Diversity And Health Assessments

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Diversity And Health Assessments

In this Discussion, you will consider different socioeconomic, spiritual, lifestyle, and other cultural factors that should be taken into considerations when building a health history for patients with diverse backgrounds.

Case 1

JC, an at-risk 86-year-old Asian male is physically and financially dependent on his daughter, a single mother who has little time or money for her father’s health needs. He has a hx of hypertension (HTN), gastroesophageal reflux disease (GERD), b12 deficiency, and chronic prostatitis. He currently takes Lisinopril 10mg QD, Prilosec 20mg QD, B12 injections monthly, and Cipro 100mg QD. He comes to you for an annual exam and states “I came for my annual physical exam, but do not want to be a burden to my daughter.” Diversity And Health Assessments

Case 2

TJ, a 32-year-old pregnant lesbian, is being seen for an annual physical exam and has been having vaginal discharge. Her pregnancy has been without complication thus far. She has been receiving prenatal care from an obstetrician. She received sperm from a local sperm bank. She is currently taking prenatal vitamins and takes Tylenol over the counter for aches and pains on occasion. She a strong family history of diabetes. Gravida 1; Para 0; Abortions 0.

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Case 3

MR, a 23-year-old Native American male comes in to see you because he has been having anxiety and wants something to help him. He has been smoking “pot” and says he drinks to help him too. He tells you he is afraid that he will not get into Heaven if he continues in this lifestyle. He is not taking any prescriptions medications and denies drug use. He has a positive family history of diabetes, hypertension, and alcoholism.

To prepare:

· Reflect on your experiences as a nurse and on the information provided in this week’s Learning Resources on diversity issues in health assessments.

· Select one of the three case studies. Reflect on the provided patient information.

· Reflect on the specific socioeconomic, spiritual, lifestyle, and other cultural factors related to the health of the patient you selected.

· Consider how you would build a health history for the patient. What questions would you ask, and how would you frame them to be sensitive to the patient’s background, lifestyle, and culture? Develop five targeted questions you would ask the patient to build his or her health history and to assess his or her health risks.

· Think about the challenges associated with communicating with patients from a variety of specific populations. What strategies can you as a nurse employ to be sensitive to different cultural factors while gathering the pertinent information?

Post

Post an explanation of the specific socioeconomic, spiritual, lifestyle, and other cultural factors associated with the patient you selected. Explain the issues that you would need to be sensitive to when interacting with the patient, and why. Provide at least five targeted questions you would ask the patient to build his or her health history and to assess his or her health risks.

This work should have Introduction and conclusion

– This work should have at 3 to 5current references (Year 2013 and up)

– Use at least 2 references from class Learning Resources Diversity And Health Assessments

The following Resources are not acceptable:

1. Wikipedia

2. Cdc.gov- nonhealthcare professionals section

3. Webmd.com

CLASS LEARNING RESOURCES

**Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2015). Seidel’s guide to physical examination (8th ed.). St. Louis, MO: Elsevier Mosby.

  • Chapter 1, “The History and      Interviewing Process” (pp. 1-20)

This chapter highlights history and interviewing processes. The authors explore a variety of communication techniques, professionalism, and functional assessment concepts when developing relationships with patients.

  • Chapter 2, “Cultural      Competency” (pp. 21–29)

This chapter highlights the importance of cultural awareness when conducting health assessments. The authors explore the impact of culture on health beliefs and practices.

**Dains, J. E., Baumann, L. C., & Scheibel, P. (2016). Advanced health assessment and clinical diagnosis in primary care (5th ed.). St. Louis, MO: Elsevier Mosby.

  • Chapter 2, “Evidenced- Based Health Screening”      (pp. 6-9)

**Melton, C., Graff, C., Holmes, G., Brown, L., & Bailey, J. (2014). Health literacy and asthma management among African-American adults: An interpretative phenomenological analysis. Journal of Asthma, 51(7), 703–713. doi: 10.3109/02770903.2014.906605

Retrieved from the Walden Library Databases.

The authors of this study discuss the relationship between health literacy and health outcomes in African American patients with asthma.

