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Brantley posted Dec 14, 2018 5:40 PM

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Women’s healthcare in the United States (US) is affected by many healthcare disparities such as socioeconomic status, no insurance, and lack of resources. To address the complex needs of the women population healthcare providers must try to understand the dynamic which women are living. There are many government agencies that are available to allow women to receive the care they deserve to meet their needs. These services can provide financial, physical, emotional, and spiritual support (Vest, Caine, Harris, Watson, Menachemi, & Halverson, 2018).

The Department of Human Services is a state agency that aids women with obtaining medical, nutrition, and mental health assistance, as well as safe living environments for women affected by abuse (Bagley & Levy, 2014). The Health department of Bay County in Panama City, Florida provide assistance to women who need obstetric and gynecological service who can’t afford a primary care practitioner. For expectant mothers lactating and prenatal services are available. Another resource available to women is provided by the Life Management Center, which assist women who have been subjected to abuse or neglect. They provide shelter, counseling, and support for them to get on their feet without the abuser. As a provider it is our duty to provide this information to a patient who seeks assistance as this can improve the quality of their life (Ruth & Marshall, 2017).

Reference:

Bagley, N., & Levy, H. (2014). Essential Health Benefits and the Affordable Care Act: Law and Process. Journal of Health Politics, Policy & Law, 39(2), 441–465. https://doi.org/10.1215/03616878-2416325

Ruth, B. J., & Marshall, J. W. (2017). A History of Social Work in Public Health. American Journal of Public Health, 107, S236–S242. https://doi.org/10.2105/AJPH.2017.304005

Vest, J. R., Caine, V., Harris, L. E., Watson, D. P., Menachemi, N., & Halverson, P. (2018). Fostering Local Health Department and Health System Collaboration through Case Conferences for At-Risk and Vulnerable Populations. American Journal of Public Health, 108(5), 649–651. https://doi.org/10.2105/AJPH.2018.304345

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Brantley posted Dec 14, 2018 5:40 PM

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Women’s healthcare in the United States (US) is affected by many healthcare disparities such as socioeconomic status, no insurance, and lack of resources. To address the complex needs of the women population healthcare providers must try to understand the dynamic which women are living. There are many government agencies that are available to allow women to receive the care they deserve to meet their needs. These services can provide financial, physical, emotional, and spiritual support (Vest, Caine, Harris, Watson, Menachemi, & Halverson, 2018).

The Department of Human Services is a state agency that aids women with obtaining medical, nutrition, and mental health assistance, as well as safe living environments for women affected by abuse (Bagley & Levy, 2014). The Health department of Bay County in Panama City, Florida provide assistance to women who need obstetric and gynecological service who can’t afford a primary care practitioner. For expectant mothers lactating and prenatal services are available. Another resource available to women is provided by the Life Management Center, which assist women who have been subjected to abuse or neglect. They provide shelter, counseling, and support for them to get on their feet without the abuser. As a provider it is our duty to provide this information to a patient who seeks assistance as this can improve the quality of their life (Ruth & Marshall, 2017).

Reference:

Bagley, N., & Levy, H. (2014). Essential Health Benefits and the Affordable Care Act: Law and Process. Journal of Health Politics, Policy & Law, 39(2), 441–465. https://doi.org/10.1215/03616878-2416325

Ruth, B. J., & Marshall, J. W. (2017). A History of Social Work in Public Health. American Journal of Public Health, 107, S236–S242. https://doi.org/10.2105/AJPH.2017.304005

Vest, J. R., Caine, V., Harris, L. E., Watson, D. P., Menachemi, N., & Halverson, P. (2018). Fostering Local Health Department and Health System Collaboration through Case Conferences for At-Risk and Vulnerable Populations. American Journal of Public Health, 108(5), 649–651. https://doi.org/10.2105/AJPH.2018.304345

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A 60-year-old man comes to your office because of a persistent cough that has been bothering him for the past 3 months. His cough is dry and is more frequent during the evenings. He also notes frequent nasal congestion, especially when he is exposed to dust and cold weather. He reports no hemoptysis, weight loss, wheezing, fever, or changes in his appetite.

What additional questions would you ask to learn more about his cough?

Do you cough up any phlegm or sputum? How much? What color is it?

Does the cough come on with activity? Position?

Which treatments have you tried?

Are you taking any prescription or over the counter medication?

Do you have shortness of breath?

Do you have asthma?

Do you have a family history of asthma?

Do you have allergies?

Do you have reflux?

Do you smoke?

Are you exposed to any environmental irritants?

