Chest pain shadow health assessment Education & Empathy

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Chest pain shadow health assessment Education & Empathy

Education & Empathy : 5 of 6 (83.3%)

During the patient interview, there are a number of opportunities to provide patient education and empathy. The opportunities listed below are those identified by nursing experts to be of particular importance to this patient. A Model Statement is provided as an example of an appropriate response to each opportunity.

  • Opportunities marked as Not Encountered are opportunities that were not elicited in the interview
  • Opportunities marked as Not Followed Up are missed opportunities that were present in the interview, but where no statements were made
  • Opportunities marked as Followed Up were followed up by students, and include the dialogue between student and patient Chest pain shadow health assessment Education & Empathy
 1 Symptoms
Followed Up

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 Description: Mr. Foster describes the symptoms that have been bothering him.
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Welcome Mr Foster. What brings you to the clinic today?

Question
10:29 AM PDT
Brian Foster

I have been having some troubling chest pain in my chest now and then for the past month. Chest pain shadow health assessment Education & Empathy
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I am sorry that you have been having the chest pain.

Empathize
10:30 AM PDT
Brian Foster

Thanks. I appreciate that.
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how long does the chest pain last ?

Question
10:37 AM PDT
Brian Foster

When I feel it, it seems to get better over the course of a couple of minutes or so.
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what is the frequency of the chest pain?

Question
10:37 AM PDT
Brian Foster

Well, it has happened three times the past month. It usually goes away after about a couple of minutes.
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Were episodes of your chest pains related? (Clarified to: What were you doing the last time you had chest pain?) Chest pain shadow health assessment Education & Empathy

Question
10:39 AM PDT
Brian Foster

Well, the pain seems to start when I’m doing something physical . . . the first time it happened while I was doing yard work, and the second time . . . I had to take the stairs at work because the elevator broke. Both times it got better if I took a break or sat down to rest. (Clarified to: what I was doing when I had chest pain last)
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how do you feel when in pain?

Question
10:41 AM PDT
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How would you rate the chest pain?

Question
10:43 AM PDT
Brian Foster

When I’m having it, it’s really tight and uncomfortable. Maybe like a 5 out of 10. Right now it’s like a zero.
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is the pain crushing ? Chest pain shadow health assessment Education & Empathy

Question
10:43 AM PDT
Brian Foster

No, it’s more tight and uncomfortable.
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Am sorry about that.

Empathize
10:44 AM PDT
Brian Foster

Thanks. I appreciate that.
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is the pain gnawing?

Question
10:44 AM PDT
Brian Foster

No, it’s not like that. [AUDIO COMING SOON]
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is the pain burning ?

Question
10:45 AM PDT
Brian Foster

Not really.
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is the pain aggravated by activity?

Question
10:45 AM PDT
Brian Foster

Well, I think it’s when I’m doing something physical most of the time. The first time it happened, my chest started hurting after I was doing some yard work. The second time happened when the elevator broke at work so I had to take the stairs. My office is on the 5th floor. Chest pain shadow health assessment Education & Empathy
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Thats understandable

Empathize
10:46 AM PDT
Brian Foster

Thanks. I appreciate that.
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Do you have stress?

Question
11:11 AM PDT
Brian Foster

Not usually, but I’m feeling pretty anxious not knowing what’s going on with my chest.
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Am sorry about this.

Empathize
11:11 AM PDT
Brian Foster

Thanks. I appreciate that.

 Model Statement: “I’m sorry you’re having these symptoms; chest pain can be uncomfortable and stressful. It’s good that you came in today so we can see what is causing your discomfort.” Chest pain shadow health assessment Education & Empathy
 2 Hypertension and High Cholesterol
Followed Up

 Description: Mr. Foster describes his past medical history of hypertension and high cholesterol.
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Have you been diagnosed with hypertension?

Question
11:02 AM PDT
Brian Foster

Yes, I supposedly have moderately high blood pressure.
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Am sorry to hear this?

Empathize
11:02 AM PDT
Brian Foster

Thanks. I appreciate that.
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Have you been monitoring your blood pressure?

Question
11:07 AM PDT
Brian Foster

Not usually. They check it when I get checkups. My doctor has never seemed overly concerned about it.
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do you remember your last blood pressure readings?

Question
11:08 AM PDT
Brian Foster

I don’t remember. I don’t think it was too bad, though.
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have you done an EKG test recently?

Question
11:08 AM PDT
Brian Foster

I had one about three months ago. They usually put one on me at my annual physical.
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well, an EKG test is all about blood pressure monitoring.

Educate
11:09 AM PDT
Brian Foster

Good to know. Thank you.

 Model Statement: “It’s good that I know you have been diagnosed with hypertension and high cholesterol, because those conditions can cause additional heart problems. I would like to find out more about your diagnosis and treatment of those conditions.” Chest pain shadow health assessment Education & Empathy
 3 Exercise
Followed Up

 Description: Mr. Foster reports that he does not exercise regularly.
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Do you exercise?

Question
11:12 AM PDT
Brian Foster

Well I used to ride my bike a lot but it got stolen a couple years ago. I guess I haven’t had much regular exercise since then. I want to get a new bike if the doctor says it is OK to exercise with this chest pain I’ve been having.
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Am sorry that the chest pain makes you not exercise.

Empathize
11:13 AM PDT
Brian Foster

Thanks. I appreciate that.

 Model Statement: “Exercise is important for everyone, and particularly for people with high blood pressure and cholesterol. Let’s talk about some healthy forms of exercise that you would be interested in trying.” Chest pain shadow health assessment Education & Empathy
 4 Diet
Followed Up

 Description: Mr. Foster describes his dietary habits.
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what is your typical breakfast?

Question
11:13 AM PDT
Brian Foster

I usually have something. Most days I drink an instant breakfast, or I’ll have a granola bar. Sometimes Maria will make a big breakfast on weekends with eggs, pancakes, bacon, hash browns, that kind of stuff. Chest pain shadow health assessment Education & Empathy
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what is your typical lunch?

Question
11:14 AM PDT
Brian Foster

There’s a sub shop near the office, so I usually get a turkey or Italian sub from there. Sometimes a salad if I’m feeling healthy . . . or guilty.
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what is your typical dinner?

Question
11:14 AM PDT
Brian Foster

My wife and I like to grill. We usually have some grilled meats and veggies for dinner.
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do you take salt?

Question
11:15 AM PDT
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Do you drink water regularly?

Question
11:15 AM PDT
Brian Foster

I usually drink water all day at work. At least four glasses, probably more. [AUDIO COMING SOON]
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Its good to take water, continue.

Educate
11:16 AM PDT
Brian Foster

Good to know. Thank you.

 Model Statement: “Paying attention to your diet is a great start. It’s best to make sure you’re eating veggies, fruits, and whole grains, and lean proteins like fish or chicken.” Chest pain shadow health assessment Education & Empathy
 5 Weight Gain
Not Encountered

 Description: Mr. Foster reports weight gain of 15 to 20 pounds in the last few years.

 Model Statement: “Gaining some weight over the years is very common. It’s a good idea to try to keep your weight in a healthy range. Things like moderate exercise and watching caloric intake can help keep you at a healthy weight.”
 6 Family History
Followed Up

 Description: Mr. Foster has a family history of heart disease.
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Do you have a family history of heart attack?

