Discussion
Mrs. Cason brings her 10-year-old child to the clinic stating my son “just isn’t breathing right, he doesn’t want to play, he just sits on my lap or lays on the couch, and this happens all the time.” Appearance of both mother and child is disheveled. The child’s wheezing can be heard across the room. When asked if her son is better at any certain time of the day the mother responds: “It’s like this all the time and has been for the past year, we just don’t come to the doctor because we don’t have any money.”
Mrs. Cason’s son was diagnosed of asthma.
Discuss short and long term treatment options for this child, inhaled beta2-adrenergic agonists. Include rationale for your recommendations.
What is your educational plan for the child?
Fetal Abnormality
write a 750-1,000-word reflection that answers the following questions:
What is the Christian view of the nature of human persons, and which theory of moral status is it compatible with? How is this related to the intrinsic human value and dignity?
Which theory or theories are being used by Jessica, Marco, Maria, and Dr. Wilson to determine the moral status of the fetus? What from the case study specifically leads you to believe that they hold the theory you selected?
How does the theory determine or influence each of their recommendations for action?
What theory do you agree with? Why? How would that theory determine or influence the recommendation for action
Discusssion
Explore one of the agencies for quality improvement listed in this module's lecture. Write a one-page summary of what the agency does, who it affects, and how it is utilized. Include references and in text citation
Discussion
Review the presentations below, Discuss how health disparities in women could affect their care (for example, geographic location, race, finances, literacy, etc.). Use the UpToDate database as one of your required references and a second scholarly reference of your choice; remember you should have at least two references for each peer post.
Post one
An 18-year-old is accompanied by her mother for her first visit to the gynecologist. She has never been sexually active. She has no concerns with her menses. Her mom reports that she brought her in “because she is 18 and when I turned 18, I had to get my first Pap smear.” Her mother requests the patient have a Pap smear and be tested for HPV “just in case.” The patient is up to date on all vaccines ""mandatory for school"" but has never had the HPV vaccine.
What are the recommendations on the HPV vaccine?
The CDC (2020) recommends that the vaccination series starts at age 11 or 12 years old and also recommends for everyone through the age of 26 years old if they have not been vaccinated before. It is a series of two or three doses depending on age when starting the series. It is not recommended for those over 26 because of effectiveness, but some providers and patients may decide to vaccinate anyway (CDC, 2020).
How would you counsel this patient about the HPV vaccine?
I would discuss the importance of the HPV vaccination to the patient as well as the mother as she is in the age range where many patients become sexually active after high school. I would inform her of what HPV is and how it could affect her life. I would also explain the benefits and risks of the vaccination. I would highly recommend that this patient start this vaccine series before she becomes sexually active. I would tell mom that since she is not sexually active and has no symptoms, testing for HPV would not be necessary but also listen to her concerns if she still feels its necessary.
What are the current ASCCP guidelines for Pap smears and HPV testing?
The ASCCP (2012) recommends that pap smears start at the age of 21. This can be younger if they are sexually active. This screening is to be done every 3 years unless there is a abnormal pap smear result. HPV testing is recommended during pap smear exam for those 30-65 years old every 5 years but not recommended for those under 30 years old. After 65 years old and no abnormal pap smears of concern, women can stop pap smear screening if recommended by their provider. These continue to be the current guidelines according to the ASCCP (ASCCP, 2012).
How will you explain the rationale to the patient and the mother?
I would explain to the patient and mother that according to the CDC and ASCCP guidelines, she is not criteria to start her pap smear exams or have HPV testing since she is under the age of 21 and is not sexually active. I would also explain the research found that “Each year, more than 13,000 women are diagnosed with cervical cancer in the United States. Yet cervical cancer is one of the most preventable cancers today.” (NCCC, 2020). I would state that at this time she doesn’t need the pap smear or HPV testing but would highly recommend the HPV vaccinations series to be started since cervical cancer is so preventable with the vaccination.
Post 2
STI Prevention and Screening
Case Study
The case study that presents itself is a 52 year old female who is recently divorced and has been engaging in unprotected sex. The patient within the case study expressed that she has been with multiple partners and has not practiced “safe sex”. This particular patient also expresses an increase in the amount of alcohol consumption during the duration of this time period. With all the information provided, the advanced practiced registered nurse (APRN), is responsible for properly educating and screening this patient for sexually transmitted infections (STI). In doing so, will ensure this patient receives high-quality care.