(Jarvis, 2016).

How would you classify his cough based on the duration to help with the diagnosis?

A cough lasting over 3 weeks is considered to be chronic (Dunphy, Winland-Brown, Porter, & Thomas, 2015). Chronic coughs can be linked to a couple of different diagnoses. Some diagnosis that may cause a chronic cough include: postnasal drip linked to allergies, postinfection such as the flu causing a cough for 8 weeks, chronic bronchitis (COPD) is characteristic of a productive cough lasting for 3 months, asthma reactive airway associated with a dry cough, gastroesophageal reflux disease (GERD) cough caused by esophagus being irritated, medications such as ACE inhibitors, and environmental exposures can all produce a chronic cough (Dunphy et al., 2015).

What diagnostic tests do you want to include to help you with your diagnosis?

Some test that could be ordered to help correctly identify COPD would include a pulmonary function test or a more common test called spirometry. Spirometer measures how much air the patient can hold and how quickly it is exhaled (Mayo Clinic, 2018). A chest x-ray can reveal other causes of a chronic cough that include emphysema, infections, tumors and GERD (Mayo Clinic, 2018). Another test you can order to diagnosis GERD is an endoscopy (Hopper, 2015).

Dunphy, L. M., Winland-Brown, J. E., Porter, B. O., & Thomas, D. J. (2015). Primary care: Art and science of advanced practice nursing, 4th ed. Philadelphia, PA: FA Davis

Hopper, A. D. (2015). Improving the diagnosis and management of GORD in adults. The Practitioner, 259(1781), 27.

Jarvis, C. (2016). Physical examination & health assessment (7th ed.). St. Louis, MO: Elsevier.

Mayo Clinic. (2018). COPD. Retrieved from https://www.mayoclinic.org/diseases-conditions/cop…

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Unit 7
Kenya Gregg posted Jul 23, 2018 10:58 PM

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The discussion topic centers on prostatitis which is a male disorder. Prostatitis is a condition of prostate inflammation which is part of the male reproductive system. Prostatitis presents with a sudden onset. The gland is positioned towards the rectum just in from of the anterior wall. The function of the gland consists of secreting an alkaline substance which sperm requires to maintain viability.

The four prostate diagnosis consists of chronic prostatitis or chronic pelvic pain syndrome, acute bacterial prostatitis, chronic bacterial prostatitis, asymptomatic inflammatory prostatitis (National Institute of Diabetes and Digestive and Kidney Diseases, n.d.).

Signs and symptoms of Prostatitis may be identified as discomfort during urination, difficulty starting a urine stream or dribbling, blood in the urine, penal or testicular pain, abdominal or groin pain, or pain during ejaculation (Mayo Clinic, 2018). Assessment findings are identified as lower back pain, pain with ejaculation, penile discomfort, discomfort with voiding, and discomfort with palpation of the prostate during the exam. The urine stream is affected with prostatitis. Prostatitis is a common identified among the 30 to 50-year-old sexually active male population. Diagnostic assessments involve a complete blood count with the results noting an increase in white blood cells, and the urinalysis which identifies bacteria within the urine. The computed tomography (CT scan) will be utilized when cancer may be suspected. A biopsy is utilized to extract tissues for culturing purposes.

The assessment commences with the history and physical which assess for signs and symptoms of prostatitis. Collect a urine specimen for a urinalysis assessing the lab results for bacteriuria. Perform a rectal examination utilizing care while avoiding extreme manipulation. Conformation of the diagnosis involves ruling out various conditions which present with the symptoms being reported, assess the lab values, and completing a physical exam.

Treatment is implemented on an outpatient basis unless he presents in a toxic state. Administer one of the following antibiotic prescriptions for 4 to 6 weeks (Dunphy, Winland-Brown, Porter, & Thomas, 2015).

Ofloxacin (Floxin) 400 mg PO Q 12 hours

Ciprofloxacin 500 mg PO Q 12 hours

Norfloxacin 400 mg PO Q 12 hours

Alternative Prescription

Trimethoprim and Sulfamethoxazole (TMP-SMX) 160/800 mg Q 12 hours

Return to the office in 4 weeks for a follow up exam.

Kenya Gregg NP

107 Seaview Road

Bridgeport, CT 06460

NPI 1524218

DEA 9530897815

July 22, 2018

Hampton Dickson

Ofloxacin (Floxin) 400 mg

PO take 1 tablet every 12 hours

Qty 88

Refill 0

May provide generic

References

Dunphy, L. M., Winland-Brown, J. E., Porter, B. O., & Thomas, D. J. (2015). Primary care: The art and science of advanced practice nursing (4th ed.). Philadelphia, PA: F. A. Davis Company.