Question
11:30 AM PDT
Brian Foster

Well, my mom’s dad died of a heart attack. He was pretty young too. Chest pain shadow health assessment Education & Empathy
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Do you have a family history of stroke?

Question
11:30 AM PDT
Brian Foster

No, none that I know of.
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Do you have a family history of pulmonary embolism?

Question
11:32 AM PDT
Brian Foster

No, nobody had that.
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Thank you Mr Foster for answering for answering my questions, I will now do the Physical examination.

Educate
11:34 AM PDT
Brian Foster

Good to know. Thank you.

 Model Statement: “Thank you for sharing your family health information. It’s important that we know about any risk factors, so that you can make healthy choices to keep those risks low.” Chest pain shadow health assessment Education & Empathy

Concept Analysis Template – Teamwork and Collaboration

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Concept Analysis Template – Teamwork and Collaboration

Concept Analysis Template

TEAMWORK & COLLABORATION

Definition:

  • The development of partnerships to achieve best possible outcomes using shared accountability, problem-solving and decision making Concept Analysis Template – Teamwork and Collaboration

 

Antecedents: <what must occur/be in place for concept to exist/function properly>

  • More than one person working together
  • Goal/outcome to achieve
  • Team dynamics

 

Defining Characteristics/Theoretical Links: <characteristics or theoretical associations that quantify/qualify normal/proper functioning of the concept>

  • Values/ethics (trust, respect)
  • Roles/responsibilities (understanding your own role)
  • Adaptability
  • Communication
  • Teams/teamwork

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Consequences (Positive/Desired): < Events or outcomes that occur with normal/proper functioning of the concept or its characteristics>

  • Collaborate regarding healthcare decision
  • Effective mentoring
  • Networking
  • Interprofessional (nurse to nurse)
  • Promotion of health
  • Shared governance

Risk Factors/Barriers (if present): <List the factors (physiologic; psychologic; physical) that may influence the normal functioning of the concept or its characteristics> Concept Analysis Template – Teamwork and Collaboration

  • Amount of education and/or experience regarding collaboration/teamwork
  • Amount of engagement by members
  • Communication techniques and skills
  • Culture

Consequences (Negative/Undesired): <outcomes that are a result of the improper functioning of the concept or its characteristics>

  • Negative impact on patient quality and safety
  • Inability to meet client/patient needs
  • Lack of mutual respect, trust
  • dissatisfaction with job
  • Professional identity

Interrelated concepts: <review list of concepts and identify which can be affected by the status of this concept – complete with faculty assistance>

  • Professional identity
  • Ethics
  • Communication
  • Safety
  • Healthcare quality
  • Care coordination

Exemplars in Curriculum: <List the exemplars taught within the curriculum – complete with faculty assistance> Concept Analysis Template – Teamwork and Collaboration

 

  • Interprofessional practice/Healthcare Teams
  • IPEC Competencies (IPE 400)
  • Mutual goal setting
  • Work Group Process (working groups)
  • Community partnerships
  • Skill: Demonstration of teamwork
  • Concept Analysis Template – Teamwork and Collaboration

Cultural competence and diversity in healthcare

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Cultural competence and diversity in healthcare

Cultural competence and diversity are often considered to have the same meaning in healthcare facilities. What is the difference between these two terms and their applicability in terms of healthcare professionals in various healthcare settings? 

Although cultural competence and diversity are often considered to have the same meaning in healthcare facilities they are different. Diversity is in fact a component of cultural competency. This includes ethnic and racial backgrounds, age, physical and cognitive abilities, family status, religion, sexual orientation, etc… cultural competency wouldnt exist without diversity . It is important for healthcare professionals to be culturally competent for the sake of the patient’s comfort in receiving services. Lack of cultural competence can lead to noncompliance, missed appointments, and patients seeking care from non-professionals. In the cultural compliance training video an older Hispanic women spoke on how her physician said they’d schedule her a new appointment and she basically said that she wouldn’t show up because it would be the same thing that happened to her at her current appointment; a miscommunication and nothing being resolved. Health professionals who are diverse tend to have a better work ethic and connection with their patients because they’re most likely to be understand certain cultural distinctions, treatment seeking behaviors, etc… (cultural  compentency for the health professional) Cultural competence and diversity in healthcare

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2) Explain the unique circumstances under which the ancestors of most Black/African American people arrived in the Americas. Why is it important for health service professionals to understand this history?

The first Africans in the New World arrived with Spanish and Portuguese explorers and settlers. By 1600 an estimated 275,000 Africans, both free and slave, were in Central and South America and the Caribbean area. Africans first arrived in the area that became the United States in 1619, when a handful of captives were sold by the captain of a Dutch man-of-war to settlers at Jamestown. Others were brought in increasing numbers to fill the desire for labor in a country where land was plentiful and labor scarce. By the end of the 17th century, approximately 1,300,000 Africans had landed in the New World. From 1701 to 1810 the number reached 6,000,000, with another 1,800,000 arriving after 1810. Some Africans were brought directly to the English colonies in North America. Others landed as slaves in the West Indies and were later resold and shipped to the mainland. (African  American History: Scholastic , n.d.) However many “black” colored individuals rather identify themselves with their family-related nationality rather than where they were born or raised. Some rather the term black when being identified and some rather be identified as African American. This is very complex. I know, myself, I do not like to identified as Black I prefer to identify myself and Haitian/Bahamian because I consider the Black culture as people who only speak English and are just Americans with darker colored skin, who eat American meals and have American traditions. I speak English and Creole, I eat Haitian meals and follow Haitian traditions. I was born in America but my parents and older sisters were born in Bahamas and had the Haitian culture bestowed in them so I identify as that. It is important for health service professionals to understand the history of how most Black/African Americans were brought to the Americas so they’d be able to establish a positive relationship with their patients. The best way to approach patients on the matter would be to just humbly ask the person how they identify themselves. (cultural compentency for the  health professional) Cultural competence and diversity in healthcare

3) Is Hispanic a racial or ethnic category? Explain. How might this impact the status of the African/Black group, for example, in terms of whether it is the largest or second largest minority group?

Many people confuse racial and ethnic categories when it comes to the Hispanic group. But that is because many people do not know the difference between one’s race and one’s ethnicity. Unlike with ethnicity, one can only belong to one race. See, race is your biologically engineered features. It can include skin color, skin tone, eye and hair color, as well as a tendency toward developing certain diseases. It is not something that can be changed or disguised. People can however change or impersonate ethnicities through choice and principles. Ethnicity is about tradition, learned behavior and customs. It is about learning where you come from, and celebrating the traditions and ideas that are part of that region.(difference  between ethnicity and race, n.d.). Thus, Hispanic would fall more into the ethnic category because the Hispanic group has no permanent physical characteristics, language or cultural norms. So a person of Hispanic decent can be Mexican, Puerto Rican, Cuban, Central or South American, or other Spanish culture or origin, regardless of race. Since Hispanic is not a racial group but an ethnic group, the Hispanic group comprise the largest minority group and the African/Black group comes in second as the second largest minority group. (cultural competency for the  health professional)

4) List the racial categories based on the OMB classification in the United States. Explain the geographic origins of the people designated for each of the categories. Why is it important for health professionals to understand cultural differences among and between groups?

