Discussion week 7

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Discussion week 7

Running head: FRENCH CANADIAN AND GERMAN HERITAGE Dilsy Ricardo Florida National University Nursing

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Department BSN Program NUR 4636 02/07/2019 Prof. Cassandre Milien, RN MSN 1 FRENCH CANADIAN AND GERMAN HERITAGE 2 1. Describe the health care beliefs of the German and French-Canadian heritages and mention the influence in the delivery of evidence-based health care. All home health duties are traditionally believed to lie with the mother in German culture. These include home remedies as well as arrangements for check-ups. The Germans believe in prevention as opposed to treatment. They are also inclined toward seeking over the counter treatment before delving into professional inquiries (Mossailos & Sarnak, 2016). They highly value natural medications such as herbs, roots and so on. Due to their high esteem, physical and mental disabilities are a hard pill to swallow for them (Osborn & Sarnak, 2015). They are, however, not opposed to any modern health care advancement as long as it does not contradict a religious belief. German beliefs often negatively influence the delivery of evidence-based health care. For instance, genetically acquired disabilities are seen as an untreatable shame in society and often left unattended to. When it comes to the French Canadians, they ensure unrestricted accessibility to healthcare upon admission into the system (Best & Miller, 2015). A class system determines health care. This is with higher economic status having personal physicians. Those on the lower side opt to wait for a life and death situation before seeking the necessary care. For the French Canadians, the language barrier proves to be a challenge. Their health care culture is greatly influenced by their Catholic faith. Blood and organ donations are a personal decision with little to no constructive interference. There is a split influence on evidence-based health care delivery due to social stratification. 2. Discuss if there is any similarity in the health care beliefs and practices of the German and French-Canadian heritage with the health care beliefs of your culture. FRENCH CANADIAN AND GERMAN HERITAGE 3 There are several similarities to be seen with my heritage beliefs and the two systems. When it comes to a comparison with the French Canadians, the first meeting point is the socioeconomic factor. In the two, health care accessibility is highly influenced by social stratification. There is also a similarity in pain expression (Rash, 2017). The immigrants record different levels of pain expression as opposed to inherent inhabitants. There is also a similarity to be viewed with a high level of OTC utilization. There is a huge number of individuals recorded to make use of over the counter drugs in both cases. There are also similarities to be identified with the German culture. For instance, there is the use of traditional and indigenous medication. This is a common ground for both cultures. There’s a considerable preference for naturally acquired medication such as herbs, spices, and the likes. They are also alike in terms of home care provision. This is in terms of the family member who is responsible for taking care of the family health care issue. The mother of the home is left with the duty of taking care of all health-related concerns in the household. There is also the fact that health care coverage is one’s prerogative. This is in contrast to the Canadian Universal Coverage plan which is made available to all individuals recorded into the system. 3. If you have to change your health care beliefs for any of one study this week, which one will you choose and why? If I were to change any of the above health care beliefs, I would choose to go with the German Health care culture. This is owing to many reasons. First off, they are high believers in the notion that prevention is better than cure. Therefore, from the onset of birth children are subjected to a preemptive sort of medication. This is such as through immunizations, daily intake of vitamins and so on. There is also the fact that the nutritional values of Germany lean toward a healthy side. This is such as the fact that they keep high-calorie diets to a minimum intake. This FRENCH CANADIAN AND GERMAN HERITAGE 4 ensures that lifestyle diseases caused by inadequate nutrition as well as malnutrition are kept at bay. Furthermore, I am inclined to the use of natural remedies. This is because they are less harmful as opposed to modern medications which are often filled with chemical toxins. This would also apply to home remedies. Putting OTC as a first priority is also a pull factor. This is because it is often a lifesaver in a fiscal sense. German culture does not contain a lot of restrictions when it comes to health care advancement. This is in a sense there is not much opposition to the use of new and developed health care innovations. The only limitation for most is often upon superimposition with the religious beliefs. However, decisions are often left to an individual’s preferences and desires. FRENCH CANADIAN AND GERMAN HERITAGE 5 References Best, K. L., Routhier, F., & Miller, W. C. (2015). A description of manual wheelchair skills training: current practices in Canadian rehabilitation centers. Disability and Rehabilitation: Assistive Technology, 10(5), 393-400. Mossialos, E., Wenzl, M., Osborn, R., & Sarnak, D. (2016). 2015 international profiles of health care systems. Canadian Agency for Drugs and Technologies in Health. Osborn, R., Moulds, D., Schneider, E. C., Doty, M. M., Squires, D., & Sarnak, D. O. (2015). Primary care physicians in ten countries report challenges caring for patients with complex health needs. Health Affairs, 34(12), 2104-2112. Rash, J. (2017). Towards the rapid assessment of pain expression: The Index of Facial Pain Expression (IFPE) (Doctoral dissertation, University of Calgary). Running head: PEOPLE OF FRENCH CANADIAN AND GERMAN HERITAGE People of French-Canadian and German Heritage Karen Echenique Florida National University Culture in Nursing Prof. Cassandre Milien, MSN 1 PEOPLE OF FRENCH CANADIAN AND GERMAN HERITAGE 2 People of French Canadian and German Heritage The first wave of German immigrants came to America for religious freedom. There are over 50 million Americans from German descendants. Although, today, communities continue to use their customs, specifically those who use healthcare. Usually