Digestion and Macronutrients

TOPIC 1: Dietary fat has been vilified.  Is this a correct characterization of this macronutrient? Is all fat bad? What types of fats can we find in our diet (go beyond our textbook)? 

Most be at least 250 words and at least 2 reference 

Informatics

  

As a DNP, you will be interacting with individual who have acute, chronic or acute on chronic disease process. For this case study, research a disease process that can either be controlled by mobile application and/or through the use of a telehealth program. 

1. Discuss the technology you choose to use to research to manage the disease process. 

2. Also address how your role as a DNP can be used to monitor and serve a population through a mobile application and/or a telehealth program.  

3.Include how you would protect the patient health information when using these technologies 

Discussion Board

 Review the following website https://phsc.edu/sites/defa ult/files/program/files/Nurs e-Practice-Act.pdf American Association of Nurse Practitioners “Standards of Practice” http://www.aanp.org/imag es/documents/publication s/standardsofpractice.pdf 

1-Discuss at least 3 regulations impose in APRN in the state of Florida.

 2-Would you like to change the process. Explain options.

APA style please, 600 words, 2 references not older than 5 years. 

nur512-Reply to this discussion Judelain

Module 5 Discussion

Healthcare has been one of the most complicated and political issues in the United States of America. Nurses continue to play important roles in the healthcare system. Nurses were among healthcare providers that supported the affordable care act because it is very beneficial for the healthcare systems and patients who did not have health insurance. The United States is one of the greatest countries in the world and there are many opportunities in this country. Healthcare should not be an issue for the citizens of this country, but sadly people continue to suffer and die because of lack of health insurance. I believe that many advocacy actions need to be taken to improve healthcare through the state and federal level, but I will talk about one of the most important actions. The advocacy action I might take to improve health care through legislation at the federal level is to decrease the cost of prescription drugs. The reason I chose that action is because private prescription drug companies continue to increase drugs prices on patients who needs the prescription drugs but not able to afford them due to low incomes.

The healthcare industry is a money machine industry. It costs lots of money to cure diseases and to buy prescription drugs. Most prescription drugs companies care more about making money and competition than their patients. I believe that congress and the senate must pass a legislation or a law that prevents prescription drugs company from increasing drugs prices on consumers. Recently, President Donald Trump took an historic action to deliver lower prescription drug prices to American patients. The president signed four Executive Orders on drug pricing directing the Secretary of Health and Huma Services to take several steps to deliver for American patients lower costs on prescription drugs, including insulin and epinephrine, and ensure Americans are getting the lowest price possible for their drugs. As a registered independent leaning more toward Democrats, I think the Trump administration is on the right path to help decrease prescription drugs prices in this country. According to Socal and Anderson (2019), as congress considers various approaches to address rising costs, one of the options is to allow Medicare to negotiate prices directly with drug manufactures on behalf of Part D beneficiaries, the challenges of this policy is the potential need for Medicare to impose a restrictive formulary to negotiate effectively with drug companies. This showed that the Trump administration and congress are trying to come up with a solution to decrease prescription drugs prices, but the private drug companies will continue to fight because it will not be beneficial for them if their drug prices lowered.

According to Fein (2019), some prescription drugs company offer multiple discounts to patients, which gives them the opportunity to purchase their medications. The article also stated that the companies provided those discounts because they want their products or invention to get on the market for advertisement purposes. Prescription drug companies have lots of powers in the political system, which makes it difficult for congress and senate to pass laws that are beneficial to the patients or consumers rather than the big prescription drug companies.

References

Socal, M. P., & Anderson, G. F. (2020). Older Americans’ Preferences Between Lower Drug Prices and Prescription Drug Plan Choice, 2019. American Journal of Public Health, 110(3), 354-356. https://doi.org/10.2105/AJPH.2019.305483 (Links to an external site.)

Fein, A. J. (2019). Don’t Blame Drug Prices on Big Pharma. Journal of Oncology Navigation & Survivorship, 10(4), 161-162.

4 page paper

Imagine that you have been appointed the director of health at the Kaluyu Memorial Hospital in Nairobi, Kenya—a for-profit hospital. The facility is also a referral hospital and receives severe cases of accidents and chronicle and communicable diseases, and it houses an HIV/AIDS ward. As you settle into your position, you realize that the employees always act scared as they approach their superiors. Some of the employees deliver files and leave your office in a hurry. 

