Health Care

/in /by

performance affect patient outcomes

Interprofessional And System Leadership Nur 6053

/in /by

Interprofessional And System Leadership Nur 6053

Assignment: Developing Organizational Policies and Practices Competing needs arise within any organization as employees seek to meet their targets and leaders seek to meet company goals. As a leader, successful management of these goals requires establishing priorities and allocating resources accordingly.  Within a healthcare setting, the needs of the workforce, resources, and patients are often in conflict. Mandatory overtime, implementation of staffing ratios, use of unlicensed assisting personnel, and employer reductions of education benefits are examples of practices that might lead to conflicting needs in practice.  Leaders can contribute to both the problem and the solution through policies, action, and inaction. In this Assignment, you will further develop the white paper you began work on in Module 1 by addressing competing needs within your organization.  To Prepare:  Review the national healthcare issue/stressor you examined in your Assignment for Module 1, and review the analysis of the healthcare issue/stressor you selected. Identify and review two evidence-based scholarly resources that focus on proposed policies/practices to apply to your selected healthcare issue/stressor. Reflect on the feedback you received from your colleagues on your Discussion post regarding competing needs. Interprofessional And System Leadership Nur 6053.

ORDER   A PLAGIARISM-FREE PAPER   NOW

The Assignment (4-5 pages):  Developing Organizational Policies and Practices  Add a section to the paper you submitted in Module 1. The new section should address the following:  Identify and describe at least two competing needs impacting your selected healthcare issue/stressor. Describe a relevant policy or practice in your organization that may influence your selected healthcare issue/stressor. Critique the policy for ethical considerations, and explain the policy’s strengths and challenges in promoting ethics. Recommend one or more policy or practice changes designed to balance the competing needs of resources, workers, and patients, while addressing any ethical shortcomings of the existing policies. Be specific and provide examples. Cite evidence that informs the healthcare issue/stressor and/or the policies, and provide two scholarly resources in support of your policy or practice recommendations. Interprofessional And System Leadership Nur 6053

Due to the nature of this assignment, your instructor may require more than 7 days to provide you with quality feedback. By Day 7 of Week 3 Submit your revised paper.  Submission and Grading Information To submit your completed Assignment for review and grading, do the following:  Please save your Assignment using the naming convention “WK3Assgn+last name+first initial.(extension)” as the name. Click the Week 3 Assignment Rubric to review the Grading Criteria for the Assignment. Click the Week 3 Assignment link. You will also be able to “View Rubric” for grading criteria from this area. Next, from the Attach File area, click on the Browse My Computer button. Find the document you saved as “WK3Assgn+last name+first initial.(extension)” and click Open. If applicable: From the Plagiarism Tools area, click the checkbox for I agree to submit my paper(s) to the Global Reference Database. Click on the Submit button to complete your submission. Due to the nature of this assignment, your instructor may require more than 7 days to provide you with quality feedback Grading Criteria To access your rubric:  Week 3 Assignment Rubric  Check Your Assignment Draft for Authenticity To check your Assignment Draft for Authenticity:  Submit your Week 3 Assignment draft and review the originality report  Submit Your Assignment by Day 7 of Week 3 To participate in this Assignment:  Week 3 Assignment  Next Module To go to the next module:  Module 3Learning Resources Required Readings American Nurses Association. (2015).Interprofessional And System Leadership Nur 6053.  Code of ethics for nurses with interpretive statements. Silver Spring, MD: Author. Retrieved from   https://www.nursingworld.org/coe-view-only  Note: Review all, with special attention to “Provision 6” (pp. 23–26).  Kelly, P., & Porr, C. (2018). Ethical nursing care versus cost containment: Considerations to enhance RN practice. OJIN: Online Journal of Issues in Nursing, 23(1), Manuscript 6. doi:10.3912/OJIN.Vol23No01Man06. Retrieved from  http://ojin.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/TableofContents/Vol-23-2018/No1-Jan-2018/Ethical-Nursing-Cost-Containment.html    Milliken, A. (2018). Ethical awareness: What it is and why it matters. OJIN: Online Journal of Issues in Nursing, 23(1), Manuscript 1. doi:10.3912/OJIN.Vol23No01Man01. Retrieved from   http://ojin.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/TableofContents/Vol-23-2018/No1-Jan-2018/Ethical-Awareness.html  Required Media Laureate Education (Producer). (2012). Ethical, Moral, and Legal Leadership [Video file]. Baltimore, MD: Author.   Accessible player  Laureate Education (Producer). (2009b). Working with Individuals [Video file]. Baltimore, MD: Author.   Accessible player  Rubric Detail   Select Grid View or List View to change the rubric’s layout.  Name: NURS_6053_Module02_Week03_Assignment_Rubric Grid View List View                  Excellent              Good     Fair         Poor Add a section to the paper you submitted in Module 1. In 4–5 pages, address the following:    ·   Identify and describe at least two competing needs impacting your selected healthcare issue/stressor.  23 (23%) – 25 (25%) The response accurately and clearly identifies at least two competing needs impacting the healthcare issue/stressor selected. 20 (20%) – 22 (22%) The response identifies at least two competing needs impacting the healthcare issue/stressor selected. 18 (18%) – 19 (19%) The response identifies at least two competing needs impacting the healthcare issue/stressor selected that is vague or inaccurate. 0 (0%) – 17 (17%) The response describes at least two competing needs impacting the healthcare issue/stressor selected that is vague and inaccurate, or is missing. ·  Interprofessional And System Leadership Nur 6053

