Discuss how functional patterns help a nurse understand the current and past state of health for a patient. Using a condition or disease associated with an elimination complexity, provide an example.
Thursday Decem 10
WK 5 Assignment
Assignment: Culture and Policy Development
Is it possible for a health policy to fail due to cultural factors? How important is it for the community to get involved with the decision-making process during policy development? After reading your Learning Resources this week, you will recognize the significance in cultural awareness and health policy development. For this Assignment, you consider community engagement in policy development.
To prepare for this Assignment, complete the readings and view the media in your Learning Resources. Consider the importance of beliefs and behaviors when developing health policies.
The Assignment (3 pages):
- Explain the importance of culturally appropriate health policies.
- Explain how one can develop a policy so that it gets the support of the community.
- Explain how you might engage the community to be part of the voice when developing a policy.
- Expand on your insights utilizing the Learning Resources.
Use APA formatting for your Assignment and to cite your resources.
help with psychology and communication
8 week class
Response to a discussion post . Advanced Pharmacology
OM
Learning Resources
Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2019). Seidel’s guide to physical examination: An interprofessional approach (9th ed.). St. Louis, MO: Elsevier Mosby.
Chapter 1, “The History and Interviewing Process”This chapter explains the process of developing relationships with patients in order to build an effective health history. The authors offer suggestions for adapting the creation of a health history according to age, gender, and disability.
Chapter 5, “Recording Information”This chapter provides rationale and methods for maintaining clear and accurate records. The authors also explore the legal aspects of patient records.
Sullivan, D. D. (2019). Guide to clinical documentation (3rd ed.). Philadelphia, PA: F. A. Davis.
Chapter 2, “The Comprehensive History and Physical Exam” (pp. 19–29)
Shadow Health Support and Orientation Resources
Use the following resources to guide you through your Shadow Health orientation as well as other support resources:
Document: Shadow Health. (2014). Useful tips and tricks (Version 2) (PDF)
With the information presented in Chapter 1 of Ball et al. in mind, consider the following:
- By Day 1 of this week, you will be assigned a new patient profile by your Instructor for this Discussion. Note: Please see the “Course Announcements” section of the classroom for your new patient profile assignment.
- How would your communication and interview techniques for building a health history differ with each patient?
- How might you target your questions for building a health history based on the patient’s social determinants of health?
- What risk assessment instruments would be appropriate to use with each patient, or what questions would you ask each patient to assess his or her health risks?
- Identify any potential health-related risks based upon the patient’s age, gender, ethnicity, or environmental setting that should be taken into consideration.
- Select one of the risk assessment instruments presented in Chapter 1 or Chapter 5 of the Seidel’s Guide to Physical Examination text, or another tool with which you are familiar, related to your selected patient.
- Develop at least five targeted questions you would ask your selected patient to assess his or her health risks and begin building a health history.
Post a summary of the interview and a description of the communication techniques you would use with your assigned patient. Explain why you would use these techniques. Identify the risk assessment instrument you selected, and justify why it would be applicable to the selected patient. Provide at least five targeted questions you would ask the patient.
Response
- Share additional interview and communication techniques that could be effective with your colleague’s selected patient.
- Suggest additional health-related risks that might be considered.
- Validate an idea with your own experience and additional research.
Respond to this post. At least 2 citations. APA format. 7th edition
Building a Health History
My assigned patient for this week’s discussion is a 14-year old biracial male living with his grandmother in a high-density public housing complex. As clinicians, it is very important to gather as much pertinent information as you possible can. This will help with building health history and identify potential issues or concerns. Building health history and gathering pertinent information also give clinicians the opportunity to customize care to a patient’s individual needs. This will also help with forming diagnosis and implementing plan of care.
