Hypertension in African Americans Research Proposal

Background

The racial differences in hypertension and the related complications for decades are recognized with African Americans having the highest risk compared to other ethnicities. Blood pressure readings have been consistently higher in African Americans with an early onset of hypertension. Despite awareness and treatment attempts, the problem of high blood pressure has continued to rise among the African American population. For this matter, various complications are associated with hypertension among this racial group (Allison, et al, 2014). Complications include end-stage renal failure, stroke, and congestive heart failure. In this case, research is focused and highly committed to determine factors associated with racial disparities in hypertension and addressing the essential need to the existing gaps. The purpose of this study, therefore, is to identify the high risk factors of hypertension and todetermine if providing health education and developments of community programs are effective in reducing hypertension in the African American community. Hypertension in African Americans Research Proposal

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Statement of problem and purpose

The major problem of discussion of this study is the high prevalence of hypertension in African Americans than other ethnicities. It is important to explore the norm, behavioral, and the disease control beliefs of the African American population in relationship to maintaining self-care behaviors that are essential in controlling and mitigating blood pressure and preventing hypertension. This would act as the first phase of studies aimed at developing clinical tools that can be utilized by the health professionals to design or develop more effective interventions aimed at reducing the disparities and prevalence of hypertension (Allison, et al, 2014).

Research question

This research is seeking to answer a specific research question concerning hypertension. In this case, the research questions would be, does the development of community programs and providing health education reduce disparities and factors associated with hypertension in predominately African American communities versus a more diverse community? Hypertension in African Americans Research Proposal

Hypothesis

The puzzle of the high risk of hypertension among African Americans has triggered various hypotheses both research and the null hypothesis. For instance, it is hypothesized that there are some genetically determined and modified physiologic differences that exist between the African Americans and whites. In this case, the Creatinine Kinase found in AfricanAmerican’s muscles has greater amounts than the Caucasians. Creatinine Kinase tends to influence blood pressure. It is also hypothesized that the environmental factors such as psychosocial and lifestyle factors are important in the development of hypertension. It is hypothesized that the African American individuals tend to have high rates of obesity. Body mass affects blood pressure and the anthropometric measurements as it relates to the risk of high blood pressure.

Study variables

Study variables are defined as those factors or things that have quantity or quality that varies or changes. In this case, there exist both dependent and independent study barriers. The variables of this study include salt sensitivity, environmental factors such as psychosocial, socioeconomic, and lifestyle factors, genetics, and the body mass index.

Operational definition of variables

Salt sensitivity

While salt sensitivity should affect blood pressure in many populations across the world, there are racial differences that exist in the intake as well as the handling of the sodium and potassium. While the prevalence of salt sensitivity in African Americans and the Caucasians remains similar, the degree of blood pressure increase and changes shows disparities (Allison, et al, 2014).

Body mass

The racial disparities in the body mass index have been recognized and suggestive of differences in blood pressure and the prevalent levels. In this case, African Americans have been associated with high chances of overweight and obesity in various age groups. However, this body mass affects blood pressure and hence the high disparities found in such individuals (Weaver et al, 2017).

Lifestyle

Hypertension can be categorized as a lifestyle disease. Research shows that African Americans, are not associated with high rates of exercise and hence they have high chances of hypertension. On the other hand, the whites take part in exercise and this helps to reduce the excessive fat in the body and hence prevention of atherosclerosis that may lead to increased blood pressure (Sessoms et al, 2015). Meeting guidelines by adhering to lifestyle modifications through the success of the DASH diet, alcohol consumption and weight loss helps to reduce hypertension in African Americans (Sessom et al, 2015). Hypertension in African Americans Research Proposal

Psychosocial factors

Research demonstrates that the psychosocial factors play a role in the development of hypertension. These factors may include occupational stress, personality, housing instability, sleep quality, and support and remain essential factors in the development of hypertension.

Socioeconomic

According to Weaver (2017), it was identified that socioeconomic factors also correlates with the blood pressure. Residential distance may be an indicator of systolic dysfunction in the African American community. Living closer to primary highways are associated with cardiac remodeling in an understudied African American population. Primary highways with limited access are typically busier and have more air pollution that can lead to heart failure.  Those also closest to primary roads were found to have less education, lower socioeconomic and government assisted insurance (Weaver et al, 2017). African Americans who live in the United States usually suffer disproportionately high chances of hypertension when compared to other ethnic groups (Chor et al, 2015).

References

Allison, D. B., Edlen-Nezin, L., & Clay-Williams, G. (2014). „Obesity among African-American Women. Prevalence, Consequences, Causes, and Developing Research.“. Womens Health, 243-274.