Describe a relevant policy or practice in your organization that may influence your selected healthcare issue/stressor.  ·   Critique the policy for ethical considerations and explain the policy’s strengths and challenges in promoting ethics.  27 (27%) – 30 (30%) The response accurately and thoroughly describes in detail a relevant policy or practice in an organization that may influence the healthcare issue/stressor selected.  The response accurately and thoroughly critiques in detail the policy for ethical considerations and explains in detail the policy’s strengths and challenges in promoting ethics. 24 (24%) – 26 (26%) The response accurately describes a relevant policy or practice in an organization that may influence the healthcare issue/stressor selected.  The response accurately critiques the policy for ethical considerations and explains the policy’s strengths and challenges in promoting ethics. 21 (21%) – 23 (23%) The response describes a relevant policy or practice in an organization that may influence the healthcare issue/stressor selected that is vague or inaccurate.  The response critiques the policy for ethical considerations and explains the policy’s strengths and challenges in promoting ethics that is vague or inaccurate. 0 (0%) – 20 (20%) The response describes a relevant policy or practice in an organization that may influence the healthcare issue/stressor selected that is vague and inaccurate, or is missing.  The response critiques the policy for ethical considerations and explains the policy’s strengths and challenges in promoting ethics that is vague and inaccurate, or is missing. ·   Recommend one or more policy or practice changes designed to balance the competing needs of resources, workers, and patients while addressing any ethical shortcomings of the existing policies. Be specific and provide examples.  ·

ORDER   A PLAGIARISM-FREE PAPER   NOW

Cite evidence that informs the healthcare issue/stressor and/or the policies and provide two scholarly resources in support of your policy or practice recommendations. 27 (27%) – 30 (30%) The response provide one or more accurate, clear, and thorough recommendations for policy or practice changes designed to balance the competing needs of resources, workers, and patients while addressing any ethical shortcomings of the existing policies.  Specific and accurate examples are provided.  Accurate and detailed evidence is cited that informs the healthcare issue/stressor selected and a specific synthesis of at least two outside scholarly resources in full support of the policy or practice recommendations is provided. The response integrates at least 2 outside resources and 2 or 3 course-specific resources that fully support the healthcare issue/stressor selected. 24 (24%) – 26 (26%) The response provides one or more recommendations for policy or practice changes designed to balance the competing needs of resources, workers, and patients while addressing any ethical shortcomings of the existing policies.  Specific examples may be provided.  Evidence is cited that informs the healthcare issue/stressor selected and a synthesis of at least one outside scholarly resource that may support the policy or practice recommendations is provided. The response integrates at least 1 outside resource and 2 or 3 course-specific resources that may support the healthcare issue/stressor selected. 21 (21%) – 23 (23%) The response provides one or more recommendations for policy or practice changes designed to balance the competing needs of resources, workers, and patients while addressing any ethical shortcomings of the existing policies that is vague or inaccurate.  Examples may be provided.  Vague or inaccurate evidence is cited from 2 or 3 resources that informs the healthcare issue/stressor selected and may support the policy or practice recommendations provided. 0 (0%) – 20 (20%) The response provides one or more recommendations for policy or practice changes designed to balance the competing needs of resources, workers, and patients while addressing any ethical shortcomings of the existing policies that is vague and inaccurate, or is missing.  Examples are missing.  Vague and inaccurate evidence is cited that informs the healthcare issue/stressor and may include at least 1 scholarly resource that vaguely and inaccurately supports the policy practice recommendations is provided, 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. A clear and comprehensive purpose statement and introduction is provided which delineates all required criteria.  5 (5%) – 5 (5%) Paragraphs and sentences follow writing standards for flow, continuity, and clarity.  A clear and comprehensive purpose statement, introduction, and conclusion is provided which delineates all required criteria. 4 (4%) – 4 (4%) Paragraphs and sentences follow writing standards for flow, continuity, and clarity 80% of the time.  Purpose, introduction, and conclusion of the assignment is stated, yet is brief and not descriptive. 3.5 (3.5%) – 3.5 (3.5%) Paragraphs and sentences follow writing standards for flow, continuity, and clarity 60%–79% of the time.  Purpose, introduction, and conclusion of the assignment is vague or off topic. 0 (0%) – 3 (3%) Paragraphs and sentences follow writing standards for flow, continuity, and clarity < 60% of the time.  No purpose statement, introduction, or conclusion was provided. Written Expression and Formatting – English writing standards:  Correct grammar, mechanics, and proper punctuation    5 (5%) – 5 (5%) Uses correct grammar, spelling, and punctuation with no errors. 4 (4%) – 4 (4%) Contains a few (1 or 2) grammar, spelling, and punctuation errors. 3.5 (3.5%) – 3.5 (3.5%) Contains several (3 or 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, 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 or 2) APA format errors. 3.5 (3.5%) – 3.5 (3.5%) Contains several (3 or 4) APA format errors. 0 (0%) – 3 (3%) Contains many (? 5) APA format errors. Total Points: 100 Name: NURS_6053_Module02_Week03_Assignment_Rubric. Interprofessional And System Leadership Nur 6053