**Centers for Disease Control and Prevention (2015). Cultural competence. Retrieved from https://npin.cdc.gov/pages/cultural-competence

This website discusses cultural competence as defined by the Center for Disease Control and Prevention (CDC). Understanding the difference between cultural competence, awareness, and sensitivity can be obtained on this website. 

**United States Department of Human & Health Services. Office of Minority Health. (2016). A physician’s practical guide to culturally competent care. Retrieved from https://cccm.thinkculturalhealth.hhs.gov/

From the Office of Minority Health, the Website offers CME and CEU credit and equips health care professionals with awareness, knowledge, and skills to better treat the increasingly diverse U.S. population they serve.

**Espey, D., Jim, M., Cobb, N., Bartholomew, M., Becker, T., Haverkamp, D., & Plescia, M. (2014). Leading causes of death and all-cause mortality in American Indians and Alaska Natives. American Journal of Public Health, 104(S3), S303-S311.

The authors of this article present patterns and trends in all-cause mortality and leading cause of death in American Indians and Alaskan Natives.

**Wannasirikul, P., Termsirikulchai, L., Sujirarat, D., Benjakul, S., Tanasugarn, C. (2016). Health literacy, medication adherence, and blood pressure level among hypertension older adults treated at primary health care centers. Southeast Asian J Trop Med Public Health., 47(1):109-20.

The authors of this study explore the causal relationships between health literacy, individual characteristics, literacy, culture and society, cognitive ability, medication adherence, and the blood pressure levels of hypertensive older adults receiving health care services at Primary Health Care Centers. Diversity And Health Assessments

Assignment: Position Paper On Health Policy

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Assignment: Position Paper On Health Policy

Now that you have analyzed many different aspects of health care policy, you are better able to form a comprehensive evidence-based opinion on its effectiveness. The policy you chose to focus on, like all policy, as you now well know, is a conglomeration of many different facets. Each of those facets is integral to the policy’s success, efficiency, and value. Assignment: Position Paper On Health Policy

As a nursing professional and advocate for change, having an all-inclusive understanding of health care policy is extremely important. Nurses have a tremendous amount of untapped power to make positive changes. Your knowledge of policy is just a first step. With this new process of breaking down and analyzing each of the pieces of health care policy, you have added another tool to your toolkit.

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To complete this Assignment, consider all of your findings from the Discussion in Week 1 and the Assignments in Weeks 2 and 3. Analyze your research on the policy, including costs, quality, and/or safety issues.

Address the following:

  1. Introduce the topic by drawing from your previous work. Introduce the policy by providing an overview of the suggested or implemented policy: background of the topic, including main elements of the policy, costs, and quality/safety. Assert your main thesis statement.
  2. Offer an evidence-based, informed opinion in support of the suggested or implemented policy. Describe at least two major contributions that this policy makes to health care, nursing, or health outcomes. Provide support with at least three sources of evidence.
  3. Discuss at least one opposing opinion to the suggested or implemented policy. Provide evidence and/or data to support the counterargument.
  4. Present a final position on the policy. Support the final defensible argument with current literature.
  5. Conclusion:
    A. Restate your argument.
    B. Provide a plan of action, but do not introduce new information. In total, your paper will be 4–5 pages in length, not including the title page or reference page. Assignment: Position Paper On Health Policy

Shadow Health Focused Exams

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  • Complete the ShadowHealth© Focused Exams – Special Populations: Chest Pain, Cough and Abdominal Pain assignments

After you have achieved at least 80% on the assignment(s) download, save and upload your LabPass document to the dropbox.

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Professional Development

  • Write a 500-word APA reflection essay of your experience with the Shadow Health virtual assignment(s). At least two scholarly sources in addition to your textbook should be utilized. Answers to the following questions may be included in your reflective essay:
    • What went well in your assessment?
    • What did not go so well? What will you change for your next assessment?
    • What findings did you uncover?
    • What questions yielded the most information? Why do you think these were effective?
    • What diagnostic tests would you order based on your findings?
    • What differential diagnoses are you currently considering?
    • What patient teaching were you able to complete? What additional patient teaching is needed?
    • Would you prescribe any medications at this point? Why or why not? If so, what?
    • How did your assessment demonstrate sound critical thinking and clinical decision making? Shadow Health Focused Exams

Off Label Drug Use

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Off Label Drug Use

When treating children, prescribers often adjust dosages approved for adults to accommodate a child’s weight. However, children are not just “smaller” adults. Adults and children process and respond to drugs differently in their absorption, distribution, metabolism, and excretion.

