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NURS 621

Guidelines -Culturally Sensitive Population Care Management Plan Paper

Overview of paper’s purpose:It is now time to bring the information together that you have learned over the semester and to develop a culturally sensitive population care management plan to address a specific mental health care disparity for the specific population that you select.

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In this paper, you will begin to bridge the gap between identifying a mental health care disparity and taking an action step forward to design a plan to correct it.  The purpose of this plan is to present to three (3) organizations or leaders for implementation.  In your written plan you will include three (3) possible funding organizations that you will seek to support your plan.  In the future,you will be able to present this plan to organizations and or leaders that you think would be interested in partnering with you to implement the plan and address the mental health care disparity. Nursing homework help

Helpful Tips: Below are some helpful tips and a template for you to use when you develop your paper.  It is very important that you use the template headings and address the specific information under each heading.

  • Make sure to set the paper up in APA format and provided a cover page with the title of your paper, your name, the course number, and your professor’s name
  • Make sure each page has a page number on it Nursing homework help
  • Make sure the reference page begins on a separate page and is double spaced
  • Check your paragraph structure and make sure you have at least 3 sentences in a paragraph and no more than 5-6 sentences

 

Template with section headings:

Assignment # 3: Culturally Sensitive Population Care Management Plan for an Underserved Community(10-12 pages excluding title page and references and appendix with list of organizations and links)

  1. Overview of population: includes RECENT demographic information on the estimated number of individuals in the community, the age range of this population, and a description of the environment they live in; provides 3 examples of cultural values and practices that impact the chosen population when a member seeks mental health care services and follows the health care providers’ instructions; includes 3 information examples on this population’s perceived value of health and access to mental health care; describe if members of this population arewilling to pay for mental health care services or mental health care insurance or if they believe it should be provided to them at no cost.
  2. Mental health disparity that needs to be addressed:describe, using RECENT (not older than 5 years) available peer-reviewed evidence, a specific mental health care disparity in this population; three (3) causes of the disparity, and what initiatives have taken place to address the disparity (including what has worked and what has not worked). Describe what needs to be done now and in the future to address this mental health disparity.
  3. Cultural competency model being applied and cultural considerations when planning care to address the mental health disparity: apply three (3) concepts from the chosen cultural competency model when conducting the assessment for mental health disparities in this patient population. Describe how you conducted the assessment of the cultural values and norms of this population using the cultural competency model.
  4. Strategies for eliminating mental health disparity: describe five (5) evidence-based strategies for eliminating the identified mental health disparity
  5. Proposed care management plan and implementation steps:describe the care management plan and at least six (6) specific steps that need to be taken to implement this plan. Include who will be carrying out the specific implementation steps and the timeline for completing the steps.
  6. Organizations to consider for grant funding:provide three (3) names of organizations that you can apply for grant funding to support implementing your Population Care Management Plan; include information on the title of the grant being applied for and a link to the grant guidelines from each of the organizations in the appendix.
  7. Measuring outcomes on mental health care disparity post implementation of care management plan:describe three (3) specific measurable outcomes to evaluate the plan’s success after implementation; describe who will collect, synthesize, create the outcomes report, and distribute the data. Determine and describe the specific tools that will be used to collect data, who will collect the data, and three (3) distribution channels that you will use to disseminate the findings
  8. Summary: 2-3 paragraphs summarizing each of the prior sections to use as an executive

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Number 1 post: PA

 

Q1. Which classes of diabetes medications are either weight neutral or cause weight loss? Please give one (1) example of a drug’s generic and trade name in that class.

Type 2 diabetes (T2D) has been recognized as a bi hormonal disorder, with insulin and glucagon exerting opposite effects on glucose metabolism. Lang, et al., (2015). GLP-1-based diabetes therapies affect glucose control through several mechanisms, including slowed gastric emptying, regulation of postprandial glucagon, reduction of food intake, and enhancement of glucose-dependent insulin secretion without the risk of hypoglycemia. Chia-Hung, et al., (2015). One of the medications in the GLP-1 class is Exenatide with a generic name Byetta. In clinical trials, Sub Q injection of Exenatide (Byetta) 5 or 10ug was taken twice daily before the two largest meals of the day produced a modest decrease in fasting blood glucose and a large decrease in postprandial blood glucose. However, patients did not gain any weight and much lost weight. Rosenthal, & Burchum (2021). Nursing homework help

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Q2. Based on the current guidelines of the ADA, it would be appropriate to treat her with monotherapy since the patient is hesitant to take any injections. What agent would you recommend? Please provide the trade name, generic name, the dose you would start the patient with frequency, and route.