Week 4: 70 Year-Old African America Female With Uncontrolled Diabetes

/in /by

Week 4: 70 Year-Old African America Female With Uncontrolled Diabetes

EXAMPLE SOAP Note Week Two  United States University FNP592: Common Illnesses Across the Lifespan Dr. Theresa Gress October 1, 2020                  SOAP Note Week Three ID: Mickey Mouse, DOB 1/1/2000, age 20, white Hispanic male presents to the clinic unaccompanied and appears to be a reliable historian.  S:  CC: “Cough, runny nose, and sore throat x 7 days” HPI:  New Asian male patient 28 yo presents to the clinic unaccompanied, complaining of non-productive cough, runny nose and sore throat x 7 days (1/7/2020). Currently somewhat controlling symptoms with Dayquil and Nyquil. Cough mild, worsened when laying flat. Highest temp at home 99 degrees. Patient wondering if he needs antibiotics. Rates pain in throat as 4/10, described as “aching, swallowing makes it worse”, relieved by Dayquil/nyquil. Week 4: 70 Year-Old African America Female With Uncontrolled Diabetes. Denies headache, denies sick contacts or recent travel. Denies feeling worse outdoors or seasonally. He is a reliable historian PMH:  Allergies: No known drug allergies. Strawberries (rash).  PMH: seasonal allergies Childhood: Asthma until high school, chickenpox at age 2 Surgical: Tonsillectomy (1998), Wisdom Teeth Removal (2005) Medications: None Vaccinations: received childhood vaccines, Last flu shot given Oct 2019. Denies psychiatric history. Social History: Denies tobacco/e-cigarette use. Admits to occasional once every 2-3 months alcohol use – last drink  2 months ago, Engaged, works in IT, Hobbies include archery.  Family History: Diabetes II (Mother) HTN (Older sister – 42 years old) Dementia (Maternal Grandmother) ROS:  General: No weight change, weakness, fatigue, fevers..  Eyes: no vision change, corrective lenses, pain redness, excessive tearing, double vision, blurred vision, or blindness.  EarsNose/Throat/mouth: no hearing change, tinnitus, earaches, infection, discharge. POSITIVE FOR RHINORHEA. No sinus pain or epistaxis. POSITIVE FOR SORE THROAT, HOARSE VOICE. No bleeding gums, dentures, sore tongue, dry mouth. Last dental exam 4 months ago. Week 4: 70 Year-Old African America Female With Uncontrolled Diabetes.  C/V: Denies chest pain, palpitations.