The racial categories based on the OMB classification in the United States are as follows:

· Native Americans or Alaskan Native: A person having origins in any of the original peoples of North America and who maintains cultural identification through tribal affiliations or community recognition.

· Asian/Pacific Islander: A person having origins in any of the original peoples of the Far East, Southeast Asia, the Indian subcontinent, or the Pacific Islands.

· African American/Black: A person having origins in any of the black racial groups of Africa.

· White: A person having origins in any of the original peoples of Europe, North Africa, or the Middle East. (cultural  competency for the health professional)

In the healthcare setting it is very important for health professionals to understand cultural differences among and between groups. In health care settings, cultural alertness, compassion, and competence conducts are essential because even such concepts as health, illness, suffering, and care mean different things to different people. Being knowledgeable of cultural customs enables health care providers to provide better service and help avoid misconstructions among staff, residents/patients, and families. Health care providers trained in cultural competency: Cultural competence and diversity in healthcare

– Demonstrate greater understanding of the central role of culture in healthcare

-Recognize common barriers to cultural understanding among providers, staff, and residents/patients

-Identify characteristics of cultural competence in health care settings

-Interpret and respond effectively to diverse older adults’ verbal and nonverbal communication cues

– Assess and respond to differences in values, beliefs, and health behaviors among diverse populations and older adults

-Demonstrate commitment to culturally and linguistically appropriate services

-Work more effectively with diverse health care staff.

-Act as leaders, mentors, and role models for other health care providers (Dawn Lehman, Paula Fenza, &  and Linda Hollinger-Smith)

5. A physical therapy office in “Little Haiti” in Miami, Florida is  closed due to lack of funds. All patients’ appointments are routed to a  nearby hospital’s physical therapy department in which the predominant  population served is Cuban. List and describe a minimum some steps you  believe the department has to take to meet the needs of the patients  from a culturally competent prospective. Cultural competence and diversity in healthcare

Caucasian Man With Hip Pain Case study

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Case Study: A Caucasian Man with Hip Pain

Introduction

Complex regional pain disorder is a chronic pain condition that mostly affects one limb normally after an injury (Zanotti et al, 2017). Apart from the pain, clients also experience anxiety, depression, sleep difficulties, paresthesias, and general deterioration of physical function.  In this case, the client is a 43-year-old Caucasian man who presented with chief complaint of hip pain. According to the client, the pain started 7 years ago after a fall at work and later on it was discovered that the cartilage surrounding the right hip joint was 75% torn. For mental status, the client reports euthymic mood Caucasian Man With Hip Pain Case study. The diagnosis is Complex regional pain disorder (reflex sympathetic dystrophy). The purpose of this essay is to make three decisions regarding the medications to be prescribed to the client. Factors that might affect the pharmacokinetic and pharmacodynamic processes will be taken into consideration.

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The selected first decision is to prescribe the client Savella 12.5 mg orally once daily on day 1; followed by…

 

Complex Regional Pain Disorder
White Male With Hip Pain

White male on crutches

BACKGROUND

This week, a 43-year-old white male presents at the office with a chief complaint of pain. He is assisted in his ambulation with a set of crutches. At the beginning of the clinical interview, the client reports that his family doctor sent him for psychiatric assessment because the doctor felt that the pain was “all in his head.” He further reports that his physician believes he is just making stuff up to get “narcotics to get high.” Caucasian Man With Hip Pain Case study

SUBJECTIVE

The client reports that his pain began about 7 years ago when he sustained a fall at work. He states that he landed on his right hip. Over the years, he has had numerous diagnostic tests done (x-rays, CT scans, and MRIs). He reports that about 4 years ago, it was discovered that the cartilage surrounding his right hip joint was 75% torn (from the 3 o’clock to 12 o’clock position). He reports that none of the surgeons he saw would operate because they felt him too young for a total hip replacement and believed that the tissue would repair with the passage of time. Since then, he reported development of a strange constellation of symptoms including cooling of the extremity (measured by electromyogram). He also reports that he experiences severe cramping of the extremity. He reports that one of the neurologists diagnosed him with complex regional pain syndrome (CRPS), also known as reflex sympathetic dystrophy (RSD). However, the neurologist referred him back to his family doctor for treatment of this condition. He reports that his family doctor said “there is no such thing as RSD, it comes from depression” and this was what prompted the referral to psychiatry. He reports that one specialist he saw a few years ago suggested that he use a wheelchair, to which the client states “I said ‘no,’ there is no need for a wheelchair, I can beat this!” Caucasian Man With Hip Pain Case study.

The client reports that he used to be a machinist where he made “pretty good money.” He was engaged to be married, but his fiancé got “sick and tired of putting up with me and my pain, she thought I was just turning into a junkie.”

He reports that he does get “down in the dumps” from time to time when he sees how his life has turned out, but emphatically denies depression. He states “you can’t let yourself get depressed… you can drive yourself crazy if you do. I’m not really sure what’s wrong with me, but I know I can beat it.” Caucasian Man With Hip Pain Case study.

During the client interview, the client states “oh! It’s happening, let me show you!” this prompts him to stand with the assistance of the corner of your desk, he pulls off his shoe and shows you his right leg. His leg is turning purple from the knee down, and his foot is clearly in a visible cramp as the toes are curled inward and his foot looks like it is folding in on itself. “It will last about a minute or two, then it will let up” he reports. Sure enough, after about two minutes, the color begins to return and the cramping in the foot/toes appears to be releasing. The client states “if there is anything you can do to help me with this pain, I would really appreciate it.” He does report that his family doctor has been giving him hydrocodone, but he states that he uses is “sparingly” because he does not like the side effects of feeling “sleepy” and constipation Caucasian Man With Hip Pain Case study. He also reports that the medication makes him “loopy” and doesn’t really do anything for the pain.

MENTAL STATUS EXAM

The client is alert, oriented to person, place, time, and event. He is dressed appropriately for the weather and time of year. He makes good eye contact. Speech is clear, coherent, goal directed, and spontaneous. His self-reported mood is euthymic. Affect consistent to self-reported mood and content of conversation. He denies visual/auditory hallucinations. No overt delusional or paranoid thought processes appreciated. Judgment, insight, and reality contact are all intact. He denies suicidal/homicidal ideation, and is future oriented.

