Nursing homework help

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Responses such as “I agree”, “thanks for that information – I didn’t know that”, “I experienced that also”, etc. will not receive participation credit. Please do not repeat what is already mentioned in the post. Responses should be a minimum of 150 words and minimum of 2 peer reviewed or scholarly sources with 5 years

Please do not to “cut and paste” answers from your references such as lists, bullet points, etc. This will not receive points for responses that are “cut and paste” even if you provide a citation.

Post 1:

If the 19 year old female patient is an Arab-American, there is much about this culture the nurse must consider in her care. Refraining from excess eye contact and physical contact (Attum, Hafiz, Malik, 2020) while building trust as her caregiver is important. Though the patient is over-age, family is as important to Arab-American’s as their religion, and family should be included in the process should they wish to be involved, as the patient advocate it is important to go to lengths to ensure a family member can be present with her to reduce her anxiety & promote healing, rest, positive treatment regimen. Modesty is highly valued in this culture, and maintaining the patient’s privacy is vital. This female will need to be seen by a female nurse and physician, as it is required in this culture to be assessed by medical professionals who are the same gender as she is (Falkner, Ch. 3, 2020). Respect to this culture’s diet is important, and the female coming in for fevers should not be offered anything consisting of “non-Halal animal fats, pork, by-products of pork, and any animals that have slaughtered in the name another diety (i.e., other than Allah, the Abrahamic God)” (Attum, Hafiz, Malik, 2020). That means no fluids that include these products. Discrimination against Arab-Americans became more apparent after the terrorist attacks in 2001, and patients of this culture may be hesitant to reach out for help. Its the nurses job to make the patient feel accepted and to build trust with her to ensure she will be safe and respected (Falkner, Ch. 3, 2020). Nursing homework help

Health care support systems within the hospital that give resources for other cultures include the language line, which can be used when a patient feels more comfortable using their prefered language. some language lines have a video conference option which puts an approved translator face to face with the patient, giving them more confidence to speak through someone they may be more familiar with. This service can increase the patients confidence with making healthcare decisions and lead to better outcomes for the patient. Because prayer and religion are highly treasured among Arab-Americans (Attum, Hafiz, Malik, 2020), the proper spiritual care in the hospital should be provided as well.

If the support systems and resources are low, there are a few community resources I’ve found for Arab-Americans to access. Arab America is a national organization and there are different resources depending on the state the patient lives in. This organization offers news, events, and health online resources in both English and Arabic What’s unique about Arab America is its purpose of “promoting an accurate image of the Arab American community and the Arab world” (AAI, 2020). They offer so much more than just health care support. A second source of support for Arab-Americans I’ve found is the AAFS, A non-profit social service that “offers support in the areas of public benefits, immigration, domestic violence, mental health, and elderly services and sponsors outreach programs to build healthier families and communities” (AAFS, 2020).

 

Reference

Anderson, L. M., Scrimshaw, S. C., Fullilove, M. T., Fielding, J. E., Normand, J., & Task Force on Community Preventive Services. (2013). Culturally competent healthcare systems: A systematic review. American journal of preventive medicine, 24(3), 68-79.

 

Attum, B., Hafiz, S., Malik, A., & Shamoon, Z. (2021). Cultural Competence in the Care of Muslim Patients and Their Families. In StatPearls. StatPearls Publishing.

 

Post 2:

Understanding one’s cultural practices is very essential during the process of providing care, because diversity in culture is as a result of the unique nature of each culture. In admitting a 19-year old Hispanic female, certain things must be considered. First of all, illness and morbidity is a big issue for Hispanics, therefore, the nurse should ensure that the patient is made comfortable, free of anxiety and reassured. Also, the nurse should try not to maintain eye contact during conversations as this can be misinterpreted as a challenge or intimidation which can make the patient uncomfortable. In addition, the Hispanics rely on home remedies a lot, the nurse should inquire what concoction the patient has taken before coming to the hospital. Lastly, the nurse should expect not to get 100% cooperation from the patient because the head of the family is responsible for making decisions about health for every member of the family (Centers for Disease Control and Prevention, n.d.). Nursing homework help

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A large percentage of the Hispanic population living in the United States have inadequate access to healthcare services, this is because they do not have health insurance coverage, and this usually makes them not to access healthcare until the situation gets worse. In the United States, there are health care support system for this group, one of which is Federally Qualified Community Health Centers. This program is affordable and available for people with limited resources who lack health insurance irrespective of their immigration status. Others include Affordable Care Act (ACA) and Ventanillas de Salud (VDS), their goals are to provide preventive health services and also increase public insurance coverage (Gomez et al, 2019).

References

 

Centers for Disease Control and Prevention, (n.d.). Cultural insights. Communicating with Hispanics/Latinos. https://www.cdc.gov/healthcommunication/pdf/audience/audienceinsight_culturalinsights.pdf

 

Gomez M. et al, (2019). Together for health: An initiative to access health services for the Hispanic/ Mexican population living in the United States. https://www.frontiersin.org/articles/10.3389/fpubh.2019.00273/full

 

 

Post 3:

Native Americans are the smallest minority group in United State (Russel, 1996), yet it has a multitude of social and health problems. It is matrilineal so women play a crucial role in some of the tribes. They have several values, lifestyles, and taboos from tribe to tribe.

Several things must be considered when interviewing a 19-year-old female in the hospital. The native American lacks trust in the health care providers. (Guadagnolo et al.,2009, Oetzelet al.,2006) It is important to maintain a trusting relationship by initiating a dialog that may make the girl trust the nurse. Communicating to the patient that you care for her, and that confidentiality will be maintained as per her choice is vital. Also maintaining privacy is of paramount importance. Most native Americans are comfortable speaking in their own language, so it is important for the nurse to ask the girl which language she prefers to use. (Hodge and Frederick,1994).

Extended family is very important, and women are the decision-makers, so it is important to ask the girl if she wants someone to be involved in her care. Gaining approval and support for care will aid in the family’s adherence to the plan. It is also important to note that Native Americans are at risk of numerous health and social risks such as Sexually transmitted diseases, adolescent pregnancy, and have the potential to contract HIV (US Department of Health and Human Services,1995). Nursing homework help

 

The native Americans practice preventive healthcare (Gilliland et al.,1999) They may incorporate prayer meetings songs, and sweat lodges into urban care and disease prevention and may emphasize the interrelatedness of spirituality and health care (Piawecki and Sanchez,1994). So nurse should consider asking if the patient has used anything for her fevers.

 

When educating this woman, it is important to consider sitting face to face with the patient (Jacobson et al.,1998). However, the nurse should avoid looking straight in her eyes as this is viewed as disrespectful. Natives believe that if one can look you straight in the eye, one can also take away one’s soul (Weave and White,1997). Also, Nurse should be aware that charts, clipboards, and documents could be a barrier to establishing rapport with a native American patient. It is also important to include the family when educating the patient.

Respond to pain differs from culture to culture. It is important to assess the pain of native Americans and offer them pain relief options even if they are not verbalizing or physically expressing the pain (Ramer,1992). It is crucial to listen to patients’ preferences before prescribing potential solutions (Whitbeck,2006). Also because they prefer to rely on their own resources, rather than behavioral health services, they may prefer traditional healing over mainstream services (Chester et al1999, Johnson and Cameroon,2001, Novins et al.,2004, Oetzel et al.,2006), so it is vital to ask her preferences.

 

There are some programs for native Americans in New Mexico. These include First Nations Community Health Source. It has provided an integrated and culturally competent health delivery system that addresses the physical, emotional and spiritual needs of its clients. Also, the University of New Mexico has a program called Dedicated Mental Health Care System for Native Americans. It provides opportunities for consultations, training, and evaluation partnerships and services.