Questions and Risk Factors
The types of questions the APRN would want to ask this patient pertain to a health history. The APRN would ask the patient if she has noticed any vaginal discharge, pain during urination, unusual vaginal bleeding, and if the patient is experience any lumps, blisters, or sores around the genital region. These types of questions will allow the APRN to identify if the patient has potentially contracted an STI and exactly what symptoms they might be experiencing. The patients present risk factors are centered around unprotected sex, increased consumption of alcohol, and a recent life-changing experience through a divorce. These risk factors will influence the APRN screening of this patient as it will allow them to ask appropriate questions related to the patients current situation and how to treat the patient accordingly.
Current Guidelines for STI
The current guild elites for STI screening are different for both men and women. According to the CDC, women, should be screened for chlamydia and gonorrhea if they are sexually active under the age of 25 or older than 25 as well (STD Screening Recommendations - 2015 STD Treatment Guidelines, 2015). For herpes, trichomonas, and HIV, women who engage in sexual activity with multiple partners without protected sex should be screened immediately upon visit (STD Screening Recommendations - 2015 STD Treatment Guidelines, 2015). With this information, the patient should be screened for chlamydia, gonorrhea, herpes, trichomonas, and HIV given her current presentation and according to CDC guidelines. In addition, a recent article highlighted that Congress has increased federal funding for STD prevention with $3.51 million in additional base funding to the CDC’s STD prevention programs (AHC MEDIA, 2020). With this increase in funding, STD prevention programs will help raise more awareness to STD’s within the community and prevent them from spreading.
Recommendations for “Safe Sex”
In order to implement “safe sex” practices, it is important to understand what this term means. Safe sex practices refer to sexual activity and especially sexual intercourse in which various measure such as latex condoms or practice of monogamy are taken to avoid STI’s (Addoh, Sng, & Loprinzi, 2017). Along with this information, it is important for the APRN to be aware of the patients current drinking situation and her behavior as well. It is reported that having sex under the influence of drugs or alcohol enhances sexual risk behaviors and is strongly associated with the increase risk of STI’s (Newville, Sorensen, Hatch-Maillette, & Calsyn, 2018). In understanding this information, this allow the APRN to incorporate safe sex practices for this particular patient. In relation to alcohol and sexual behavior, it is important for the APRN to educate the patient about this increased risk of contracting an STI. In addition to alcohol and sexual intercourse education, the APRN should educate the patient about the importance of latex condoms, hand hygiene, receiving immunizations, and becoming familiar with a partners sexual history.
Other Preventative Guidelines
For this particular patient, there are no other additional guidelines that should be discussed with this patient. Education surrounding alcohol and sexual intercourse is a primary discussion point with this patient. Also, engaging in sexual intercourse with multiple partners without using proper protection further increases this patients risk for STI’s. These guidelines surrounding education in relation to the topics discussed above will allow the patient to receive the necessary knowledge needed to reduce her chances of contracting an STI.
Pharmacology
) Minimum 4 full pages
Part 1: minimum 2 pages
Part 1 (a) : minimum 2 pages
Submit 1 document per part
2)¨******APA norms, please use headers
All paragraphs must be narrative and cited in the text- each paragraphs
Bulleted responses are not accepted
Dont write in the first person
Dont copy and pase the questions.
Answer the question objectively, do not make introductions to your answers, answer it when you start the paragraph
Submit 1 document per part
3) It will be verified by Turnitin and SafeAssign
4) Minimum 6 references not older than 5 years
Minimum 3 references per part
5) Identify your answer with the numbers, according to the question.
Example:
Q 1. Nursing is XXXXX
Q 2. Health is XXXX
6) You must name the files according to the part you are answering:
Example:
Part 1.doc
Part 2.doc
_____________________________________________________
You must answer the part 1 questions posted, 2 times.
You must submit 2 documents (each one 2 pages: Part 1 and Part 1a)
Copy and paste will not be admitted.
You should address the questions with different wording, different references, but always, objectively answering the questions.