It is appropriate to treat this patient with monotherapy. Metformin is a first-line treatment for T2DM that has been used for over 60 years. Upon ingestion, approximately 50% of metformin is absorbed primarily from the duodenum and jejunum, and systemically available metformin is renally excreted unchanged. Henry. (2018).

I would recommend Metformin since it is the first-line therapy for Type 2 diabetes, it is  a medication in the drug class of Biguanide with a generic name Metformin (Glucophage). Patient will take 500 mg/tablet, once a day, taken orally with food. Nursing homework help

Q3. What are the contraindications of your selected diabetic therapy?

Liver and renal dysfunction and heart failure and severe metabolic acidosis for the patient with significant renal impairment. Rosenthal, & Burchum. (2021).

The patient returns to your office six months later complaining of fatigue for the past two months, constipation, and heavy, irregular menses. Upon examination, you note that her skin is dry, and her fingernails are brittle. You suspect she has hypothyroidism.

Q4. What lab workup should you obtain? What sort of results will you see in patients who have hypothyroidism and hyperthyroidism?

The lab work-up I will obtain during this patient visit will be her thyroid hormone test. Which include: TSH (thyroid-stimulating hormone), T4 (Thyroxine). Free T4 is preferred and Free T3 (Triiodothyronine).  TSH, T3, and T4 can be used to diagnose, monitor, and treat thyroid disorders. Low T3, T4, and high TSH levels are seen with hypothyroidism, whereas high freeT3, T4, and Low TSH levels may indicate hyperthyroidism.

Q5. What is the treatment of choice for hypothyroidism? What is the mechanism of action? Please provide the initial dose, trade, and generic name of the drug, route, and frequency.

I will prescribe medication with the brand name Synthroid and a generic (Levothyroxine)50mcg PO daily with a max dose of 300mcg/day. Levothyroxine is the most used medicine. Hypothyroidism (2018). Levothyroxine increases metabolic rate, decreases thyroid-stimulating hormone (TSH) production from the anterior lobe of the pituitary gland, and, in peripheral tissues, is converted to T3. Thyroxine is released from its precursor protein thyroglobulin through proteolysis and secreted into the blood where is it then peripherally deiodinated to form triiodothyronine (T3) which exerts a broad spectrum of stimulatory effects on cell metabolism. (Physiology, Thyroid Stimulating Hormone Pirahanchi).

Q6. What are the adverse effects, and what important teaching will you provide this patient on thyroid replacement therapy?

Side effects include fever, hot flashes, sensitivity to heat, sweating, headache, nervousness, irritability, nausea, sleep problems (insomnia).

Patient will be informed that she will be prescribed the lowest dose possible that relieves her symptoms and brings her blood hormone levels back to normal. When starting on this medicine, the doctor may check the hormone levels every 2 to 3 months. After that, her thyroid hormone levels should be monitored at least once every year. Patients will be told not to stop taking the medicine even when she feels better, she needs to continue taking it exactly as the doctor prescribed. Thyroid medicine works best on an empty stomach and is taken 1 hour before any other medicines. I will also inform the patient that it may take one to three weeks after initiating therapy with levothyroxine or changing the dose before the effects are seen.

 

 

Number 2 post: BP

DM
Q1. Classes of DM medications that increase weight loss are identified as GLP-1-RA and SGL2. An example of a GLP1-RA is Semaglutide with the brand name Ozempic (Higbea et al., 2017). An example of an SGL2 drug would be Empagliflozin sold as the brand name Jardiance (Higbea et al., 2017). Weight neutral DM medications include drugs such as Biguanides and DDP4i medications (Higbea et al., 2017). Biguanides include medications such as Glucophage which goes by the generic name Metformin. DDP4i medications include drugs such as sitagliptin, the brand name Januvia (Higbea et al., 2017).

Q2. The American Diabetes Association defines a hgbA1C above 6.5% as Diabetic (American Diabetes Association, 2022). The patient’s hgbA1C is 8.4% which requires treatment (American Diabetes Association, 2022). The American Diabetes Association would suggest Metformin and lifestyle changes for this patient. Glucophage that goes by the generic name Metformin. Starting dose for this patient would be 500mg PO once daily (Lexicomp, 2021).

Q3. Precautions for this drug include decreased absorption post-bariatric surgery, renal impairment, hepatic impairment, heart failure, and increased stress levels (Lexicomp, 2021). Metformin products should be temporarily held for surgical procedures and studies using Iodine contrast, and the black box warning includes Lactic Acidosis (Lexicomp, 2021).

