Category: Nursing

MN 576 Quiz Submissions – Unit 5 Midterm

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Question 1

2 / 2 points

Which HPV types are most often associated with cervical and anogenital cancer?

Question options:

1)

1, 2, and 3

2)

6 and 11

3)

16 and 18

4)

22 and 24

Question 2

2 / 2 points

During a breast exam you note all of the findings below as normal except:

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Question options:

1)

asymetrical size

2)

a supernumerary nipple

3)

hyperpigmentation

4)

breasts that move up symmetrically with raising the arms

Question 3

2 / 2 points

A 30-year-old woman presents without symptoms but states that her male partner has dysuria without penile discharge MN 576 Quiz. Examination reveals a friable cervix covered with thick yellow discharge. This description is most consistent with an infection caused by:

Question options:

1)

Chlamydia trachomatis.

2)

Neisseria gonorrhoeae.

3)

human papillomavirus (HPV).

4)

Trichomonas vaginalis.

Question 4

2 / 2 points

The vaccine Gardasil that is used to prevent some strains of HPV infection is recommended in both males and females.

Question options:

1) True

2) False

Question 5

2 / 2 points

Lesbians may experience which of the following barriers to health care?

Question options:

1)

Homophobia from the healthcare provider

2)

Incorrect knowledge about health care needs of lesbians by healthcare providers

3)

Lack of insurance and/or access under partner’s coverage MN 576 Quiz

4)

All of the above

Question 6

2 / 2 points

Which of the following best describes lesions associated with condyloma acuminatum?

Question options:

1)

verruciform

2)

plaque-like

3)

vesicular-form

4)

bullous

Question 7

2 / 2 points

Presumptive treatment for PID should be initiated in sexually active young women and other women at risk for STDs if they are experiencing pelvic or lower abdominal pain, if no cause for the illness other than PID can be identified, and if one or more of the following minimum clinical criteria are present on pelvic examination:

Question options:

1)

cervical motion tenderness

2)

uterine tenderness

3)

adnexal tenderness.

4)

All of the above

Question 8

2 / 2 points

How long after contact do clinical manifestations of syphilis typically occur?

Question options:

1)

less than 1 week

2)

1 to 3 weeks

3)

2 to 4 weeks

4)

4 to 6 weeks

Question 9

2 / 2 points

In assessing a woman with disabilities, which of the following terms should be avoided?

Question options:

1)

Crippled

2)

Handicapped

3)

Mentally retarded MN 576 Quiz

4)

All of the above

Question 10

2 / 2 points

The definition of menopause is

Question options:

1)

Frequently skipping period for one year

2)

One year without a period

3)

Onset of hot flashes and night sweats with irregular menstruation

4)

None of the above

Question 11

2 / 2 points

MN 576 Quiz Treatment options for bacterial vaginosis include all of the following except:

Question options:

1)

oral metronidazole.

2)

clindamycin cream.

3)

oral clindamycin.

4)

oral azithromycin.

Question 12

2 / 2 points

Physical examination of a 19-year-old woman with a 3-day history of vaginal itch reveals moderate perineal excoriation, vaginal erythema, and a white, clumping discharge. Expected microscopic examination findings include:

Question options:

1)

a pH greater than 6. 0.

2)

an increased number of lactobacilli.

3)

hyphae.

4)

an abundance of white blood cells.

Question 13

2 / 2 points

Which of the following is a contraindication to estrogen/progestin-containing methods (combined oral contraception [COC], patch [Ortho Evra], or ring [NuvaRing]) MN 576 Quiz?

Question options:

1)

mother with a history of breast cancer

2)

personal history of hepatitis A at age 10 years

3)

presence of factor V Leiden mutation

4)

cigarette smoking one pack per day in a 22-year-old

Question 14

2 / 2 points

Recommendations for adolescents with disabilities include a comprehensive sex education program that should be tailored to fit their specific needs.

Question options:

1) True

2) False

Question 15

0 / 2 points

In assessing a 13 year old female, you know that the presence of breast bud  with elevation of breast and papilla; enlargement of areola indicate which Tanner Stage?

Question options:

1)

Stage1

2)

Stage 2

3)

Stage 3

4)

Stage 4

Question 16

2 / 2 points

The Pap test should not be considered a screening test for STDs.

Question options:

1) True

2) False

Question 17

2 / 2 points

Which of the following agents is most active against C. trachomatis?