S.H., age 47, reports difficulty falling asleep and staying asleep. These problems have been ongoing for many years, but she has never mentioned them to her health care provider. She has generally “lived with it” and selftreated the problem with OTC Tylenol PM. Currently, she is also experiencing perimenopausal symptoms of night sweats and mood swings. Current medical problems include hypertension controlled with medications. Past medical history includes childhood illnesses of measles, chickenpox, and mumps. Family history is positive for diabetes on the maternal side and hypertension on the paternal side. Her only medication is an angiotensinconverting enzyme inhibitor and diuretic combination for hypertension control. She generally does not like taking medication and does not take any other OTC products.
Diagnosis: InsomnIa
1. List specific goals of therapy for S.H.
2. What drug therapy would you prescribe? Why?
3. What are the parameters for monitoring the success of the therapy?
4. Discuss specific patient education based on the prescribed therapy
5. List one or two adverse reactions for the selected agent that would cause you to change therapy.
6. What would be the choice for second-line therapy?
7. What OTC and/or alternative medicines might be appropriate for this patient?
8. What dietary and lifestyle changes might you recommend?
9. Describe one or two drug–drug or drug–food interactions for the selected agent.
Discussion
Mr. Wilko is a 40-year-old salesperson with a wife and three teenage children. He has recently begun to have a beer at lunch and a few drinks after work to reduce his work-related stress. An economic downturn in the housing industry has reduced the need for new home appliances and his income and sales record has been affected. Several other salespeople have been laid off at his firm. He has been told that if his sales and attendance records do not improve he will be fired. He and his wife are constantly arguing about finances and the children's increasing demands for money. His drinking has increased to several beers at lunch and continued drinking after dinner. When he returns to work with alcohol on his breath, he is dismissed from his job. He continues to consume alcohol during the day as he attempts a job search. His wife is very concerned, as are his teenage children.
Mr. Wilko states he is a social drinker and “can stop at any time.” How accurate is his self-assessment?
What stressors are present in Mr. Wilko's case?
Why does Mr. Wilko continue to increase his alcohol intake?
What changes in liver function can Mr. Wilko expect if he continues to drink large amounts of alcohol?
Mr. Wilko complains to his wife that all the stress is causing “indigestion.” How do stress and alcohol consumption affect GI function?
Why is Mr. Wilko at greater risk of trauma?
Discussion
For this assignment, you will locate a minimum of 4 research articles related to the topic and PICOT questions that you developed in Week 2. The articles must be current (2002 to the present), and two articles must be quantitative, and two articles must be qualitative. These articles should be somewhat related to your PICOT questions.
These were the PICOT Questions that I used before..
PICOT QUESTIONS
1. By what percentage will diabetes cases reduce, within 12 months, among adults 20 years and above from the Hispanic community, if they get an education on diabetes, compared to when they receive no training on the same?
2. What will be the effect on diabetes prevalence among children below 20 years, when adults above 20 years receive treatment for diabetes compared to when they do not receive treatment, for two years?
3. How will the use of bicycles as a means of transport as compared to using personal vehicles reduce obesity among the Hispanic community, in 1 year?
(do not use these two articles )
Testerman, J., & Chase, D. (2017). Influences on Diabetes Self-Management Education
Participation in Low-Income, Spanish-Speaking, Latino Population. Diabetes
Spectrum, 31(1), 47–57. https://doi.org/10.2337/ds16-0046
Yamaoka, K., Nemoto, A., & Tango, T. (2019). Comparison of the Effectiveness of Lifestyle
Modification with Other Treatments on the Incidence of Type 2 Diabetes in People at High Risk: A Network Meta-Analysis. Nutrients, 11(6), 1373. https://doi.org/10.3390/nu11061373
Articles used for one assignment can't be used for the other assignments(students should find new research articles for each assignment).
The selected articles should be original research articles. Review articles, meta-analysis, meta-synthesis, and systemic review should not be used.
Mixed-methods studies should not be used.
There are two parts to this assignment.
Part 1: Complete a Rapid Critical Appraisal Checklist chart for each research article (4 total).Download the following files in the Worksheets, Forms, and Templates area at left:
Rapid Critical Appraisal Checklist (pdf)
Rapid Critical Appraisal Checklist (doc)
Part II: Write a summary (2–3 pages)
Describe the similarities and differences among the four research articles.