Thyroid
Q1. The preferred test to run is a TSH (thyroid-stimulating hormone) level. The anterior pituitary is sensitive to changes in serum t3 and serum t4 levels, which can cause a rise in TSH levels (Rosenthal & Burcham, 2021). Other tests include the “serum thyroxine test” which measures T4 levels, both free and total (Rosenthal & Burcham, 2021). In addition, the “Serum Triiodothyronine Test” measures T3 levels free and total (Rosenthal & Burcham, 2021). Normal TSH levels range from 0.3-6, over 6 is reflective of hypothyroidism, and under 0.3 is indicative of hyperthyroidism (Rosenthal & Burcham, 2021). Hypothyroidism would include total T4 under 4.5, free T4 under 0.9, total T3 under 80, and free T3 under 230 (Rosenthal & Burcham, 2021). Hyperthyroidism would include ranges such as total T4 over 12.5, free T4 over 2, total T3 over 220, and free T3 over 620 (Rosenthal & Burcham, 2021).

Q2. The treatment of choice for Hypothyroidism is Levothyroxine also known as Synthroid (brand name). Hypothyroidism results in insufficient secretion of thyroid hormones including T4 (Correa &Eghtedari, 2021). Levothyroxine is the synthetic version of thyroid hormone T4. In a normally functioning thyroid, the anterior pituitary secretes TRH (thyroid- releasing hormone). TRH stimulates TSH (thyroid-stimulating hormone) which in turn stimulates the release of T4 (Correa &Eghtedari, 2021). T4 is then converted to T3 which is responsible for metabolism, cardiac function, and development (Rosenthal & Burcham, 2021). The starting dose of Levothyroxine is 1.6 mg/kg per day PO in the morning. Follow up with labs and titrate does up as necessary based on TSH levels.

Q3. Although side effects are rare, severe adverse reactions such as toxicity can occur which can include tachycardia, angina, tremor, nervousness, and insomnia (Rosenthal & Burcham, 2021). Patient teaching should include notifying the provider of any of these signs and symptoms. Toxicity is treatable with Cholestyramine, glucocorticoids, or PTU (Rosenthal & Burcham, 2021). Certain drugs accelerate the metabolism of Levothyroxine such as certain seizure medications and Zoloft (Rosenthal & Burcham, 2021). Levothyroxine increases the breakdown of Vitamin K (Rosenthal & Burcham, 2021). Therefore it should be used with caution for patients on Warfarin. It also increases the effects of catecholamines, increasing the risk for arrhythmia (Rosenthal & Burcham, 2021). It can also increase insulin and digoxin needs(Rosenthal & Burcham, 2021). Patients must understand that this medication cannot be skipped or discontinued without instructions and monitoring from a healthcare provider (Lexicomp, 2021). Education regarding medication administration includes taking medication on an empty stomach 30-60m before food in the morning, and 4hrs between calcium or iron-containing products (Lexicomp, 2021). It must be taken at the same time every day.

 

 

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Episodic/Focused SOAP Note Template

 

Patient Information:

Initials, Age, Sex, Race

S.

CC (chief complaint) a BRIEF statement identifying why the patient is here – in the patient’s own words – for instance “headache”, NOT “bad headache for 3 days”.

HPI: This is the symptom analysis section of your note. Thorough documentation in this section is essential for patient care, coding, and billing analysis. Paint a picture of what is wrong with the patient. Use LOCATES Mnemonic to complete your HPI. You need to start EVERY HPI with age, race, and gender (e.g., 34-year-old AA male). You must include the seven attributes of each principal symptom in paragraph form not a list. If the CC was “headache”, the LOCATES for the HPI might look like the following example:

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Location: head Nursing homework help

Onset: 3 days ago

Character: pounding, pressure around the eyes and temples

Associated signs and symptoms: nausea, vomiting, photophobia, phonophobia

Timing: after being on the computer all day at work

Exacerbating/ relieving factors: light bothers eyes, Aleve makes it tolerable but not completely better Nursing homework help

Severity: 7/10 pain scale

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

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

PMHx: include immunization status (note date of last tetanus for all adults), past major illnesses and surgeries. Depending on the CC, more info is sometimes needed

Soc Hx: include occupation and major hobbies, family status, tobacco & alcohol use (previous and current use), any other pertinent data. Always add some health promo question here – such as whether they use seat belts all the time or whether they have working smoke detectors in the house, living environment, text/cell phone use while driving, and support system.

Fam Hx: illnesses with possible genetic predisposition, contagious or chronic illnesses. Reason for death of any deceased first degree relatives should be included. Include parents, grandparents, siblings, and children. Include grandchildren if pertinent.

ROS: cover all body systems that may help you include or rule out a differential diagnosis You should list each system as follows: General: Head: EENT: etc. You should list these in bullet format and document the systems in order from head to toe.