Question options:

1)

amoxicillin

2)

metronidazole

3)

azithromycin

4)

ceftriaxone

Question 18

2 / 2 points

When performing a bimanual exam all of the following are noted as normal findings except:

Question options:

1)

retoverted uterus

2)

anteflexed uterus

3)

fixed immobile uterus

4)

smooth, firm ovary

Question 19

2 / 2 points

Routine screening for C. trachomatis on an annual basis is recommended for all sexually active females aged <25 years . Question options: 1) True 2) False Question 20 2 / 2 points When performing a pelvic examination the first part of the external genitalia exam is Question options: MN 576 Quiz 1) speculum examination 2) palpation 3) inspection 4) cervical sampling Question 21 2 / 2 points In women who have experienced a spinal cord injury, temporary cessation of menses is normal for up to one year following the injury. Question options: 1) True 2) False Question 22 2 / 2 points When counseling a woman about COC use, you advise that: Question options: 1) long-term use of COC is discouraged because the body needs a “rest” from birth control pills from time to time. 2) fertility is often delayed for many months after discontinuation of COC. 3) there is an increase in the rate of breast cancer after protracted use of COC. 4) premenstrual syndrome symptoms are often improved with use of COC. Question 23 2 / 2 points Which of the following terms describes the mechanism of action of imiquimod (Aldara)? Question options: 1) keratolytic 2) immune modulator 3) cryogenic 4) cytolytic Question 24 2 / 2 points Treatment of vulvovaginitis caused by Candida albicans includes: Question options: 1) metronidazole gel. 2) clotrimazole cream. 3) hydrocortisone ointment. 4) clindamycin cream. Question 25 2 / 2 points Screening for osteoporosis with DEXA scan should begin Question options: 1) age 50 2) one year after menopause 3) age 65 4) age 60 Question 26 2 / 2 points What is the approximate incubation period for Neisseria gonorrhoea? Question options: 1) 1 to 5 days 2) 7 to 10 days 3) 18 days 4) 28 days Question 27 2 / 2 points What percentage of anogenital and cervical cancers can be attributed to HPV infection? Question options: 1) less than 30% 2) at least 50% 3) at least 70% 4) 95% or greater Question 28 2 / 2 points Universal screening for chlamydia and gonorrhea in women ≤35 years entering juvenile and adult correctional facilities has been a long-standing recommendation. Question options: 1) True 2) False Question 29 2 / 2 points A 22-year-old woman taking a 35-mcg ethinyl estradiol COC calls after forgetting to take her pills for 2 consecutive days. She is 2 weeks into the pack. You advise her to: Question options: 1) take the last pill missed immediately, even if this means taking 2 pills today. 2) discard two pills and take two pills today. 3) discard the rest of the pack and start a new pack with the first day of her next menses. 4) continue taking one pill daily for the rest of the cycle. Question 30 2 / 2 points HCV infection is the most common chronic bloodborne infection in the United States, with an estimated 2.7 million persons living with chronic infection Question options: 1) True 2) False Question 31 2 / 2 points Adolescent girls are not candidates for IUD use for contraception Question options: 1) True 2) False Question 32 2 / 2 points About ____ of patients with genital warts have spontaneous regression of the lesions? MN 576 Quiz Question options: 1) 10% 2) 25% 3) 50% 4) 75% Question 33 2 / 2 points Complementary and alternative medicine (CAM) is defined as a group of therapies that are not considered part of Western culture and include all of the following except: Question options: 1) Congugated estrogen 2) Aromatherapy 3) Tai Chi 4) Yoga Question 34 2 / 2 points Which HPV types are most likely to cause genital condyloma acuminatum? Question options: 1) 1, 2, and 3 2) 6 and 11 3) 16 and 18 4) 22 and 24 Question 35 2 / 2 points Which test is performed around the time of ovulation to diagnose the basis of