Mayo Clinic. (2018). Prostatitis. Retrieved from https://www.mayoclinic.org/diseases-conditions/pro…

National Institute of Diabetes and Digestive and Kidney Disorders. (n.d.). Prostatitis: Inflammation of the Prostate. Retrieved from https://www.niddk.nih.gov/health-information/urolo…

Tags: nursing prostate

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Devary posted Jul 28, 2018 1:50 PM

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What questions will you want to ask your patients at every visit in order to get the information needed to provide individualized preventive services?

As a provider I would focus on primary prevention questions to assist me to provide individualized preventive services. The answer to these questions would prompt me to educate, advise, and promote healthier lifestyle and social habits.

Questions that should be asked at every visit include: (Not in any particular order)

Do you tan? Sunbath?
What do you normally eat in a day?
What do you normally drink in a day? How much water do you intake?
Do you smoke? Do you do any narcotics or illegal drugs?
Do you wear a seat belt?
Do you feel safe at home?
Do you Drink alcohol?
Do you wear hearing aids or glasses/contacts?
Do you wear a helmet on a bicycle or motorcycle?
Do you exercise? If so, how many times per week and how long?
Do you feel stressed? What brings on your stress? What do you do for stress?
Do you diet or use weight control methods?
Are you aware of your immunization status? Do you get a flu shot every year?
Are you exposed to any environments hazards?
(Dunphy, Winland-Brown, Porter, & Thomas, 2015).

How does the age and gender of the patient impact your approach to delivering preventive services and providing health education?

Age can impact the approach of a provider when delivering preventive services and providing health education. With a pediatric client the provider has to engage the family with health promotion and educate and advise the family on health education and preventive services. The provider must get the family on board with what is offered at appropriate ages such as immunizations to be able to give the child health services. In this case the child cannot make decision on their own so the provider is solely working with the family. Especially with adolescent and teenage population research suggests that parents influence children through behavior patterns and supportive home environments (Hutchens & Lee, 2018).

How does the patient’s developmental milestones impact their ability to make healthy changes and take charge of their health?

Developmental milestones do impact the patient’s ability to make healthy changes and take charge of their health. The youth of our society have to be taught by parenting or through school and community environments. The Centers for Disease Control and Prevention (2018) discuss the initiative toward youth health promotion called DASH which stands for the division of adolescent and school health. This program has a goal to promote environments where children can be educated on healthy behaviors, connect to health services, and learn how to avoid becoming pregnant or infected with STDs or HIV (CDC, 2018).

What are some risk factors associated with health promotion?

Screening patients for potential known risk factors is vital for effective health promotion and intervention by the advanced nurse practitioner is part of this (Dunphy, Winland-Brown, Porter, & Thomas, 2015). There are modifiable risk factors and non-modifiable. Modifiable risk factors include weight, diet, social habits, lifestyle choices, and stress whereas non-modifiable risk factors include age, sex, and genetics (Dunphy, Winland-Brown, Porter, & Thomas, 2015). The advanced nurse practitioner should be aware of the modifiable and non-modifiable risk factors through a comprehensive health assessment and physical assessment. The information provided by the patient can lead the provider to intervene through education, diagnostic testing, and health promotion and prevention techniques to assist the patient to change the modifiable risk factors and understand the non-modifiable risk factors.

References

Dunphy, L. M., Winland-Brown, J. E., Porter, B. O., & Thomas, D. J. (2015). Primary care the art and science of advanced practice nursing (4th ed.). Philadelphia, PA: F.A. Davis Company.

Hutchens, A., & Lee, R. (2018). Parenting practices and children’s physical activity: An integrative review. Journal of School Nursing, 34(1), 68-85.

The Centers for Disease Control and Prevention (CDC). (2018). About the division of adolescent and school health. Retrieved from https://www.cdc.gov/healthyyouth/about/index.htm

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L Charles posted Aug 1, 2018 12:07 PM

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Helping and Healing Relationships

When patients seek the services of their health care provider, they believe that they possess the capabilities to help them restore their health and improve their well-being. It is the perception that informed the growing demand for healthcare services and series of reforms to modify the system into a patient-centered one. One of the ways that healthcare provider can develop a healing and helping relationship between them and their patients is the recognition of the emotional, physical and spiritual needs of their patients and families. According to Pullen and Mathias (2014), a trusting and mutually beneficial patient-provider relationship can be established through the use of effective verbal and nonverbal communication methods for the interactions between the parties. They stated that the information that is derived from this approach would help patients and their relatives understand the complexity and severity of the condition, its implications on their resources, and their role in the processes for achieving wellness.