ORDER   A PLAGIARISM-FREE PAPER   NOW

 

Pulmonary: POSITIVE FOR NON-PRODUCTIVE COUGH, negative hemoptysis, dyspnea, wheezing, pleuritic pain Neuro: No headache dizziness, focal numbness/weakness, nausea, vomiting.  Lymph: Denies swollen lymph nodes in neck. Allery/immunology: Denies seasonal allergies or allergy to pets, pollen or other. Denies frequent illness.  O:  VS: T – 98 P – 80 R – 16 BP – 128/72 O2 sat – 99% – 4/10 pain in throat. Wt: 205 Ht: 72 in BMI: 27.8 Skin: Natural in color, warm, smooth and dry. Good skin turgor, no lesions, rashes, ecchymosis or moles. Nails without clubbing or cyanosis.  HEENT:    Ears: pinna clean, no exudate noted. TM intact and pearly gray with cone of light bilat.  Nose: nasal mucosa pink and moist. Inferior turbinates slightly reddened bilat. Nares patent bilat. No sinus pain upon palpation. Septum midline. Throat: oral mucosa pink and moist, tongue mobile without lesions, tonsils absent. Posterior pharynx with erythema but no cobblestone appearance.  Neck: non-tender cervical area, no lymph nodes palpable. Non-enlarged thyroid palpated. Trachea midline. Neuro: Alert and oriented x 4. Cardio: RRR. Crisp S1 S2 without clicks or murmurs.  Thorax and lungs: Thorax is symmetric with good expansion. Respirations are even and unlabored. No use of accessory muscles, stridor, grunting, or nasal flaring. Lungs CTA Bilaterally.    A:  Differential DDX:      INCLUDE AT LEAST 3 DIFFERENTIALS Viral pharyngitis – as evidenced by sore throat, cough, no fever Strep Throat – not as likely; no fever and 7 days duration, age not as consistent with this dx Allergic rhinitis – no report of sx increasing with outdoor activity or exposure to allergens, sx with sore throat are less likely for allergies.   DX: Viral pharyngitis  P: In house throat swab for rapid strep – negative.  Continue to rest and drink lots of fluids (Cash & Glass, 2017). Continue OTC Dayquil/Nyquil PRN per directions on the box – Safe dosing discussed, sedation may occur with Nyquil, avoid driving or operating heavy machinery after taking. Encourage tea with honey and lemon to help with cough and sore throat. Gargle with warm salt water 2-3 times a day for 30 sec, swish and spit.  Do not drink alcohol while taking these medications.   Cover mouth when coughing, do not drink after other people (Cash & Glass, 2017). Return to office in 3-4 days if symptoms do not improve, worsen, or get better and then again get worse (Cash & Glass, 2017). Call 911 or go to ER for trouble breathing or any other emergent concern.      References:  Cash, J. & Glass, C. (2017). Family practice guidelines. New York, NY. Springer.  Stead, W. (2019). Symptomatic treatment of acute pharyngitis in adults. In L. Kunnis  (Ed.). UpToDate Retrieved February 12, 2020 from:  https://www.uptodate.com/contents/symptomatic-treatment-of-acute-pharyngitis- in-adults. Week 4: 70 Year-Old African America Female With Uncontrolled Diabetes

 

Global Health Nursing: Stroke Education. Annotated Bibliography For Review Of Literature Project

/in /by

Global Health Nursing: Stroke Education. Annotated Bibliography For Review Of Literature Project

I need for the writer to find 5 scholarly sources and create an annotated bibliography.  This assignment will later continue on to a full review of literature paper and I may request the same writer to complete that assignment as well for continuity.  Global Health Nursing: Stroke Education. Annotated Bibliography For Review Of Literature Project. The topic of my paper is Stroke education and its importance to community/ global health.  All of the sources must be in APA 7 format and the sources should support the topic for my review of literature. Please do not take this assignment if you do not have experience creating annotated bibliographies and review of literature  papers.

ORDER   A PLAGIARISM-FREE PAPER   NOW

This writer MUST have a medical background preferably in nursing! Read the following instructions below:  You will be creating an annotated bibliography to use as resources when writing your Review of Literature (ROL). The annotated bibliography is a sample of articles you select to begin your work on your Review of Literature. The faculty will review your completed annotated bibliography to provide feedback and make sure you are on the ‘right track’ with the types of journal articles/research articles you are selecting.