 

References

Cesario, S, K(2001) Care of the Native American Woman: Strategies for Practice, Education, and Research  https://www.jognn.org/article/S0884-2175(15)33875-2/fulltex DOI:https://doi.org/10.1111/j.1552-6909.2001.tb01517.x

 

Community-Focused Care Mental Health Resources for Native Americans (2022)

https://unmhealth.org/services/behavioral-health/native-american.html

 

Podlogar M.C, Novins, M.D  Quality of care in American Indian child and adolescent behavioral health: A pilot study of patients and family perspectives  ncbi.nlm.nih.gov doi:10.1037/a0038560

 

 

Post 4:

There is an ethical and moral duty to every health care provider to offer the best possible care to every patient. Nurse can use cultural awareness, knowledge, skill and encounter to gather information from patient. It involves the integration of knowledge, attitude and skills that enhance cross-cultural communication and foster meaningful, respectful interaction with others. it helps the nurse to understand the patient better, also to recognize and manage sociocultural issues that happens in encounters.

Islamic community is an unfamiliar culture to me. Important things to remember while interviewing an Islamic patient. It is important for the nurse to know her cultural values, belief, and practices, and appreciate how they may be different from others. The nurse should consider each client as unique, influenced but not defined by their culture. Learn as much as she can about cultural groups in her community. Make an effort to include beliefs and practices from other cultures into her care. The nurse should never let her own biases about people and groups stand in the way of good care. Try to encourage helpful cultural practices into her care and discourage harmful ones. Be mindful of her body language, verbal and non-verbal patterns during communication. Learn from her mistakes. Nursing homework help

The nurse has to understand important differences in culture and spiritual values of Muslims, including diet, privacy, touch restriction, ideas of modesty and alcohol intake restriction. Islamic faith can influence decision making, family dynamics, health practices and risk. Islamic patient prefers same sex (gender) healthcare provider. knowledge of Islamic beliefs will assist healthcare professional in delivering appropriate healthcare in a culturally sensitive manner and can be accompanied by understanding religious implications, perspectives, on family, health, illness, diet, the influence on traditional medicine and privacy concerns. The nurse should minimize eye and physical contact with patient of opposite gender. e.g. male doctor asking question to female patient in the Prescence of her spouse without response, the doctor should ask her if she want him to talk to her husband. Islam rules prohibits alcohol, non-Halal animal, fats, pork, by-products of pork and any animal that have been slaughtered in the name of another deity. Islam prayer times may interfere with medical care and facility mealtime, so special arrangement needs to be made for home food, if not possible, provide foods like eggs, fruits, seafood, and vegetables.

Health practitioners should be aware of cultural and religious factors to help provide culturally competent and appropriate promotion and education of health services to the Islamic population.

Islamic community center is a health care support system available in the community for Islamic group. The joint commission is an independent nonprofit organization that seeks to improve healthcare among its accredited healthcare members, holds hospital accountable for addressing and maintain patients rights. Joint commission accreditation must have experts in administrative affairs, clinical practice and policy. Amendment 14 of US constitution is a law implemented by the government to provide equal treatment for all without inequality on the basis of social and economic condition.

References:

Statpearls-NCBI Bookshelf Cultural Competence in the Care of Muslim Patients and Their Families. Attum B, Hafiz S, Malik A, et al. https://www.ncbi.nlm.nih./gov/books/BNK 499933/

Oakland Islamic Community Center (OICC). https://www.oaklandislamiccenter.org

Joint Commission Standards for Effective Communication. Retrieved from: https://www.jointcommission.org

 

 

 

 

 

 

 

 

Nursing Practitioning

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As a family nurse practitioner you are working in a rural health clinic. You are evaluating a 16-year-old adolescent patient who comes complaining of having a difficulty concentrating in school. On exam you also note that the patient is very thin and frail in appearance and is asking you for diet pills. Explain the following questions in a 2 page Word document:

  1. What are some initial areas for concern?
  2. What screening tools can help lead you closer to your diagnosis?
  3. Describe 1 health promotion strategy you can discuss with the patient.
  4. Make a plan of care that addresses the following: possible pharmacological and non-pharmacological (OTC) interventions, labs, follow-up, teaching, and referrals.

Support your work with a minimum of two (2) evidence-based guidelines and/or articles published within 3-5 years.

Reference:

Centers for Disease Control and Prevention. (2013). Youth risk behavior surveillance system (YRBSS).

Nursing homework help

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Reflection Journal Instructions on nursing leadership
Introduction: Describe your most recent experience in the clinical setting.
1. Describe 1 specific activity that you engaged in (today at
clinical, code GRAY was announced because the patient
was aggressive, being aggressive, abusive, violent, or
displaying threatening behavior because the patient was
experiencing delirium from alcohol withdrawal
symptoms.. The nurse leader I shadowed immediately
acted promptly to de-escalate the situation by…
Reflection on action: Was it easy/difficult, pleasant/unpleasant etc.

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1. What you found easy or difficult
2. What you liked about what you did (I think being as a
nurse leader, it is just about managing the staff but also
about how to handle the situation …
Reflection on what you learned: Nursing homework help
1. How you might want to follow it up
2. How you used your theory knowledge on the subject
Conclusion: Identify gaps
1. What other information do you need
2. What could you do differently in this type of situation next
time
Assignment instructions: this class is about nursing leadership in an Teleetry unit in the
hospital. Please Write a 1.5 pages reflection using the instructions above in APA Style
Format, using 2 scholarly references APA format. References must be within 5 years.
This paper is about reflection journal. Not a research paper. Please write an reflection
paper that with make up story. Thanks. Nursing homework help
Fill out this log
Objectives of the
week:
I need to do the
following:
How do you
know you met
your goals?
and start my
project as well.
Did you meet your
objectives/goals? How
do you know?

Obesity In Adults

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Task 1: Social Media Campaign

Introduction:

Part of cultural competency is advocating for sensitive patient populations with regard to health issues or needed improvements in the community. A big part of advocacy is uncovering effective stories discovered in your community assessment. Equally important is understanding how to broadcast your discoveries to the larger community. In our society today, social media is a powerful leveraging tool to get a story out, build support, and demonstrate advocacy.

Requirements:

Your submission must be your original work. No more than a combined total of 30% of the submission and no more than a 10% match to any one individual source can be directly quoted or closely paraphrased from sources, even if cited correctly. Use the Turnitin Originality Report available in Taskstream as a guide for this measure of originality.

You must use the rubric to direct the creation of your submission because it provides detailed criteria that will be used to evaluate your work. Each requirement below may be evaluated by more than one rubric aspect. The rubric aspect titles may contain hyperlinks to relevant portions of the course.

Part 1: Field Experience Project Submission

Note: Your timelog must be submitted with your assessment. If both are not submitted at the same time, your task may be returned to you without evaluation.

A. Submit a completed “Community Health Field Experience Timelog” by doing the following:

  1. Include the date of each activity.
  2. Include a brief description of each activity.
  3. Include the name of the contact person, a working phone number, and a full physical address.

Note: If an email address is available for the contact person, you may choose to include it.

  1. Include the number of hours spent on each activity (not including preparation time).
  2. Describe how each activity relates to your selected Field Experience topic.
  3. Record a total of 90 hours that meet each of the following requirements:

● 65 student planned activity hours based on the attached “Field Experience Activities List”

● a maximum of five individual interview hours (i.e., no more than five interviews, no more than one hour per interview)

● no prep time hours (i.e., prep time is not to be included in reported hours)

Note: If your timelog is returned from evaluation, you are required to do an addendum. Please use the link below to access the DocuSign addendum document. Both the original timelog and the addendum timelog must be submitted with the task.

Note: Random audits and verification of time log activities do occur. Violation of the WGU Code of Student Conduct or the Academic Authenticity Policy could result in disciplinary action.

Part 2: Social Media Campaign

Note: The “CDCynergy” web link provided in the web links section below may be useful in completing your social media campaign. The use of this web link is optional, i.e., not required.

