: Due: Monday, Length: A minimum of 150 words per post, not includ

Peer Responses:
Due: Monday,
Length: A minimum of 150 words per post, not including references
Citations: At least one high-level scholarly reference in APA per post from within the last 5 years
Peer Post:
What concerns do you have about her current regimen, and what alternatives will you discuss and offer? What other screenings might you apply? What are your own ethical standards on this case that you might consider in addition to legal standards? In this particular case, one major concern is the request for 6 months of Norco. Substance abuse with narcotics is very common and needs to be closely monitored. This patient would benefit from a pain contract to have her accountable and also protect the provider’s license. Aside from the addiction standpoint, it would be advantageous to the patient to have baseline lab values to monitor kidney and liver function while on these medications. Random drug testing for this patient might also be beneficial to make sure they are taking this appropriately to monitor how much drug they have in their system as well as checking to see if they are abusing any other drugs. The patient’s blood pressure should also be monitored as her systolic bp is slightly elevated at 135. She should be monitoring her BP daily prior to pill administration or if she is symptomatic. Stress seems to be an issue in her life and managed with smoking. I would provide her with smoking cessation information as well as healthy lifestyle information and stress reliving education like medication and exercise.
Provide a sample of an appropriate pain contract that would suit this patient and address her specific safety concerns (cite it and attach the actual contract you found – you do not have to make your own – there are plenty online)
“Beginning January 1, 2021, the dispensing of a controlled substance must be reported to the Controlled Substance Utilization Review and Evaluation System (CURES) within one working day after the medication is released to the patient or the patient’s representative. Previously, the deadline to report was seven days after dispensing” (DCA, 2021).
Further, this law requires reporting the dispensing of Schedule V drugs, in addition to Schedules II, III, and IV. This requirement applies to pharmacists and prescribers who dispense controlled substances” (DCA, 2021).
If you were to keep her current list, what are the laws surrounding refills and the amounts you are allowed to dispense with the schedule II and III medications in the state of CA? In your own state? “prescribers may continue to issue electronically transmitted prescription for Schedule III, IV, and V controlled substances, as authorized by Health and Safety Code section 11164 (b)(1). “
Questions to ask when refilling according to Rosenthal & Burchum (2021)—Is this a newer medication for the patient, and I changing the dose or frequency, am I adding meds, any side effects to be concerned with, when is follow-up, is this a schedule II-If any other the answers were yes consider a shorter time between refills (1-3 months)
Which medications on her list may you call into the pharmacy and which would you need a written script or electronic order? What are some elements required to include on the prescription form (paper or electronic signature) for the scheduled medications? Written prescriptions are still acceptable until January 2022, as are oral prescriptions for Schedule III-V controlled substances. If used, electronic prescriptions for Schedule II-V controlled substances must meet DEA regulatory requirements . Also of note, “These federal laws include incentive payments under Medicare for prescribers who reach certain e-prescribing and/or EMR thresholds. Prescribers may receive incentive payments on their billings of up to 2% in 2009 and 2010, 1% in 2011 and 2012, and 0.5% in 2013; they may be hit with penalties of 1% in 2012, 1.5% in 2013, and 2% in 2014 and beyond, for failure to meet these e-prescribing/EMR thresholds” (DCA, 2021).
According to the DCA (2021) “Starting January 1, 2021, pads used to write and fill prescriptions for controlled substances are required to have a 12-character serial number, a corresponding barcode, required by Assembly Bill 149. Prescribers who do not possess these prescription pads are encouraged to place an order as soon as possible from a Security Prescription Printer approved by the Department of Justice. ”
***The Board would also like to remind you that by January 1, 2022, all prescriptions must be submitted electronically, with a few exemptions, pursuant to Assembly Bill 2789 of 2018.
The following information must be included in the script: Date of issue, Patient’s name and address, Clinician name, address, DEA number, Drug name, Drug strength, Dosage form, Quantity prescribed, Directions for use, Number of refills, & Signature of prescriber (DCA, 2021).
In the case of this patient, it is best practice to electronically fill these scripts however it is possible to call in all the drugs that are not schedule III to V. This would mean her Norco and diazepam would not be able to be called in.
After you prescribe, how, when, and where would you (or your staff) go about making a report of your scheduled prescription in the state registry so that other prescribers and pharmacies could be aware?
According to the DCA (2021) “Beginning January 1, 2021, the dispensing of a controlled substance must be reported to the Controlled Substance Utilization Review and Evaluation System (CURES) within one working day after the medication is released to the patient or the patient’s representative. Previously, the deadline to report was seven days after dispensing” (DCA, 2021).
In restricted states, APRN prescribers must follow a standardized procedure or protocol for furnishing schedule II and III controlled substances with a patient-specific approach. Please outline the minimum required components of a protocol. You may outline this in bullet form. Alternatively, you may find an appropriate protocol, clinical guideline, or standardized procedure from a literature search and attach it in lieu of outlining your own protocol.
The minimum required components of a protocol might include: Checking cures for complete list of patient controlled medications, assess for duplications, interactions, and allergies. Enter prescription info into Cures with in one day (Stachowicz, 2021)
OR THE PREPOPULATED PAIN CONTROL POROTCOL

Click to access pain-guidelines.pdf


Medical Board of California. (2021). New Prescribing and Reporting Rules for Controlled Substances Coming January 1, 2021. Retrieved from Prescribing Rules (ca.gov)
California State Board of Pharmacy and Medical Board of California. (2010). Transmission and Receipt of Electronic Controlled Substance Prescriptions. Retrieved from E Prescribing (ca.gov)
Rosenthal, L.D., & Burchum, J. R. (2021). Lehne’s pharmacotherapeutics for Advanced Practice Nurses (2nd ed.). St. Louis, MO: Elsevier.
Stachowicz. D. (2021). CA APRN Furnishing Resources. Retrieved from CA APRN Furnishing Resources – Google Docs (loom.com)
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Design a women’s health brochure for Ovarian Cancer include the following: Overv

Design a women’s health brochure for Ovarian Cancer
include the following:
Overview of the disease including disease process, signs and symptoms, and risk factors
Preventative screening
Diagnostics tests
Treatment
Multidimensional nursing care interventions
Save assignment as a Microsoft Word document

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