Interview and Communication Techniques
When conducting an interview with an adolescent, it is imperative that you develop a rapport with the patient, parents, or guardian. Developing a rapport will make the adolescent comfortable and easier to communicate with. I would provide privacy so that the patient and I are away from his family. This will allow the patient to share information with me that he may not disclose if his family was present. I would first find out about his interests, hobbies, and other things he enjoys doing. I would inform him that the environment is a safe space, and he should express himself as he sees fit. I would then begin my head to toe assessment, informing the patient of what I am doing while doing it. While doing my head to toe assessment, I would allow the teen to talk about any concerns he may currently have. I would also use the opportunity to enquire about school, nutrition, health, activities with friends and his homelife. After completing my assessment, I would invite his guardian to rejoin us and give her the opportunity to express any concerns or issues she may have. I would advocate for my patient as I see fit and I would educate all parties involved on any abnormal findings and the best plan of care. When communicating, I would use simple words that are easily understood, to prevent any miscommunication or misunderstanding.
Risk Assessment Instrument
I chose the HEADSS interview tool for my adolescent patient. This is a screening tool that is used to facilitate communication and to create a sympathetic, confidential, and respectful environment where youths may be able to attain adequate healthcare (BC Children’s Hospital, n.d.).
Home: Who lives with the adolescent? Does he have roommates? What are the relationships like with the other persons living in his household?
Education and Employment: Which school is he attending? How are his grades? What is his favorite subject? Does he like going to school? How is his relationship with his teachers and classmates? What are his future goals?
Activities: Sports activities, hobbies, favorite music/movies, and exercise regimen.
Drugs: Any tobacco use, illicit drug, or alcohol use?
Sexuality: Sexual orientation, any physical or sexual abuse, ask if patient is sexually active, knowledge of STD, and use of condoms.
Suicide/Depression: Enquire about suicidal or homicidal ideation (past or present), mood swings, emotional outburst, and feelings of depression.
Substance abuse is an identified risk factor among adolescents. According to the World Health Organization (2018), harmful drinking among adolescents is a major concern because it is an underlying cause of injuries, violence and premature deaths.
Five Targeted Questions
My five target questions are:
• Have you ever had any thoughts of harming yourself or anybody else?
• Are you sexually active and if so, are you using condoms?
• Have you ever used alcohol, or illicit drugs?
• Do you feel comfortable at home or at school?
• Tell me about how you feel at home. Are you comfortable, do you think you are being treated
fairly?
References
BC Children’s Hospital (n.d.). H.E.A.D.S.S.- A Psychosocial Interview for Adolescents.
http://www.bcchildrens.ca/youth-health-clinic-
site/documents/headss20assessment20guide1.pdf
World Health Organization (2018). Adolescents: health risks and solutions.
https://www.who.int/news-room/fact-sheets/detail/adolescents-health-risks-and-
solutions#:~:text=prevent%20these%20deaths.-
,Mental%20health,of%20developing%20mental%20health%20problems.
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Utilitarianism Paper
I need to apply the 4 major points, apply 2 or more aspects of Bentham’s principle of utility, and apply 3 or more utilitarianism claims?
Asthma PPT A6
In a 20 slide presentation, using at least 2 APA style cited references, complete the following:
- You have several students with Asthma. Discuss the difference between an asthma action plan and an Individualized health plan. Create a PowerPoint or Prezi on asthma. The first 2 slides should be a description of these plans. Then create five slides to be used to train teachers about their students with asthma.
- You have several epinephrine pens in your office for children with severe allergies. Discuss how you would collaborate with the head of nutrition in your school district to keep these students safe? Create a PowerPoint or Prezi on allergies. The first two would discuss how to collaborate with the nutrition department. Then create five slides that you would use to teach the bus drivers how to use an epinephrine pen.
- As a closing element, discuss the importance of collaboration for these two conditions.
Feel free to use other resources for your teachings and explanations, such as YouTube in your teaching.
Nursing and the aging Family DQ week 4 Part 1 student reply Grettel Hernandez
The following post is from another student to wish I have to reply adding some extra information related to the post
APA
less than 10 % similarity
short answer
With the realization that pain is highly prevalent among older adults, please answer the following questions:
Part One: What are some ways you as the nurse can utilize to determine pain in the older adult?