Diagnosis: Complex regional pain disorder (reflex sympathetic dystrophy)

Decision Point One

Select what the PMHNP should do:
Savella 12.5 mg orally once daily on day 1; followed by 12.5 mg BID on day 2 and 3; followed by 25 mg BID on days 4-7; followed by 50 mg BID thereafter
Amitriptyline 25 mg po QHS and titrate upward weekly by 25 mg to a max dose of 200 mg per day
Neurontin 300 mg po BEDTIME with weekly increases of 300 mg per day to a max of 2400 mg if needed
Decision Point One
Savella 12.5 mg once daily on day 1; followed by 12.5 mg BID on day 2 and 3; followed by 25 mg BID on days 4-7; followed by 50 mg BID thereafter

RESULTS OF DECISION POINT ONE

  •  Client returns to clinic in four weeks
  •  Client comes into the office to without crutches but is limping a bit. The client states that the pain is “more manageable since I started taking that drug. I have been able to get around more on my own. The pain is bad in the morning though and gets better throughout the day”. On a pain scale of 1-10; the client states that his pain is currently a 4. When asked what pain level would be tolerable on a daily basis, the client states, “I would rather have no pain but don’t think that is possible. I could live with a pain level of 3.”. When questioned further, the PMHNP asks what makes the pain on a scale of 1-10 different when comparing a level of 9 to his current level of 4?”. The client states that since using this drug, I can get to a point on most days where I do not need the crutches. ” The client is also asked what would need to happen to get his pain from a current level of 4 to an acceptable level of 3. He states, “If I could get to the point everyday where I do not need the crutches for most of my day, I would be happy.”
  •  Client states that he has noticed that he frequently (over the past 2 weeks) gets bouts of sweating for no apparent reason. He also states that his sleep has “not been so good as of lately.” He does complain of nausea today
  •  Client’s blood pressure and pulse are recorded as 147/92 and 110 respectively. He also admits to experiencing butterflies in his chest. The client denies suicidal/homicidal ideation and is still future oriented
Decision Point Two
Select what the PMHNP should do next:
Continue with current medication but lower dose to 25 mg twice a day
Discontinue Savella and start Lyrica (pregabalin) 50 mg orally BID
Discontinue Savella and start Zoloft (sertraline) 50 mg daily
Decision Point One
Amitriptyline 25 mg po QHS and titrate upward weekly by 25 mg to a max dose of 200 mg per day

RESULTS OF DECISION POINT ONE

  •  Client returns to clinic in four weeks
  •  Client comes to the office still using crutches. He states that the pain has improved but he is a bit groggy in the morning
  •  Client’s pain level is currently a 6 out of 10. The PMHNP questions the client on what would be an acceptable pain level. He states, “I would rather have no pain but don’t think that is possible. I could live with a pain level of 3.” He states that his pain level normally hovers around a 9 out of 10 on most days of the week before the amitriptyline was started. The PMHNP asks what makes the pain on a scale of 1-10 different when comparing a level of 9 to his current level of 6?” The client states, “I’m able to go to the bathroom or to the kitchen without using my crutches all the time. The achiness is less and my toes do not curl as often as they did before.” The client is also asked what would need to happen to get his pain from a current level of 6 to an acceptable level of 3. He states, “Well, that is kind of hard to answer. I guess I would like the achiness and throbbing in my right leg to not happen every day or at least not several times a day. I also could do without my toes curling in like they do. That really hurts.”
  •  Client denies suicidal/homicidal ideation and is still future oriented
Decision Point Two
Select what the PMHNP should do next:
Continue current medication and increase dose to 125 mg at BEDTIME this week continuing towards the goal dose of 200 mg daily. Instruct the client to take the medication an hour earlier than normal starting tonight and call the office in 3 days to report how his function is in the morning
Reduce the dose of Elavil to 75 mg at BEDTIME (dose has been titrated at weekly intervals by 25mg per week). Add on Biofreeze roll-on therapy to his right leg below the knee and into the foot and toes to be used as needed daily for muscle cramping
: Reduce dose of amitriptyline Elavil to 75 mg po orally at BEDTIME and add- on Neurontin (gabapentin) 300 mg po orally at BEDTIME. Schedule a Ffollow-up phone call in 1 week to assess pain control
Decision Point Two
Continue current medication and increase dose to 125 mg at BEDTIME this week continuing towards the goal dose of 200 mg daily. Instruct the client to take the medication an hour earlier than normal starting tonight and call the office in 3 days to report how his function is in the morning

RESULTS OF DECISION POINT TWO

  •  Client returns to clinic in four weeks
  •  The change in administration time seemed to help. The client states he is not as groggy in the morning and is able to start his day sooner than before
  •  Client’s current pain level is a 4 out of 10. He states that he is now taking 125 mg of amitriptyline at bedtime.
  •  Client’s has noticed that he is putting on a little weight. When asked, the client states that he has gained 5 pounds since he started taking this medication. He currently weighs in at 162 pounds. He is 5’ 7”. He states that his right leg doesn’t bother him nearly as much as it used to and his toes have only “cramped up” twice in the past month. He states that he is able to get around his apartment without his crutches and that he has even started seeing someone he met at the grocery store. The weight gain seems to bother him a lot and he is asking if there is a way to avoid it
Decision Point Three
Select what the PMHNP should do next:
Continue with the Elavil at his current 125 mg a day dose and start Qsymia (phentermine and topiramate) 3.75 mg/23 mg tablet once daily and titrate as required by package insert
Reduce the dose of Elavil to 100 mg a day and follow up in a month
Continue the current dose of Elavil of 125 mg per day, refer the client to a life coach who can counsel him on good dietary habits and exercise
Decision Point One
Neurontin (gabapentin) 300 mg orally at BEDTIME with weekly increases of 300 mg per day to a max of 2,400 mg if needed

RESULTS OF DECISION POINT ONE

  •  Client returns to clinic in four weeks
  •  Client returns to the office today and seems to be in agony. He states that the Neurontin did not help him at all. He also states that he is foggy in the morning. His current pain level is a 9 out of 10. The PMHNP questions the client on what would be an acceptable pain level. He states, “I would rather have no pain but don’t think that is possible. I could live with a pain level of 3.” The client is also asked what would need to happen to get his pain from a current level of 9 to an acceptable level of 3. He states, “I guess I would like this achiness and throbbing in my right leg to not happen every day or at least not several times a day. I also could do without my toes curling in like they do. That really hurts.” Caucasian Man With Hip Pain Case study
  •  Clientis denies suicidal/homicidal ideation and is still future oriented. He does seem to be discouraged throughout the interview about his current pain
Decision Point Two
Select what the PMHNP should do next:
Discontinue Neurontin. Start Zoloft (sertraline) 50 mg orally daily and titrate at weekly intervals to a dose of 200 mg
Continue with Neurontin but double the current dose (600 mg PO orally 4 times a day)
Increase the Neurontin dose to 900 mg orally TID and add on Celexa 20 mg orally daily. Increase dose to a max of 40 mg daily
Decision Point Two
Discontinue Neurontin. Start Zoloft (sertraline) 50 mg orally daily and titrate at weekly intervals to a dose of 200 mg

RESULTS OF DECISION POINT TWO

  •  Client returns to clinic in four weeks
  •  Client returns today with a current pain level of 5 out of 10. He appears anxious, which is a new presentation. He states that he feels “amped up” and he cannot seem to control it
  •  Client also states that he hasn’t been able to get an erection in over a week and thinks his pain may be causing erectile dysfunction Caucasian Man With Hip Pain Case study.
  •  Although client’s pain is “more manageable than it has been before”, he thinks it may have gotten the best of him. His new problems really have him discouraged
Decision Point Three
Add on Wellbutrin (bupropion) XL 150 mg orally in the MORNING. Give the client a short course (2 weeks) of Ativan to help with his anxiety

Guidance to Student
Anxiety is a transient effect of SSRI and SNRI therapy and should be anticipated. Counseling the client is key in continuing the therapeutic alliance you have with the client. Short course benzodiazepines will usually be sufficient to bridge this time period. Erectile dysfunction is a side effect of all SSRI’s and should be a counseling point for men. It happens in roughly 10% of men using SSRI’s. A dose reduction in Zoloft will certainly help with the side effects but will most likely result in increased pain. A change in therapy is always an option at this point but will normally not reduce the anxiety or erectile dysfunction experienced and will still require short course benzodiazepine therapy and appropriate counseling. It would be most prudent, in this case, to add-on Wellbutrin XL 150 mg po QAM to help with the side effect of erectile dysfunction. Although we have told you throughout this course that the addition of a medication to treat a side effect is not good therapy, this is one of those cases where it is recommended, especially when the client is experiencing relief from a regimen that took time to achieve. Wellbutrin is a DNRI and does not overlap in SSRI therapy (maybe a little in the DRI of Zoloft) Caucasian Man With Hip Pain Case study.

