NUR 514 Week 3 Discussion Organizational Leadership and Informatics

DQ1 How have you seen or experienced organizational change within an organization? Did it go well or not? Was there any correlation in how the organizations used stakeholders or change models?

DQ2 You have been selected to serve on a community outreach committee within your state’s nursing organization. The committee includes registered nurses of different specialties. At your first meeting, it becomes evident that not everyone is in agreement with a recent position statement about the role of spiritual care, with some members arguing they will no longer support the committee if the position statement is not revised or reversed. As a nurse leader, how could you draw from change theory to address these concerns and encourage collaboration on the committee?

Organizational change is the movement of an organization from one state of affairs to another. A change in the environment often requires change within the organization operating within that environment. Change in almost any aspect of a company’s operation can be met with resistance, and different cultures can have different reactions to both the change and the means to promote the change. To better facilitate necessary changes, several steps can be taken that have been proved to lower the anxiety of employees and ease the transformation process. Often, the simple act of including employees in the change process can drastically reduce opposition to new methods. In some organizations, this level of inclusion is not possible, and instead organizations can recruit a small number of opinion leaders to promote the benefits of coming changes.

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Organizational change can take many forms. It may involve a change in a company’s structure, strategy, policies, procedures, technology, or culture. The change may be planned years in advance or may be forced on an organization because of a shift in the environment. Organizational change can be radical and swiftly alter the way an organization operates, or it may be incremental and slow. In any case, regardless of the type, change involves letting go of the old ways in which work is done and adjusting to new ways. Therefore, fundamentally, it is a process that involves effective people management.

Managers carrying out any of the P-O-L-C functions often find themselves faced with the need to manage organizational change effectively. Oftentimes, the planning process reveals the need for a new or improved strategy, which is then reflected in changes to tactical and operational plans. Creating a new organizational design (the organizing function) or altering the existing design entails changes that may affect from a single employee up to the entire organization, depending on the scope of the changes. Effective decision making, a Leadership task, takes into account the change-management implications of decisions, planning for the need to manage the implementation of decisions. Finally, any updates to controlling systems and processes will potentially involve changes to employees’ assigned tasks and performance assessments, which will require astute change management skills to implement. In short, change management is an important leadership skill that spans the entire range of P-O-L-C functions.

NRNP 6552 Week 8 Common Health Conditions with Implications for Women

Case studies: Common Health Conditions with Implications for Women

The patient in this case is a 48-year-old Asian American female who presents for evaluation of “thin bones” due to a strong maternal history of osteoporosis, which was followed by a hip fracture. The patient went through an early menopause between the ages of 43 and 44. In addition, the patient has additional risk factors for bone loss, such as having a low body weight, smoking cigarettes, having hypothyroidism, and having limited access to healthcare due to failing to have insurance. She claims that she has never consumed alcohol and has no personal history of fractures. In terms of physical examination, there are no noteworthy findings; nonetheless, her DEXA scan reveals a T-score of -1.2, which is in line with osteopenia. Because of her age, the history of her family, and the lifestyle hazards that can be altered, it is critical to detect osteoporosis at an early stage and take preventative measures to prevent its progression (Sobh et al., 2022). This paper will provide an overview of the findings, both subjective and objective, as well as diagnostic testing, differential diagnoses, management choices, socioeconomic determinants of health, and collaborative care requirements for this particular patient.

Outline subjective data.

Outline

Objective findings.

Identify diagnostic tests, procedures, and laboratory work indicated.

Distinguish at least three differential diagnoses.

Identify appropriate medications, treatments, or other interventions for each differential diagnosis.

Explain key

Social Determinants of Health (SDoH) for your chosen case.

Describe collaborative care referrals and patient education needs for your chosen case.

The patient’s concern about bone health, a family history of osteoporosis with fracture, early menopause, a smoking history of one pack per day for twenty years, hypothyroidism, and the absence of insurance are all examples of subjective data. Both previous fractures and alcohol use are denied by her. Additional information that is required includes the consumption of calcium and vitamin D through the diet, the amount of physical activity, the adherence to medication for hypothyroidism, the fracture risk assessment (FRAX), and the history of menopausal symptoms.

The findings that are objective include a body mass index (BMI) of 19.2, vital signs that are normal, a musculoskeletal exam that is normal, and a DEXA T-score of -1.2, which indicates osteopenia. Neither discomfort nor malformations have been observed. A laboratory study of calcium, vitamin D, thyroid-stimulating hormone (TSH), and parathyroid hormone levels, as well as new height measurements, is required in order to determine whether or not spinal compression has occurred throughout the course of time.