in German families, the mother is the person in charge of the children receiving check-ups, immunizations, and ensuring the intake of supplements. In traditional families, women in the families are often the main overseer of home remedies and treatments. Roots, soups, camphor, peppermint, ammonia, herbs, and poultices are among the most common ingredients for natural remedies. Over the counter medications are also widely used by German Americans because they often believe that each individual is responsible for their own health. Physical disabilities caused by injuries are more accepted than that of innate disabilities. Mental disabilities are lacked in acceptance and are view as a mistake. Germany is among the leading countries in the world who developed both the National and Biomedical insurance in Europe. Biomedical care is general for all of its citizens and is said to be of high quality. Germans have an advantage in medical technology because of their economy and they are able to have many hospitals and doctors per say. In 1997, there was an outbreak of heart disease and cancer which accounted to about 48% of all deaths in eastern and western Germany. Thanks to their advancement in medicine, Germans, were able to help and save many people at the time. As a tradition, Germans, also believe in “naturopathic medicine” which includes water cures of several types. Most members of the German Biomedical corporation have opposed naturopathic medicine but are still used to some length. Most German-Americans demand straight-forward verbal communication about diagnoses and treatments. Moreover, these individuals are always promptly on time and strictly PEOPLE OF FRENCH CANADIAN AND GERMAN HERITAGE 3 believe on being punctual especially when it deals with health. Health care providers and their team should ensure to meet these patients on time and on schedule along with their medication. (Betancourt, Green, Carrillo, & Owusu Ananeh-Firempong, 2016). The use of contraceptives is highly frowned upon in strict German Catholics. Additionally, female patients prefer consulting with the same sex health care personnel but have no problem with receiving treatment from either gender. Conclusively, they have no problem or limitations on blood transfusions or transplantations of any sort. Alcoholism and cigarette smoking are prevalent health behaviors for this specific group of people. Therefore, there are higher chances for cardiac and respiratory diseases. Residing in America, there are about 2.2 million individuals who are French-Canadian. The two main languages are French and English, and less than half of the population uses French as their native language. French-Canadians inherited most of their customs from the first French settlers. Canada has free, general health coverage for all of its residents. Moreover, people in the upper socioeconomic class have family doctors rather than seeking medical care from local community centers or hospitals. Health care providers hold a promising status for FrenchCanadians, especially geriatrics. The health insurance system in Canada is attentive to patients who are practicing folk remedies outside of the law or government issued care. Most FrenchCanadians also use over the counter medications on the regular and have no problem receiving donations, transplantations or blood transfusions. The decision to donate or receive an organ is based on the individual’s personal decision and based on family or cultural influence. Some of their natural cultural beliefs play a significant role in evidence-based compentent care. They strongly believe in natural childbirth and its benefits. Moreover, in the delivery room, men are usually allowed depending on the mother’s choice. Respect from health care personnel PEOPLE OF FRENCH CANADIAN AND GERMAN HERITAGE 4 is expected, especially in older adults. Their heritage expects the expression of one’s feeling and therefore will be open with the provider during the assessment and procedures. In addition, women rarely use contraception that is inserted vaginally but are fine with using other forms of contraception’s as in pills and tubal ligation. French-Canadians and Germans share some similarities with my heritage including accepting blood transfusions, transplantations and donations. As seen in both cultures, the mother is the alpha of the family. She is in charge of all the health care related issues such as immunization and medication regimens. Prayers are usually connected with giving the patient strength and faith as they recover from their illnesses. Conclusively, most often, oral contraceptives are accepted as the most common form of birth control. Most geriatric patients prefer a same sex provider for consultations and admissions but don’t mind different genders for treatments. If I were to change to my health care beliefs to any of the cultures mentioned above, I would probably change to German health culture. Initially, Germans are high believers in preventing any illnesses before you have to cure them, and critically, I think it is a smart idea. I am a big believer in natural remedies as well, they are less harmful contrasting to medications used today. Additionally, from birth, children receive immunizations to prevent many diseases and intake of supplements and vitamins. Germans also value nutrition and believe in high calorie diets, which is a factor I need to learn to improve my diet. German heritage also does not limit the use of health care technology, expect those who impose due to religious beliefs, which is only a small percentage of individuals. PEOPLE OF FRENCH CANADIAN AND GERMAN HERITAGE 5 References Best, K. L., Routhier, F., & Miller, W. C. (2015). A description of manual wheelchair skills training: current practices in Canadian rehabilitation centers. Disability and Rehabilitation: Assistive Technology, 10(5), 393-400. Mossialos, E., Wenzl, M., Osborn, R., & Sarnak, D. (2016). 2015 international profiles of health care systems. Canadian Agency for Drugs and Technologies in Health. Betancourt, J. R., Green, A. R., Carrillo, J. E., & Owusu Ananeh-Firempong, I. I. (2016). Defining cultural competence: a practical framework for addressing racial/ethnic disparities in health and health care. Public health reports. Zimmermann, Kim Ann. (2018). German Culture: Facts, Customs and Traditions. Retrieved from: https://www.livescience.com/44007-german-culture.html
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Contemporary Nursing Practice Discussion