Children even respond differently during stages from infancy to adolescence. This poses potential safety concerns when prescribing drugs to pediatric patients. As an advanced practice nurse, you have to be aware of safety implications of the off-label use of drugs with this patient group.

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To Prepare
  • Review the interactive media piece in this week’s Resources and reflect on the types of drugs used to treat pediatric patients with mood disorders.
  • Reflect on situations in which children should be prescribed drugs for off-label use.
  • Think about strategies to make the off-label use and dosage of drugs safer for children from infancy to adolescence. Consider specific off-label drugs that you think require extra care and attention when used in pediatrics.
By Day 5 of Week 11

Write a 1-page narrative in APA format that addresses the following:

  • Explain the circumstances under which children should be prescribed drugs for off-label use. Be specific and provide examples.
  • Describe strategies to make the off-label use and dosage of drugs safer for children from infancy to adolescence. Include descriptions and names of off-label drugs that require extra care and attention when used in pediatrics. Off Label Drug Use

Borderline Case: Ethics of Patient Care

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Borderline Case: Ethics of Patient Care

For this discussion, you will be applying defining attributes to an actual patient case. Please listen to the NPR podcast, “If You Have Dementia, Can You Hasten Death As You Wished?” Additionally, review Wilkinson’s defining attributes (found in the Wilkinson (1997) reading in the Learning Materials section). See attachments.

https://www.npr.org/sections/health-shots/2015/02/10/382725729/if-you-have-dementia-can-you-hasten-death-as-you-wished

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Please respond to the following prompts:

1. Review Wilkinson’s (1997) defining attributes and describe how the NPR podcast, “If You Have Dementia, Can you Hasten Death As You Wished?” case story meets the definition of a borderline case.

2. Describe the ethical issues the case raises.

3. If it were changed to meet criteria for a model case, what ethical issues would come to the forefront?

Your post should contain two to three (2–3) paragraphs with three to four (3–4) sentences per paragraph. The post should integrate a minimum of three readings and/or other evidence-based research articles no more than three years old and use APA formatting for citations and references.

The Moral And Ethical Considerations Of Organ Conscription Policies And Theories

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The Moral And Ethical Considerations Of Organ Conscription Policies And Theories

Scarcity of Medical Resources

For this assessment, you will continue your survey of ethical principles in health care. Especially in our contemporary world, where needs for health care outstrip available resources, we regularly face decisions about who should get which resources. The Moral And Ethical Considerations Of Organ Conscription Policies And Theories

There is a serious shortage of donor organs. Need vastly outstrips supply, due not only to medical advances related to organ transplantation, but also because not enough people consent to be cadaveric donors (an organ donor who has already died). Munson (2014) points out that in the United States, approximately 10,000 patients die each year because an organ donor was not available, which is three times the number of people killed in the terrorist attacks on 9/11.

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But what is an efficient and morally sound solution to this problem? The policy of presumed consent, where enacted, has scarcely increased supply, and other alternatives, such as allowing donors to sell their organs, raise strong moral objections. In light of this, some have advocated for a policy of conscription of cadaveric organs (Spital & Erin, 2002). This involves removing organs from the recently deceased without first obtaining consent of the donor or his or her family. Proponents of this policy argue that conscription would not only vastly increase the number of available organs, and hence save many lives, but that it is also more efficient and less costly than policies requiring prior consent. Finally, because with a conscription policy allpeople would share the burden of providing organs after death and allwould stand to benefit should the need arise, the policy is fair and just.