infertility? Question options: 1) Hysterosalpingogram 2) Ultrasonography 3) Laparoscopy 4) Follicle-stimulating hormone (FSH) level Question 36 2 / 2 points The NP is seeing a 30-year-old woman before her routine gynecologic examination, the NP questions that patient about her recent menstrual cycles. Which statement made by the patient should prompt further investigation? Question options: 1) “My flow is very heavy all the time.” 2) “I have occasionally spot in between cycles” 3) “My menstrual cycles varies from 25 to 30 days.” 4) “I have cramping prior to my cycle starting” Question 37 2 / 2 points Women with bacterial vaginosis typically present with: Question options: 1) vulvitis. 2) pruritus. 3) dysuria. 4) malodorous discharge. Question 38 2 / 2 points Treatment options for patients with condyloma acuminatum include all of the following except: Question options: 1) topical acyclovir. 2) cryotherapy. 3) podofilox. 4) trichloroacetic acid. Question 39 0 / 2 points The average onset of perimenopause is between the ages of: Question options: 1) 35 to 40 years. 2) 40 to 45 years. 3) 45 to 50 years. 4) 50 to 55 years. Question 40 2 / 2 points Which of the following is not representative of the presentation of primary syphilis? Question options: 1) painless ulcer 2) localized lymphadenopathy 3) flu-like symptoms 4) spontaneously healing lesion Question 41 2 / 2 points Noncontraceptive benefits of COC use include a decrease in all of the following except: Question options: 1) iron-deficiency anemia. 2) pelvic inflammatory disease (PID). 3) cervicitis. 4) ovarian cancer. Question 42 2 / 2 points MN 576 Quiz In patients who are allergic to azithromycin, an alternative treatment to chlamydia is Question options: 1) Doxycycline 100mg twice daily for 7 days 2) Macrobid 100mg twice daily for 5 days 3) BactimDS  1 PO BID for 3 day 4) All of the above Question 43 2 / 2 points Puberty consists of a series of predictable events, and the sequence of changes in secondary sexual characteristics has been categorized by several groups. The staging system utilized most frequently used to describe these events is Tanner staging. Question options: 1) True 2) False Question 44 2 / 2 points Which of the following may be a useful tool in screening for Female Sexual Disorder (FSD)? Question options: 1) The Female Sexual Function Index 2) The Female Sexual Distress Scale 3) The Orgasmic Disorder Scale 4) A and B Question 45 2 / 2 points Which of the following is found in tertiary syphilis? Question options: 1) arthralgia 2) lymphadenopathy 3) macular or papular lesions involving the palms and soles 4) gumma Question 46 2 / 2 points A patient presents to you with a chief complaint of primary dysmenorrhea, which nonpharmacologic intervention might you recommend she try first? Question options: 1) participating in physical activity 2) increase iron rich foods to replace blood that is lost 3) use of a heating pad on the pelvis for cramping 4) use of an NSAID Question 47 2 / 2 points Which of the following agents is active against N. gonorrhoeae? Question options: 1) ceftriaxone 2) metronidazole 3) ketoconazole 4) amoxicillin Question 48 0 / 2 points A recommended treatment for rectal gonorrhea is: Question options: 1) oral amoxicillin. 2) oral azithromycin. 3) oral ciprofloxacin. 4) ceftriaxone injection. Question 49 2 / 2 points When charting on a patient whom you have noted a breast lump it is important to document Question options: 1) tenderness 2) size 3) location 4) mobility 5) all of the above MN 576 Quiz Question 50 2 / 2 points A 24-year-old woman presents with a 1-week history of thin, green-yellow vaginal discharge with perivaginal irritation. Physical examination findings include vaginal erythema with petechial hemorrhages on the cervix, numerous white blood cells, and motile organisms on microscopic examination. These findings most likely represent: Question options: 1) motile sperm with irritative vaginitis. 2) trichomoniasis. 3) bacterial vaginosis. 4) condyloma acuminatum. Bottom of Form