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Contemporary Nursing Practice Discussion

The field of nursing has changed over time. In a 750-1,000 word paper, discuss nursing practice today by addressing the following:

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Explain how nursing practice has changed over time and how this evolution has changed the scope of practice and the approach to treating the individual.
Compare and contrast the differentiated practice competencies between an associate and baccalaureate education in nursing. Explain how scope of practice changes between an associate and baccalaureate nurse.
Identify a patient care situation and describe how nursing care, or approaches to decision-making, differ between the BSN-prepared nurse and the ADN nurse.
Discuss the significance of applying evidence-based practice to nursing care and explain how the academic preparation of the RN-BSN nurse supports its application.
Discuss how nurses today communicate and collaborate with interdisciplinary teams and how this supports safer and more effective patient outcomes.
Prepare this assignment according to the guidelines found in the APA Style Guide

This assignment uses a rubric which I have attached

1 attachments

Paragraph 6

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Paragraph 6

Please write a paragraph responding to the discussion bellow. Add citations and references in alphabetical order.

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Based on the objective data presented, apparently Mr. C. is undergoing various medical health risk condition correlate with his excessive gaining weight (obesity) which warrant him to seek medical intervention for possible bariatric surgery. However, according to National Institute of Health (NIH, n. d), sequel to his elevated body mass index (BMI) of 47.8, with his height of 68inches (5feet 6inhces) and weight 134.5kg (296lbs), basically surgery is an option for his weight loss. However, obesity can constitute a complex progressively or exacerbate a wide spectrum of co-morbidities, including type 2 diabetes mellitus (T2DM), hypertension, dyslipidemia, cardiovascular disease (CVD), liver dysfunction, respiratory and musculoskeletal disorders, sub-fertility, psychosocial problems, and certain types of cancer (American Heart Association, 2017).

Upon careful assessment and evaluation of the below data:

High blood pressure elevated: 172/96,(120/80)
Diabetes with elevated Fasting blood Glucose: 146mg/dlL (<100mg/dL) 5.6mmol/l
High Cholesterol (Fatty Liver): elevated 250mg/dL (<200mg/dL)
Hyperlipemia with Triglycerides elevated 312mg/dL (<150mg/dL)
sleep apnea. Rapid respiration of 26
Metabolic disorder is not factor for Mr. C to gain weight, maybe he has genetical impact/leptin resistance/certain food habits or sedentary life style caused sudden recent weight gain about 100pounds in last 2-3years as reflected in the data.

Obesity is an abnormal accumulation of fat, it is one of the biggest health problems in the world. It correlates or associated with diverse or various other diseases, which combined kill millions of people per year.In another contemporary, Obesity constitutes a worldwide epidemic with prevalence rates which are increasing in most Western societies and in the developing world. According toWorld Health Organization (WHO) declared obesity a global epidemic,

Bariatric surgery should be a last priority after trying conventional therapies such as consuming fewer calories, increasing exercise, commercial weight-loss programs, etc. His BMI is 47.9 along with other comorbidities he has and may leads to further health impediment or problems so, he has to lose weight by taking aggressive approach (National Institute of Health n. d). Mr. C can undergo gastric bypass surgery if conventional therapies are not helping in losing weight. Gastric bypass is surgery that helps you lose weight by changing how your stomach and small intestine handle the food you eat(American Society for Metabolic and Bariatric Surgery).

For his Peptic ulcer disease Mr. C Should follow the below drug administration chart

Magnesium hydroxide/aluminum hydroxide (Mylanta) 15 mL

10AM (3hrs after breakfast)

4PM (3hrs after Lunch)

9PM (3hrs after Dinner)

10.30PM (At bed time)

Ranitidine (Zantac) 300 mg PO at bedtime. 10.30

10.30 PM (At bed time)

Sucralfate/Carafate 1 g or 10ml suspension (500mg / 5mL)

6AM (1hr before Breakfast)

12PM (1hr before Lunch)

5pm (1hr before dinner)

10.30 PM (At bed time)

ANS 1:

Assessment of Mr. C. functional health patterns:

Health perception/ health management-Mr. C. may be depressed because of his weight so he needs medication and diet compliance and also will need regular exercises and regular annual checkups.
Nutritional metabolic pattern – his pattern of food consumption and fluid intake will have to be moderated so that it can reduce his weight also help in his metabolism
Sexuality-reproductive activity- may be affected with low libido and dissatisfaction due to his weight and also could also affect his sexual relationships
Coping/ stress tolerance-Mr. C. may not be able to tolerate lots of stress because of his body image and thoughts of his weight so he may need available support systems to help him to cope
Value-belief-Mr. C. may have problems with his value beliefs and spiritual goals so he may need guidance and spiritual support as his values or beliefs may conflict with his health issues and special religious practices.
Elimination-his patterns of excretory patterns may be affected especially bowel movement by the medications he is taking, and there may be frequency or pain in urination and appearance of urine and stool secondary to the disease process and medications.
Activity/ Exercise-his patterns of activity will be affected by his weight with problems to exercise or have leisure times and also due to respiratory mobility and may affect his activities of daily living
Cognitive perception-he may have sensory problems following his disease especially if he suffers from diabetes (neuropathy). His vision may be affected, taste sensory, and may have problems to manage his condition and decision making
Sleep/ Rest pattern-Mr. C., may have problems with sleep and rest as he is already having sleep apnea, his quality of sleep will be affected, and he may need sleeping aids
Self-perception/self -concept- his self-perception can be affected especially as a father figure or husband and may not provide family satisfaction as the head and bread winner and also with social interactions (Gordon’s 11 functional health patterns).
ANS 2:

The identified Actual or potential health problems:

1. Type2 Diabetes with Rationale : It may be that being overweight causes cells to change, making them resistant to the hormone insulin. Insulin carries sugar from blood to the cells, where it is used for energy. When a person is insulin resistant, blood sugar cannot be taken up by the cells, resulting in high blood sugar.

2. High Blood Pressure with Rationale: Having a large body size may increase blood pressure because your heart needs to pump harder to supply blood to all your cells. Excess fat may also damage your kidneys, which help regulate blood pressure.

3. Heart disease with Rationale: People who are overweight or obese often have health problems that may increase the risk for heart disease. Excess weight may cause changes to your heart that make it work harder to send blood to all the cells in your body.

4. Sleep Apnea with Rationale: A person who is overweight may have more fat stored around his or her neck. This may make the airway smaller. A smaller airway can make breathing difficult or loud (because of snoring), or breathing may stop altogether for short periods of time. In addition, fat stored in the neck and throughout the body may produce substances that cause inflammation. Inflammation in the neck is a risk factor for sleep apnea.

5. Osteoarthritis with Rationale: Extra weight may place extra pressure on joints and cartilage (the hard but slippery tissue that covers the ends of your bones at a joint), causing them to wear away. In addition, people with more body fat may have higher blood levels of substances that cause inflammation. Inflamed joints may raise the risk for osteoarthritis.

Reference:

American Society for Metabolic and Bariatric Surgery Integrated Health Nutritional Guidelines for the Surgical Weight Loss Patient 2016. Retrieved from: https://asmbs.org/app/uploads/2008/09/ASMBS-Nutritional-Guidelines-2016-

Nursing Research Discussion Violence Against Healthcare Professionals

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Nursing Research Discussion Violence Against Healthcare Professionals

Nursing research is used to study a dilemma or a problem in nursing. Examine a problem you have seen in nursing. Why should it be studied? Justify your rationale.

Tags: discussion research nursing Nursing research

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Quantitative and Qualitative Designs Paper

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Quantitative and Qualitative Designs Paper

Quantitative and Qualitative Designs. For this discussion question, you will read two assigned articles that represent quantitative and qualitative research designs. Following your review, you will conduct a critical analysis of these articles, comparing and contrasting strengths, limitations, and the tendencies of each while addressing the questions and items listed below.

Quantitative Article:
The Effect of Educational Intervention on the Pain and Rehabilitation Performance of Patients Who Undergo a Total Knee Replacement.
Address each of the following:
• Identify and define the quantitative design used.
• Is the choice of design appropriate for the research question? Why or why not?
• What are the threats to external and internal validity?
• What ethical concerns did you identify?

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Qualitative Article:
A Qualitative Study of Nurses’ Attitudes Towards and Accommodations of Patients’ Expressions of Religiosity and Faith in Dementia Care.

Address each of the following:
• Identify and define the qualitative design used.
• Discuss the sample and analysis/interpretation of data. Quantitative and Qualitative Designs Paper
• Discuss techniques used to meet the four elements of evaluation.
• What ethical concerns did you identify?
• Discuss how qualitative studies can be used to create an EBP.

Discussion Guidelines: Support your responses with credible or scholarly academic references, using proper APA style citations. The Scholarly, Peer Reviewed, and Other Credible Sources table offers additional guidance on appropriate source types, and the In-Text Citation Helper: A Guide to Making APA In-Text Citations tutorial can clarify further questions you might have on APA. Assigned course readings and Ashford University Library resources are preferred. In your first post, provide a substantive exposition that illustrates a well-reasoned and thoughtful response to the topic, is factually correct, provides examples, and demonstrates a clear connection to the readings.