Demonstration of Proficiency

By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and scoring guide criteria:

  • Competency 1: Articulate ethical issues in health care.
    • Articulate the moral concerns surrounding a policy of organ conscription.
    • Articulate questions about the fairness and justness of organ conscription policy.
    • Explain the relevance and significance of the concept of consent as it pertains to organ donation.
    • Evaluate alternative policies for increasing available donor organs.
  • Competency 5: Communicate in a manner that is scholarly, professional, and respectful of the diversity, dignity, and integrity of others and is consistent with health care professionals.
    • Exhibit proficiency in clear and effective academic writing skills.
References

Munson, R. (2014). Intervention and reflection: Basic issues in bioethics (concise ed.). Boston, MA: Wadsworth.

Spital, A., & Erin, C. (2002). Conscription of cadaveric organs for transplantation: Let’s at least talk about it. American Journal of Kidney Disease, 39(3), 611–615. The Moral And Ethical Considerations Of Organ Conscription Policies And Theories

Instructions

Do you consider the policy of organ conscription to be morally sound?

Write a paper that answers this question, defending that answer with cogent moral reasoning and supporting your view with ethical theories or moral principles you take to be most relevant to the issue. In addition to reviewing the suggested resources, you are encouraged to locate additional resources in the Capella library, your public library, or authoritative online sites to provide additional support for your viewpoint. Be sure to weave and cite the resources throughout your work.

In your paper, address the following:

  • On what grounds could one argue that consent is not ethically required for conscription of cadaveric organs? And on what grounds could one argue that consent is required?
  • Is the policy truly just and fair, as supporters claim? Explain.
  • Do you consider one of the alternative policies for increasing available donor organs that Munson discusses to be preferable to conscription? Explain why or why not.

The Moral And Ethical Considerations Of Organ Conscription Policies And Theories

Case Study Advanced Pharmacology

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Case Study Advanced Pharmacology

Purpose Problem-based learning is a methodology designed to help students develop the reasoning process used in clinical practice through problem-solving actual patient problems in the same manner as they occur in practice. The purpose of this activity is to develop students’ clinical reasoning skills using a case-based learning exercise. Through participation in an online discussion forum, students identify learning issues in a self-directed manner which facilitates learning for the entire group. Activity Learning Outcomes Through this discussion, the student will demonstrate the ability to: Case Study Advanced Pharmacology

  1. Synthesize clinical knowledge, didactic learning and research findings to provide appropriate pharmacological care to primary care patients. (CO 1, 2, 3, 4 & 5)

Case Study & Discussion Questions Claudia (G2P2) is a 36-year-old mother who recently delivered a child 9 months ago. She has been using condoms for birth control for the last 7 months. Today she is requesting a more convenient method of birth control. She is not sure of her current pregnancy plans, however, she does not wish to discuss sterilization or an IUD. She has no religious contraindications for treatment.PMH: positive for mild hypertension with first pregnancy, seasonal allergies.Surgeries: Left inguinal hernia and tonsillectomy.Family history: Mother-HTN; Father-Colon CA (both deceased)Social History: Denies tobacco use, wine one to two glasses a week, denies recreational drugs, exercises twice a week.Drug allergies-Sulfa causes a rash.Current medications-MVI with Fe, Calcium chews, Allegra 10mg daily prn for allergies.Vitals: Height 67 inches, weight 157 pounds, BP 110/75, P 70, R 16. PAP collected today, breast exam WNL, urine pregnancy negative.A physical exam is normal. Case Study Advanced Pharmacology

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  1. What are your treatment goals for Claudia today?
  2. What are two possible medications (in different classes) that you can recommend for Claudia? Please provide a detailed rationale and mechanism of actions for each medication. Make sure that all recommendations are cited with guidelines or scholarly, peer-reviewed articles and always include medication, strength, dosage form, route, frequency, and duration when making recommendations.
  3. Pick one of the medications from your response above and list five (5) patient-centered teaching points to communicate to the patient.
  4. What would your contraceptive choice be if Claudia smoked 10-15 cigarettes per day? Explain your answer.