Decision Point One
Amitriptyline 25 mg po QHS and titrate upward weekly by 25 mg to a max dose of 200 mg per day

RESULTS OF DECISION POINT ONE

  •  Client returns to clinic in four weeks
  •  Client comes to the office still using crutches. He states that the pain has improved but he is a bit groggy in the morning
  •  Client’s pain level is currently a 6 out of 10. The PMHNP questions the client on what would be an acceptable pain level. He states, “I would rather have no pain but don’t think that is possible. I could live with a pain level of 3.” He states that his pain level normally hovers around a 9 out of 10 on most days of the week before the amitriptyline was started. The PMHNP asks what makes the pain on a scale of 1-10 different when comparing a level of 9 to his current level of 6?” The client states, “I’m able to go to the bathroom or to the kitchen without using my crutches all the time. The achiness is less and my toes do not curl as often as they did before.” The client is also asked what would need to happen to get his pain from a current level of 6 to an acceptable level of 3. He states, “Well, that is kind of hard to answer. I guess I would like the achiness and throbbing in my right leg to not happen every day or at least not several times a day. I also could do without my toes curling in like they do. That really hurts.” Caucasian Man With Hip Pain Case study
  •  Client denies suicidal/homicidal ideation and is still future oriented
Decision Point Two
Select what the PMHNP should do next:
Continue current medication and increase dose to 125 mg at BEDTIME this week continuing towards the goal dose of 200 mg daily. Instruct the client to take the medication an hour earlier than normal starting tonight and call the office in 3 days to report how his function is in the morning
Reduce the dose of Elavil to 75 mg at BEDTIME (dose has been titrated at weekly intervals by 25mg per week). Add on Biofreeze roll-on therapy to his right leg below the knee and into the foot and toes to be used as needed daily for muscle cramping
: Reduce dose of amitriptyline Elavil to 75 mg po orally at BEDTIME and add- on Neurontin (gabapentin) 300 mg po orally at BEDTIME. Schedule a Ffollow-up phone call in 1 week to assess pain control
Decision Point Two
Continue current medication and increase dose to 125 mg at BEDTIME this week continuing towards the goal dose of 200 mg daily. Instruct the client to take the medication an hour earlier than normal starting tonight and call the office in 3 days to report how his function is in the morning Caucasian Man With Hip Pain Case study

RESULTS OF DECISION POINT TWO

  •  Client returns to clinic in four weeks
  •  The change in administration time seemed to help. The client states he is not as groggy in the morning and is able to start his day sooner than before
  •  Client’s current pain level is a 4 out of 10. He states that he is now taking 125 mg of amitriptyline at bedtime.
  •  Client’s has noticed that he is putting on a little weight. When asked, the client states that he has gained 5 pounds since he started taking this medication. He currently weighs in at 162 pounds. He is 5’ 7”. He states that his right leg doesn’t bother him nearly as much as it used to and his toes have only “cramped up” twice in the past month. He states that he is able to get around his apartment without his crutches and that he has even started seeing someone he met at the grocery store. The weight gain seems to bother him a lot and he is asking if there is a way to avoid it
Decision Point Three
Select what the PMHNP should do next:
Continue with the Elavil at his current 125 mg a day dose and start Qsymia (phentermine and topiramate) 3.75 mg/23 mg tablet once daily and titrate as required by package insert
Reduce the dose of Elavil to 100 mg a day and follow up in a month
Continue the current dose of Elavil of 125 mg per day, refer the client to a life coach who can counsel him on good dietary habits and exercise Caucasian Man With Hip Pain Case study
Guidance to Student
At this point, the client is almost at his goal pain control and increased functionality. Weight gain is a common side effect with amitriptyline and should be a counseling point at the initiation of therapy. He has a small weight gain of 5 pounds in 8 weeks. A reduction in dose may have an effect on the weight gain but at a considerable cost of pain to the client. This would not be in the best interest of the client at this point. Amitriptyline has a side effect of cardiac arrhythmias. He is not experiencing this at this point. The drug, qsymia contains a product called phentermine which has a history of causing cardiac arrhythmias at higher doses. This product is also only approved for a client with obesity defined as a BMI greater than 30 kg/m2. Your client’s BMI is currently 25.5 kg/m2. He does not meet the definition of obesity but is considered overweight. His best course of action would be to continue the same dose of Elavil, counsel him on good dietary and exercise habits and connect him with a life coach who will help him with this problem in a more meaningful way than a 10 minute counseling session will be able to accomplish. Caucasian Man With Hip Pain Case study

Case Study: A Caucasian Man with Hip Pain

Introduction

Complex regional pain disorder is a chronic pain condition that mostly affects one limb normally after an injury (Zanotti et al, 2017). Apart from the pain, clients also experience anxiety, depression, sleep difficulties, paresthesias, and general deterioration of physical function.  In this case, the client is a 43-year-old Caucasian man who presented with chief complaint of hip pain. According to the client, the pain started 7 years ago after a fall at work and later on it was discovered that the cartilage surrounding the right hip joint was 75% torn. For mental status, the client reports euthymic mood. The diagnosis is Complex regional pain disorder (reflex sympathetic dystrophy). The purpose of this essay is to make three decisions regarding the medications to be prescribed to the client. Factors that might affect the pharmacokinetic and pharmacodynamic processes will be taken into consideration. Caucasian Man With Hip Pain Case study.

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The selected first decision is to prescribe the client Savella 12.5 mg orally once daily on day 1; followed by 12.5 mg BID on day 2 and 3; followed by 25 mg BID on days 4-7; followed by 50 mg BID thereafter. I chose Savella because Savella has been shown to be effective in treating fibromyalgia a condition that affects muscles, cartilages and other supporting tissues. Savella is a serotonin-norepinephrine reuptake inhibitor (SNRI and has NMDA antagonist activity and thus balances neurotransmitters in the brain and produces analgesia effect at the site of nerve endings (Abida et al, 2016).

Savella was selected over other options because Savella (milnacipran) does not have affinity for adrenergic, cholinergic and histaminergic receptors, and hence does not have some of the adverse and side effects evident in other medications (English et al, 2010).

The expected results are that the pain will decline and the client will stop using crutches. It is also expected that the client will have minimal side effects and that his mood will stabilize. The outcome of this decision was that the pain had reduced. However, the client reports sweating bouts, nausea, elevated blood pressure and heart rate, and experiencing butterflies in his chest.  These are some of the side effects of milnacipran (Abida et al, 2016).