Guided Response: In your responses to at least two of your peers, provide constructive feedback adding to the critical analysis of the articles reviewed. Your response must display reflective thought that illustrates an understanding of the topic under discussion and be supported with relevant evidence. Quantitative and Qualitative Designs Paper

write a response to the paper attached below 200-300 words

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write a response to the paper attached below 200-300 words

My understanding of disparities in healthcare is that there are imbalanced health differences interrelated with social,

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economic or environmental disadvantages that adversely affect groups of people. The term describes how certain groups of people suffer from health problems in comparison to other groups. The groups can be categorized by sex, ethnicity, age, or income status. The following are 2 Healthy People 2020 Objectives for health disparities: HDS-5.2 Reduce the proportion of children and adolescents with hypertension (8-17 years old) (“Disparities | Healthy People 2020”, 2019). The data states that from 2011 -2014, 3.4% of Mexican American children suffered from hypertension compared to the lowest rate which was 1.7% (white children, not Hispanic), Overall, 3.5 % of children suffer from hypertension, with the 2020 target being 3.2%. C-4: Cervical cancer deaths (age adjusted, per 100,000 population) (“Disparities | Healthy People 2020”, 2019). The data shows that Black or African American females die at a higher rate than other races from cervical cancer. In 2016, 3.2 black women per 100,000 died from cervical cancer compared to the best groups death rate (Asian and Pacific Islander) which was 1.7 per 100,000. The average is 2.5 with the 2020 target being 2.2 deaths per 100,000. The Minority Health and Health Disparity Research Center began in 2002 dedicated to conducting research and operating an outreach center that addresses health disparities in populations that are considered vulnerable. It was made successful with the partnership of NBA player Charles Barkley in 2004. The organization is especially dedicated to minority health issues and disadvantaged communities. Currently, the center has several ongoing research projects aimed at helping the community in areas such as obesity, Diabetes, children’s health, and elderly healthcare. The center has also provided more than 4.1 million dollars in funding to research projects that is dedicated to decreasing health disparities among disadvantaged populations. The center sponsors several outreach programs such as Healthy Happy Kids which educates children on the importance of nutrition and staying active. Childhood obesity is a real problem in the U.S., especially in the South. This program has worked to make eating healthy a rewarding experience through activities such as having local chefs show children how to prepare healthy foods, sometimes in a form of “an Iron Chef-Inspired competition”. This innovative program has been a big success for the center. They also sponsor an especially interesting program called The Center for Healthy African American Men through Partnerships (CHAAMPS) (“UAB – School of Medicine “, 2019). African American men are at a high risk for several diseases such as cardiovascular disease, diabetes, and hypertension. The CHAAMPS program is aimed at conducting research that focuses on the health of black American men that they believe have been overlooked over the years. The research program acknowledges that poor health among black men is contributed to social position, socially determined circumstances, and socioeconomic factors that plague this population. References Disparities | Healthy People 2020. (2019). Retrieved from https://www.healthypeople.gov/2020/about/foundation-health-measures/Disparities UAB – School of Medicine – Minority Health & Health Disparities Research Center – Healthy Happy Kids. (2019). Retrieved from https://www.uab.edu/medicine/mhrc/outreachprograms/healthy-happy-

Clinical Supervision Essay Paper

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Clinical Supervision Essay Paper

Clinical Supervision Essay

Consider a client whom you do not think is adequately progressing according to expected clinical outcomes.
Reflect on a child or adolescent client you are currently counseling or have previously counseled at your practicum site who has been diagnosed with an anxiety disorder.
Describe the client. Note: Do not use the client’s actual name.
Explain your therapeutic approach with the client, including the perceived effectiveness of your approach.
Identify any additional information about this client that may potentially impact expected outcomes Clinical Supervision Essay Paper

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J.T is a 16-year-old Caucasian male patient. He presents to the clinic with the claim that he experienced increased anxiety. He has been experiencing anxiety attacks for the last six months which have increased intensely for the last two weeks. He has been on anxiety medication during the last one week and reports minimal positive progression.  He reports increased insomnia and shakiness since the beginning of his treatment plan and considers the drugs ‘futile and more sickening’. The symptoms are currently affecting his daily activities. He is often tensed and has difficulties paying attention in class and finishing his assignments.

On examination, J.T. feels stressed all the time and worries about failing his examinations constantly. He is also afraid of making presentations in class which increases tension since one of his teachers expects the class members to participate in public speaking from time to time. He exhibits normal speech volume, rate and coherent articulation. He appears tensed but with intact language skills. The general demeanor and facial expressions demonstrate a stressed mood. The affect is appropriate, congruent and affluent with no delusion and hallucination signs. He does not abuse drugs but he is under pressure to try by his peers. Cognitive functioning and memory are age appropriate and intact Clinical Supervision Essay Paper.

Therapeutic Approach

The patient will be treated using thee cognitive behavioral therapy which is considered to the most effective approach towards anxiety disorder management. This will be combined with the exposure therapy which was not included in the previous treatment plan Clinical Supervision Essay. The objective of these combined techniques will be to overcome the clients fear, calm their mind and reduce their levels of anxiety. Exposure therapy will involve exposing the client to his fearful situations to relieve the tension that triggers anxiety (Topper et al., 2017). The client will be requested to think of the scary situations and direct exposure through systematic desensitization. Relaxation techniques will be applied to confront the trigger in this case.