B. Write your community health nursing diagnosis statement.

  1. Explain how the health concern from your community health nursing diagnostic statement is linked to a health inequity or health disparity within the target population.

a. Discuss the primary community resources and primary prevention resources currently in place to address the health concern.

b. Discuss the underlying causes of the health concern.

  1. Discuss the evidence-based practice associated with the Field Experience topic.

a. Identify data about the selected Field Experience topic from the local (e.g., county), state- Florida, and/or national level.

C. Develop a community health nursing social media campaign strategy that will convey your health message and address the Field Experience topic by doing the following:

  1. Describe your social media campaign objective.
  2. Recommend two population-focused social marketing interventions and justify how each would improve the health message related to your selected Field Experience topic.
  3. Describe a social media platform you would use that is appropriate for communicating with the target population-Adults

a. Discuss the benefits of the selected social media platform in supporting preventative healthcare.

  1. Discuss how the target population will benefit from your health message.

D. Describe best practices for implementing social media tools for health marketing.

E. Create a social media campaign implementation plan by doing the following:

  1. Describe stakeholder roles and responsibilities in implementing the plan.
  2. Discuss potential public and private partnerships that could be formed to aid in the implementation of your campaign.
  3. Create a specific timeline for implementing your campaign.
  4. Explain how you will evaluate the effectiveness of the campaign.
  5. Discuss the costs of implementing your campaign.

F. Reflect on how social media marketing supports the community health nurse’s efforts to promote healthier populations.

  1. Reflect on how your social media campaign could apply to your future nursing practice.

G. Acknowledge sources, using in-text citations and references, for content that is quoted, paraphrased, or summarized.

H. Demonstrate professional communication in the content and presentation of your submission.

SOAP NOTE on Striae Gravidarum

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Comprehensive SOAP Exemplar

 

Purpose: To demonstrate what each section of the SOAP note should include. Remember that Nurse Practitioners treat patients in a holistic manner and your SOAP note should reflect that premise.

 

Patient Initials: _______                 Age: _______                                   Gender: _______

 

SUBJECTIVE DATA:

 

Chief Complaint (CC): Coughing up phlegm and fever

 

History of Present Illness (HPI): Eddie Myers is a 58 year old African American male who presents today with a productive cough x 3 days, fever, muscle aches, loss of taste and smell for the last three days. He reported that the “cold feels like it is descending into his chest and he can’t eat much”. The cough is nagging and productive. He brought in a few paper towels with expectorated phlegm – yellow/green in color. He has associated symptoms of dyspnea of exertion and fatigue. His Tmax was reported to be 100.3, last night. He has been taking Tylenol 325mg about every 6 hours and the fever breaks, but returns after the medication wears off. He rated the severity of her symptom discomfort at 8/10. SOAP NOTE on Striae Gravidarum

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Medications:

  • Norvasc 10mg daily
  • Combivent 2 puffs every 6 hours as needed
  • Advair 500/50 daily
  • Singulair 10mg daily
  • Over the counter Tylenol 325mg as needed
  • Over the counter Benefiber
  • Flonase 1 spray each night as needed for allergic rhinitis symptoms

 

Allergies:

Sulfa drugs – rash

Cipro-headache

 

Past Medical History (PMH):

1.) Asthma

2.) Hypertension

3.) Osteopenia

4.) Allergic rhinitis

5.) Prostate Cancer

 

Past Surgical History (PSH):

  • Cholecystectomy 1994
  • Prostatectomy 1986

 

Sexual/Reproductive History:

Heterosexual

 

Personal/Social History:

He has never smoked

Dipped tobacco for 25 years, no longer dipping

Denied ETOH or illicit drug use.

 

Immunization History:

Covid Vaccine #1 3/2/2021 #2 4/2/2021 Moderna

Influenza Vaccination 10/3/2020

PNV 9/18/2018

Tdap 8/22/2017

Shingles 3/22/2016

 

Significant Family History:

One sister – with diabetes, dx at age 65

One brother–with prostate CA, dx at age 62. He has 2 daughters, both in 30’s, healthy, living in nearby neighborhood. SOAP NOTE on Striae Gravidarum

 

Lifestyle:

He works FT as Xray Tech; widowed x 8 years; lives in the city, moderate crime area, with good public transportation. He is a college grad, owns his home and financially stable.

 

He has a primary care nurse practitioner provider and goes for annual and routine care twice annually and as needed for episodic care. He has medical insurance but often asks for drug samples for cost savings. He has a healthy diet and eating pattern. There are resources and community groups in his area at the senior center but he does not attend. He enjoys golf and walking. He has a good support system composed of family and friends.

 

Review of Systems:

 

General: + fatigue since the illness started; + fever, no chills or night sweats; no recent weight gains of losses of significance.

 

HEENT: no changes in vision or hearing; he does wear glasses and his last eye exam was 6 months ago. He reported no history of glaucoma, diplopia, floaters, excessive tearing or photophobia. He does have bilateral small cataracts that are being followed by his ophthalmologist. He has had no recent ear infections, tinnitus, or discharge from the ears. He reported no sense of smell. He has not had any episodes of epistaxis. He does not have a history of nasal polyps or recent sinus infection. He has history of allergic rhinitis that is seasonal. His last dental exam was 1/2020. He denied ulceration, lesions, gingivitis, gum bleeding, and has no dental appliances. He has had no difficulty chewing or swallowing.

 

Neck: Denies pain, injury, or history of disc disease or compression..

 

Breasts:. Denies history of lesions, masses or rashes.

 

Respiratory: + cough and sputum production; denied hemoptysis, no difficulty breathing at rest; + dyspnea on exertion; he has history of asthma and community acquired pneumonia 2015. Last PPD was 2015. Last CXR – 1 month ago.

 

CV: denies chest discomfort, palpitations, history of murmur; no history of arrhythmias, orthopnea, paroxysmal nocturnal dyspnea, edema, or claudication. Date of last ECG/cardiac work up is unknown by patient.

 

GI: denies nausea or vomiting, reflux controlled, Denies abd pain, no changes in bowel/bladder pattern. He uses fiber as a daily laxative to prevent constipation. SOAP NOTE on Striae Gravidarum

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GU: denies change in her urinary pattern, dysuria, or incontinence. He is heterosexual. No denies history of STD’s or HPV. He is sexually active with his long time girlfriend of 4 years.

 

MS: he denies arthralgia/myalgia, no arthritis, gout or limitation in her range of motion by report. denies history of trauma or fractures.

 

Psych: denies history of anxiety or depression. No sleep disturbance, delusions or mental health history. He denied suicidal/homicidal history.

 

Neuro: denies syncopal episodes or dizziness, no paresthesia, head aches. denies change in memory or thinking patterns; no twitches or abnormal movements; denies history of gait disturbance or problems with coordination. denies falls or seizure history.

 

Integument/Heme/Lymph: denies rashes, itching, or bruising. She uses lotion to prevent dry skin. He denies history of skin cancer or lesion removal. She has no bleeding disorders, clotting difficulties or history of transfusions.

 

Endocrine: He denies polyuria/polyphagia/polydipsia. Denies fatigue, heat or cold intolerances, shedding of hair, unintentional weight gain or weight loss.

 

Allergic/Immunologic: He has hx of allergic rhinitis, but no known immune deficiencies. His last HIV test was 2 years ago.

 

 

OBJECTIVE DATA

 

Physical Exam:

Vital signs: B/P 144/98, left arm, sitting, regular cuff; P 90 and regular; T 99.9 Orally; RR 16; non-labored; Wt: 221 lbs; Ht: 5’5; BMI 36.78

General: A&O x3, NAD, appears mildly uncomfortable

HEENT: PERRLA, EOMI, oronasopharynx is clear

Neck: Carotids no bruit, jvd or thyromegally

Chest/Lungs: Lungs pos wheezing, pos for scattered rhonchi

Heart/Peripheral Vascular: RRR without murmur, rub or gallop; pulses+2 bilat pedal and +2 radial

ABD:  nabs x 4, no organomegaly; mild suprapubic tenderness – diffuse – no rebound

Genital/Rectal: pt declined for this exam

Musculoskeletal: symmetric muscle development – some age related atrophy; muscle strengths 5/5 all groups.