Example of Complete ROS:

GENERAL:  Denies weight loss, fever, chills, weakness or fatigue.

HEENT:  Eyes: Denies visual loss, blurred vision, double vision or yellow sclerae. Ears, Nose, Throat:  Denies hearing loss, sneezing, congestion, runny nose or sore throat.

SKIN:  Denies rash or itching.

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

RESPIRATORY:  Denies shortness of breath, cough or sputum.

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

GENITOURINARY:  Burning on urination. Pregnancy. Last menstrual period, MM/DD/YYYY.

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

MUSCULOSKELETAL:  Denies muscle, back pain, joint pain or stiffness.

HEMATOLOGIC:  Denies anemia, bleeding or bruising.

LYMPHATICS:  Denies enlarged nodes. No history of splenectomy.

PSYCHIATRIC:  Denies history of depression or anxiety.

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

ALLERGIES:  Denies history of asthma, hives, eczema or rhinitis.

O.

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

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

A.

Differential Diagnoses (list a minimum of 3 differential diagnoses).Your primary or presumptive diagnosis should be at the top of the list. For each diagnosis, provide supportive documentation with evidence based guidelines.

This section is not required for the assignments in this course (NURS 6512) but will be required for future courses.

References

You are required to include at least three evidence based peer-reviewed journal articles or evidenced based guidelines which relates to this case to support your diagnostics and differentials diagnoses. Be sure to use correct APA 7th edition formatting.

 

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Discussion 2: Your Leadership Profile Nursing homework help

Do you believe you have the traits to be an effective leader? Perhaps you are already in a supervisory role, but as has been discussed previously, appointment does not guarantee leadership skills. Nursing homework help

How can you evaluate your own leadership skills and behaviors? You can start by analyzing your performance in specific areas of leadership. In this Discussion, you will complete Gallup’s StrengthsFinder assessment. This assessment will identify your personal strengths, which have been shown to improve motivation, engagement, and academic self-conference. Through this assessment, you will discover your top five themes—which you can reflect upon and use to leverage your talents for optimal success and examine how the results relate to your leadership traits. Nursing homework help

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To Prepare:

Complete the StrengthsFinder assessment instrument, per the instructions found in this Module’s Learning Resources. (Repost is attached for you to use for this assignment)

  • Once you have completed your assessment, you will receive your “Top 5 Signature Themes of Talent” on your screen. (Repost is attached for you to use for this assignment)
  • Click the Download button below Signature Theme Report, and then print and save the report. We also encourage you to select the Apply tab to review action items. (Repost is attached for you to use for this assignment)

NOTE: Please keep your report. You will need your results for future courses. Technical Issues with Gallup:

If you have technical issues after registering, please contact the Gallup Education Support group by phone at +1.866-346-4408. Support is available 24 hours/day from 6:00 p.m. Sunday U.S. Central Time through 5:00 p.m. Friday U.S. Central Time.

  • Reflect on the results of your Assessment, and consider how the results relate to your leadership traits.
  • Download your Signature Theme Report to submit for this Discussion.

By Day 3 of Week 5

Post a brief description of your results from the StrengthsFinder assessment. Then, briefly describe two core values, two strengths, and two characteristics that you would like to strengthen based on the results of your StrengthsFinder assessment. Be specific. Note: Be sure to attach your Signature Theme Report to your Discussion post.

 

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Part III: Synthesis of Findings

Synthesis of Findings

Describe the Rationale/Mechanism for how/why Finding of each intervention/factor helps your Research Question (i.e. how/what mechanism does music therapy help pain, how does sucking stimulation increase oral intake for pre-term infants)

Should NOT repeat same contents you had on Findings section and/or article Nursing homework help

May include citations from other sources for above-described rationale/mechanism (i.e. textbooks, CDC…etc)

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Nursing Implications

How the nurses can implement the research findings into nursing practice.

 

Group Article Summary Table (All group members)

Describe each group member’s article on Research Article Summary Table.

Use bullet points for each category. Nursing homework help

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Grading Rubric&Description for IAPRA

Part I (80)
Research Question 5 ·  Accurately/Clearly states group’s Research Question as your group formulated
Purpose of Study 5 · Describe the purpose of the study as the author stated in the article.

§ Do NOT change or modify the statement on the article
Variables 10

 

 

 ·  Identify study variables from the above stated Purpose of Study

§ Quantitative Study: Dependent & Independent variables

OR

§ Descriptive, Qualitative Study: Variables of Interest
Participants 5

5

5

 ·  Enrollment: How did they recruit eligible participants in the study?

