Examine U.S. healthcare policy structures and the role of the nursing leader as a change agent at the public policy table.DirectionsYou will decide on a policy issue that needs to be addressed. You may choose a policy issue that interests you. Below are suggested topics for proposed policy change, however if you wish to address another topic please contact your instructor for approval:Treatment of veterans after deployment and post-traumatic stress disorder (PTSD).Cost of end of life care.Costs of drugs in the United States as compared to other countries.Quarantine of health care workers that have been exposed to communicable diseases.Medical care for illegal immigrants.Right to die with euthanasia methods.Disclosure of medical records of pilots and other safety sensitive professionals and HIPAA violations.Restrictions of roles of nurse practitioners and advanced practice nurses in certain states.Health care reform.Requirements of meaningful use to meet core measures.ICD-10 issues.Entry into practice issues.Mandatory vaccination of children.Allowing nurses educated in other countries to practice in the United States.Faculty shortages in U.S. nursing education programs.You will write a letter using professional business format to one of your Federal legislators outlining what the issue is and why it is important. The letter will address:The current policy structure.The need for the change.The suggested change.Cost implications if the change is implemented.The role the nurse as a change agent will take at the policy table. Assignment RequirementsBefore finalizing your work, you should:be sure to read the Assignment description carefully (as displayed above);consult the Grading Rubric (under the Course Resources) to make sure you have included everything necessary; andutilize spelling and grammar check to minimize errors. Your writing Assignment should:follow the conventions of Standard English (correct grammar, punctuation, etc.);be well ordered, logical, and unified, as well as original and insightful;display superior content, organization, style, and mechanics; anduse APA formatting and citation style

Discussion Question: Cardiovascular Case StudyBy the due date assigned, respond to the case study questions below and submit your responses to the Discussion Area.Respond to the question using the lessons and vocabulary found in the readings. Support your answers with examples and research. Your responses should clarify your understanding of the topic. They should be your own, original, and free from plagiarism. Follow APA format for writing style, spelling and grammar, and citation of sources.Start reviewing and responding to the postings of your classmates as early in the week as possible. Respond to at least two of your classmates. Participate in the discussion by analyzing each response for completeness and accuracy and by suggesting specific additions or clarifications for improving the discussion question response. Complete your participation for this assignment by the end of the week.Cardiovascular Case StudyA 76-year old woman with hypertension, peripheral artery disease, Hyperlipidemia, and lower extremity edema visits her PCP. Her major complaint is her high blood pressure (BP) and some associated fatigue. Her systolic blood pressure (SBP) ranges from 140 to 200 mm Hg and diastolic BP ranges from 70 to 104 mm Hg when measured at home. She is 5'2” and weighs 175 pounds. Her body mass index (BMI) is 32 and her waist circumference is 36”. She is afebrile with a pulse of 70. Her BP is elevated in the office at 160/84 mm Hg, even with repeated readings.ROS:Constitutional: Reports mild weight gain, moderate fatigue Respiratory: Dyspnea with exertionCardiovascular: Reports LE pedal edemaMeds:Metoprolol XL 50 mg twice a dayFurosemide 40 mg once a dayOlmesartan 20 mg every bedtimeClonidine 0.2 mg 4 times a day and as neededAspirin 81 mg once a dayClopidogrel 75 mg once a dayEzetimibe 10 mg/simvastatin 40 mg once a dayDespite these medications, her BP remains elevated. She adheres to her diet but admits to indulging at times. She also complains of bouts of headaches and some facial redness, both of which signal an acute rise in BP, for which she takes clonidine 0.2 mg 4 times a day and as necessary for relief. She goes on to relate that she has been doing some reading on supplements and vitamins and is interested in taking garlic supplements, omega-3 fatty acids, and Vitamin E. She says that garlic supplements claim to lower blood pressure, omega-3 fatty acids have anti-inflammatory properties and Vitamin E is good for the heart among other benefits.Question answers should be based on evidence found in readings and from peer-reviewed literature. At least two sources must be used and cited in APA format for each question. Only one source can be a textbook. Resources should generally be within 5 years unless you are explaining the pathophysiology of a disease or providing pertinent background informationDiscussion Questions:Review factors that affect blood pressure control with age, and explain from a pathophysiology standpoint what could be contributing to the ongoing issues with hypertension. Explain the four factors that affect cardiac output and that impact on blood pressure control.What impact does her other medical conditions potentially have on the blood pressure control? Support with evidence while discussing these pathologies.