Case Study Advanced Pharmacology

 

Evidence-Based Practice Proposal – Section E: Implementation Plan

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Evidence-Based Practice Proposal – Section E: Implementation Plan

Evidence-Based Practice Proposal – Section E: Implementation   Plan

In 1,250-1,500 words, provide a description of the methods to be used to implement the proposed solution. Include the following:

1. Describe the setting and access to potential subjects. If there is a need for a consent or approval form, then one must be created. Although you will not be submitting the consent or approval forms in Topic 5 with the narrative, you will include the consent or approval forms in the appendices for the final paper. Evidence-Based Practice Proposal – Section E: Implementation Plan

2. Describe the amount of time needed to complete this project. Create a timeline. Make sure the timeline is general enough that it can be implemented at any date. Although you will not be submitting the timeline in Topic 5 with the narrative, you will include the timeline in the appendices for the final paper.

3. Describe the resources (human, fiscal, and other) or changes needed in the implementation of the solution. Consider the clinical tools or process changes that would need to take place. Provide a resource list. Although you will not be submitting the resource list in Topic 5 with the narrative, you will include the resource list in the appendices for the final paper.

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4. Describe the methods and instruments, such as a questionnaire, scale, or test to be used for monitoring the implementation of the proposed solution. Develop the instruments. Although you will not be submitting the individual instruments in Topic 5 with the narrative, you will include the instruments in the appendices for the final paper.

5. Explain the process for delivering the (intervention) solution and indicate if any training will be needed.

6. Provide an outline of the data collection plan. Describe how data management will be maintained and by whom. Furthermore, provide an explanation of how the data analysis and interpretation process will be conducted. Develop the data collection tools that will be needed. Although you will not be submitting the data collection tools in Topic 5 with the narrative, you will include the data collection tools in the appendices for the final paper.

7. Describe the strategies to deal with the management of any barriers, facilitators, and challenges.

8. Establish the feasibility of the implementation plan. Address the costs for personnel, consumable supplies, equipment (if not provided by the institute), computer-related costs (librarian consultation, database access, etc.), and other costs (travel, presentation development). Make sure to provide a brief rationale for each. Develop a budget plan. Although you will not be submitting the budget plan in Topic 5 with the narrative, you will include the budget plan in the appendices for the final paper.

9. Describe the plans to maintain, extend, revise, and discontinue a proposed solution after implementation.

You are required to cite five to 10 sources to complete this assignment. Sources must be published within the last 5 years and appropriate for the assignment criteria and nursing content.

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

Evidence-Based Practice Proposal – Section E: Implementation Plan

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

All my papers for this class will be based on the below PICOT statement. This is one paper.  Evidence-Based Practice Proposal – Section E: Implementation Plan

PICOT Statement

(P) – Population/ problem:There has been an increase case of death among Asian Americans due to cancer.

(I) – Intervention: Reliable policy, procedure establishment and provision of necessary education to address the problem of cancer are important factors. The government should make sure there are credible institutions to train nursing professionals. The government should also make sure there are adequate public awareness classes given to ensure general population has adequate knowledge about the disease process.

(C) – Americans born and raised in united states.

(O) The above intervention will help to fight against cancer in early detection and curb its spread. Government organizations and non government organizations should work in collaboration with the public and the society to make sure the problem of cancer is addressed and public is educated about the early detection and treatment modalities.

(T) – one year Evidence-Based Practice Proposal – Section E: Implementation Plan

Nursing Multidimensional Care2

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Nursing Multidimensional Care2

Module 05 Written Assignment – Acid-Base Imbalance

Competency

Describe strategies for safe, effective multidimensional nursing care for clients with acid-base imbalances.

Scenario

Tony is a 56-year-old, Hispanic male that presented to the Emergency Room with complaints of shortness of breath, which he has been experiencing for the past two days. He states “I haven’t felt good for about a week, but couldn’t afford to miss work.” He complains of a cough, fever, and feeling exhausted. Past medical history includes asthma, chronic obstructive pulmonary disease and diabetes. Upon physical examination, you notice that Tony is struggling to breathe, his respiratory rate is 36 breaths per minute and labored, heart rate 115 beats per minute, blood pressure 90/40 mm Hg, and his pulse oximetry is 84% on room air. You notify the MD. He orders oxygen at 4 L via NC and an arterial blood gas. Nursing Multidimensional Care2

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Tony’s ABG results:

pH 7.28
PaCO2 – 55 mm Hg
PaO2 – 70 mm Hg
HCO3 – 30 mEq/L

Instructions

In a 1-2 page Word document:

  1. Determine Tony’s acid-base imbalance
  2. Describe possible causes of the imbalance
  3. Identify the signs and symptoms that Tony is exhibiting as a result of the acid-base imbalance
  4. List the multidimensional care strategies that are appropriate for the care of Tony

Resources

For assistance with citations, refer to the APA Guide.