Definitions: An annotation is a summary and/or evaluation. An annotated bibliography includes a summary and/or evaluation of each of the sources.  Contents of an annotated bibliography: summarize, assess, reflect.  To complete this assignment you will select journal articles related to your ROL topic, review each article selected (5), and annotate these 5 gold standard peer-reviewed journal sources for your review of literature paper. Create a Word document for your annotated bibliography. Write one paragraph for each annotation element: summarize, assess, reflect. Use one page for each journal source. You are only be expected to submit the 5 annotated references for this assignment.   Here are some instructions as to how to create an annotated bibliography. Additional instructions to follow will be provided upon request.   https://www.youtube.com/watch?v=lPhWhRlEWtI&feature=youtu.be http://owl.english.purdue.edu/owl/resource/614/01/ http://owl.english.purdue.edu/owl/resource/614/02/ http://owl.english.purdue.edu/owl/resource/614/03/ Global Health Nursing: Stroke Education. Annotated Bibliography For Review Of Literature Project

Psychiatric Disorders And Screening Assignment

/in /by

Psychiatric Disorders And Screening Assignment

Part 1  Choose two geriatric assessment tools that are appropriate for primary care (excluding depression, anxiety and pain screening tools) and discuss the following:  -explain the purpose of the tool -explain the scoring guidelines -how you apply the assessment in practice  Part 2 Anxiety and depression are the most common psychiatric problems you will encounter in your primary care practice.  Review this case study  HPI: KB, 55 year old Caucasian female who presents to office with complaints of fatigue. The fatigue has been present for 6 months and seems worse in the morning, improving slightly through the day. KB reports a lack of energy and “loss of joy”. States” I really don’t feel like going anywhere or doing anything” Reports she often has difficulty staying on task and completing projects for work. She reports not feeling hungry and does not feel rested when she wakes up in the morning. Psychiatric Disorders And Screening Assignment.  KB is a widow for 2 years, social events that are couples only can make her symptoms worse. She tries to do at least one social activity a week but it can be really exhausting. Her husband died in their car while she was driving him to the hospital and sometimes driving in that car makes all the memories come back. She recently got a puppy, which she thought would help with the loneliness but the care of the puppy seems overwhelming at times.

ORDER   A PLAGIARISM-FREE PAPER   NOW

Rest and exercise, specifically yoga and meditation seem to make her feel better. At this time she does not want to do either. She has not tried any medications, prescribed or otherwise. She reports drinking a lot of coffee, but that does not seem to help.  Current medications: Excedrin PM about once a week when she can’t sleep, seems to help a bit. NKDA.  PMH: no major illnesses. Immunizations up to date.  SH: widowed, employed full time as a manager. Drinks wine, 1 glass every night. No tobacco, no illicit drugs. Previously married while living in France, reports an abusive relationship. The French government gave custody of her son to the ex-husband. She returned to US without her son 10 years ago. She sees her son two times a year, they skype and text “all the time” but she misses him.  FH: Parents are alive and well. Has one son, age 21, he is healthy but lives in France with his father.  ROS  CONSTITUTIONAL: reports weight loss of 2-3 pounds, no fever, chills, or weakness reported  HEENT: Eyes: No visual loss, blurred vision, double vision or yellow sclera. Ears, Nose, Throat: No hearing loss, sneezing, congestion, runny nose or sore throat.  CARDIOVASCULAR: No chest pain, chest pressure or chest discomfort. No palpitations or edema.  RESPIRATORY: No shortness of breath, cough or sputum.  GASTROINTESTINAL: Reports decreased appetite for about 3 months. No nausea, vomiting or diarrhea. No abdominal pain or blood. Psychiatric Disorders And Screening Assignment.

NEUROLOGICAL: No headache, dizziness, syncope, paralysis, ataxia, numbness or tingling in the extremities. No change in bowel or bladder control.  GENITOURINARY: no burning on urination. Last menstrual period 4 years ago.  PSYCHIATRIC: No history of diagnosed depression or anxiety. Reports great anxiety due to verbal and concern for physical abuse, reports feeling very sad and anxious when divorcing and leaving her son in France. Did not seek treatment. She started to feel better after about 4 months.  ENDOCRINOLOGIC: No reports of sweating, cold or heat intolerance. No polyuria or polydipsia  ALLERGIES: No history of asthma, hives, eczema or rhinitis.  Discussion Questions:  1. Research screening tools for depression and anxiety.  Choose one screening tool for depression and one screening tool for anxiety that you feel are appropriate to screen KB.