Neuro: CN II – XII grossly intact, DTR’s intact

Skin/Lymph Nodes: No edema, clubbing, or cyanosis; no palpable nodes. SOAP NOTE on Striae Gravidarum

 

 

Diagnostics/Lab Tests and Results:

CBC – WBC 15,000 with + left shift

SAO2 – 98%

Covid PCR-neg

Influenza- neg

Radiology:

CXR – cardiomegaly with air trapping and increased AP diameter

ECG

Normal sinus rhythm

Spirometry- FEV1 65%

 

Assessment:

 

Differential Diagnosis (DDx):

  • Asthmatic exacerbation, moderate
  • Pulmonary Embolism
  • Lung Cancer

 

Primary Diagnoses:

 

1.) Asthmatic Exacerbation, moderate

 

PLAN: [This section is not required for the assignments in this course, but will be required for future courses.]S OAP NOTE on Striae Gravidarum

 

Nutrition Assignment paper

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Choose a single vitamin or multivitamin supplement that has been promoted for a targeted population.

Example: Certain age group, health condition, or gender group (men’s health, women’s health).

two-page paper, address the following: Investigate the rationale for the vitamin composition of the vitamin.

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Determine what natural food sources can give the same nutritional benefits as the vitamin.

Discuss any side effects or interactions with the vitamin

Based on the research that you have conducted, provide your opinion regarding whether or not you feel the vitamin is a good addition to a natural food source diet.  Explain and support your answer.

Assignment Expectations for Grading:

1. Demonstration of critical thinking, scholarship, and ability to connect and apply the material. Comprehensiveness and completeness of your responses . Adherence to the written instructions . Spelling and grammar APA Style References to support your paper (150-175 words) Nutrition Assignment paper

Nutrition Assignment paper

Nursing homework help

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In part 1 each student is finding and summarizing one peer-reviewed primary research article for your group. (10 pts)

Directions for each individual summary:

  1. Find one peer-reviewed primary (Original Research) article on Topic 6.
  2. Read and evaluate the article chosen.

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  1. Write a summary of the article that answers the following questions for the article:
    1. Who were the participants of the study? (i.e. healthy men, postmenopausal women)
    2. What is the intervention and control; or the comparison?
    3. What type of study was done? (i.e. RCT, case-control)
    4. What is the main finding of the peer-reviewed article?
    5. List 2 or more strengths and 2 or more weaknesses of the study design (not the results).
  2. Write this summary in a paragraph format.
  3. Include the full references for the chosen article in AMA format. A guide to AMA is posted on Canvas. Note: This is NOT just the URL! Also, journal articles need to be formatted like journal articles, not the website you found the article.
  4. Post this summary in the thread I started for Part 1. Nursing homework help

Week 4 _ Assignment: Assessing And Diagnosing Patients With Anxiety Disorders, PTSD, And OCD

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Week 4 _ Assignment: Assessing And Diagnosing Patients With Anxiety Disorders, PTSD, And OCD

Training Title 85 Name: Mrs. Carol Holliman Gender: female Age: 42 years old T- 98.0 P- 77 R 18 132/72 Ht 5’0 Wt 127lbs Background: Born and raised in Northern Ireland, parents brought her and her 5 sisters to U.S. when she was 15 to go to U.S. university where she met her husband. They live in Charleston, SC. She obtained her bachelor’s degree in education; no history of mental health or substance use treatment, no family history. Her husband reported a recent school shooting nearby 3 weeks ago “flipped a switch” in her. She is watching the news 24/7, barely sleeping, and even when she does, it is only a few hours, Appetite is decreased. Hx of hysterectomy, NKDA, no legal hx. Symptom Media. (Producer). (2017). Training title 85 [Video]. https://video-alexanderstreetcom.ezp.waldenulibrary.org/watch/training-title-85. Week 4 _ Assignment: Assessing And Diagnosing Patients With Anxiety Disorders, PTSD, And OCD

 

Transcript

BEGIN TRANSCRIPT:

00:00:15

CAROL Sorry, I, I can’t find it.

 

00:00:20

OFF CAMERA It’s okay.

 

00:00:20

CAROL No, it’s not. Where is it? I never, I never leave without it. Oh Jesus.

 

00:00:30

OFF CAMERA What is it you’re looking for?

 

00:00:30

CAROL My cell. I never check the b. . . um, the trunk. I have to go.

 

00:00:45

OFF CAMERA You seem very upset not to have your phone with you.

 

00:00:50

CAROL Of course, who wouldn’t be? We’ll have to talk some other time.

 

00:00:55

OFF CAMERA Your husband must have his phone, he called that you were running late.

 

00:01:00

CAROL Yeah, he has his phone, but . . .

 

00:01:00

OFF CAMERA But what?

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00:01:05

CAROL The children do not call their father when they want something.

 

00:01:10

OFF CAMERA They never call your husband?

 

00:01:10

CAROL No, they only call me.

 

00:01:10

OFF CAMERA Uh-huh, are you expecting your children to call?

 

00:01:15

CAROL My children are at home with the babysitter, my neighbor. She’s a widow. I just, I don’t feel comfortable, in case they need me. And I always call, they’ll be worried if I don’t.

 

00:01:35

OFF CAMERA How often do you call your children when you’re away from home?

 

00:01:40

CAROL I don’t know, a few times. Just normal checking.

 

00:01:45

OFF CAMERA Do you work?

 

00:01:45

CAROL I’m a mother, so yes, I work.

 

00:01:50

OFF CAMERA I’m sorry, I didn’t mean to suggest parenting isn’t work. It very much is work. Do you also have a job outside of the home?

 

00:02:00

CAROL I used to work from home. I quit my job after my last child, Colin, he’s five now. But, this really isn’t the time for this right now. Nor ever, really. I’m just here as a courtesy, no offense. Week 4 _ Assignment: Assessing And Diagnosing Patients With Anxiety Disorders, PTSD, And OCD

 

00:02:20

OFF CAMERA I understand you do not want to be here. But it would be helpful if we could talk for a few minutes. Perhaps your husband can call your children. Do you want me to go get him for you?

 

00:02:35

CAROL I’ll be fine. We can talk for five more minutes.

 

00:02:40

OFF CAMERA Thank you. You seem to have strong feelings that you want to call your children. But you do not have strong feelings that you want to ask your husband to call them.

 

00:02:50

CAROL He refuse. We don’t see eye-to-eye. But I’m not here for marriage counseling.

 

00:03:00

OFF CAMERA What is your understanding about why you’re here?

 

00:03:00

CAROL Ask my husband, Greg.

 

00:03:05

OFF CAMERA What current concerns do you have when you leave your children?

 

00:03:10

CAROL There’s a laundry list on that one. Start with serial rapists and end with Newtown, and you’ve only scratched the surface.

 

00:03:20

OFF CAMERA How often do you worry about those types on incidents?

 

00:03:20

CAROL I’m mother of three. I have to keep in mind the world as it is. Part of my job description. Every day, people die from gun deaths. 18,000 people are raped. Over 50,000 children go missing every year.

 

00:03:40

OFF CAMERA Those are unsettling statistics.

 

00:03:45

CAROL Dr. Phil did a profile on a serial rapist, that was horrifying. I called my friends to watch it. I TiVo’ed it for them.

 

00:03:50

OFF CAMERA Do you follow a lot of news programs?

 

00:03:55

CAROL Yeah.

 

00:03:55

OFF CAMERA What do you tend to watch?

 

00:03:55

CAROL Most of the shows. I have CNN on background for when I’m doing laundry or cooking, or prepping lessons.