·  Eligibility: Describe Inclusion & Exclusion Criteria

·  Numbers: Total numbers of participants in the study
Intervention Procedures

 

 

 

 

 

 

Obtaining Information Procedures

 

 

 35 Quantitative Study:

·   Intervention Group: Describe the detailed Intervention contents, procedures, and person who provided Intervention for Intervention group.

·   Control Group: Describe the detailed contents, procedures, and person who provided contents for Control group

OR
Descriptive Study:

·  Describe the detailed procedure for obtaining information/data (i.e. made appointment to meet each participant, visited home/met clinical……etc)
Format 10 Followed APA format for paper and in-text citations
Part II (75)
Data Collection

 

Measurement Tools

 5

 

25

 ·  Describe ALL data collection methods in detail (i.e. survey, interview, observation)

·  Describe each measurement tool/instrument used to measure study outcomes in detail.
Participant Characteristics/Sociodemographic Findings

 

 

 

All other Results/Findings

 10

 

 

 

 

 

25

 

 

 

 

 

 

 

 

 ·   Must be descriptive and comprehensive

·   Describe participant characteristics or sociodemographic findings

·   Describe the findings of Tables/Figures to provide comprehensive information about participant characteristics as article provided

 

 

·   Describe ALL Other Results/Findings besides above participant characteristics in the article in detail for each Result item

·    Each Result item may include Headings/Subheadings of Results as the article provided.

·    Do NOT simply saying “pain level was decreased,” “adherence was increased” – provide numbers or % if available

·    Do NOT include contents from Discussion and/or Conclusion in the article.
Format 10 ·   Followed APA format for paper and in-text citations
 

Part III (45)
Synthesis of Findings

 

 10 ·   Describe the Rationale for how/why Finding of each intervention/factor helps your Research Question (i.e. how or by what mechanism doesmusic therapy help pain? How does sucking stimulation increase oral intake for pre-term infants?)

·   Should NOT repeat same contents you had on Findings section and/or article

·   Should have citation of analyzed article(s)

·   May include citations from other sources for above described rationale and mechanism (i.e. textbooks, CDC…etc)
Nursing Implication 7 ·   How can nurses implement the research findings into nursing practice?
Format 3 ·  Followed APA format for paper, in-text citation, references.
Article Summary Table (Group) 25 ·  Describe article on Research Article Summary Table

·  Use bullet points for each column in the Table

·  Submit Table as separate document

 

Total Points: 200 Points

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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Diversity Module 2: Discussion

Overview

For this discussion, first, read chapters 3, 5, and 6 in your textbook, Transcultural Concepts in Nursing Care, Cultural Competence in Nursing and Cultural Competence or Cultural Humility? Moving Beyond the Debate.  Nursing homework help

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Then, address the following questions:

  1. In your own words, define cultural competence.
    2. In your own words, define cultural humility.
    3. Do you feel culturally competent or culturally humble when taking care of your patients or dealing with families or communities? Why?
    4. Choose an example of a time you had to overcome a cultural barrier in your nursing practice. What was the issue? What did you do to overcome the issue?

Your initial post must be posted before you can view and respond to colleagues, must contain minimum of two (2) references, in addition to examples from your personal experiences to augment the topic. The goal is to make your post interesting and engaging so others will want to read/respond to it. Synthesize and summarize from your resources in order to avoid the use of direct quotes, which can often be dry and boring. No direct quotes are allowed in the discussion board posts.

Post a thoughtful response to at least two (2) other colleagues’ initial postings. Responses to colleagues should be supportive and helpful (examples of an acceptable comment are: “This is interesting – in my practice, we treated or resolved (diagnosis or issue) with (x, y, z meds, theory, management principle) and according to the literature…” and add supportive reference. Avoid comments such as “I agree” or “good comment.” Nursing homework help

 

Points: 30

Due Dates:

  • Initial Post: Fri, April 1 by 11:59 p.m. Eastern Standard Time (EST) of the US.
  • Response Post: Sun, April 3 by 11:59 p.m. Eastern Standard Time (EST) of the US – (the response posts cannot be done on the same day as the initial post).

References:

  • Initial Post: Minimum of two (2) total references: one (1) from required course materials and one (1) from peer-reviewed references.
  • Response posts: Minimum of one (1) total reference: one (1) from peer-reviewed or course materials reference per response.

Words Limits

  • Initial Post: Minimum 200 words excluding references (approximately one (1) page)
  • Response posts: Minimum 100 words excluding references.

 

Note: Since it is difficult to edit the APA reference in the Blackboard discussion area, you can copy and paste APA references from your Word document to the Blackboard discussion area.  Points will not be deducted because of format changes in spacing.