As you make your routine departmental visits, you realize that there are tensions between nurses and doctors, and there is a sentiment that the nurses tend to do the majority of the work within patient care but the doctors get all the credit. You realize that the employees are always looking forward to the end of their shifts when they can go home. Some employees even come back to work wearing the same unwashed clothes as the previous day. Too many employees are calling in sick, and many of them give weak reasons for their tardiness.

There is also a sense that employees and nurses dominate other employees in similar positions. In meetings and conference calls, some employees are quiet and never participate. You notice that people with families tend to gather and talk quietly on breaks. The new mothers working for the hospital have to use bathrooms to pump breast milk for their infants, and the refrigerators do not work well. Looking at the financial statements of the hospital, you realize that the hospital’s expenses are higher than the industry standard, and it makes losses year after year.
Note: You may create or make all necessary assumptions needed for the completion of this assignment.

Preparation
As part of your preparation for this assignment, please read the following:

  • The Future of Healthcare Leadership.
  • Reading: Herzberg’s Two-Factor Theory.
  • McClelland’s Acquired Needs Theory.
  • Maslow’s Hierarchy of Needs.
  • Requirements
    Write a 4–6 page paper in which you:
  • Investigate the major demotivational factors at Kaluyu Memorial Hospital. Assess the level of impact that the identified factors could have on specific areas of service and business if the administration does not address the situation. Support your response with at least two examples of the potential negative impact of the identified demotivational factors on the hospital.
  • Read the overviews of the three major motivational theories (Maslow’s hierarchy of needs, Herzberg’s two-factor theory, and McClelland’s acquired needs theory). After reading all three, choose the theory that you think best fits this scenario and defend that choice in your assignment.
  • Formulate a communication system that will have the greatest impact on improving the situation, and specify the major reasons why your system will influence the employee behaviors for the better. Justify your response.
  • Go to Basic Search: Strayer University Online Library to find four recent (within the last five years) quality academic resources for this assignment. Note: Wikipedia and other websites do not qualify as quality academic resources.

Discussion

 I NEED A RESPONSE TO THIS ASSIGNMENT

2 REFERENCES

A comprehensive psychiatric assessment is a necessary element for the Psychiatric Mental Health Nurse Practitioner (PMHNP) to provide the necessary treatment for a client with mental illness while establishing a  criteria-based diagnosis (Sadock, Sadock & Ruiz, 2014).  A comprehensive psychiatric assessment depends on the skills and training of the PHMNP to interact well with their client and gather the information that will guide them to an accurate diagnosis and course of treatment.

 Classification of mental health diagnosis in a clinical setting for diagnosis, treatment, and evaluation for the child or adolescent depends on the availability of reliable and valid instruments such as standardized diagnostic interviews (SDIs).  These SDIs include the Diagnostic Interview Schedule for Children, 4th ed. That takes 90-120 minutes to administer,  and the Mini International Neuropsychiatric Interview for Children and Adolescents and takes about thirty-five minutes to administer, enabling the PMHNP to document the presence and severity of symptoms and diagnose a specific psychiatric disorder (Duncan et al., 2018).

These assessments will include background information regarding family, whom the client lives with if the parents are separated, and their relationship with family members—information of past mental health issues, inpatient or outpatient treatment, and current medication.  The PMHNP will also need to know about any medical conditions the client may have, and there is a need for medication.  The client will also give information about his or her social life, friends, school activities, how well they are doing in school, and favorite subject. All of this information helps to discuss goals and develop a treatment plan.

This discussion is based on the video by YMH Boston, 2013 where I am observing an initial interview between and the provider and a male adolescent give additional suggestions of improvement and concerns that may or may not have been addressed during the initial interview and any additional questions that may need to be asked.

Observation of what the Practitioner Did Well and Areas of Improvement

The practitioner addressed confidentiality issues and when confidentiality will be broken, and Shawn was receptive and understood. The practitioner was able to establish a rapport with Shawn and obtain some basic information. The practitioner was able to talk about school sports, favorite subjects, and identify two people who can relate.