For assistance with research, refer to the Nursing Research Guide. Nursing Multidimensional Care2

Differential Diagnosis For Skin Conditions

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Differential Diagnosis For Skin Conditions

Also, for the skin disorder, you will chose a skin disorder,  You will give CC one sentence.  HPI   example:     A 75 yo woman presents today with itchy red rash.  Give location, description, onset, assorciating or alleviating factors.    You can also use the soap note template that is attached  as guide, PMH, allergies, meds. ROS  ect.    Please let me know if you have any questions or concerns.

  • Your soap note template can also be found in the resource under week 4 which is to the right of the page. One can chose which ever picture. Download the SOAP Template found in this week’s Learning Resources, and use this template to complete this Lab Assignment. Differential Diagnosis For Skin Conditions

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The Lab Assignment

  • Choose one skin condition graphic (identify by number in your Chief Complaint) to document your assignment in the SOAP (Subjective, Objective, Assessment, and Plan) note format rather than the traditional narrative style. Refer to Chapter 2 of the Sullivan text and the Comprehensive SOAP Template in this week’s Learning Resources for guidance. Remember that not all comprehensive SOAP data are included in every patient case.
  • Use clinical terminologies to explain the physical characteristics featured in the graphic. Formulate a differential diagnosis of three to five possible conditions for the skin graphic that you chose. Determine which is most likely to be the correct diagnosis and explain your reasoning using at least three different references, one reference from current evidence-based literature from your search and two different references from this week’s Learning Resources. Also, please access your grading rubric..
By Day 7 of Week 4

soap note template.docx

Properly identifying the cause and type of a patient’s skin condition involves a process of elimination known as differential diagnosis. Using this process, a health professional can take a given set of physical abnormalities, vital signs, health assessment findings, and patient descriptions of symptoms, and incrementally narrow them down until one diagnosis is determined as the most likely cause.

In this Lab Assignment, you will examine several visual representations of various skin conditions, describe your observations, and use the techniques of differential diagnosis to determine the most likely condition.

To Prepare

  • Review the Skin Conditions document provided in this week’s Learning Resources, and select one condition to closely examine for this Lab Assignment.
  • Consider the abnormal physical characteristics you observe in the graphic you selected. How would you describe the characteristics using clinical terminologies?
  • Explore different conditions that could be the cause of the skin abnormalities in the graphics you selected.
  • Consider which of the conditions is most likely to be the correct diagnosis, and why.
  • Search the Walden library for one evidence-based practice, peer-reviewed article based on the skin condition you chose for this Lab Assignment.
  • Review the Comprehensive SOAP Exemplar found in this week’s Learning Resources to guide you as you prepare your SOAP note.
  • Download the SOAP Template found in this week’s Learning Resources, and use this template to complete this Lab Assignment. Differential Diagnosis For Skin Conditions

The Lab Assignment

  • Choose one skin condition graphic (identify by number in your Chief Complaint) to document your assignment in the SOAP (Subjective, Objective, Assessment, and Plan) note format rather than the traditional narrative style. Refer to Chapter 2 of the Sullivan text and the Comprehensive SOAP Template in this week’s Learning Resources for guidance. Remember that not all comprehensive SOAP data are included in every patient case.
  • Use clinical terminologies to explain the physical characteristics featured in the graphic. Formulate a differential diagnosis of three to five possible conditions for the skin graphic that you chose. Determine which is most likely to be the correct diagnosis and explain your reasoning using at least three different references, one reference from current evidence-based literature from your search and two different references from this week’s Learning Resources. Differential Diagnosis For Skin Conditions