The selected decision is for the client to continue with the current prescribed medication (Savella) but lower the dose to 25 mg twice daily. The rationale for choosing this decision is that this medication is proofing to be effective in reducing the pain for the patient and the client does not report any mood problems. However, since the client reported some side effects, it is appropriate to lower the dosage in order to minimize the side effects. The rationale for not selecting Lyrica is that this medication has more side effects than Savella and evidence indicate that Lyrica causes mood problems and suicidal thoughts (Goodman & Brett, 2017). Similarly, Sertraline has worse side effects and is not indicated for fibromyalgia (Zhu et al, 2013). In addition, sudden stop of milnacipran therapy is not recommended because the client may develop withdrawal symptoms (Mease et al, 2014). Caucasian Man With Hip Pain Case study

The expected result for choosing this decision was that the pain score would reduce to acceptable level of 3 and that there will be minimal side effects. The outcome of the selected decision was that the pain score has increased compared to previous prescription and this is really affecting his mood. However, the side effects have reduced. The increased pain score can be attributed to the reduced dosage that is not being effective in reducing the pain.  The recommended dosage for Milnacipran is 2.5 mg/day for the first day, 25 mg/day on the 2nd and 3rd day, 50 mg/day on 4th-7th day and after 7th day 100 mg/day. The dose can also be increased to 200 mg/day (Mease et al, 2014).  This therefore might explain the reduced efficacy of the prescribed dosage for the client in regard to pain reduction.

The selected third decision is to change Savella to 25 mg orally in the MORNING and 50 mg orally at BEDTIME. This decision was selected because increased dosage of Milnacipran has been shown to be more effective. Evidence shows that if the response the standard-dose milnacipran therapy is poor, the dose can be increased but keep on assessing patient responses (Hayashi et al, 2017).  In addition, the dose was increased during bedtime in order to reduce side effects when the patient is awake. The second option was not selected because if the client abruptly stops taking milnacipran he may have withdrawal symptoms. The third option was not selected because combination of Savella and Celexa (citalopram) both drugs inhibit serotonin reuptake and hence can cause serotonin toxicity or serotonin syndrome. In addition, using both medications can increase side effects for the client (Masuda et al, 2014). Caucasian Man With Hip Pain Case study

Conclusion

The first selected decision was to prescribe Savela for the client and keep on increasing the dosage as recommended. The rationale for selecting this decision is that Savella has been shown to be effective in treatment of fibromyalgia. Savella balances neurotransmitters in the brain and produces analgesia effect at the site of nerve endings. With this decision, the pain score reduced though the client experienced side effects from the medication. Therefore, the second decision was to continue Savella but lower the dose to 25 mg twice daily. This decision eradicated the side effect but the pain score increased compared to the previous higher dose. As a result, the third decision was to change Savella to 25 mg orally in the MORNING and 50 mg orally at BEDTIME. This decision was selected because increased dosage would increase drug efficacy and hence reduce pain score and during bedtime the client would be able to tolerate side effects better during sleep. Caucasian Man With Hip Pain Case study

References

Abida M, Alam T, Said I, Feky E & Hagg M. (2016). Recent Drugs For The Management  And   Treatment Of Fibromyalgia. IAJPS. 3 (11), pp: 1361-1365

English C, Rey J & Rufin C. (2010). Milnacipran (Savella), a Treatment Option for            Fibromyalgia. PMCID. 35(5), pp: 261–266.

Goodman C & Brett A. (2017). Gabapentin and Pregabalin for Pain — Is Increased Prescribing a             Cause for Concern? N Engl J Med. 1(377), pp: 411-414.

Hayashi M, Mimura M, Otsubo T & Kamijima K. (2017). Effect of high-dose milnacipran in         patients with depression. Neuropsychiatr Dis Treat. 3(5), pp: 699–702.

Masuda T, Inoue T, Naoki T, Shin N, Yuji K, Koyama T & Kusumi I. (2014). Effect of the          coadministration of citalopram with mirtazapine or atipamezole on rat contextual       conditioned fear. Neuropsychiatr Dis Treat. 1(10), pp: 289–295.

Mease P, Clauw D, Trugman J, Plamer R & wang Y. (2014). Efficacy of long-term milnacipran    treatment in patients meeting different thresholds of clinically relevant pain relief:          subgroup analysis of a randomized, double-blind, placebo-controlled withdrawal study. Journal of Pain Research. 1(7), pp: 679—687.

Zanotti G, Ariel P, Comba F, Buttaro M & Piccaluga F. (2017). Three cases of type-1 complex     regional pain syndrome after elective total hip replacement. SICOT J. 3(52).

Zhu H, Bogdanov MB, Boyle SH, Matson W, Sharma S, Matson S, et al. (2013). Pharmacometabolomics of Response to Sertraline and to Placebo in Major Depressive   Disorder – Possible Role for Methoxyindole Pathway. PLoS ONE. 8(7) Caucasian Man With Hip Pain Case study

Health related issue Survey Design And Reflection

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Health related issue Survey Design And Reflection

Choose a health related issue. Using literature as a guide create a 15-20-question survey that would help to gain information about individuals impacted by the health related issue. After the questions are created, write a review on why you chose the questions; how did the research guide your questions.

In 750-1,000 words Health related issue Survey Design And Reflection paper,

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1.Describe how best practices were used in design and analysis when constructing the survey questions.

2.For each question, explain why you chose the question and how the research helped you formulate the question.

3.Explain what method you would use to conduct your survey, including why you would use that method over others.

Be sure to turn in both the essay and your survey questions, see the document “How to Attach Multiple Documents to an Assignment Submission,” located under the resources tab.

Prepare this Health related issue Survey Design And Reflection assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required. Health related issue Survey Design And Reflection

Pharmacotherapy for Cardiovascular Disorders Essay

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Pharmacotherapy for Cardiovascular Disorders Essay

Cardiovascular diseases cause significant morbidity and mortality globally and in the US. Besides, their prevalence in the US is increasing gradually thus, they pose potential threats and challenges to the American healthcare system. Despite the advancement in treatment, patients with cardiovascular diseases do not receive optimal care. This is attributed to their complex nature, which requires a good understanding of their risk factors and pathophysiology and how these factors influence pharmacodynamics and pharmacokinetic processes. Pharmacotherapy for Cardiovascular Disorders Essay.

Case Overview

The selected case study for this assignment involves a patient named AO who was obese and has subsequently gained 9 pounds. AO has a diagnosis of hyperlipidemia and hypertension with the following prescribed medications: Sertraline 25 mg, doxazosin 8 mg, atenolol 12.5 mg and Simvastatin 80 mg daily, with hydralazine 10 mg qid.

Patient Factors

The selected patient factor is behavior concerning AOs obesity. This means that AO’s lifestyle has a high-calorie intake and decreased physical activity. As explained by Shattat (2015), the pathophysiology of obesity-related hypertension is attributed to the accumulation of fat in the intravascular space and intra-abdominal muscles, it activates the renin-angiotensin system and leads to retention of sodium hence increased renal absorption.