Explain why you chose that particular tool for KB. If you can, attempt to score KB based on the information provided (not all data may be provided). Include what questions could be scored, and your chosen sore.  2. Identify your next step for evaluation and treatment for KB.  What medication, if any, would you recommend for treatment? Provide the rationale. This should include the medication class, mechanism of action of the medication and why this medication is appropriate for KB. Include initial prescribing information.  If the medication works as expected, when should KB expect to start feeling better? Psychiatric Disorders And Screening Assignment

 

The Use Of Clinical Systems To Improve Outcomes And Efficiencies Assignment

/in /by

The Use Of Clinical Systems To Improve Outcomes And Efficiencies Assignment

New technology—and the application of existing technology—only appears in healthcare settings after careful and significant research. The stakes are high, and new clinical systems need to offer evidence of positive impact on outcomes or efficiencies. Nurse informaticists and healthcare leaders formulate clinical system strategies. As these strategies are often based on technology trends, informaticists and others have then benefited from consulting existing research to inform their thinking.

ORDER   A PLAGIARISM-FREE PAPER   NOW

The Use Of Clinical Systems To Improve Outcomes And Efficiencies Assignment.  In this Assignment, you will review existing research focused on the application of clinical systems. After reviewing, you will summarize your findings.  To Prepare:  Review the Resources and reflect on the impact of clinical systems on outcomes and efficiencies within the context of nursing practice and healthcare delivery. Conduct a search for recent (within the last 5 years) research focused on the application of clinical systems. The research should provide evidence to support the use of one type of clinical system to improve outcomes and/or efficiencies, such as “the use of personal health records or portals to support patients newly diagnosed with diabetes.” Identify and select 4 peer-reviewed research articles from your research.  In a 4- to 5-page paper, synthesize the peer-reviewed research you reviewed. The Use Of Clinical Systems To Improve Outcomes And Efficiencies Assignment. Format your Assignment as an Annotated Bibliography. Be sure to address the following:  Identify the 4 peer-reviewed research articles you reviewed, citing each in APA format. Include an introduction explaining the purpose of the paper. Summarize each study, explaining the improvement to outcomes, efficiencies, and lessons learned from the application of the clinical system each peer-reviewed article described. Be specific and provide examples. In your conclusion, synthesize the findings from the 4 peer-reviewed research articles. Use APA format and include a title page.

Advanced Pharmacology Assignment

/in /by

Advanced Pharmacology Assignment

Discussion response post Bipolar disorder treatment management.  Bipolar disease is a severe biological illness characterized by fluctuations in mood. Bipolar disorder afflicts more than 6.7 million Americans (Rosenthal & Burchum, 2021). Bipolar 1 is characterized by experiences in extreme maniac episodes. The hallmark of treatment is an individualized approach geared towards achieving effective and therapeutic treatment. It is important to consider the role genetics, race, gender, family history, and other extenuating circumstances such as PTSD and stressful events play in the mental and psychological health of patients. Gathering subjective and objective data will also guide the choice of the treatment decisions we make. Advanced Pharmacology Assignment.  Thorough review of the patient’s medical history, medication interaction, and list of allergies is also crucial for better treatment outcome.  The interactive media reveals that the patient is of a Korean descent and has had genetic testing done because she typically was unresponsive to past medications. One of the findings revealed that the patient is positive for CYP2D6*10 allele, which basically influences the pharmacotherapeutics and pharmacodynamics of how her body processes drugs (Lu et al., 2021).  Background Information  The client is a 26-year-old woman of Korean descent who presented to her appointment with acute mania. She is post 21 days in-patient hospitalization. She is alert and oriented to person, place, time and event. She is however inappropriately dressed for the appointment where the case study reveals she’s wearing what seemed like an evening gown. She is distracted and playing with items on the table. She reveals she abruptly stopped her lithium; the case study doesn’t tell whether she experienced any side effect from the Lithium, or whether she thought she didn’t need it. Speech is rapid, pressured and tangential, mood is euthymic, while affect is broad. She denies any suicidal ideation, auditory or visual hallucinations.  Assessment finding reveals poor insight into disease process and situation as evidenced by stating that “they said I was bipolar, I don’t believe that, do you? I just like to talk, and dance, and sing. Did I tell you that I liked to cook?”. Easily distracted as evidenced by touching and playing with things on the table.  Also, The Young Mania Rating Scale (YMRS) where she scored 22 means she is exhibiting extreme mania. YRMS was originally developed in 1978, used to rate the severity of mania in the past 8 hours through a structured interview with the patient and observation, score of <29 shows the person is experiencing extreme mania (Admin, 2018).     Treatment plan and medication review  T       Three groups of medications are used for the treatment of bipolar disease: mood stabilizers, antipsychotics, and antidepressants (Rosenthal & Burchum, 2021). The choices of drugs presented in the interactive media are Lithium, Risperidone, and Seroquel.  Lithium is the mainstay therapy for stabilizing moods in bipolar disorder. The patient in the interactive media mentioned that she stopped the medication abruptly, I will first find out why she stopped the medication to rule out unpleasant side effects. I will restart Lithium 300 mg twice daily. Patient teaching has been shown to promote medication adherence.