Cognitive behavior therapy addresses negative distortions and behaviors thus changing our perception of the selves and the world (Hofmann & Otto, 2017). This in turn develops positive behaviors that help in the adaptation to the reality and reduction of fears that trigger anxiety. This will modify the client’s thoughts and behaviors as well as his cognitions to determine the anxiety triggers. Moreover, it will address the reactions and behaviors towards different situations particularly public speaking, socialization and examination situations which are identified as the key triggers to his anxiety Clinical Supervision Essay. This will be followed by the process of cognitive restructuring or thought challenging which will entail the identification of the client’s thoughts, challenging the negative ones through evaluation of the provoking thoughts, questioning evidence, analyzing beliefs and evaluating the reality of negative predictions (Stein & Sareen, 2015). Consequently, the negative thoughts will be replaced by the realistic thoughts.

Additional information

The history of the client’s sickness will be an added advantage to accurate diagnosis and treatment. This will help learn the previous mental conditions experience before and the type of treatment that were effective in the management of the condition. Moreover the family history will facilitate the identification of probable disorders that might run in the family and hence improve clinical decision-making. Additionally, information regarding their allergies will help determine the cause of minimal progress of the treatment plan that involved the use of medication (Lader, 2015). This is because; allergies could worsen the client’s symptoms rather than improve them and hence risk the patient’s safety Clinical Supervision Essay Paper.

 

References

Hofmann, S. G., & Otto, M. W. (2017). Cognitive behavioral therapy for social anxiety disorder: Evidence-based and disorder specific treatment techniques. Routledge.

Lader, M. (2015). Generalized anxiety disorder. Encyclopedia of psychopharmacology, 699-702.

Stein, M. B., & Sareen, J. (2015). Generalized anxiety disorder. New England Journal of Medicine, 373(21), 2059-2068.

Topper, M., Emmelkamp, P. M., Watkins, E., & Ehring, T. (2017). Prevention of anxiety disorders and depression by targeting excessive worry and rumination in adolescents and young adults: A randomized controlled trial. Behaviour research and therapy, 90, 123-136. Clinical Supervision Essay Paper

Anxiety Among School Children Discussion

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Anxiety Among School Children Discussion

Choose articles (peer reviewed and 4 years old ) that will answer answer this questions. Reference APA format.

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My Title is: Anxiety Among School Children

Please attach pdf versions of articles used.

Level 1 Questions

How do personal or family religious preferences affect on anxiety level at school?
Will cultural or sport activities reduce anxiety level among students?
Does spiritual education reflect on anxiety level during academic activities?
Level 2 Questions

How can cultural or spiritual activities effect on anxiety treatment?
Can cultural or lifestyle preference become a way of reducing anxiety and outcome to higher results on tests?
Will marijuana or smoking as a cultural preference become a legal treatment against anxiety at schools?
Tags: anxiety APA format nursing School Children anxiety level at school

N512 Acute Pericarditis Assignment

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N512 Acute Pericarditis Assignment

N512 Acute Pericarditis

Mrs. Johnson is a thirty-five-year-old married Black female. Of importance, she presents with chest pain, rated as an eight on a scale of 1-10, that is sharp, located behind the sternum and radiates to the back. Pain increases on inhalation and is made better with leaning forward. Medical history non-contributory. Denies active medications and tobacco, alcohol, and drug use. N512 Acute Pericarditis Vitals reveal mild tachycardia. Patient confirms flu-like illness, but currently afebrile. Physical exam positive for mucus in nasal passage, erythematous oropharynx, and high-pitched squeaking sound.

Mrs. Johnson’s likely diagnosis is acute pericarditis. She presents with the classic indications of pericarditis pain (Hammer & McPhee, 2019):

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  • Sharp and retrosternal in nature
  • N512 Acute Pericarditis
  • Worsens with deep breathing, coughing, lying flat
  • Improved with sitting upright and leaning forward

A high pitched three component squeaking sound is also heard on cardiac examination. She could potentially have infection, acute myocardial infarction, thoracic cavity trauma. Although medication side effects can potentially cause some of these symptoms, she reports no medication use to include street drugs. N512 Acute Pericarditis According to Hammer and McPhee, “Viruses, particularly, the coxsackieviruses, are the most common cause of acute pericarditis. Viruses are also probably responsible for “idiopathic” pericarditis” (2019). Other potential viral culprits include echovirus, adenoviruses, parvovirus B19, HIV, influenza as well as multiple herpes viruses such as EBV and CMV. There is also evidence of bacterial infections as etiologies, but it is not usually seen in developed countries (Dababneh & Siddique, 2020) N512 Acute Pericarditis. Based on clinical presentation of shotty anterior cervical lymphadenopathy, the most likely etiology is viral infection. This is further strengthened by the patient’s report of recent flu-like illness. According to Dababneh & Siddique, “Due to the parietal layer’s rich innervation, any inflammatory process mediated by an infectious, autoimmune or traumatic insult can result in severe retrosternal chest pain, as is commonly seen in acute pericarditis. N512 Acute Pericarditis This explains why the vast majority of presentations (>90%) have chest discomfort” (2020). A thorough post discharge plan of care would include:

  • Educating patient on indicators of worsening disease processes. When to notify primary care provider, when to seek emergency help
  • Take prescribed medicines as directed. First line of treatment is most often NSAIDS. Some cases will also require treatment with antibiotics and/ or steroids. N512 Acute Pericarditis Assignment
  • Eat a healthy diet. Drink appropriate fluids. Get enough sleep/exercise. N512 Acute Pericarditis
  • Manage stress. According to the case study she is married. Utilize family support to decrease anxiety and tension. Assess job responsibilities as a potential source of stress and implement ways to lower strain.