 

00:04:05

OFF CAMERA Lessons, what lessons do you prepare?

 

00:04:10

CAROL For the children.

 

00:04:10

OFF CAMERA Oh, do you school your children at home?

 

00:04:15

CAROL Yes, I homeschool my children. I don’t appreciate your connotations. The stereotype that homeschooling is for religious nuts is outdated. The reality is our school systems are broken. Our public schools can’t even afford protection for our children.

 

00:04:35

OFF CAMERA Was that one of the reasons you decided to homeschool your children was because of school violence?

 

00:04:45

CAROL You mean… ?

 

00:04:45

OFF CAMERA Pardon?

 

00:04:45

CAROL Ridge View?

 

00:04:50

OFF CAMERA Yes, Ridge View, uh-huh.

 

00:04:50

CAROL 12 students murdered, three teachers gunned down trying to protect students. They couldn’t protect themselves. Campus police didn’t have time to stop it. That kid’s mother and father lay dead in their house for over a week before that school massacre. Today Show profiled the ex-girlfriend. She said there was plenty of warning signs. Did the administrators listen? No. No one was capable of seeing what was coming. Yet, their signs were obvious. That child murderer drew horrifying pictures in his art classes, and you know what the teachers said?

 

00:05:25

OFF CAMERA No.

 

00:05:25

CAROL The teachers defended him. Said his evil artwork was a school assignment. Yes, to answer your question. Yes, I think school violence is a reason for homeschooling children.

 

00:05:45

OFF CAMERA Do these violent events seem to stay with you, hang with you?

 

00:05:55

CAROL I see those children’s faces. They could have been my children. Greg is heartless. Instead of helping me protect our children, he sent me to a shrink.

 

00:06:15

OFF CAMERA Do you think that there are times where you over-worry?

 

00:06:25

CAROL I won’t lose my children.

 

00:06:25

OFF CAMERA Do you fear that similar violent events may happen here at these schools?

 

00:06:35

CAROL Ridge View is only 100 miles from here, 100. That may as well be one mile.

 

00:06:45

OFF CAMERA How long have you been homeschooling your children?

 

00:06:50

CAROL Two months.

 

00:06:50

OFF CAMERA So you began homeschooling them, so that was about a month after the Ridge View incident shootings?

 

00:07:00

CAROL Yeah. When I pulled the children from school, Greg and I had a big fight, but it’s for the best. The children are learning more now than they ever learned at school. They still socialize, they still have friends. Now, my girlfriends are considering doing the same with their children. They see how well mine are doing. My girlfriends are every bit as frightened as I was. This isn’t some sort of frantic phobia on my part. I’m an educated woman about these matters. Greg, doesn’t understand what it’s like to lose family. Week 4 _ Assignment: Assessing And Diagnosing Patients With Anxiety Disorders, PTSD, And OCD

 

00:07:50

OFF CAMERA Do you have stronger feelings about losing people than your husband does?

 

00:07:55

CAROL Yes, I do.

 

00:08:00

OFF CAMERA Have you lost people who were close to you?

 

00:08:05

CAROL My parents, car accident, drunk driver, I was 19.

 

00:08:10

OFF CAMERA Oh, I’m sorry to hear that.

 

00:08:15

CAROL It happens, like that. They’re gone. I won’t lose a child. I won’t lose more people I love.

 

00:08:25

OFF CAMERA Have these fears been increasing more recently for you? Preoccupying you, more of your time?

 

00:08:35

CAROL Yes. I think about what happened to me, to my parents, what could happen to my children.

 

00:08:50

OFF CAMERA What is it like to realize you cannot protect them all of the time?

 

00:09:00

CAROL That’s what Greg says.

 

00:09:05

OFF CAMERA Do you disagree with him?

 

00:09:10

CAROL You protect them from what you can. You stop what you can. I couldn’t prevent that driver from sideswiping my parents, pinning them to the freeway median. I can prevent another Adam Lanza from pointing a gun at my babies. I won’t send them back to school. I won’t turn off the television, and I won’t stop informing myself. I will do what I can as a mother to protect my children. I’m sorry, I have to end this now, and call my children. I’ll call them now. 

Week (enter week #): (Enter assignment title)

Subjective:

CC (chief complaint):

HPI:

Past Psychiatric History:

  • General Statement:
  • Caregivers (if applicable):
  • Hospitalizations:
  • Medication trials:
  • Psychotherapy or Previous Psychiatric Diagnosis:

Substance Current Use and History:

Family Psychiatric/Substance Use History:

Psychosocial History:

Medical History:

 

  • Current Medications:
  • Allergies:
  • Reproductive Hx:

ROS:

  • GENERAL:
  • HEENT:
  • SKIN:
  • CARDIOVASCULAR:
  • RESPIRATORY:
  • GASTROINTESTINAL:
  • GENITOURINARY:
  • NEUROLOGICAL:
  • MUSCULOSKELETAL:
  • HEMATOLOGIC:
  • LYMPHATICS:
  • ENDOCRINOLOGIC:

Objective:

Physical exam: if applicable

Diagnostic results:

Assessment:

Mental Status Examination:

Differential Diagnoses:

Assignment: Assessing and Diagnosing Patients With Anxiety Disorders, PTSD, and OCD

“Fear,” according to the DSM-5, “is the emotional response to real or perceived imminent threat, whereas anxiety is anticipation of future threat” (APA, 2013). All anxiety disorders contain some degree of fear or anxiety symptoms (often in combination with avoidant behaviors), although their causes and severity differ. Trauma-related disorders may also, but not necessarily, contain fear and anxiety symptoms, but their primary distinguishing criterion is exposure to a traumatic event. Trauma can occur at any point in life. It might not surprise you to discover that traumatic events are likely to have a greater effect on children than on adults. Early-life traumatic experiences, such as childhood sexual abuse, may influence the physiology of the developing brain. Later in life, there is a chronic hyperarousal of the stress response, making the individual vulnerable to further stress and stress-related disease.

 

For this Assignment, you practice assessing and diagnosing patients with anxiety disorders, PTSD, and OCD. Review the DSM-5 criteria for the disorders within these classifications before you get started, as you will be asked to justify your differential diagnosis with DSM-5 criteria.

 

Assignment Instructions:

 

  • Use the Comprehensive Psychiatric Evaluation Template (Attached) to complete this Assignment.

 

  • Review the Comprehensive Psychiatric Evaluation Exemplar (Attached) to see an example of a completed evaluation document.

 

  • Select a specific video case study to use for this Assignment from the Video Case Selections choices in the Learning Resources. Video # 85 (See the transcript).

 

  • Consider what history would be necessary to collect from this patient.

 

  • Consider what interview questions you would need to ask this patient.

 

  • Identify at least three possible differential diagnoses for the patient.

 

  • Complete and submit your Comprehensive Psychiatric Evaluation (attached), including your differential diagnosis and critical-thinking process to formulate a primary diagnosis. Incorporate the following into your responses in the template:

 

  • Subjective:What details did the patient provide regarding their chief complaint and symptomology to derive your differential diagnosis? What is the duration and severity of their symptoms? How are their symptoms impacting their functioning in life?

 

  • Objective:What observations did you make during the psychiatric assessment?

 

  • Assessment:Discuss the patient’s mental status examination results. What were your differential diagnoses? Provide a minimum of three possible diagnoses with supporting evidence, listed in order from highest priority to lowest priority. Compare the DSM-5 diagnostic criteria for each differential diagnosis and explain what DSM-5 criteria rules out the differential diagnosis to find an accurate diagnosis.

Explain the critical-thinking process that led you to the primary diagnosis you selected. Include pertinent positives and pertinent negatives for the specific patient case. Week 4 _ Assignment: Assessing And Diagnosing Patients With Anxiety Disorders, PTSD, And OCD

 

  • Reflection notes:What would you do differently with this client if you could conduct the session over? Also include in your reflection a discussion related to legal/ethical considerations (demonstrate critical thinking beyond confidentiality and consent for treatment!), health promotion and disease prevention taking into consideration patient factors (such as age, ethnic group, etc.), PMH, and other risk factors (e.g., socioeconomic, cultural background, etc.).