ORDER   A PLAGIARISM-FREE PAPER   NOW

Patient will be enlightened that Lithium requires long term treatment, and cannot be stopped even if you feel better. Advanced Pharmacology Assignment. Also, missing doses will increase the risk for relapse. Teach patient that it can take more than two weeks for the full benefits of the medication.  Risperidone is an oral antipsychotic drug. It is used to control symptoms during severe maniac episodes. Since this patient had a genetic testing done because she was not responding to treatment, it was found that she is positive for CYP2D6*10 allele which is common with people of Korean descent. According to Lu et al., (2021), people who are positive for the CYP2D6 have higher plasma level of risperidone, more adverse effects and less relieve of symptoms. I will discontinue the Risperidone and start on Olanzapine 10 mg daily which is another anti-psychotic medication and schedule a follow up visit in four weeks.  I will also discontinue the Seroquel since it is another anti-psychotic medication used to treat schizophrenia and bipolar disorder, it can also be used to treat major depression when it is added to another anti-depressant medication (WellnowDoctor, 2019). In patients with BD, antidepressants medications are usually combined with a mood stabilizer to achieve a therapeutic effect (Rosenthal & Burchum, 2021). I will start SSRI Prozac 20 mg daily as an initial dose.  Cognition Behavior Therapy (CBT): CBT is a type of behavior therapy that can help manage some of the psychotic symptoms associated with bipolar. The goal is to teach patients to manage their thoughts and emotions so that when they come, they recognize them, and don’t buy into them (Gomes et al., 2019). The use of CBT as an adjunct therapy to medications in patients with BD is recommended because of the positive effects observed post-treatment and at follow-up. The benefits include decreased levels of depression and mania, decreased relapse rates, and increased levels of psychosocial functioning (Chiang et al., 2017).  New orders  Continue Lithium 300 mg twice daily, Olanzapine 10 mg daily, and Prozac 20 mg daily. Referral to Cognitive Behavior therapy.  Follow up in one month. Labs: Monitor Lithium level and renal function due to narrow therapeutic index, toxicity and renal impairments.  Patient Teaching  Teach patient to never stop medication abruptly due to possibility of relapse and withdrawal symptoms. Explain that Lithium has a narrow therapeutic index making it easily toxic to the body. Advice patient to stay hydrated because dehydration can lead to Lithium toxicity. Teach avoiding dehydrating foods like coffee and alcohol. Report any episodes that can lead to dehydration like diarrhea and vomiting. Avoid NSAID due to toxicity to kidney. Keep all lab appointments to help monitor lithium level and renal function. For dry mouth use hard a hard candy or ice chips. Antipsychotic and depressive medication can cause weight gain; eat a healthy diet and exercise. Report any suicidal ideations immediately.  It is important for the NP to continue to regularly schedule follow up visits to help monitor the progress of the treatment. Adjustments and modifications can be made to the medication until a therapeutic effect is achieved. Advanced Pharmacology Assignment

 

Nursing Psychotherapy Nurs 6650

/in /by

Nursing Psychotherapy Nurs 6650

Abnormal brain development or damage at an early age can lead to neurodevelopmental disorders. Within this group of disorders, some are resolvable with appropriate and timely interventions, either pharmacological or nonpharmacological, while other disorders are chronic and need to be managed throughout the lifespan.  For this Assignment, you will develop a study guide for an assigned disorder and share it with your colleagues. In sum, these study guides will be a powerful tool in preparing for your certification exam. Nursing Psychotherapy Nurs 6650.   Photo Credit: Getty Images/iStockphoto