Application: Taking a Stand

Effective leaders have a high degree of self-awareness and know how to leverage their strengths in the workplace. Assessments are a valuable tool that professionals can use to learn more about themselves and consider how their temperament and preferences influence their interactions with others.

As you engage in this learning process, it is important to remember that everyone—regardless of temperament type or related preferences—experiences some challenges with regard to leadership. The key to success is being able to recognize and leverage your own strengths while honoring differences among your colleagues.

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At some point in your leadership career, you will encounter an ethical or moral dilemma that requires you to take a stand and defend your position. Application: Taking a Stand.

For this Assignment, you evaluate an issue and consider how you could act as a moral agent or advocate, facilitating the resolution of the issue for a positive outcome.

To prepare:

·        Consider the examples of leadership demonstrated in this week’s media presentation and the other Learning Resources. Application: Taking a Stand.

·        To further your self-knowledge, you are required to complete the Kiersey Temperament as indicated in this week’s Learning Resources. Consider your leadership style, including your strengths for leading others and include your results from Kiersey Temperament Sorter to describe potential challenges related to your leadership style.

·        Mentally survey your work environment, or one with which you are familiar, and identify a timely issue/dilemma that requires you to perform the leadership role of moral agent or advocate to improve a situation (e.g., speaking or acting on behalf of a vulnerable patient, the need for appropriate staffing, a colleague being treated unfairly). Application: Taking a Stand.

·        What ethical, moral, or legal skills, dispositions, and/or strategies would help you resolve this dilemma? Define the differences between 
ethical, moral, and legal leadership.

·        Finally, consider the values and principles that guide the nursing profession; the organization’s mission, vision, and values; the leadership and management competencies addressed in this course; and your own values and reasons for entering the profession. What motivation do you see for taking a stand on an important issue even when it is difficult to do so? Application: Taking a Stand.

To complete:

Write a 4 to 5 page paper (page count does not include title and reference page) that addresses the following:

·        Introduce the conceptual frameworks of the ethical constructs of ethics, moral, or legal standards and the purpose of the Application: Taking a Stand paper.

·        Consider  an ethical, moral, or legal dilemma that you have encountered in your work environment and describe it.

·        Analyze the moral, ethical, and legal implications utilized in this situation. Describe your role as a moral agent or advocate for this specific issue.

·        Consider your leadership styles identified by your self-assessment and determine if they act as a barrier or facilitation during this dilemma.

Self Assessment results

Guardians (SJ’s)
are the cornerstone of society, for they are the temperament given to serving and preserving our most important social institutions. Guardians have natural talent in managing goods and services–from supervision to maintenance and supply — and they use all their skills to keep things running smoothly in their families, communities, schools, churches, hospitals, and businesses Application: Taking a Stand.

Guardians can have a lot of fun with their friends, but they are quite serious about their duties and responsibilities. Guardians take pride in being dependable and trustworthy; if there’s a job to be done, they can be counted on to put their shoulder to the wheel. Guardians also believe in law and order, and sometimes worry that respect for authority, even a fundamental sense of right and wrong, is being lost. Perhaps this is why Guardians honor customs and traditions so strongly — they are familiar patterns that help bring stability to our modern, fast-paced world.

Practical and down-to-earth, Guardians believe in following the rules and cooperating with others. They are not very comfortable winging it or blazing new trails; working steadily within the system is the Guardian way, for in the long run loyalty, discipline, and teamwork get the job done right. Guardians are meticulous about schedules and have a sharp eye for proper procedures. They are cautious about change, even though they know that change can be healthy for an institution. Better to go slowly, they say, and look before you leap.

Guardians make up as much as 40 to 45 percent of the population, and a good thing, because they usually end up doing all the indispensable but thankless jobs everyone else takes for granted.

You are most comfortable when your life is structured. As a result you usually prefer a workplace that lets you create a routine you can settle into. Because you are dependable and exacting, your colleagues and customers rely on your work. Your ideal job offers you a clear chain of command, and lets you progress through a hierarchy based on your meeting expectations Application: Taking a Stand.

The School of Nursing requires that all papers submitted include a title page, introduction, summary, and references.

 Course Readings

·        Marquis, B. L., & Huston, C. J. (2015). 
Leadership roles and management functions in nursing: Theory and application
 (8th ed.). Philadelphia, PA: Lippincott, Williams & Wilkins.

o   Chapter 4, “Ethical Issues”

This chapter examines ethical frameworks for decision making and principles of ethical reasoning. You are also introduced to the ANA Code of Ethics and Professional Standards, MORAL decision-making model, and ethics committees. Application: Taking a Stand.

o   Chapter 5, “Legal and Legislative Issues”

Chapter 5 provides an overview of the many legal and legislative issues of which leaders and managers need to be aware. As you read this chapter, keep these issues in mind.

o   Chapter 6, “Patient, Subordinate, and Professional Advocacy”

Nurses are the best advocates for patients and the profession. This chapter examines more closely the role of becoming an advocate, patient rights, subordinate advocacy, whistle-blowing, professional advocacy, advocacy in legislation and public policy, and media.