Obesity and hyperlipidemia complicate the management of cardiovascular disorders. Therefore, poor circulation and poor nutrition affect the pharmacokinetics and pharmacodynamics of this patient. It is inarguable that AO has poor nutrition and reduced circulation, which is influenced by obesity and limited physical activity respectively. The two factors lead to vasoconstriction that accompanies hypertension and the build-up of plaque as observed in hyperlipidemia. As emphasized by Arcangelo & Peterson (2013), it is necessary to understand how these risk factors affect the management of cardiovascular disorders and their side effects on the patient’s ability to respond to drug therapy to achieve desired therapeutic outcomes. This understanding will also influence clinical decision making on appropriate dietary and therapeutic modifications to attain specific treatment goals. AO should consider making modifications to his diet and have a regular physical exercise to improve his cardiovascular health and efficacy of the recommended treatment plan. Pharmacotherapy for Cardiovascular Disorders Essay

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Pharmacodynamics & Pharmacokinetics

It is not clear if AO adheres to prescribed medications since he has several pills to take daily. Based on the recommendations provided by the AHA (American Heart Association), patients with hypertension should be given combined therapy to reduce the risks of side effects and non-compliance. AO is at a high risk of hydralazine associated SLE. Besides, the combination of doxazosin and atenolol produces synergistic effects such that, the latter blocks alpha 1 receptors resulting in the dilation of blood vessels reducing the peripheral resistance (Pokrovsky, Polishchuk & Polischuk, 2017).  However, atenolol is cardio-selective thus blocks beta 1 receptors even at the lowest doses.

Improving the Drug Therapy Plan

AO’s drug plan has numerous areas that need improvement. First, AO’s prescription has atenolol, which is a beta-blocker. Beta-blockers act by blocking the effects of adrenaline to influence vasodilation, improve the flow of blood and lower blood pressure. Beta-blockers are major contributors to hyperlipidemia according to currently existing research (Carey & Wheaton, 2018).  Besides, according to the recommendations provided by the FDA, it is not the 1st line dug of choice in hypertension management. Based on these reasons, atenolol must be discontinued in this patient’s drug therapy. Discontinuation of atenolol should also prompt the discontinuation of hydralazine since the latter is administered alongside a diuretic and a beta-blocker. Pharmacotherapy for Cardiovascular Disorders Essay.

The FDA recommends diuretics for hypertension 1st line managements. For this patient, a daily dose of 12.5mg hydrochlorothiazide (HCTZ) is the most appropriate. As a thiazide diuretic, HCTZ acts on the renal system by decreasing the reabsorption of sodium in the distal convoluted tubule (Roush & Sica, 2016). It is also worth mentioning that thiazides are not only beneficial but also safe in patients with diabetes and reduce the risk of high mortalities from stroke and heart disease. However, it should be administered in the lowest dose possible. AO is not a known diabetic. However, she has several risk factors for diabetes, which should prompt the need to determine whether she has diabetes.

Simvastatin, a statin, is appropriate for managing this patient’s hyperlipidemia. Simvastatin acts by decreasing cholesterol production in the liver by blocking the HMG CoA enzyme (Arcangelo & Peterson, 2013). Besides, it is the FDA‘s recommended drug for the 1st line management of hyperlipidemia based on a patient’s blood cholesterol levels. Therefore, to determine if simvastatin is still effective, I would order for a blood cholesterol test. On the other hand, I would recommend that AO take doxazosin at night since it causes orthostatic hypotension as a major side effect. Pharmacotherapy for Cardiovascular Disorders Essay.

 References

Arcangelo, V. P., and Peterson A. M. (Eds.). (2013). Pharmacotherapeutics for advanced practice: A practical approach (3rd ed.). Ambler, PA: Lippincott Williams & Wilkins

Carey, R. M., & Wheaton, P. K. (2018). Prevention, detection, evaluation, and management of high blood pressure in adults: Synopsis of the 2017 American College of Cardiology/American Heart Association hypertensive guideline. Annals of Internal Medicine, 168(5), 351-358.

Pokrovsky, V., Polishchuk, L., & Polischuk, S. (2017). The methodology for assessing the effectiveness of the therapy. Research Results in Pharmacology, 3, 91.

Roush, G. C., & Sica, D. A. (2016). Diuretics for hypertension: a review and update. American journal of hypertension, 29(10), 1130-1137. Pharmacotherapy for Cardiovascular Disorders Essay

Shattat, G. F. (2015). A review article on hyperlipidemia: types, treatments and new drug targets. Biomedical and Pharmacology Journal, 7(1), 399-409.

Paper details

Despite the high mortality rates associated with cardiovascular disorders, improved treatment options do exist that can help address those risk factors that afflict the majority of the population today.  As an advanced practice nurse, it is your responsibility to recommend appropriate treatment options for patients with cardiovascular disorders. To ensure the safety and effectiveness of drug therapy, advanced practice nurses must consider aspects that might influence pharmacokinetic and pharmacodynamic processes such as medical history, other drugs currently prescribed, and individual patient factors.

Reference: Murphy, S. L., Xu, J., Kochanek, K. D., & Arias, E. (2018). Mortality in the United States, 2017. Retrieved from https://www.cdc.gov/nchs/products/databriefs/db328.htm

To Prepare

  • Review the Resources for this module and consider the impact of potential pharmacotherapeutics for cardiovascular disorders introduced in the media piece.
  • Review the case study assigned by your Instructor for this Assignment.
  • Select one the following factors: genetics, gender, ethnicity, age, or behavior factors.
  • Reflect on how the factor you selected might influence the patient’s pharmacokinetic and pharmacodynamic processes.
  • Consider how changes in the pharmacokinetic and pharmacodynamic processes might impact the patient’s recommended drug therapy.
  • Think about how you might improve the patient’s drug therapy plan based on the pharmacokinetic and pharmacodynamic changes. Reflect on whether you would modify the current drug treatment or provide an alternative treatment option for the patient. Pharmacotherapy for Cardiovascular Disorders Essay

Write a 2- to 3-page paper that addresses the following:

  • Explain how the factor you selected might influence the pharmacokinetic and pharmacodynamic processes in the patient from the case study you were assigned.
  • Describe how changes in the processes might impact the patient’s recommended drug therapy. Be specific and provide examples.
  • Explain how you might improve the patient’s drug therapy plan and explain why you would make these recommended improvements.
  • Scenario: Patient AO has a history of obesity and has recently gained 9 pounds. The patient has been diagnosed with hypertension and hyperlipidemia. Drugs currently prescribed include the following:
  • Atenolol 12.5 mg daily
  • Doxazosin 8 mg daily
  • Hydralazine 10 mg QID
  • Sertaline 25 mg daily
  • Pharmacotherapy for Cardiovascular Disorders Essay

Cardiovascular disease and cancer death in the United States Essay

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Cardiovascular disease and cancer death in the United States Essay

Part 1

Consider the following scenario:

Due to an increase in cardiovascular disease and cancer death in the United States, the Center for Disease Control and Prevention (CDC), the Food & Drug Administration (FDA), and the National Cancer Institute (NCI) have formed a joint task force and has tasked you with developing an educational presentation on one of these topics to share with your community. Due to the public’s lack of knowledge on these topics, it is your job to create a presentation that is informative and educational regarding your chosen topic. Cardiovascular disease and cancer death in the United States Essay

Research your topic using online sources such as the FDA, CDC, NCI, and local sources for content on your topic for this presentation.