When talking about Shawn’s relationship with his mother, the practitioner’s comment makes Shawn uncomfortable and defensive when Shawn does not understand why his mom sent him for therapy. Shawn also becomes defensive when the practitioner probes why Shawn’s mom wants him to come to this appointment.  The practitioner could have asked more questions regarding the school and the reasons for Shawn not liking school, and how Shawn’s dad fit into the picture.

Compelling Concerns and Additional Questions

The concerns would be at the root of the anger and how Shawn’s father fits into the picture. Does he take an active role in Shawn’s life, and I would ask Shawn about his dad, especially when Shawn states that he can confide in his coach and sees him as a father figure. I would want to know more about the difficulties he has at school, and his mom is aware of these difficulties.  How do these issues need to be addressed? How are his grades? Does he need a tutor or peer support for subjects such as English to keep his grades up so that he can continue to play basketball?

I would also want to know what makes him angry, are there any identifiable triggers? Does he threaten his mom physically or verbally? Does he need group therapy whose focus is on anger management?  Once again, are his school issues overflowing into his relationship with his mom, causing these angry outbursts?

Conclusion

One possible diagnosis for Shawn based on the interview would be Disruptive Mood Dysregulation Disorder 296.99 (F34.81). Shawn states that he loses his temper nearly every day and that his angry mood and yelling cause problems at home and could be a possible cause at school. He clearly stated that he gets upset when his mom asks him questions, mostly about school that triggers him, and he starts yelling. He stated that his mom set up the appointment because she believes he needs help managing his anger.

I would want to know about anxiety or depression, but there was not enough information or screening questions to come to any other diagnoses.

Anger is a secondary emotion that the root cause can be due to various internal and external factors. These factors can be biological, psychological, and social, a particular personality trait, anxiety and depression, and the ability to problem-solve, leading to verbal and physical aggression. By helping Shawn to acknowledge his anger and learns more about his anger and ways to manage the triggers that cause his anger, he will see a decrease in aggressive behavior and an increase in communication skills (Farisandy & Hartini, 2020)

References

American Psychiatric Association. (2013).  Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.

Duncan, L., Comeau, J., Wang, L., Vitoroulis, I., Boyle, M. H., & Bennett, K. (2018). Research         review: Test-retest reliability of standardized diagnostic interviews to assess child and                      adolescent psychiatric disorders: A systematic review and meta-analysis. Journal of             Child Psychology and Psychiatry, 60(1), 16–29. https://doi.org/10.1111/jcpp.12876

Farisandy,E., & Hartini, N. (2020). The effect of anger manatment training toward aggressive

            Behavior in adolescents. Jurnal Psikologi, 19(1),95-107.             https://doi.org/10.14710/jp.19.1.95-107

Sadock, B. J., Sadock, V. A., & Ruiz, P. (2014). Kaplan & Sadock’s synopsis of psychiatry: Behavioral sciences/clinical psychiatry (11th ed.). Philadelphia, PA: Wolters Kluwer.

YMH Boston. (2013, May 22). Vignette 4 – Introductions to a mental health assessment [Video file]. Retrieved from https://www.youtube.com/watch?v=JCJOXQa9wcE

Mental Health Discussion

M.L. is a 15-year-old female who presents to the family planning clinic for her first visit. Prior to seeing the patient, the nurse reads through the initial paperwork and notes that the patient is requesting a pregnancy test and birth control counseling. The nurse calls the patient into the triage room and begins the initial interview and the sexual history assessment. When the nurse inquires about the patient’s age of first sexual encounter, the patient becomes upset and starts to cry. The nurse consoles the patient and listens carefully as the patient describes how her father has been sexually abusing her since she was 5 years old. The patient explains that the abuse continues on a weekly basis. The patient also shares that it has been 2 months since her last menstrual cycle, and she is worried that she may be pregnant. M.L. is in a monogamous relationship with her boyfriend of 1 year and is sexually active with this partner.

  1. – How should the nurse proceed with the screening and interview?
  2. – M.L. answers yes to questions 1 through 3 on the AAS (Abuse Assessment Screen).  (Links to an external site.)How should the nurse proceed?
  3. – What is the nurse’s role in reporting the suspected abuse?
  4. – How would the nurse proceed with the physical examination?

minimum of 250 words with three references in correct APA format.