·        Cianci, A. M., Hannah, S. T., Roberts, R. P., & Tsakumis, G. T. (2014). The effects of authentic leadership on followers’ ethical decision-making in the face of temptation: An experimental study. 
The Leadership Quarterly
, 
25
(3), 581-594. doi:10.1016/j.leaqua.2013.12.001

Abstract excerpt: The present research investigates the impact of authentic leadership on followers’ morality, operationalized as ethical decision-making, in the face of temptation. This experiment finds that authentic leadership and temptation interacted to affect individuals’ ethical decision-making. Specifically, authentic leadership significantly inhibited individuals’ from making unethical decisions in the face of temptation, whereas followers of neutral or less authentic leaders were more likely to succumb to temptation. Application: Taking a Stand.

·        Disch, J. (2014). Using Evidence-Based Advocacy to Improve the Nation’s Health. 
Nurse Leader
, 
12
(4), 28-31. doi:10.1016/j.mnl.2014.05.003

Abstract excerpt: Evidence-based practice is 1 of the 5 competencies that the Institute of Medicine has identified for all health professionals. Its intent is to employ evidence-based practice and integrate best research results, clinical expertise, and patient values to make patient care decisions. Application: Taking a Stand. This article will explore the concept of evidence-based advocacy and describe ways in which one prominent nursing organization, the American Academy of Nursing, uses evidence-based advocacy to positively impact the nation’s health and advance the nursing profession

·        Martin, M. B. (2014). Transcultural Advocacy and Policy in the Workplace: Implications for Nurses in Professional Development. 
Journal for nurses in professional development
, 
30
(1), 29-33.  doi: 10.1097/NND.0000000000000027

Abstract: This article introduces the role of nursing professional development specialists in serving as a resource for both patient and staff advocacy regarding cultural and linguistic matters. The impact of changing demographics, support for civil rights, and established policy related to culture and linguistics is emphasized. An overview of policy at local, state, and national levels is suggested to promote nursing professional development in the interest of culturally and linguistically compliant nursing practice. Application: Taking a Stand.

·        Woods, M. (2014). Beyond moral distress preserving the ethical integrity of nurses. 
Nursing Ethics
, 
21
(2), 127-128.

This guest editorial discusses the difficulties involved in dealing with those sometimes-painful moral problems encountered in practice. Application: Taking a Stand.

ccmh 551 week 5 client termination and evaluation reflection sample essay

Client Termination and Evaluation Reflection

Termination should be discussed at the same time the goals are being created so that the client understands the process of the relationship and the realization that this is not a forever relationship sets in. Once the client has adapted to the processes and utilizes the interventions to better themselves and is successful at it, then the job of the counselor is over, and termination of the relationship must be implemented.

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The process of terminating the counselling relationship is the official term employed when a therapist and a client stop working together. I would think it could be a rather difficult time for both myself the counselor and the client, due to the emotional state of mind that comes when all things end, good or bad. It may, stir perhaps the feelings of past loss and preceding endings for both client and counselor. Termination may also represent time of positive replication and a feeling of achievement by reviewing the work accomplished together. Additionally, some healing about previous losses and/or conclusions might well be achieved when these sentiments and prior occurrences are brought out into the light of day ccmh 551 week 5 client termination and evaluation reflection sample essay.

I think that termination can and will end with mixed emotions on both ends of the spectrum. On the positive side, with some patients, as we discuss and review the work we have completed together, I am sure I will see some amazing changes that have taken place inside this relationship that will truly amaze me and leave me and the client feeling gratified. Once you have reached the clients goals termination is a must, to keep the relationship viable after that point is a disservice to the client and is unethical on the part of the counselor.

Thinking about parallel processing, I suspect that is just a part of the difficulty in saying good-bye to clients, it will represent the reflection of the feelings shared between the client and myself. I assume it will be very hard for me to part from some of my future patients, and undoubtedly I will always wonder where there are in their lives and if I truly made the difference for them.  Finally, after all I have read, I have come to believe that termination might also be viewed as a new beginning and not so much an ending.  I will try in future endeavors to view client’s as graduating to a point where they no longer need therapy, or perhaps they are moving on to a relationship with a new therapist of which can provide a service outside the scope of my abilities.

Without regard of what the new foundation might be, I believe that we both will certainly grow and transform from the distinct therapeutic bond that developed between us. No matter how it all plays out in the future I will be forever grateful to those first few clients that allowed me to be a partner on their journey. ccmh 551 week 5 client termination and evaluation reflection sample essay.