 

Instructions

To be successful, complete the following steps in order:

STEP 1. Review the instructional materials and finish learning activities for this module.

STEP 2. Click here to download the rubric.

STEP 3. Create a new Word document, type your initial post.

STEP 4. Copy the initial post from the Word document.

STEP 5. Click on the “Click to Launch” link OR on the “DISCUSSIONS” tab located on the left-hand side of your screen in Blackboard.

STEP 6. Post in the discussion forum titled “M2 A3 DB: “CULTURAL COMPETENCY VS. CULTURAL HUMILITY”

 

Got questions? Please post them to the ‘QUESTION & ANSWER FORUM’ in Blackboard.

 

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Writing for Nursing/ Module 4 Discussion

Overview

One of the tasks that health care professionals perform is that of translating health care information so laypersons can understand that information.  All too frequently we forget that what is everyday language to us is as foreign as Klingon (Star Trek) or Sindarin (Lord of the Rings) to others.  It is our responsibility to convey health information so it can be understood.  The task in this assignment is to review an article (one you have used in a previous assignment) and create an explanation of that article that would be understood by a layperson. Nursing homework help

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Some useful material can be found in the Module 4 Instructional Materials folder.

are required for the initial post; one can be the ACOG article. The initial post is to be 250-300 words in length.

Instructions

  1. Read the ACOG article(Committee on Health Care for Underserved Women) also found in the Instructional Materials folder in Module 3.
    2.    Provide an explanation of the relationship between the social determinants of health and cultural awareness in the delivery of health care.  This explanation must be tailored to the understanding of a layperson.
    3. The initial post explanation needs to be between 250-300 words in length.
    4. A minimum of one (1) reference is required for the initial post.  This reference will be in addition to any reference you wish to use from the ACOG article.  It is okay to use textbook material to support points in the discussion, but it does not count towards the required minimum reference. Nursing homework help
    5. As with the other discussion boards you need to respond to two (2) peers.  The responses must be between 150-200 words each.  Remember that the responses cannot be posted on the same day that you post the initial post.
  • To post the discussion board click on the “Click to Launch” link OR on the on “Discussions” tab in the menu bar on the left-hand side of the Blackboard screen. Post the material in the forum titled “M2-A3 Social Determinants of Health in the US”

Due date:

  • The initial post is due by 11:59 PM EST on the Friday of the relevant week of class. There is a 10% deduction for each day a post is late until 11:59 PM EST Sunday. for the post.
  • The responses to peers must be posted by 11:59 PM EST Sunday.  No posts will be accepted after this time.
  • Any material posted after 11:59 PM EST on the relevant Sunday will be zero (0) points.

Refer to Rubric for evaluation guidelines

Sample Student Posting

  • Click on “DISCUSSIONS” section located on the left-hand side of your screen in Blackboard
    Post in the discussion forum titled “M4-A3 DB EXPLANATION FOR LAYPERSON”.
  • Point value: 20
  • Due Date: See Course Calendar/Checklist

Writing for Nursing/ Module 4

Book Chapters:

DeSilva, M., Hamlin, A., Naas, J., Rubio, C., Savage, M., Merck, B., & Gross, A. (2017). Technical writing. Chapter 2. Open Oregon Educational Resources. https://openoregon.pressbooks.pub/technicalwriting/

Malka, S.T., Kessler, C. S., Abraham, J., Emmet, T. W., & Wilbur, L. (2015). Professional e-mail communication among health care providers: Proposing evidence-based guidelines. Academic Medicine, 90(1), 25-29. https://doi.org/10.1097/ACM.0000000000000465

Click here to download the article Nursing homework help

University of Minnesota (2015). Writing for success. Click here to download the pdf. Chapter 9 Developing a strong, clear thesis statement, pp. 342-371

Videos:

Social Determinants of Health

Watch Video

YouTube URL: http://www.youtube.com/watch?v=8PH4JYfF4Ns

Other Documents:

Centers for Disease Control and Prevention. (2009). Simply put: A guide for creating easy-to-understand materials. Centers for Disease Control and Prevention.

Click here to download the document

University of Birmingham. (2015). A short guide to reflective writing.

Click here to download the document

University of Salford Manchester. (2016). Reflective writing.

Click here to download the document

Structure of the Social Determinants Of Health Impact Anaylsis Assignment

Click here to download the document.

 

 

Health Literacy

https://www.cdc.gov/healthliteracy/shareinteract/TellOthers/html

https://www.cdc.gov/healthliteracy/learn/index.html/

Potentially useful fact from several sources: The general population in the United States best understands material written between the sixth and eighth grade level.