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Choose ONE of the following topics:

  • Chronic diseases
  • Coronary artery disease
  • Congenital heart disease
  • Congestive heart failure
  • Hypertensive heart disease
  • Diabetes type I
  • Asthma Chronic
  • Obstructive Pulmonary Disease (COPD)
  • Arthritis
  • Obesity
  • Alzheimer’s Disease
  • Kidney disease
  • Cancer
    • Breast cancer
    • Prostate cancer
    • Lung cancer
    • Melanoma
  • Additional topic choices as approved by faculty

Create a 15- to 18-slide Microsoft® PowerPoint® presentation with appropriate images to be presented to your community.

Include the following points:

  • Provide a brief background on your chosen disease.
  • Identify how this disease develops or how individuals contract the disease.
  • Identify ways of preventing this disease.
  • How could a fitness or exercise program, if any, help prevent this disease?
  • Explain how to treat this disease using conventional medicine and complementary and alternative medicine (CAM), otherwise known as holistic medicine.
  • Identify the nutritional needs of the individual with this disease, as well as what their diet should be to meet the nutritional needs.
  • Make recommendations for where your audience might search for more information regarding this disease.
  • Include credible sources for the information (e.g. not Wikipedia). This will be in addition to the 15-18 slides.
  • For Local Campus students, these are oral presentations accompanied by Microsoft®PowerPoint® presentations.
  • For Online and Directed Study students, the virtual presentation can be created as a Microsoft® PowerPoint® presentation with audio files connected to each slide, podcast, webcast, teleconference, or any other virtual communication tool. Cardiovascular disease and cancer death in the United States Essay

Part 2

Choose an infectious disease that is currently a human health risk. 

Research your topic using online sources such as the NIH, CDC, and WHO.

Write a 350- to 525-word blog entry on the disease.  You are getting the word out to your chosen audience.  Answer the following questions:

  1. Describe the cause and symptoms of the disease.
  2. Which populations are most susceptible to infection? How is the disease transmitted?
  3. Is there a vaccine or treatment available for the disease?
  4. Is the disease new or has it occurred in the past?
  5. Does the disease present a significant problem for the human population globally, or is it localized?

Format the reference consistent with APA guidelines. Cardiovascular disease and cancer death in the United States Essay

Essay on state of adult obesity in Texas

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Essay on state of adult obesity in Texas

Respond to the following essay on state of adult obesity in Texas

Texas County has a 33% of adults who reported a BMI of 30 or more. The top performer in this category has 26% with the state of Missouri recording 31% in the category. I feel like this is an area that needs improvement especially considering the dire health outcomes of obesity which include prevalence of acute and chronic conditions like hypertension (Brennan et al., 2014). Texas county and by extension the entire state of Missouri need to address the problems of adult obesity as the numbers do not make for good reading. Clearly, improvements need to be made to at least get to the level of the leading state at 26%. Essay on state of adult obesity in Texas

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Health resources available

With statistics showing that one in every three adults in the state of Missouri are obese, the state of through the Missouri Department of Health and Senior Services (DHSS) has partnered with Centers for Disease Control and Prevention (CDC) for The Missouri Disability and Health Collaborative (Dietz, 2015). This is meant to get the necessary funds to support people who are intellectually challenged ad help them access an array of evidenced based physical activity. This collaborative move seeks to ensure individuals with intellectual disabilities can access Missouri’s public health facilities in terms of adapting evidenced based physical activity and nutrition to improve their health (Dietz, 2015). Essay on state of adult obesity in Texas

Health policy

Preventing obesity at childhood is the best possible way if reducing the rates of obesity in the long term (Brennan et al., 2014). Good Early childhood education (ECE) can encourage good dieting and physical activities for children and cultivate a healthy culture. In that regard, I would suggest the state of Missouri to continue encouraging healthy eating habits for children at a young age. While there is a state policy which requires licensed ECE programs to allow breastfeeding on site up to at least a year, it should be extended to even unlicensed ECE programs. This is to ensure that the rate of obesity is lowered in the state.

References

Brennan, V. M., Kumanyika, S. K., & Zambrana, R. E. (Eds.). (2014). Obesity interventions in underserved communities: evidence and directions. JHU Press.

Dietz, W. H. (2015). The response of the US Centers for Disease Control and Prevention to the obesity epidemic. Annual review of public health, 36, 575-596. Essay on state of adult obesity in Texas

Raising Awareness About HIV Essay

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Raising Awareness About HIV Essay

Thank you for sharing  Raising awareness about HIV. Do you know if Florida’s legislation is currently working on this initiative? I often scan through what is going on in the state of New Hampshire and look at the list of Bills. Sometimes I find some of what is on the dockets very interesting. Sometimes, I even get a good chuckle.

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Use an APA 7 style and a minimum of 250 words. Provide support from a minimum of at least three (3) scholarly sources. The scholarly source needs to be: 1) evidence-based, 2) scholarly in nature, 3) Sources should be no more than five years old (published within the last 5 years), and 4) an in-text citation. citations and references are included when information is summarized/synthesized and/or direct quotes are used, in which APA style standards apply. Include the Doi or URL link.

• Textbooks are not considered scholarly sources. 

• Wikipedia, Wikis, .com website or blogs should not be used Raising Awareness About HIV Essay

Obesity in Miami Essay

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Obesity in Miami Essay

To offer discussion response to Obesity in Miami Essay

Miami-Dade County, Florida. According to the website that I researched (County Health Rankings, 2017), health in this county seems to be pretty good. Ninety-nine percent of individuals living in this county have access to exercise opportunities however, obesity is a problem because 21 percent of the individuals are physically inactive – this corresponds to an adult obesity rate that is also 21 percent. Although this sounds like a fairly high rate (a little more than one-fifth of the population) it is important to keep  in mind that it is quite a bit less than the national adult obesity rate of 36.5 percent (CDC, 2016). Obesity in Miami Essay

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Obesity is an important health problem that should not be ignored as it contributes to several different types of adverse health outcomes. These include cardiovascular disease, diabetes, some cancers, and stroke risk (CDC, 2016). There are several lifestyle factors that contribute to obesity, and the main ones are dietary intake and physical inactivity. It seems pretty clear from the statistics in County Health Rankings (2017) that physical inactivity in Miami-Dade, Florida and obesity are going hand-in-hand, as the physical inactivity rate and the obesity rate in that county are exactly the same. Dietary intake is also important in that individuals who consume too much food are at great risk of obesity, especially when this consumption of food (and therefore the input of energy) greatly outpaces the activity level of the individual (and therefore the outflow of energy). Some health resources available to address the problem include the availability of counseling and therapy services, and weight loss centers and programs (for individuals who have enough money to afford these), and self-help groups like Overeaters Anonymous that are free and therefore available to people with lower income levels as well. These methods are useful for addressing the food-intake component of obesity. For addressing the physical inactivity component, there are gyms and county and neighborhood parks that everyone can utilize to increase their activity levels.

CDC. (2016). Overweight and obesity. Retrieved March 7, 2016, from http://www.cdc.gov/obesity/data/index.html

County Health Rankings. (2017). County Health Rankings and Roadmaps. Retrieved from http://www.countyhealthrankings.org/ Obesity in Miami Essay