ORDER   A PLAGIARISM-FREE PAPER   NOW

To Prepare Your Instructor will assign you to a specific neurodevelopmental disorder from the DSM-5. *******(Intellectual disability) is my topic Research your assigned disorder using the Walden Library. Then, develop an organizational scheme for the important information about the disorder. The Assignment Create a study guide for your assigned disorder. Your study guide should be in the form of an outline with references, and you should incorporate visual elements such as concept maps, charts, diagrams, images, color coding, mnemonics, and/or flashcards. Be creative! It should not be in the format of an APA paper. Your guide should be informed by the DSM-5 but also supported by at least three other scholarly resources.  Areas of importance you should address, but are not limited to, are:  Signs and symptoms according to the DSM-5 Differential diagnoses Incidence Development and course Prognosis Considerations related to culture, gender, age Pharmacological treatments, including any side effects Nonpharmacological treatments Diagnostics and labs Comorbidities Legal and ethical considerations Pertinent patient education considerations By Day 7 of Week 8 Submit your Assignment to the forum as an attachment. Although no responses are required, collegial discussion is welcome. You are encouraged to utilize your peers’ submitted guides on their assigned neurodevelopmental disorders for study.  Submission and Grading Information Grading Criteria. Nursing Psychotherapy Nurs 6650

Assignment: Literature Review: The Use Of Clinical Systems To Improve Outcomes And Efficiencies

/in /by

Assignment: Literature Review: The Use Of Clinical Systems To Improve Outcomes And Efficiencies

choose a clinical application system or some form of technology related to healthcare. Think beyond electronic medical records. Choose one of these topics. The articles that you chose should be research based and no more than five years old. Your paper should focus on one technology not four different technologies. You will lose points if your paper does not follow the rules related to the topic of the paper.  If you are unsure of your topic, please contact me, and I will give you guidance.

ORDER   A PLAGIARISM-FREE PAPER   NOW

Please abide by the page limit. Your paper should be no more than 5 pages (that does not include the title or reference page).In a 4- to 5-page paper, synthesize the peer-reviewed research you reviewed. Format your Assignment as an Annotated Bibliography.

Be sure to address the following:  Identify the 4 peer-reviewed research articles you reviewed, citing each in APA format. Summarize each study, explaining the improvement to outcomes, efficiencies, and lessons learned from the application of the clinical system each peer-reviewed article described. Be specific and provide examples. In your conclusion, synthesize the findings from the 4 peer-reviewed research articles 2. Make sure to have an introduction and conclusion.  3. You must have level headings.  4. Be careful about plagiarism.   5. Only write about one technology.  You will lose point if you do different topic.  6. Make sure that you synthesize the four articles at the end of  the paper.  7. Answer all parts of the question for each article. Assignment: Literature Review: The Use Of Clinical Systems To Improve Outcomes And Efficiencies

Gastrointestinal Case Study Paper

/in /by

Gastrointestinal Case Study Paper

A.O. is a 28-year-old woman who presents to your clinic with complaints of rectal bleeding and weakness. Five days ago, she noticed bright red blood in her stools. Furthermore, she reports that her daily bowel movements have increased to five or six with significant diarrhea. She has been weak for approximately three days. She has not traveled outside of the city, been hospitalized, or received antibiotics recently.  A proctosigmoidoscopy was conducted three days after the patient’s discharge from the acute care clinic. A significant pseudopolyps formation could be seen. Biopsies of the colon revealed erosions of the mucosa and ulcerations into the submucosa with mixed acute (i.e., neutrophils) and chronic (lymphocytes and macrophages) inflammatory cells. No dysplastic cells suggesting the development of colon carcinoma were seen. No multinucleated giant cells suggesting Crohn’s disease were seen. Inflammation and ulceration were limited to the rectum and sigmoid colon only. Crypts of Lieberkühn were intensely inflamed.

ORDER   A PLAGIARISM-FREE PAPER   NOW

Gastrointestinal Case Study Paper. Marked hemorrhaging of capillaries in the mucosa was also observed.   Laboratory Blood Test Results  Na+ = 143 meq/L BUN = 20 mg/dL Plt = 315,000/mm3 AST = 33 IU/L K+ = 3.2 meq/L Cr = 1.1 mg/dL PO4-3 = 4.0 mg/dL ESR = 24 mm/hr ALT = 41 IU/L Cl- = 108 meq/L Hb = 10.8 g/dL CRP = 1.5 mg/dL T bilirubin = 0.9 mg/dL Alb = 3.1 g/dL HCO+3 = 18 meq/L Hct = 36% Ca+2 = 8.9 mg/dL PT = 11.3 sec Glu, fasting = 132 mg/dL WBC = 9,400/mm3  Questions (answer all 3):  1. What is the relevance of the last sentence in the first paragraph: “She has not traveled outside of the city, been hospitalized, or received antibiotics recently”? Explain your answer in detail.  2.What is the diagnosis? Explain your answer. Why and how did you come up with this diagnosis?  3. Identify eight abnormal laboratory blood test values and provide a brief pathophysiological explanation for each of them. Gastrointestinal Case Study Paper