You should:
Use current APA format to style your paper and to cite your sources.
Submit the 4 completed charts along with your summary
Cognitive Behavioral therapy in Group setting VS family setting
As you might recall from Week 5, there are significant differences in the applications of cognitive behavior therapy (CBT) for families and individuals. The same is true for CBT in group settings and CBT in family settings. In your role, it is essential to understand these differences to appropriately apply this therapeutic approach across multiple settings. For this Discussion, as you compare the use of CBT in group settings and family settings, consider challenges of using this approach with your own groups.
Learning Objectives
Students will:
· Compare the use of cognitive behavioral therapy for groups to cognitive behavioral therapy for families
· Analyze challenges of using cognitive behavioral therapy for groups
· Recommend effective strategies in cognitive behavioral therapy for groups
To prepare:
· Reflect on your practicum experiences with CBT in group and family settings.
Post an explanation of how the use of CBT in groups compares to its use in family settings. Provide specific examples from your own practicum experiences. Then, explain at least two challenges counselors might encounter when using CBT in the group setting. Support your response with specific examples from this week’s media.
Required Readings ( Need 3 references).
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.
Bjornsson, A. S., Bidwell, L. C., Brosse, A. L., Carey, G., Hauser, M., Mackiewicz Seghete, K. L., & ... Craighead, W. E. (2011). Cognitive-behavioral group therapy versus group psychotherapy for social anxiety disorder among college students: A randomized controlled trial. Depression and Anxiety, 28(11), 1034-1042. doi:10.1002/da.20877
Safak, Y., Karadere, M. E., Ozdel, K., Ozcan, T., Türkçapar, M. H., Kuru, E., & Yücens, B. (2014). The effectiveness of cognitive behavioral group psychotherapy for obsessive-compulsive disorder. Turkish Journal of Psychiatry, 25(4), 225-233.
Yalom, I. D., & Leszcz, M. (2005). The theory and practice of group psychotherapy (5th ed.). New York, NY: Basic Books.
Chapter 11, “In the Beginning” (pp. 309–344)
Yalom, I. D., & Leszcz, M. (2005). The theory and practice of group psychotherapy (5th ed.). New York, NY: Basic Books.
Chapter 12, “The Advanced Group” (pp. 345–390)
Nursing Discussion
Comparing Existential-Humanistic Therapy to Other Types of Therapy
Understanding the strengths of each type of therapy and which type of therapy is most appropriate for each client is an essential skill of the Psychiatric Mental Health Nurse Practitioner. In this Discussion, you will compare Existential-Humanistic therapy to a therapy you select from the previous weeks of this course. You will identify the strengths and challenges of each and describe a fictional client that you think is best suited for each.
Learning Objectives
Students will:
Compare types of psychotherapy
To prepare:
Review this week's Learning Resources
Review this week’s media and consider the insights provided.
Review the other types of psychotherapy presented in this course and select the one that resonates with you the most at this time
Note: For this Discussion, you are required to complete your initial post before you will be able to view and respond to your colleagues’ postings. Begin by clicking on the ""Post to Discussion Question"" link and then select ""Create Thread"" to complete your initial post. Remember, once you click Submit, you cannot delete or edit your own posts, and cannot post anonymously. Please check your post carefully before clicking Submit!
By Day 3
Post a summary of the psychotherapy that you selected and explain why it resonates with you the most at this time. Then compare the psychotherapy you selected with existential-humanistic therapy. What are the strengths and challenges of each type of psychotherapy? Describe a fictional client that you think would be best suited for the therapy you selected and one fictional client you think would be best suited for existential-humanistic therapy. Explain why.
Note: Do not use a client’s actual name.
Note: Nurse practitioners must have strong oral communication skills. This Discussion is designed to help you hone these skills. When filming your Kaltura video, be sure to dress and speak in a professional manner.
Nursing Care Plan Paper
Write a 3 page paper, not including title and reference page.
Paper should follow APA guidelines with a minimum of 5 references within 5 year span.
Patient:
95-year old male with depression and anorexia. Patient is forgetful and lives alone.
Organize an interdisciplinary plan of care for your client and the delivery of safe and effective care including interventions with rationals, short term and long term goals, and desired patient outcomes. Apply standards that are evidenced based which help support for the protection of your client.