Chor, D., Ribeiro, A. L. P., Carvalho, M. S., Duncan, B. B., Lotufo, P. A., Nobre, A. A., … & Barreto, S. M. (2015). Prevalence, awareness, treatment and influence of socioeconomic variables on control of high blood pressure: results of the ELSA-Brasil Study. PLOS one, 10(6), e0127382.

Sessoms, J., Reid, K., Williams, I., & Hinton, I. (2015). Provider Adherence to National Guidelines for Managing Hypertension in African Americans. International Journal Of Hypertension, 20151-7. doi:10.1155/2015/498074

Weaver, A. M., Wellenius, G. A., Wen-Chih, W., Hickson, D. A., Kamalesh, M., & Yi, W. (2017). Residential distance to major roadways and cardiac structure in African Americans: cross-sectional results from the Jackson Heart Study. Environmental Health: A Global Access Science Source, 161. doi:10.1186/s12940-017-0226-4

Hypertension in African Americans Research Proposal

Professionalism and Social Media Essay

Social media plays a significant role in the lives of nurses in both their professional and personal lives. Additionally, social media is now considered a mainstream part of the process for recruiting and hiring candidates. Inappropriate or unethical conduct on social media can create legal problems for nurses as well as the field of nursing.
Login to all social media sites in which you engage. Review your profile, pictures and posts. Based on the professional standards of nursing, identify items that would be considered unprofessional and potentially detrimental to your career and that negatively impact the reputation of the nursing field. Professionalism and Social Media Essay

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In 500-750 words, summarize the findings of your review. Include the following:
Describe the posts or conversations in which you have engaged that might be considered inappropriate based on the professional standards of nursing Professionalism and Social Media Essay.
Discuss why nurses have a responsibility to uphold a standard of conduct consistent with the standards governing the profession of nursing at work and in their personal lives. Include discussion of how personal conduct can violate HIPAA or be considered unethical or unprofessional. Provide an example of each to support your answer.
Based on the analysis of your social media, discuss what areas of your social media activity reflect Christian values as they relate to respecting human value and dignity for all individuals. Describe areas of your social media activity that could be improved.
Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.
This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.
You are required to submit this assignment to LopesWrite. Refer to the LopesWrite Technical Support articles for assistance. Professionalism and Social Media Essay

Practicum: Decision Tree
For this Assignment, as you examine the client case study in this week’s Learning Resources, consider how you might assess and treat adult and older adult clients presenting symptoms of a mental health disorder.

Learning Objectives
Students will:
Evaluate clients for treatment of mental health disorders
Analyze decisions made throughout diagnosis and treatment of clients with mental health disorders
Examine Case 2: You will be asked to make three decisions concerning the diagnosis and treatment for this client. Be sure to consider co-morbid physical, as well as mental factors that might impact the client’s diagnosis and treatment. Practicum: Decision Tree

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At each Decision Point stop to complete the following:

Decision #1: Differential Diagnosis
Which Decision did you select?
Why did you select this Decision? Support your response with evidence and references to the Learning Resources.
What were you hoping to achieve by making this Decision? Support your response with evidence and references to the Learning Resources. Practicum: Decision Tree
Explain any difference between what you expected to achieve with Decision #1 and the results of the Decision. Why were they different?
Decision #2: Treatment Plan for Psychotherapy
Why did you select this Decision? Support your response with evidence and references to the Learning Resources.
What were you hoping to achieve by making this Decision? Support your response with evidence and references to the Learning Resources.
Explain any difference between what you expected to achieve with Decision #2 and the results of the Decision. Why were they different?
Decision #3: Treatment Plan for Psychopharmacology
Why did you select this Decision? Support your response with evidence and references to the Learning Resources.
What were you hoping to achieve by making this Decision? Support your response with evidence and references to the Learning Resources. Practicum: Decision Tree
Explain any difference between what you expected to achieve with Decision #3 and the results of the decision. Why were they different?
Also include how ethical considerations might impact your treatment plan and communication with clients and their family.

Note: Support your rationale with a minimum of three academic resources. While you may use the course text to support your rationale, it will not count toward the resource requirement. Practicum: Decision Tree

// A young woman with Depression
Case #2
A young woman with Depression

SUBJECTIVE
Stefanie is a 32-year-old female from Puerto Rico who presents to your office today with complaints of difficulty sleeping. You learn that Stefanie can go for a few days with minimal sleep (about 3 hours/night), but does not seem to be fatigued the next day. Stefanie explains that after 3 days with minimal sleep, she “crashes” and has a good night’s sleep. She states that sleep will be “alright” for a few days, even a few weeks, and then she will have a similar issue with sleep.