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  • Minimums 5 references

INSTRUCTIONS ON HOW TO USE EXEMPLAR AND TEMPLATE—READ CAREFULLY

If you are struggling with the format or remembering what to include, follow the Comprehensive Psychiatric Evaluation Template AND the Rubric as your guide. It is also helpful to review the rubric in detail in order not to lose points unnecessarily because you missed something required. Below highlights by category are taken directly from the grading rubric for the assignment in Weeks 4–10. After reviewing the full details of the rubric, you can use it as a guide.

In the Subjective section, provide:

  • Chief complaint
  • History of present illness (HPI)
  • Past psychiatric history
  • Medication trials and current medications
  • Psychotherapy or previous psychiatric diagnosis
  • Pertinent substance use, family psychiatric/substance use, social, and medical history
  • Allergies
  • ROS
  • Read rating descriptions to see the grading standards!

In the Objective section, provide:

  • Physical exam documentation of systems pertinent to the chief complaint, HPI, and history
  • Diagnostic results, including any labs, imaging, or other assessments needed to develop the differential diagnoses.
  • Read rating descriptions to see the grading standards!

In the Assessment section, provide:

  • Results of the mental status examination, presented in paragraph form.
  • At least three differentials with supporting evidence. List them from top priority to least priority. Compare the DSM-5 diagnostic criteria for each differential diagnosis and explain what DSM-5 criteria rules out the differential diagnosis to find an accurate diagnosis. Explain the critical-thinking process that led you to the primary diagnosis you selected. Include pertinent positives and pertinent negatives for the specific patient case.
  • Read rating descriptions to see the grading standards!

Reflect on this case. Include: Discuss what you learned and what you might do differently. Also include in your reflection a discussion related to legal/ethical considerations (demonstrate critical thinking beyond confidentiality and consent for treatment!), health promotion and disease prevention taking into consideration patient factors (such as age, ethnic group, etc.), PMH, and other risk factors (e.g., socioeconomic, cultural background, etc.).

(The comprehensive evaluation is typically the initial new patient evaluation. You will practice writing this type of note in this course. You will be ruling out other mental illnesses so often you will write up what symptoms are present and what symptoms are not present from illnesses to demonstrate you have indeed assessed for all illnesses which could be impacting your patient. For example, anxiety symptoms, depressive symptoms, bipolar symptoms, psychosis symptoms, substance use, etc.)

EXEMPLAR BEGINS HERE

CC (chief complaint): A brief statement identifying why the patient is here. This statement is verbatim of the patient’s own words about why presenting for assessment. For a patient with dementia or other cognitive deficits, this statement can be obtained from a family member.

HPI: Begin this section with patient’s initials, age, race, gender, purpose of evaluation, current medication and referral reason. For example:

N.M. is a 34-year-old Asian male presents for psychiatric evaluation for anxiety. He is currently prescribed sertraline which he finds ineffective. His PCP referred him for evaluation and treatment.

Or

P.H., a 16-year-old Hispanic female, presents for psychiatric evaluation for concentration difficulty. She is not currently prescribed psychotropic medications. She is referred by her therapist for medication evaluation and treatment.

Then, this section continues with the symptom analysis for your note. Thorough documentation in this section is essential for patient care, coding, and billing analysis.

Paint a picture of what is wrong with the patient. First what is bringing the patient to your evaluation.  Then, include a PSYCHIATRIC REVIEW OF SYMPTOMS.  The symptoms onset, duration, frequency, severity, and impact. Your description here will guide your differential diagnoses. You are seeking symptoms that may align with many DSM-5 diagnoses, narrowing to what aligns with diagnostic criteria for mental health and substance use disorders.

Past Psychiatric History: This section documents the patient’s past treatments. Use the mnemonic Go Cha MP. 

General Statement: Typically, this is a statement of the patients first treatment experience. For example: The patient entered treatment at the age of 10 with counseling for depression during her parents’ divorce. OR The patient entered treatment for detox at age 26 after abusing alcohol since age 13.

Caregivers are listed if applicable.

Hospitalizations: How many hospitalizations? When and where was last hospitalization? How many detox? How many residential treatments? When and where was last detox/residential treatment? Any history of suicidal or homicidal behaviors? Any history of self-harm behaviors?

Medication trials: What are the previous psychotropic medications the patient has tried and what was their reaction? Effective, Not Effective, Adverse Reaction? Some examples: Haloperidol (dystonic reaction), risperidone (hyperprolactinemia), olanzapine (effective, insurance wouldn’t pay for it) Week 4 _ Assignment: Assessing And Diagnosing Patients With Anxiety Disorders, PTSD, And OCD

Psychotherapy or Previous Psychiatric Diagnosis: This section can be completed one of two ways depending on what you want to capture to support the evaluation. First, does the patient know what type? Did they find psychotherapy helpful or not? Why? Second, what are the previous diagnosis for the client noted from previous treatments and other providers. Thirdly, you could document both.

Substance Use History: This section contains any history or current use of caffeine, nicotine, illicit substance (including marijuana), and alcohol. Include the daily amount of use and last known use. Include type of use such as inhales, snorts, IV, etc. Include any histories of withdrawal complications from tremors, Delirium Tremens, or seizures.

Family Psychiatric/Substance Use History: This section contains any family history of psychiatric illness, substance use illnesses, and family suicides. You may choose to use a genogram to depict this information. Be sure to include a reader’s key to your genogram or write up in narrative form.

Social History: This section may be lengthy if completing an evaluation for psychotherapy or shorter if completing an evaluation for psychopharmacology.  However, at a minimum, please include:

Where patient was born, who raised the patient

Number of brothers/sisters (what order is the patient within siblings)

Who the patient currently lives with in a home? Are they single, married, divorced, widowed? How many children?

Educational Level

Hobbies:

Work History: currently working/profession, disabled, unemployed, retired?

Legal history: past hx, any current issues?

Trauma history: Any childhood or adult history of trauma?

Violence Hx: Concern or issues about safety (personal, home, community, sexual (current & historical)

Medical History: This section contains any illnesses, surgeries, include any hx of seizures, head injuries.

 

Current Medications: Include dosage, frequency, length of time used, and reason for use. Also include OTC or homeopathic products.

Allergies: Include medication, food, and environmental allergies separately. Provide a description of what the allergy is (e.g., angioedema, anaphylaxis). This will help determine a true reaction vs. intolerance.

Reproductive Hx: Menstrual history (date of LMP), Pregnant (yes or no), Nursing/lactating (yes or no), contraceptive use (method used), types of intercourse:  oral, anal, vaginal, other, any sexual concerns

ROS: Cover all body systems that may help you include or rule out a differential diagnosis.  Please note: THIS IS DIFFERENT from a physical examination!

You should list each system as follows: General: Head: EENT: etc. You should list these in bullet format and document the systems in order from head to toe.

Example of Complete ROS:

GENERAL: No weight loss, fever, chills, weakness, or fatigue.

HEENT: Eyes: No visual loss, blurred vision, double vision, or yellow sclerae. Ears, Nose, Throat: No hearing loss, sneezing, congestion, runny nose, or sore throat.

SKIN: No rash or itching.

CARDIOVASCULAR: No chest pain, chest pressure, or chest discomfort. No palpitations or edema.

RESPIRATORY: No shortness of breath, cough, or sputum.

GASTROINTESTINAL: No anorexia, nausea, vomiting, or diarrhea. No abdominal pain or blood.

GENITOURINARY: Burning on urination, urgency, hesitancy, odor, odd color

NEUROLOGICAL: No headache, dizziness, syncope, paralysis, ataxia, numbness, or tingling in the extremities. No change in bowel or bladder control.