References

Hackney, Harold, and L. Sherilyn Cormier. 
The Professional Counselor: A Process Guide to Helping
. Boston, Mass: Allyn & Bacon, 1996 ccmh 551 week 5 client termination and evaluation reflection sample essay.

Critiquing a Change Effort

As a nurse leader, you need to have the skills and knowledge to collaborate and communicate with those who plan for and manage change. This capacity is valuable in any health care setting and for many different types of change. Furthermore, it is essential to be able to evaluate a change effort and determine if it is promoting improved outcomes and making a positive difference within the department or unit, or for the organization as a whole.

To prepare:

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· Review Chapters 7 and 8 in the course text. Focus on the strategies for planning and implementing change in an organization, as well as the roles of nurses, managers, and other health care professionals throughout this process Critiquing a Change Effort.

· Reflect on a specific change that has recently occurred in your organization or one in which you have worked previously. What was the catalyst or purpose of the change?

· How did the change affect your job and responsibilities?

· Consider the results of the change and whether or not the intended outcomes have been achieved.

· Was the change managed skillfully? Why or why not? How might the process have been improved? Critiquing a Change Effort.

By Day 3

Post 
a summary of a specific change within an organization and describe the impact of this change on your role and responsibilities. Explain the rationale for the change, and whether or not the intended outcomes have been met Critiquing a Change Effort. Assess the management of the change, and propose suggestions for how the process could have been improved.

Learning Resources

Required Readings

Marquis, B. L., & Huston, C. J. (2017). 
Leadership roles and management functions in nursing: Theory and application 
(9th ed.). Philadelphia, PA: Lippincott, Williams & Wilkins.

· Review Chapter 7, “Strategic and Operational Planning”

· Chapter 8, “Planned Change”

 

This chapter explores methods for facilitating change and the theoretical underpinnings of implementing effective change. Critiquing a Change Effort.

McAlearney, A., Terris, D., Hardacre, J., Spurgeon, P. Brown, C.,  Baumgart, A.,  Nyström, M. (2014). Organizational coherence in health care organizations: Conceptual guidance to facilitate quality improvement and organizational change. 
Quality Management in Health Care, 23
(4), 254–267 doi: 10.1097/QMH.0b013e31828bc37d

An international group of investigators explored the issues of organizational culture and Quality Improvement (QI) in different health care contexts and settings. The aim of the research was to examine if a core set of organizational cultural attributes are associated with successful QI systems. Critiquing a Change Effort.

Mitchell, G. (2013). Selecting the best theory to implement planned change. 
Nursing Management – UK
, 
20
(1), 32–37. doi: 10.7748/nm2013.04.20.1.32.e1013

Retrieved from the Walden Library databases.

Shirey, M. R. (2013). Lewin’s Theory of Planned Change as a strategic resource. 
The Journal of Nursing Administration
, 
43
(2), 69–72. doi:10.1097/NNA.0b013e31827f20a9

Retrieved from the Walden Library databases.

Required Media

Laureate Education (Producer). (2012g). 
Organizational dynamics: Planned change and project planning.
Baltimore, MD: Author. Critiquing a Change Effort.

Optional Resources

Marquis, B. L., & Huston, C. J. (2017). 
Leadership roles and management functions in nursing: Theory and application 
(9th ed.). Philadelphia, PA: Lippincott, Williams & Wilkins.

· Chapter 9, “Time Management”

Batras, D., Duff, C., & Smith, B. J. (2014). Organizational change theory: implications for health promotion practice. 
Health Promotion International
,
 Retrieved from MEDLINE with Full Text
, EBSCO
host Critiquing a Change Effort

This article reviews select organizational change models to identify the most pertinent insights for health promotion practitioners Critiquing a Change Effort.