References

Dababneh, E., & Siddique, M. S. (2020). Pericarditis. In StatPearls. StatPearls Publishing. N512 Acute Pericarditis

Hammer, G. & McPhee, S. (2019). Pathophysiology of disease: An introduction to clinical medicine (8th ed.). New York, NY: McGraw-Hill Education /Medical

 

Discussion 2

Jackie Johnson, a 35 y.o. African-American, married female, advertising executive, presents to the emergency department with complaints of chest pain N512 Acute Pericarditis. The pain is described as 8 on a scale ranging from 1 to 10, retrosternal, and sharp in nature. It radiates to the back, is worse with taking a deep breath, and is improved by leaning forward. On review of systems, she has noted a “flulike illness” over the last several days, including fever, rhinorrhea, and cough. She has no medical history and is taking no medications. She denies tobacco, alcohol, or drug use. On physical examination, she appears in moderate distress from pain, with a blood pressure of 125/85 mm Hg, heart rate 105 bpm, respiratory rate 18/min, and oxygen saturation of 98% on room air. She is currently afebrile. Her head and neck examination is notable for clear mucus in the nasal passages and a mildly erythematous oropharynx. N512 Acute Pericarditis The neck is supple, with shotty anterior cervical lymphadenopathy. The chest is clear to auscultation. Jugular veins are not distended. Cardiac examination is tachycardic with a three-component high-pitched squeaking sound. Abdominal and extremity examinations are normal.

In this discussion:

  1. Provide and discuss this patient’s likely diagnosis with your colleagues. Why do you support this “likely” diagnosis? N512 Acute Pericarditis Assignment
  2. Discuss your differential diagnoses clinical reasoning. Why do you support this list of potential differential diagnoses?
  3. Provide and discuss what the most common causes of this disease are, and which is most likely in this patient?
  4. Identify the pathophysiologic mechanism for her chest pain N512 Acute Pericarditis.
  5. Develop a plan of care post-discharge based upon your recommendations living arrangements and social supports.

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Support your discussion with citations from the external literature and your textbook.

Remember to respond to at least two of your peers. Please refer to the Course Syllabus for Participation Guidelines & Grading Criteria.

The symptoms experienced by 35-year-old Jackie Johnson is suggestive of acute pericarditis which I strongly support based upon her history.  Her presenting complaint is sharp retrosternal chest pain radiating to the back which worsens with deep breaths and improves when leaning forward, 8 out of 10 on the pain scale.  She further complains of “flu-like illness”, fever, rhinorrhea, and cough for several days and denies any previous medical or medication history.  Her cardiac examination revealed that she was tachycardic with a pulse rate of 105 and a three-component high-pitched squeaking sound.  Pericarditis is the inflammation of the pericardium which is a fluid-filled sac surrounding the heart and is commonly diagnosed in a primary care setting based on physical examination, and electrocardiogram (ECG), and patient history such as the symptoms experienced by Jackie Johnson (Rahman & Saraswat, 2017) N512 Acute Pericarditis.

Some differential diagnosis would include myocardial infarction (MI), pulmonary embolism, and pneumonia to name a few (Rahman & Saraswat, 2017).  Chest pains are quite common in an MI so cardiac enzymes and an ECG would be needed to rule this out.  Pulmonary embolism also can present with chest pains so a D-dimer blood test and lung scans can rule this out. N512 Acute Pericarditis The patient also complained of cough, fever, and  “flu-like” symptoms which can be caused by pneumonia so a chest x-ray, blood cultures, and a complete blood count can confirm this diagnosis.  “The characteristic ECG findings in patients with acute pericarditis are a diffuse elevation of the ST-segment and ST-segment depression in lead aVR and depression of the PR segment, especially in leads V5 and V6 (Saricam & Saglam, 2016).