Similarly, practitioners can use effective communication practices to develop the cooperative and collaborative partnerships with other members of the clinical team involved in the care of their patients. Babiker et al. (2014) noted that one of the advantages of effective teamwork is the increased level of patient safety and outcomes regarding their health condition. As empirical evidence of several studies has shown, the level of efficiency achieved by clinical teams in the care of their patients plays a significant role in the reduction of the rate co-morbidities of diseases. An additional method for developing partnerships with other members of the clinical team is through the sharing of the culture and principles of patient-centered care, which involves placing the needs of the patient above the professional status of the team. Babiker et al. (2014) stated that it is one of the keys for forming teams that provide exceptional care to their patients.

Finally, some of the personal behaviors and attitudes that need to be changed for effective team collaboration include the use of subjective language when addressing colleagues from other disciplines and disregard for the perspective of other team members on the appropriate approaches for patient care. Also, cultural bias is another aspect of the behavior and attitude of healthcare practitioners that should be addressed for working with others to deliver the expected level of services (Berger, 2014). For example, these changes are important when resolving conflicts because they would prevent the practitioner from focusing on who is right or wrong but on what is right for the patient. So far in my profession, I have never judge anyone on their religious beliefs, cultural values, or sexual orientation. I believed that everyone is entitled to their personal and medical privacy.

References

Babiker, A., El Husseini, M., Al Nemri, A., Al Frayh, A., Al Juryyan, N., Faki, M. O., … & Al Zamil, F. (2014). Health care professional development: Working as a team to improve patient care. Sudanese Journal of Paediatrics, 14(2), 9.

Berger, C. R. (2014). Interpersonal Communication. Berlin: De Gruyter Mouton.

Pullen Jr, R. L., & Mathias, T. (2014). Fostering therapeutic nurse-patient relationships. Nursing Made Incredibly Easy 8 (3),

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Circle of Caring

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Holistic nursing involves looking at the patient as a whole involving their mind, body, spirit, social/cultural, emotions, relationships and environment combined to overall diagnose and treat a patient. The diagnosis involves each part of these elements as well as the healing culture of holistic nursing involves healing each part of these elements by different techniques. Biomedical nursing is the biomedical approaches used to care and influence nurses while providing care and these include pathology, physiology, biology, and biochemistry. I believe biomedical also refers to the devices and technology used from the health care team to diagnose and cure the diseases on hand. Mazzotta (2016) discusses how biomedical nursing is predominant in the 21st century and aides in nurses and providers care for patients. As healthcare advances so does the biomedical and technological devices utilized to provide patient care.

Where biomedical refers to more physical aspects and holistic refers to maybe more spiritual the circle of caring model actually builds on these two in addition by obtaining the subjective data, objective data, diagnosis, outcome, plan, and evaluation but adds additional unique qualities (Dunphy, Winland-Brown, Porter, & Thomas, 2015). The National Alliance of Caregiving (2018) describes the circle of caring model as not only looking at the patient but in the plan of care should include families, communities, thoughts, and feelings of the patient. The additional unique qualities of the circle of caring model also includes obtaining in depth understanding of a patients situation, life, strengths, weaknesses, and social determinants of health (Dunphy, Winland-Brown, Porter, & Thomas, 2015). Another unique aspect is that of actually giving labels to patients concerns and responses to illnesses in the daily life of a patient (Dunphy, Winland-Brown, Porter, & Thomas, 2015). Circle of caring aslso discusses not only a holistic approach, but a creative approach to a therapeutic plan and lastly, it involves not only the patient but the family, social groups, and the community perceptions of how the patient has improved (Dunphy, Winland-Brown, Porter, & Thomas, 2015). Overall, it is a broadened approach to patient care that includes the nursing model, holistic nursing, and biomedical nursing.

References

Dunphy, L. M., Winland-Brown, J. E., Porter, B. O., & Thomas, D. J. (2015). Primary care the art and science of advanced practice nursing (4th ed.). Philadelphia, PA: F.A. Davis Company.

National Alliance for Caregiving. (2018). Circle of care. Retrieved from https://www.caregiving.org/circleofcare/

Mazzotta, C.P. (2016). Biomedical approaches to care and their influence on point of care nurses: a scoping review. Journal of Nursing Education and Practice, 6(8), 93-101.