A baseline DEXA scan is one of the recommended diagnostics to measure bone mineral density and track progression. To find out what metabolic factors cause bone loss, lab tests should include blood calcium, 25-hydroxyvitamin D, TSH, and alkaline phosphatase. Based on her age, history of smoking, and family history, a FRAX score is needed to estimate her 10-year fracture risk and help with treatment choices (Khurmah et al., 2024).

The primary differential diagnosis that is supported by the patient’s DEXA T-score of -1.2, which falls between -1.0 and -2.5, points to osteopenia as the most likely diagnosis (Zhang et al., 2025). Osteoporosis is also taken into consideration since she has a significant maternal history of osteoporosis with fracture, early menopause, a history of smoking, and a low body mass index, all of which put her at a high risk for developing osteoporosis in the future (Khurmah et al., 2024). Given her endocrine problem, early menopause, and the possible impact on bone metabolism, secondary bone loss that is attributable to hypothyroidism or estrogen shortage is taken into consideration (Sobh et al., 2022).

Stopping smoking, doing weight-bearing exercise, and taking calcium and vitamin D supplements are the first things that should be done to treat osteopenia. If osteoporosis happens, bisphosphonates may be needed to lower the risk of breaking a bone (Da Fonseca Grili et al., 2023). To stop too much bone turnover, it is important to get the right thyroid hormone supplement. Due to the early onset of menopause, hormone therapy should be chosen with caution, taking into account both the benefits and potential risks (Sobh et al., 2022).

Among the most important socioeconomic variables that are affecting this patient are her lack of health insurance, the financial strain that she is experiencing as a result of her spouse’s unemployment, and her smoking habit. It may be necessary for her to delay treatment if there is limited access to preventive care and diagnostic tests, which is detrimental to her health. As another factor that may contribute to inadequate bone strength, sedentary work may also play a role (Zhang et al., 2025). Because of these variables, her susceptibility to the course of the disease is increased, and she needs management techniques that are both accessible and cost-effective (Da Fonseca Grili et al., 2023).

The referral to an endocrinologist should be included in collaborative treatment in the event that secondary reasons are detected, and nutrition counseling for bone health should also be considered (Da Fonseca Grili et al., 2023). Programs to help people quit smoking and community-based fitness tools that are inexpensive are both extremely important. Education of patients should center on preventing fractures, ensuring adequate intake of calcium and vitamin D, preventing falls, and highlighting the significance of undergoing follow-up DEXA scans to evaluate bone density over time (Anupama et al., 2022).

References

Anupama, D. S., Noronha, J. A., Acharya, K. K. V., Prabhu, M. M., Shetty, J., Shankar, R., & Nayak, B. S. (2022). Burden of Osteopenia and Osteoporosis among Postmenopausal Women in India: A Systematic Review and Meta-Analysis. Journal of Mid-life Health, 13(2), 107–114. https://doi.org/10.4103/jmh.jmh_207_21

Da Fonseca Grili, P. P., Vidigal, C. V., Da Cruz, G. F., Albergaria, B., Marques-Rocha, J. L., Pereira, T. S. S., & Guandalini, V. R. (2023). Nutrient patterns and risk of osteopenia in postmenopausal women. Nutrients, 15(7), 1670. https://doi.org/10.3390/nu15071670

Khurmah, M. H. A., Alkhatatbeh, M. J., Alshogran, O. Y., & Alarda, H. M. (2024). Prevalence and risk factors of osteopenia and osteoporosis among postmenopausal women: A cross‐sectional study from Jordan. Public Health Nursing, 41(5), 996–1005. https://doi.org/10.1111/phn.13379

Sobh, M. M., Abdalbary, M., Elnagar, S., Nagy, E., Elshabrawy, N., Abdelsalam, M., Asadipooya, K., & El-Husseini, A. (2022). Secondary osteoporosis and metabolic bone diseases. Journal of Clinical Medicine, 11(9), 2382. https://doi.org/10.3390/jcm11092382

Zhang, J., Wang, Y., Guo, J., Liu, H., Lei, Z., Cheng, S., & Cao, H. (2025). The association between ten anthropometric measures and osteoporosis and osteopenia among postmenopausal women. Scientific Reports, 15(1), 10994. https://doi.org/10.1038/s41598-025-94218-4

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Case studies provide the opportunity to simulate realistic scenarios involving patients presenting with various health problems or symptoms. Such case studies enable nurse learners to apply concepts, lessons, and critical thinking to interviewing, screening, and diagnostic approaches, as well as to the development of treatment plans.