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Introductions

Nordquist, R. (2018, July 5). Examples of great introductory paragraphs.  https://www.thoughtco.com/introductory-paragraph-essays-and-reports-1691081

The Writing Center. (2018). Introductions.  https://writingcenter.unc.edu/tips-and-tools/introductions/

Nursing homework help

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Nursing homework help

CASE STUDY 1: Focused Throat Exam

 

Lily is a 20-year-old student at the local community college. When some of her friends and classmates told her about an outbreak of flu-like symptoms sweeping her campus during the past 2 weeks, Lily figured she shouldn’t take her 3-day sore throat lightly. Your clinic has treated a few cases similar to Lily’s. All the patients reported decreased appetite, headaches, and pain with swallowing. As Lily recounts these symptoms to you, you notice that she has a runny nose and a slight hoarseness in her voice but doesn’t sound congested. Nursing homework help

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Using the Episodic/Focused SOAP Template:
· Create documentation or an episodic/focused note in SOAP format about the patient in the case study to which you were assigned.

·  Provide evidence from the literature to support diagnostic tests that would be appropriate for your case.—

  • List five different possible conditions for the patient’s differential diagnosis, and justify why you selected each.—

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 are provided that delineate all required criteria.—

Written Expression and Formatting – English writing standards:
Correct grammar, mechanics, and proper punctuation—

Written Expression and Formatting – The paper follows correct APA format for title page, headings, font, spacing, margins, indentations, page numbers, running heads, parenthetical/in-text citations, and reference list.—

Using the Episodic/Focused SOAP Template:
· Create documentation or an episodic/focused note in SOAP format about the patient in the case study to which you were assigned.

·  Provide evidence from the literature to support diagnostic tests that would be appropriate for your case.—

  • List five different possible conditions for the patient’s differential diagnosis, and justify why you selected each.—

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 are provided that delineate all required criteria.—

Written Expression and Formatting – English writing standards:
Correct grammar, mechanics, and proper punctuation—

Written Expression and Formatting – The paper follows correct APA format for title page, headings, font, spacing, margins, indentations, page numbers, running heads, parenthetical/in-text citations, and reference list.—5 APA citations

Week 4

Skin Comprehensive SOAP Note Template

 

Patient Initials: _______                 Age: _______                                   Gender: _______

 

 

SUBJECTIVE DATA:

 

Chief Complaint (CC):

 

History of Present Illness (HPI):

 

Medications:

 

Allergies:

 

Past Medical History (PMH):

 

Past Surgical History (PSH):

 

Sexual/Reproductive History:

 

Personal/Social History:

 

Health Maintenance:

 

Immunization History:

 

Significant Family History:

 

Review of Systems:

 

General:

            HEENT:

            Respiratory:

            Cardiovascular/Peripheral Vascular:

            Gastrointestinal:

            Genitourinary:

            Musculoskeletal:

            Neurological:

            Psychiatric:

            Skin/hair/nails:

 

 

OBJECTIVE DATA:

 

Physical Exam:

Vital signs:

General:

HEENT:

Neck:

Chest/Lungs:.

Heart/Peripheral Vascular:

Abdomen:

Genital/Rectal:

Musculoskeletal:

Neurological:

Skin:

 

Diagnostic results:

 

ASSESSMENT:

 

PLAN: This section is not required for the assignments in this course (NURS 6512), but will be required for future courses. Nursing homework help

 

Nursing homework help

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Nursing homework help

Use the Episodic/Focused SOAP Template and create an episodic/focused note about the patient in the case study to which you were assigned using the episodic/focused note template provided in the Week 5 resources. Provide evidence from the literature to support diagnostic tests that would be appropriate for each case. List five different possible conditions for the patient’s differential diagnosis and justify why you selected each. Nursing homework help

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Case Study 2: Focused Thyroid Exam

Kali, a 44 year old female is in the office for a complete physical examination. She complains of proptosis and feeling fatigued. Her TSH levels are elevated, she has hyperlipidemia, her neck appears swollen, and is overweight. Nursing homework help

 

Episodic/Focused SOAP Note Exemplar

Focused SOAP Note for a patient with chest pain

S.
CC: “Chest pain”

HPI: The patient is a 65 year old AA male who developed sudden onset of chest pain, which began early this morning.  The pain is described as “crushing” and is rated nine out of 10 in terms of intensity. The pain is located in the middle of the chest and is accompanied by shortness of breath. The patient reports feeling nauseous. The patient tried an antacid with minimal relief of his symptoms.

 

Medications: Lisinopril 10mg, Omeprazole 20mg, Norvasc 5mg

PMH: Positive history of GERD and hypertension is controlled

FH: Mother died at 78 of breast cancer; Father at 75 of CVA.  No history of premature cardiovascular disease in first degree relatives.