There are multiple causes for pericarditis and the most common is a viral disease caused by the coxsackievirus but bacterial, mycotic organisms, and tuberculosis can be the causal factors in addition to other medical conditions such as neoplasms and autoimmune diseases such as rheumatoid arthritis (Hammer & McPhee, 2019).  Based on Jackie Johnson’s complaint of “flu-like” symptoms, she may have a viral cause for her pericarditis.  Her chest pain was probably caused by the inflammation of the pericardium and the three-component high-pitched squeaking sound in her heart was likely due to pericardial friction rub (Hammer & McPhee, 2019) N512 Acute Pericarditis. N512 Acute Pericarditis Assignment

Before discharge planning, I will have a conversation with the physician, patient, and spouse to be clear on the medication, follow-up appointment, psycho-social considerations, and activity restrictions.  With this information, I will teach the patient about the medications and side effects, notifying her physician if there is any worsening of symptoms, make sure she has a follow-up appointment, offer her psychological counseling if needed, advise her of social support groups, and stress the importance of rest and avoidance of strenuous activities (Rahman & Saraswat, 2017).

References

 

Hammer, G. & McPhee, S. (2019). Pathophysiology of disease: An introduction to clinical medicine (8th ed.). New York, NY: McGraw-Hill Education /Medical

Rahman, A., & Saraswat, A. (2017). Pericarditis. Australian Family Physician, 46(11), 810-814. Retrieved from https://search-proquest-  com.americansentinel.idm.oclc.org/docview/1961747048?pq-origsite=summon N512 Acute Pericarditis

Saricam, E., & Saglam, Y. (2016). Potentially missed acute pericarditis: Atypical pericarditis. The American Journal of Emergency Medicine, 34(12), 2451-2453. doi:http://dx.doi.org.americansentinel.idm.oclc.org/10.1016/j.ajem.2016.09.020  Retrieved from https://search-proquest-com.americansentinel.idm.oclc.org/docview/1961747048?pq-origsite=summon N512 Acute Pericarditis

Child Maltreatment Essay Paper

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Child Maltreatment Essay Paper

Give a positive response to the following child maltreatment essay by a student;

Young infants, less than six months old are subject to child maltreatment and have rates of physical and abusive trauma twice the rate of children one to three years in age (Harper, et.al., 2014). Abuse symptoms most often seen in non-mobile infants are bruising, burns, fractures and traumatic brain injuries. Infants have a wide variety of developmental ability and mobility, but in general they are not mobile enough to sustain fractures, or get into things in their environment that would cause the injuries that they may present with. Often with infant abuse, mother’s or parents bring their infants to be evaluated for difficult temperaments or excessive crying. The provider may notice bruising, and when assessing and questioning the parent may give inconsistent stories on how or when the bruising appeared. Bruising in any pre-mobile infant is a red flag for abuse with high suspicion for more serious internal injuries (Harper, et.al., 2014). Injuries of this nature should always lead to further investigation. On imaging studies, fractures may be seen on the skull, in long bones of legs and arms as well as hands and feet. Multiple fractures of varying stages of healing almost always are attributed to infant abuse. Fractures in the absence of trauma confirms the likelihood of physical abuse and the incidence is higher the younger the child (Paddock, Sprigg, &Offiah, 2017). Failure to thrive, threatening weight loss, uncleanliness and diapering may also lead the provider to further investigations of suspected abuse. The most serious of abuse and injuries is that of shaken baby syndrome, resulting in traumatic brain injury, retinal hemorrhages, and intracranial bleeds. An emotional assessment can be difficult in infancy in revealing abuse. Although, infants can be withdrawn or cry excessively from the pain of physical injuries. Traditional cultural healing can also be misidentified as abuse, when the provider visualizes burns, abrasions, or petechial marks on the chest or back of infants. For example, in the Asian community treatment of cough and fever may be alleviated by heated ointments applied by metal coins or spoons. Minor burns may result from the vigorous rubbing of heated herbs and appear as linear abrasions or bruising (Stanford Medicine, 2017). Child Maltreatment Essay Paper

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As a medical professional and nurse, I am a mandated reporter of suspected abuse. There are often medical diagnosis that can lead to injuries that mimic abuse, although in California they do not need to be ruled out prior to reporting.  The standard for which a report should be made is “reasonable suspicion” (Rady’s Children’s Hospital San Diego, 2012). Failure to report can result in a misdemeanor, imprisonment, and fines. Reports should be made immediately or as soon as possible to the county child welfare services or police/sheriff’s department. The report can be made by phone or written report transmitted by fax, mail or electronically. Child Maltreatment Essay.

 

 

References

Harper, N. S., Feldman, K. W., Sugar, N. F., Anderst, J. D., & Lindberg, D. M. (2014). Additional Injuries in Young Infants with Concern for Abuse and Apparently Isolated Bruises. The Journal Of Pediatrics, 165383-388.e1. doi:10.1016/j.jpeds.2014.04.004

National Center on Shaken Baby Syndrome (2016). Retrieved from https://dontshake.org/learn-more

Paddock, M., Sprigg, A., & Offiah, A. (2017). Imaging and reporting considerations for suspected physical abuse (non-accidental injury) in infants and young children. Part 1: initial considerations and appendicular skeleton. Clinical Radiology, (3), 179. doi:10.1016/j.crad.2016.11.016

Rady Children’s Hospital San Diego (2012). The California Child Abuse and Neglect Report Law. Retrieved from http://mandatedreporterca.com/images/pub132.pdf. Child Maltreatment Essay Paper