For this Case Study Assignment, you will chose from four case studies to identify common health implications for women. You will then explore the chosen case study to determine the diagnosis, diagnostic tests, and treatment options for the patient.

Resources

Be sure to review the Learning Resources before completing this activity.

Click the weekly resources link to access the resources.

WEEKLY RESOURCES

Learning Resources

Required Readings

Schuiling, K. D., & Likis, F. E. (2022). Gynecologic health care (4th ed.). Jones and Bartlett Learning.

Chapter 17, “Breast Conditions” (pp. 337-349)

Chapter 32, “Anatomy and Physiologic Adaptations of Normal Pregnancy” (pp. 677–673)

Chapter 19, “Pregnancy Diagnosis, Decision-Making support, and Resolution” (pp. 367-379

Document: Week 8 Case Studies Download Week 8 Case Studies (PDF)

Document: Week 8 Case Study Template Download Week 8 Case Study Template (Word document)

General Guidelines for Health Screenings

American Academy of Family Practice (AAFP). (2020). Browse AAFP clinical recommendations Links to an external site.. https://www.aafp.org/home.html

American Cancer Society, Inc. (ACS). (2020). Cancer A-Z Links to an external site.. https://www.cancer.org/

Note: As you review this resource, select the “Cancer A-Z” topic in the navigation to review information and Resources about for Cancer: Breast, Colon, Lung, Prostate, Skin.

American College of Obstetricians and Gynecologists (ACOG). (2020). Clinical topics Links to an external site.. https://www.acog.org/

Note: As you review this source, make sure to navigate to the “Topics” section in the navigation to review the clinical topics.

HealthyPeople 2030. (2020). Healthy People 2030 Framework Links to an external site.. https://www.healthypeople.gov/2020/About-Healthy-People/Development-Healthy-People-2030/Framework

U.S. Preventive Services Task Force (USPTFS). (2017, September). Search and Filter All Recommendation Topics Links to an external site.. https://www.uspreventiveservicestaskforce.org/uspstf/topic_search_results?topic_status=P&searchterm=

FNP Resources

Centers for Disease Control and Prevention. (CDC). (n.d.). Disease & conditions Links to an external site.. https://www.cdc.gov/DiseasesConditions

The American Association of Nurse Practitioners (AANP). (2020). AANP practice: Clinical Resources, Business, acumen and opportunities for professional recognition Links to an external site.. https://www.aanp.org/practice

Geriatric Resources

Nicholas, J. A., & Hall, W. J. (2011). Screening and preventive services for older adults Links to an external site.. The Mount Sinai Journal of Medicine, New York, 78(4), 498–508. https://go.openathens.net/redirector/waldenu.edu?url=https://doi.org/10.1002/msj.20275

Document: General Guidelines for Health Screenings Matrix Template Download General Guidelines for Health Screenings Matrix Template (Word document)

Required Media

Common Health Conditions

Dr. Anne Salomone reviews and discusses the topics found in Weeks 7 & 8 (40 mins).

Optional Resources

Note: In Weeks 1-10, these resources are optional for your review. In Week 11, you will be required to review each of the PowerPoint slides from the text Gynecologic Health Care (4th ed.).

Chapter 17, “Breast Conditions Download Breast Conditions”

Chapter 32, “Anatomy and Physiologic Adaptations of Normal Pregnancy Download Anatomy and Physiologic Adaptations of Normal Pregnancy”

Chapter 19, “Pregnancy Diagnosis, Decision-Making support, and Resolution Download Pregnancy Diagnosis, Decision-Making support, and Resolution”

To prepare:

Review the 4 case studies in this week’s Learning Resources. Select one of the cases to prepare your written assignment.

Review the Learning Resources for this week.

Assignment Instructions:

Use the Case Study Template from the Learning Resources to complete the assignment. Your submission must include a brief case write-up, followed by the fully completed template, which must be integrated into the document rather than submitted separately.

Include a title page, a case summary in your own words, the completed template, and a reference page formatted in APA style.

Ensure your submission meets all criteria outlined in the template and rubric for completeness and accuracy.

By Day 7 of Week 8

Submit your case study assignment by Day 7 of Week 8.

submission information

Before submitting your final assignment, you can check your draft for authenticity. To check your draft, access the Turnitin Drafts from the Start Here area.