MUSCULOSKELETAL: No muscle, back pain, joint pain, or stiffness.

HEMATOLOGIC: No anemia, bleeding, or bruising.

LYMPHATICS: No enlarged nodes. No history of splenectomy.

ENDOCRINOLOGIC: No reports of sweating, cold, or heat intolerance. No polyuria or polydipsia.

Physical exam (If applicable and if you have opportunity to perform—document if exam is completed by PCP): From head to toe, include what you see, hear, and feel when doing your physical exam. You only need to examine the systems that are pertinent to the CC, HPI, and History. Do not use “WNL” or “normal.” You must describe what you see. Always document in head-to-toe format i.e., General: Head: EENT: etc.

Diagnostic results: Include any labs, X-rays, or other diagnostics that are needed to develop the differential diagnoses (support with evidenced and guidelines).

Assessment

Mental Status Examination: For the purposes of your courses, this section must be presented in paragraph form and not use of a checklist! This section you will describe the patient’s appearance, attitude, behavior, mood and affect, speech, thought processes, thought content, perceptions (hallucinations, pseudohallucinations, illusions, etc.)., cognition, insight, judgment, and SI/HI. See an example below. You will modify to include the specifics for your patient on the above elements—DO NOT just copy the example. You may use a preceptor’s way of organizing the information if the MSE is in paragraph form.

He is an 8-year-old African American male who looks his stated age. He is cooperative with examiner. He is neatly groomed and clean, dressed appropriately. There is no evidence of any abnormal motor activity. His speech is clear, coherent, normal in volume and tone. His thought process is goal directed and logical. There is no evidence of looseness of association or flight of ideas. His mood is euthymic, and his affect appropriate to his mood. He was smiling at times in an appropriate manner. He denies any auditory or visual hallucinations. There is no evidence of any delusional thinking.   He denies any current suicidal or homicidal ideation. Cognitively, he is alert and oriented. His recent and remote memory is intact. His concentration is good. His insight is good.

Differential Diagnoses: You must have at least three differentials with supporting evidence. Explain what rules each differential in or out and justify your primary diagnosis selection. You will use supporting evidence from the literature to support your rationale. Include pertinent positives and pertinent negatives for the specific patient case.

 

Also included in this section is the reflection. Reflect on this case and discuss whether or not you agree with your preceptor’s assessment and diagnostic impression of the patient and why or why not. What did you learn from this case? What would you do differently?

Also include in your reflection a discussion related to legal/ethical considerations (demonstrating critical thinking beyond confidentiality and consent for treatment!), health promotion and disease prevention taking into consideration patient factors (such as age, ethnic group, etc.), PMH, and other risk factors (e.g., socioeconomic, cultural background, etc.).

References (move to begin on next page)

You are required to include at least three evidence-based, peer-reviewed journal articles or evidenced-based guidelines which relate to this case to support your diagnostics and differentials diagnoses. Be sure to use correct APA 7th edition formatting. Week 4 _ Assignment: Assessing And Diagnosing Patients With Anxiety Disorders, PTSD, And OCD

 

 

 

 

Technology

/in /by

To Prepare:

Review the concepts of technology application

Reflect on how emerging technologies such as artificial intelligence may help fortify nursing informatics as a specialty by leading to increased impact on patient outcomes or patient care efficiencies.

The Assignment: (4-5 pages)

In a 4- to 5-page project proposal written to the leadership of your healthcare organization, propose a nursing informatics project for your organization that you advocate to improve patient outcomes or patient-care efficiency. Your project proposal should include the following:

Describe the project you propose.

Identify the stakeholders impacted by this project.

Explain the patient outcome(s) or patient-care efficiencies this project is aimed at improving and explain how this improvement would occur. Be specific and provide examples.

Identify the technologies required to implement this project and explain why.

Identify the project team (by roles) and explain how you would incorporate the nurse informaticist in the project team.

Rubric

Name: NURS_6051_Module02_Week03_Assignment_Rubric

Grid View

List View

ExcellentGoodFairPoorIn a 4- to 5-page project proposal written to the leadership of your healthcare organization, propose a nursing informatics project for your organization that you advocate to improve patient outcomes or patient care efficiency. Your project proposal should include the following:

· Describe the project you propose.

· Identify the stakeholders impacted by this project.

· Explain the patient outcome(s) or patient-care efficiencies this project is aimed at improving, and explain how this improvement would occur. Be specific and provide examples.

· Identify the technologies required to implement this project and explain why.

· Identify the project team (by roles) and explain how you would incorporate the nurse informaticist in the project team.77 (77%) – 85 (85%)The response accurately and thoroughly describes in detail the project proposed.

The response accurately and clearly identifies the stakeholders impacted by the project proposed.

The response accurately and thoroughly explains in detail the patient outcome(s) or patient-care efficiencies that the project proposed is aimed at improving, including an accurate and detailed explanation, with sufficient supporting evidence of how this improvement would occur.

The response accurately and clearly identifies the technologies required to implement the project proposed with a detailed explanation why.

The response accurately and clearly identifies the project team (by roles) and thoroughly explains in detail how to incorporate the nurse informaticist in the project team.68 (68%) – 76 (76%)The response describes the project proposed.

The response identifies the stakeholders impacted by the project proposed.

The response explains the patient outcome(s) or patient-care efficiencies that the project proposed is aimed at improving, including an explanation, with some supporting evidence of how this improvement would occur.

The response identifies the technologies required to implement the project proposed with an explanation why.

The response identifies the project team (by roles) and explains how to incorporate the nurse informaticist in the project team.60 (60%) – 67 (67%)The response describing the project proposed is vague or inaccurate.

The response identifying the stakeholders impacted by the project proposed is vague or inaccurate.

The response explaining the patient outcome(s) or patient-care efficiencies the project proposed is aimed at improving, including an explanation of how this improvement would occur, is vague or inaccurate, or includes little to no supporting evidence.

The response identifying the technologies required to implement the project proposed with an explanation why is vague or inaccurate.

The response identifying the project team (by roles) and an explanation of how to incorporate the nurse informaticist in the project team is vague or inaccurate.0 (0%) – 59 (59%)The response describing the project proposed is vague and inaccurate, or is missing.

The response identifying the stakeholders impacted by the project proposed is vague and inaccurate, or is missing.

The response explaining the patient outcome(s) or patient-care efficiencies the project proposed is aimed at improving, including an explanation of how this improvement would occur, is vague and inaccurate, includes no supporting evidence, or is missing.

The response identifying the technologies required to implement the project proposed with an explanation why is vague and inaccurate, or is missing.

The response identifying the project team (by roles) and an explanation of how to incorporate the nurse informaticist in the project team is vague and inaccurate, or is missing.Written Expression and Formatting – Paragraph Development and Organization:

Paragraphs make clear points that support well developed ideas, flow logically, and demonstrate continuity of ideas. Sentences are carefully focused–neither long and rambling nor short and lacking substance.5 (5%) – 5 (5%)Paragraphs and sentences follow writing standards for flow, continuity, and clarity.4 (4%) – 4 (4%)Paragraphs and sentences follow writing standards for flow, continuity, and clarity 80% of the time.3.5 (3.5%) – 3.5 (3.5%)Paragraphs and sentences follow writing standards for flow, continuity, and clarity 60%- 79% of the time.0 (0%) – 3 (3%)Paragraphs and sentences follow writing standards for flow, continuity, and clarity < 60% of the time.Written Expression and Formatting – English writing standards:

Correct grammar, mechanics, and proper punctuation5 (5%) – 5 (5%)Uses correct grammar, spelling, and punctuation with no errors.4 (4%) – 4 (4%)Contains a few (1-2) grammar, spelling, and punctuation errors.3.5 (3.5%) – 3.5 (3.5%)Contains several (3-4) grammar, spelling, and punctuation errors.0 (0%) – 3 (3%)Contains many (≥ 5) grammar, spelling, and punctuation errors that interfere with the reader’s understanding.Written Expression and Formatting – The paper follows correct APA format for title page, headings, font, spacing, margins, indentations, page numbers, running head, parenthetical/in-text citations, and reference list.5 (5%) – 5 (5%)Uses correct APA format with no errors.4 (4%) – 4 (4%)Contains a few (1-2) APA format errors.3.5 (3.5%) – 3.5 (3.5%)Contains several (3-4) APA format errors.0 (0%) – 3 (3%)Contains many (≥ 5) APA format errors.Total Points: 100

SOAP Note on a 65 year old female with UTI

/in /by

SOAP Note on a 65 year old female with UTI

SOAP Note Patient with UTI

ID: L.U. a female patient presented to the clinic accompany by self, patient is a reliable historian.