: What are some of the potential barriers related to self-reporting of pain in the older adult?
Chronic pain is common in older adults but should not be taken as an everyday occurrence. Due to so many barriers, some patients may leave hospitals with unrelieved pain. Undertreatment increases the chances of developing more severe emotional, cognitive, and physical conditions such as anxiety, depression, and sleep problems. Therefore, nurses should perform a thorough pain assessment to prevent these conditions.
As a nurse, I will carry out a thorough pain assessment to an older patient by obtaining the necessary pain history and performing a complete physical examination. For example, getting to know the patient’s age, any medication they might be taking, surgical history, allergies, and cognitive status will help see the risk and degree of pain. The right communication skills are essential in obtaining this information. I will give patients all the time they might require to consider and answer my question. In areas where I fail to get information from the patient, family members can answer questions on their medical history.
I will also use advanced tools such as pain thermometers, face pain scale, and verbal descriptor scale. Before releasing the patient, I will perform a physical exam on the pain complaint area to determine whether the tissue or site has full mobility without any issues. Overall, proper pain assessment is necessary to prevent treatment that could cause more problems.
Communication and cognitive barriers are the main factors that hinder self-reporting for older adults. The majority of adults at such ages experience sensory and motor ability problems that make them have communication difficulties. They will have a hard time explaining or quantifying pain. Worse still, it is hard to observe pain expressions in older adults. Diagnosis of dementia in people of this age group has also posed a challenge in pain assessment. Some patients fear the side effects and addiction that may result from taking pain medications also makes patients fail to self-report their pain. All these factors increase the risks of pain under treatment for the older people population. However, with proper education for healthcare workers, we can overcome such barriers.
References
Bonham Howe, B. L. (2015). The Gerontology Nurse’s Guide to the Community-Based Health Network [PDF]. Springer Publishing Company, LLC, NY. Retrieved from https://www.pdfdrive.com/the-gerontology-nurses-guide-to-the-community-based-health-network-e177862497.html
Reviews, C. T. (2020). OUTLINES & HIGHLIGHTS FOR GERONTOLOGICAL NURSING: COMPETENCIES FOR CARE BY MAUK, KRISTEN L., ISB. Retrieved from https://www.pdfdrive.com/gerontological-nursing-e34319591.html
Assessing a Healthcare Program/Policy Evaluation
Program/policy evaluation is a valuable tool that can help strengthen the quality of programs/policies and improve outcomes for the populations they serve. Program/policy evaluation answers basic questions about program/policy effectiveness. It involves collecting and analyzing information about program/policy activities, characteristics, and outcomes. This information can be used to ultimately improve program services or policy initiatives.
Nurses can play a very important role assessing program/policy evaluation for the same reasons that they can be so important to program/policy design. Nurses bring expertise and patient advocacy that can add significant insight and impact. In this Assignment, you will practice applying this expertise and insight by selecting an existing healthcare program or policy evaluation and reflecting on the criteria used to measure the effectiveness of the program/policy.
To Prepare:
- Review the Healthcare Program/Policy Evaluation Analysis Template provided in the Resources.
- Select an existing healthcare program or policy evaluation or choose one of interest to you.
- Review community, state, or federal policy evaluation and reflect on the criteria used to measure the effectiveness of the program or policy described.
The Assignment: (2–3 pages)
Based on the program or policy evaluation you selected, complete the Healthcare Program/Policy Evaluation Analysis Template. Be sure to address the following:
- Describe the healthcare program or policy outcomes.
- How was the success of the program or policy measured?
- How many people were reached by the program or policy selected?
- How much of an impact was realized with the program or policy selected?
- At what point in program implementation was the program or policy evaluation conducted?
- What data was used to conduct the program or policy evaluation?
- What specific information on unintended consequences was identified?