SH : Negative for tobacco abuse, currently or previously; consumes moderate alcohol; married for 39 years

 

Allergies: PCN-rash; food-none; environmental- none

 

Immunizations: UTD on immunizations, covid vaccine #1 1/23/2021 Moderna; Covid vaccine #2 2/23/2021 Moderna

ROS
General–Negative for fevers, chills, fatigue
Cardiovascular–Negative for orthopnea, PND, positive for intermittent lower extremity edema
Gastrointestinal–Positive for nausea without vomiting; negative for diarrhea, abdominal pain
Pulmonary–Positive for intermittent dyspnea on exertion, negative for cough or hemoptysis

O.

VS: BP 186/102; P 94; R 22; T 97.8; 02 96% Wt 235lbs; Ht 70”

 

General–Pt appears diaphoretic and anxious

Cardiovascular–PMI is in the 5th inter-costal space at the mid clavicular line. A grade 2/6 systolic decrescendo murmur is heard best at the

second right inter-costal space which radiates to the neck.

A third heard sound is heard at the apex. No fourth heart sound or rub are heard. No cyanosis, clubbing, noted, positive for bilateral 2+ LE edema is noted.

Gastrointestinal–The abdomen is symmetrical without distention; bowel

sounds are normal in quality and intensity in all areas; a

bruit is heard in the right para-umbilical area. No masses or

splenomegaly are noted. Positive for mid-epigastric tenderness with deep palpation.

Pulmonary— Lungs are clear to auscultation and percussion bilaterally

 

Diagnostic results: EKG, CXR, CK-MB (support with evidenced and guidelines)

 

 

 

 

 

A.

Differential Diagnosis:

1) Myocardial Infarction (provide supportive documentation with evidence based guidelines).

2) Angina (provide supportive documentation with evidence based guidelines).

3) Costochondritis (provide supportive documentation with evidence based guidelines).

 

Primary Diagnosis/Presumptive Diagnosis: Myocardial Infarction

 

 

 

 

A.

Differential Diagnosis:

1) Myocardial Infarction (provide supportive documentation with evidence based guidelines).

2) Angina (provide supportive documentation with evidence based guidelines).

3) Costochondritis (provide supportive documentation with evidence based guidelines).

 

Primary Diagnosis/Presumptive Diagnosis: Myocardial Infarction

 

 

 

  1. This section is not required for the assignments in this course (NURS 6512) but will be required for future courses.

 

 

 

Nursing homework help

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you are working with an adolescent with bulimia.

1- Do a  breve and concise description of the eating disorders, risk factors, prevalence.

2-  Any medical conditions to consider as possible causes? *[ Medical issues should be reviewed, including weight and menstrual history. A complete review of systems is indicated, as anorexia nervosa can manifest a multitude of disturbances, including cardiovascular symptoms (e.g., bradycardia and other arrhythmias, including QTc prolongation, and hypotension), gastrointestinal symptoms (e.g., slow motility, esophageal inflammation associated with purging), endocrinologic symptoms (low estrogen in females, low testosterone in males, osteopenia, and osteoporosis), and dermatologic changes, such as the development of a layer of fine hair (lanugo) on the face and extremities]. Nursing homework help

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3- To establish your differential diagnosis and prove that your patient has anorexia, describe the DSM-5, criteria for the diagnosis for:

– anorexia nervosa. *[The patient has … and meet the DSM-5 criteria for the diagnosis of anorexia nervosa]

– bulimia. *[symptoms include…, she doesn’t meet the criteria for the diagnosis of bulimia]

– Obsessive-compulsive disorder symptoms of food avoidance and distorted beliefs about one’s body. *[the patient doesn’t has … symptoms, so doesn’t meet the criteria for the diagnosis of OCD]

4 – What is the neurobiological cause of eating disorders? ( focus your attention on the diagnosis of your patient: anorexia nervosa). *[neurobiological hypotheses suggested abnormalities in CNS serotonin, increased serotonin activity, such as elevated levels of the serotonin metabolite 5-hydroxyindoleacetic acid in the CSF and reduced binding potential of 5-HT 2A receptors, suggestive of higher levels of circulating CNS serotonin, in several brain regions].

5 – Why is important a multidisciplinary approach for weight restoration as a treatment of eating disorders?

all the answers need to be supported by a reference, concise and straight to the point.

*Know that All responses will be Turnitin checked.

Instructions:

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

• Textbooks are not considered scholarly sources. 

• Wikipedia, Wikis, .com website or blogs should not be use