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You learn throughout the assessment process that Stefanie has had this problem for years. She noticed that it began in college and thought it was just because of the workload and academic demands. However, she found that it persisted after college. She also notices that she has periods where she will engage in increased amounts of goal-directed activity. She states that things will just “pile up” at work and she gets this burst of energy to “make everything right.” She states that these bursts will last most of the day. She states that these periods show up probably every 2 to 3 weeks. Practicum: Decision Tree
Stefanie also confesses to problems with being “down in the dumps.” She states that when she has her episodes in which she endeavors to “make everything right,” she feels fantastic and on top of the world. However, when these periods of energy end, she reports that she feels “depressed”—but then states: “well, maybe not depressed, but I definitely feel sad and empty.” She also endorses feelings of fatigue and a decreased ability to concentrate when she is feeling sad. She finally tells you: “I have lived with this for so long, I have to admit that it is finally a relief to tell someone how I feel!”

OBJECTIVE
Stefanie is dressed appropriately to the weather. She has no gait abnormalities. Physical assessment is unremarkable. Gross neurological assessment is within normal limits.

MENTAL STATUS EXAM
Stefanie is alert and oriented × 4 spheres. Her speech is clear, coherent, goal directed, and spontaneous. Self-reported mood is “sad.” Affect does appear consistent with dysphoria. Eye contact is normal. Speech is clear, coherent, and goal directed. She denies visual or auditory hallucinations. No overt evidence of paranoid or delusional thought processes noted. She denies suicidal or homicidal ideation and is future oriented.
At this point, please discuss any additional diagnostic tests you would perform on Stefanie.
Decision Point One Practicum: Decision Tree
BASED ON THE INFORMATION PROVIDED IN THE SCENARIO ABOVE, WHICH OF THE FOLLOWING DIAGNOSES WOULD THE PSYCHIATRIC/MENTAL HEALTH NURSE PRACTITIONER (PMHNP) GIVE TO STEFANIE?
In your write-up of this case, be certain to link specific symptoms presented in the case to DSM–5 criteria to support your diagnosis. Practicum: Decision Tree

Bipolar I, current phase, depressed

Bipolar II, current phase, hypomanic

Cyclothymic disorder

Decision Point One

Bipolar I, current phase, depressed
Bipolar I, current phase, depressed
Decision Point Two
BASED ON THIS DIAGNOSIS, SELECT YOUR CHOICE OF ACTIONS:

Begin Latuda 40 mg orally daily

Lamictal 100 mg orally daily

Begin psychotherapy using a psychodynamic approach

Decision Point One

BipBipolar II, current phase, hypomanic
olar II, current phase, hypomanic
Decision Point Two
BASED ON THIS DIAGNOSIS, SELECT YOUR CHOICE OF ACTIONS:

Begin Lithium 300 mg orally twice a day

Begin Olanzapine 10 mg orally at bedtime

Begin Abilify 10 mg orally daily Practicum: Decision Tree

Cyclothymic disorder

Cyclothymic disorder

Decision Point Two
BASED ON THIS DIAGNOSIS, SELECT YOUR CHOICE OF ACTIONS:

Begin Depakote 250 mg orally three times daily

Begin Abilify 10 mg orally daily

Arrange to see Stefanie every 3 months for routine follow-up Practicum: Decision Tree

Women’s And Men’s Health/Infections And Hematologic Systems.

As an advanced practice nurse, you will likely experience patient encounters with complex comorbidities. For example, consider a female patient who is pregnant who also presents with hypertension, diabetes, and has a recent tuberculosis infection. How might the underlying pathophysiology of these conditions affect the pharmacotherapeutics you might recommend to help address your patient’s health needs? What education strategies might you recommend for ensuring positive patient health outcomes?

You will be assigned a patient case study and will consider how to address the patient’s current drug therapy plans. You will then suggest recommendations on how to revise these drug therapy plans to ensure effective, safe, and quality patient care for positive patient health outcomes Women’s And Men’s Health/Infections And Hematologic Systems..

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THE CASE STUDY

A 46-year-old, 230lb woman with a family history of breast cancer. She is up to date on yearly mammograms. She has a history of hypertension (HTN). She complains of hot flushing, night sweats, and genitourinary symptoms. She had felt well until 1 month ago and she presented to her gynecologist for her annual gyn examination and to discuss her symptoms. She has a history of ASCUS about 5 years ago on her pap, other than that, Pap smears have been normal. Home medications are Norvasc 10mg qd and HCTZ 25mg qd. Her BP today is 150/90. She has regular monthly menstrual cycles. Her LMP was 1 month ago.

THE QUESTION:

1:  Describe the patient’s health needs from the patient case study you assigned. Be specific.

2: Then, explain the type of treatment regimen you would recommend for treating the patient, including the choice or pharmacotherapeutics you would recommend and explain why. Be sure to justify your response.

3: Explain a patient education strategy you might recommend for assisting the patient with the management of their health needs. Be specific and provide examples. Women’s And Men’s Health/Infections And Hematologic Systems Women’s And Men’s Health/Infections And Hematologic Systems..