To submit your completed assignment, save your Assignment as Wk8Assgn_LastName_Firstinitial

Then, click on Start Assignment near the top of the page.

Next, click on Upload File and select Submit Assignment for review.

Rubric

NRNP_6552_Week8_Case_Study_Assignment_Rubric

Criteria Ratings Pts

This criterion is linked to a Learning Outcome Analyzes subjective and objective data and outlines applicable diagnostic tests related to case studies.

30 to >26.7 pts Excellent The response provides clear, complete, and comprehensive descriptions of subjective and objective case data, appropriately outlining all diagnostic tests, clinical procedures and pharmacological interventions.

26.7 to >23.7 pts Good The response provides clear, complete partial descriptions of the components of the subjective and objective case data, appropriately outlining most of the diagnostic tests, clinical procedures and pharmacological interventions.

23.7 to >20.7 pts Fair The response provides some components of the subjective and objective case data, but they are incomplete, vague or inaccurate, outlining some of the diagnostic tests, clinical procedures and pharmacological interventions.

20.7 to >0 pts Poor The response provides unclear or incomplete components of subjective and objective case data. The diagnostic tests, clinical procedures and pharmacological interventions are missing, incorrect, or inappropriately applied.

30 pts

This criterion is linked to a Learning Outcome Identifies differential diagnoses related to case studies.

30 to >26.76 pts Excellent The response contains at least 3 differential diagnoses relevant and applicable to the case.

26.76 to >23.7 pts Good The response contains at least 2 differential diagnoses relevant and applicable to the case.

23.7 to >20.7 pts Fair The response contains at least 1 differential diagnosis relevant and applicable to the case.

20.7 to >0 pts Poor The response contains few or no differential diagnoses and/or diagnoses are not relevant and applicable to the case.

30 pts

This criterion is linked to a Learning Outcome Formulates a treatment plan related to case studies based on scientific rationale, evidence- based standards of care, and practice guidelines. Integrates ethical, psychological, physical, financial issues and Social Determinants of Health in plan.

30 to >26.76 pts Excellent Formulates a thorough treatment plan including explanations of appropriate diagnostic tests and treatment options. Fully incorporates syntheses representative of knowledge gained from the resources for the module and current credible sources, with no less than 75% of the treatment plan having exceptional depth and breadth. Supported by at least 3 current peer- reviewed, references or professional practice guidelines.

26.76 to >23.7 pts Good Formulates a partially complete treatment plan including partial explanations of appropriate diagnostic tests and treatment options. Somewhat incorporates syntheses representative of knowledge gained from the resources for the module and current credible sources with no less than 50% of the treatment plan having exceptional depth and breadth. Supported by at least 3 current peer- reviewed, references or professional practice guidelines.

23.7 to >20.7 pts Fair Formulates a minimally complete treatment plan including incomplete or vague explanations of appropriate diagnostic tests and treatment options. Lacking in synthesis of knowledge gained from the resources for the module and current credible sources. Supported by at least 2 current peer- reviewed, references or professional practice guidelines.

20.7 to >0 pts Poor Formulates a treatment plan that contains incomplete explanations of appropriate diagnostic tests and treatment options and/ or explanations are missing. Lacks synthesis gained from the resources for the module and current credible sources. Supported by 1 or no current peer- reviewed, references or professional practice guidelines.

30 pts

This criterion is linked to a Learning Outcome Written Expression and Formatting – English writing standards:

Correct grammar, mechanics, and proper punctuation

5 to >4.45 pts Excellent Uses correct grammar, spelling, and punctuation with no errors.

4.45 to >3.95 pts Good Contains a few (1 or 2) grammar, spelling, and punctuation errors.

3.95 to >3.45 pts Fair Contains several (3 or 4) grammar, spelling, and punctuation errors.

3.45 to >0 pts Poor Contains many (≥ 5) grammar, spelling, and punctuation errors that interfere with the reader’s understanding.

5 pts

This criterion is linked to a Learning Outcome Written Expression and Formatting – The paper follows correct APA format for title page, headings, font, spacing, margins, indentations, page numbers, parenthetical/in-text citations, and reference list.

5 to >4.45 pts Excellent Uses correct APA format with no errors.

4.45 to >3.95 pts Good Contains a few (1 or 2) APA format errors.

3.95 to >3.45 pts Fair Contains several (3 or 4) APA format errors.

3.45 to >0 pts Poor Contains many (≥ 5) APA format errors.

5 pts

Total Points: 100