Client’s Initials: L.U

Age :65 years.

Race: African American

Gender: Female

Date of Birth: 08

Insurance: BlueCross BlueShield .

Marital Status: Married

Subjective: “ I have been having pain and burning during urination for two weeks now and the pain goes to my lower abdomen, and I have been unable to hold urine, I now urinate on myself because I can no longer hold it until I get to the bathroom”.

CC: Pain and burning during urination.

HPI:

Patient stated symptoms began within the past two weeks and have worsened over the past seven days. The patient complains of severe pain and burning sensation during urination that radiates to lower abdomen, with urgency.  The urine is cloudy and has a foul smell odor. After attempting to pass urine, the pain subsides for a little while, yet it reoccurs. Patient states that she has been sexually active only with the same partner for the past 15 years. On assessment patient reports pain of 8 /10 on pain scale. Patient denies having blood in urine, fever, headache, shortness of breath or chest pain at the moment. SOAP Note on a 65 year old female with UTI

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ROS

Constitutional: Patient states she is in good state of health she denies headache , chest pain weakness fever chills, weight loss or gain.

Eyes: Denies double vision, change in vision factors, or blurry vision.

Ears/Nose/Mouth/Throat: denies sore throat, hearing issues, or nose congestion.

Cardiovascular: denies any kind of orthopnea, rapid heart rate, palpitations, or chest pain.

Pulmonary: Denies

Gastrointestinal: c/o moderate to severe pain in the abdominal area.

Genitourinary: acknowledged presence of  increase in urgency and frequency of urination. Major pain while urinating for the past ten days.

Musculoskeletal: Denies any kind of pain

Integumentary & breast: Denies issues

Neurological: Denies issues

Psychiatric: Denies any kind of depression or mood swing

Endocrine: Denies having any problem

Hematologic/Lymphatic: Denies

Allergic/Immunologic: No Known allergy

 

Past Medical History:

  • Medical problem list: patient denies having any major illnesses and only reports headaches and sometimes common seasonal allergy or cold.
  • Denies history of chronic medical problems with father or mother.
  • Preventative care: None indicated
  • Surgeries: Denies
  • Hospitalizations: Denies
  • LMP: Patient states she do have a 28 days menstrual cycle and the last cycle was 2 weeks ago. She has had three pregnancies and three cesarean section. SOAP Note on a 65 year old female with UTI

Allergies: No known food or drug allergy

 

  • Medications: Patient takes only Centrum vitamins and sometimes Tylenol for headache. Family History: Patient’s mother has hypertension that she manages by taking daily medication and exercising. The patient’s father has hypertension too and takes a similar treatment approach as his wife. Patient has four younger siblings who report not cases of physical conditions.
  • Social History: Patient lives with her partner who is five years older than her. She works with an agency as janitor t where she has been working for the past ten years. Patient denies any illicit drug use. She said she has great support system surrounded with family and friends

Sexual history: Patient is sexually active has only one partner and they do not use kind of protection.

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Other:

Vital Signs:   HR:70   BP:122/77       Temp:98.5       RR:18       SpO2:98%           Pain:8/10

Height: 5ft 8 inches     Weight: 150lb.            BMI: 22.81.

 

Physical Exam

General Survey:  Patient afebrile , no chest pain , no breathing problems or general weakness

A test indicated that patient had CVA tenderness upon palpitation. There was a suprapubic tenderness on the patient. A deep abdominal palpitation on the patient indicated tenderness.

Assessment

Diagnosis:

Assessment shows a clinical outcome of dysuria, suprapubic tenderness, and frequency and urgency of urination which indicates UTI (Sabih & Leslie, 2021). Noted no evidence of vaginal discharge, so therefore not consistent with vaginitis

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Differential:

  1. 2. Pyelonephritis (ICD-9 code 590.80). Pain in the lower abdomen especially increased due to urination. Pyelonephritis got eliminated since the patient did not have myalgia, nausea, vomiting, fever, or flank pain (Beahm et al., 2017
  2. ). Overactive bladder (ICD 9-596.51). Suitable since patient reports highly frequent urination. An overactive bladder got eliminated since the urine dipstick gave a different result.
  3. Vaginitis (ICD-9-616.10). Pain around the vagina area and lower abdomen. Ruled after dip stick urine. SOAP Note on a 65 year old female with UTI

 

Diagnosis:

Assessment shows a clinical outcome of dysuria, suprapubic tenderness, and frequency and urgency of urination which indicates UTI (Sabih & Leslie, 2021). Noted no evidence of vaginal discharge, so therefore, not consistent with vaginitis

Plan

Diagnostics/ Labs : To rule out UTI are urinalysis and urine culture.

A dipstick urine test shows presence of nitrite and leukocyte esterase

Treatment:

Double strength prescription of trimethoprim 160 mg and sulfamethoxazole 800 mg 2 times daily for three days. Patient can also take cranberry juice as studies has shown that it is very good to treat UTI because of its acid base properties.

Education:

  • Instruct patient to avoid spermicidal products that increase risk of a UTI occurring.
  • Teach patient to wipe the genital area from front to back after urination to avoid getting bacteria from anus to her virgina
  • Teach patient to adhere to all treatment directions
  • Teach patient and make sure patient understands the course of treatment which is 5 days, and to take all medication same time each day.
  • Teach patient on the importance of drinking minimum of eight glasses of water per day. Add that this will help the body to fight bacteria..
  • Teach patient to always urinate after sexual intercourse since that would flush out every bacterium from her urethra
  • Teach patient to engage in physical exercises since this would improve her wellbeing and connection to proactive physical behavior. The patient should take note that both her parents have hypertension and should thus get her blood pressure reading taken during many intervals since this would allow detection of hypertension.
  • Teach patient to reduce sexual intercourse with her partner especially since she is not aware if she is the only sexual partner her boyfriend has.
  • Teach patient to always get routine vaccination against common illnesses since the technique would allow her to have proper wellbeing and management of her condition. .
  • Teach patient to make a timetable of taking water since such fluids would increase urine and thus, that would flush out bacteria through the urethra.
  • Teach patient to avoid sexual intercourse during the time she is taking medication to prevent any new infections. This will prevent patient from further getting affected in their ability to receive full bacterial treatment.

Follow Up And Recommendations

  1. Return to the clinic within 7 days if symptoms persist.
  2. Pap smear every 3 years for ages 21- 65.
  3. Cranberry Juice can also be helpful it is rich in vitamin C and potent immune system booster, studies indicate that it balances the PH of the body with its acidic properties that helps fight infection. SOAP Note on a 65 year old female with UTI

References

Beahm, N. P., Nicolle, L. E., Bursey, A., Smyth, D. J., & Tsuyuki, R. T. (2017). The assessment and management of urinary tract infections in adults: Guidelines for pharmacists. Canadian pharmacists journal : CPJ = Revue des pharmaciens du Canada : RPC, 150(5), 298–305. https://doi.org/10.1177/1715163517723036.

Sabih, A. & Leslie, S.W. (2021). Complicated Urinary Tract Infections. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK436013/