- What stakeholders were identified in the evaluation of the program or policy? Who would benefit most from the results and reporting of the program or policy evaluation? Be specific and provide examples.
- Did the program or policy meet the original intent and objectives? Why or why not?
- Would you recommend implementing this program or policy in your place of work? Why or why not?
- Identify at least two ways that you, as a nurse advocate, could become involved in evaluating a program or policy after 1 year of implementation.
Submit your completed healthcare program/policy evaluation analysis.
Jarvis
1. Define the apical impulse and describe its normal location, size, and duration.
2. Which abnormal conditions may affect the location of the apical impulse?
3. Explain the mechanism producing normal first and second heart sounds.
4. What is syncope?
5. Define the third heart sound.
6. Define pulmonic stenosis.
7.Define physiologic splitting.
Reply answering the questions above using APA format.
NUR504- REPLY TO SAVANNAH
Gastrointestinal & Endocrine
42 year old, African American Female patient with a chief complaint of neck swelling that has progressively gotten worse over a period of a year. She also confirms that she has loss weight without any changes to her diet. Patient is tachycardic with a pulse of 102, anxious but no acute distress.
What other subjective data would you obtain?
Subjectively we know the patient has complaints of neck swelling, weight loss, and difficulty swallowing. Additional questions should be asked to gather additional information to aid in reaching a proper diagnosis for this patient. Initial questions should be general such as any changes in bowel habits, how they feel in hot or cold weather and any changes in energy. The most common thyroid diseases are Hypothyroid and Hyperthyroid. These two diseases manifest with opposite symptoms.
What other objective findings would you look for?
With the documented weight loss, tachycardia and anxiety. Additional questions and testing should be geared towards Hyperthyroidism. Key objective assessment findings for Hyperthyroidism include tachycardia, palpitations, weight loss, elevated T4 and T3, decreased TSH and diaphoresis. When you have hyperthyroidism, your body is producing excessive amounts of the thyroid hormones T3 and T4. Since these hormones regulate your metabolism (how your body processes and uses energy), having too high a level will cause symptoms related to a high metabolism (Milas, 2019).
What diagnostic exams do you want to order?
Diagnostic testing includes blood tests, iodine uptake scan and thyroid scan. Blood tests are preformed to measure the levels of thyroid hormones. T4 and T3, must be high to diagnosis a patient with hyperthyroidism. Thyroid stimulation hormone (TSH) is also measured and is low in hyperthyroidism. The iodine uptake scan is used to measure the thyroid function by determining how much iodine is taken up by the thyroid gland. Normal values are up to 25% in a 24-hour period. If the percentage is above 35% in 24 hours the abnormal results could indicate hyperthyroidism, hashimoto’s or goiter. Hyperthyroidism speeds up some of your body’s processes. Thyroid scan is typically done at the same time as the iodine uptake test. Thyroid scans use the emissions of gamma rays from radioactive iodine to obtain a picture of the thyroid (UCLA Health, n.d.).
Name 3 differential diagnoses based on this patient presenting symptoms? Give rationales for each differential diagnosis.
Hyperthyroidism is an excessive concentration of thyroid hormones in tissues. The most common causes of excessive production of thyroid hormones are Graves’ disease, toxic multinodular goiter, and toxic adenoma. Graves’ disease is an autoimmune process in which antibodies stimulate the TSH receptor leading to overproduction of thyroid hormones. With Graves’ symptoms include anxiety, moist skin, weight loss, enlarged thyroid gland, bulging eyes and palpitations.
References
Milas, K. (2019). Hyperthyroidism Symptoms. Retrieved November 20, 2020, from https://www.endocrineweb.com/conditions/hyperthyroidism/hyperthyroidism-symptoms (Links to an external site.)
UCLA Health. (n.d.). Radioactive Iodine Uptake Test. Retrieved November 20, 2020, from https://www.uclahealth.org/endocrine-center/radioactive-iodine-uptake-test