Treatment of Paranoid Personality Disorder sample essay

Treatment of a Personality Disorder

Paranoid Personality Disorder

The following paper is to include a discussion of Paranoid Personality Disorder (PPD) by applying the major theories of personality, and the problems and impacts associated with this disorder on both a normal and abnormal development scale as it pertains this personality theory. This disorder will be analyzed through literary review using evidence-based counseling strategies that are related to the intervention or the prevention efforts accompanied by PPD Treatment of Paranoid Personality Disorder sample essay. A critique of the reviewed research will discuss what can be learned about this specific disorder as well as what should be further researched to continue the advancement of potential interventions which could sustain the symptoms and ultimately give sufferers a level of functionality. Further discussion will involve how this research can advance the profession of mental health counseling, counselors and clinicians. The conclusion of this paper will entail the application of the theory in treatment by providing a justification for specific treatment models, per current research within the domain of PPD. A detailed description of interventions that are associated with PPD will be demarcated, and the current shortcomings that exist in the future study arenas that may pertain to areas such as cultural, gender, race, socioeconomic and immigrant status. Treatment of Paranoid Personality Disorder sample essay.

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Discussion

Paranoid Personality Disorder is a Cluster A personality type and it is diagnosed by seven (7) major criteria. The Diagnostic and Statistical Manuel states the disorder numerically as 301.0 (F60.0). The populations vary across race, gender, culture, socioeconomic class and immigration status. PPD occurs in the general population at the rate of 4.4%, and is more prevalent in the homeless population occurring at the rate of 13%. It is more prevalent in males than females, and can be a precursor to other disorders if untreated Treatment of Paranoid Personality Disorder sample essay.  The disorder is usually identified in young adults and exists in an array of situations, specified using four (4) or more of the listed symptoms below:

Suspicion without adequate proof, that people are manipulating, hurting or misleading them.

Obsession with unwarranted doubts about the loyalties or ability to trust friends, family and acquaintances.

Unwillingness to disclose information to others, due to unwarranted fears that such dialogue will be used against them maliciously.

Finds hidden connotations or intimidating connotations into benevolent comments or happenings.

Is unable to forgive any insults, grievances or rebuffs and holds onto a grudge.

Sees attacks on character or status that no one else can see and is swift to counterattack with anger.

Maintains regular suspiciousness without proper justifications about partner or spouse fidelity (DSM V, 2013. P649). Treatment of Paranoid Personality Disorder sample essay.

The nature of PPD usually appears in early adulthood at a time when most people are entering the workforce, and they can appear normal in certain settings with people whom they are not familiar. On certain levels of function, they tend to have normal psychology by being viewed as self-reliant, independent and focused, with a strong presence of autonomy (Lenzenweger 2015). They can also be perceived as the strong quiet type, with leadership qualities. But after a bout of inability to collaborate with others, and the strong need to control their environment and the people around them, this illusion dissipates rather quickly (DSM V, 2013. P650).

Whereas in the abnormal psychology they are secretive, quick to anger, distrusting and view the world and people around them as all having hidden agendas to cause them harm either physically, mentally or emotionally Treatment of Paranoid Personality Disorder sample essay. They have a deep distrust of others and rarely seek out mental health services, believing it is not them who have the problem it is everyone else. Another generally difficulty is that those who suffer from PPD find it hard to maintain close interpersonal relationships (DSM V, 2013. P652). They do not get along with others, and because of their hypervigilance tend to be argumentative, have reoccurring complaints about others or on the other end of the spectrum can appear quiet with apparent hostile aloofness. Within the abnormal frame of PPD, these individuals can also seem cold and standoffish with a lack of tender feelings for anything (Edens, 2013) Treatment of Paranoid Personality Disorder sample essay. They act guarded and secretive, and display devious mannerisms, which nearly all their worry comes from ill perceived notions that the world is out to get them. People who suffer from this disorder will look for ways to prove themselves right about others and their intentions (Ahktar, 2014).

Literature Review – Analyzing Evidence-based Interventions & Preventions

           
Preventing PPD is nearly impossible due to the nature of the disorder and its eruption time of early adulthood (Bernstein, 2015). With a predisposition, genetically and the innumerous social, environmental and interpersonal outcomes of every possibility giving regard to upbringing, social status, geographic local etc. It would be a very elusive game of cat and mouse to try to pinpoint cause let alone every prevention (Fulton, 2013).

The interventions however, tend to be positive, if one could build the trust of the client troubled with this disorder. Once trust is established there are several therapies that have worked successfully on PPD. Dialectical Behavior Therapy, Cognitive Behavior Therapy and Client Centered Approach therapy are the most common therapies utilized for the treatment of this personality disorder. All therapist, counselors and clinicians who have communication with clients who suffer from PPD need to maintain a clearly conscious state of being straight-forward with these clients (Hoermann, 2013). Treatment of Paranoid Personality Disorder sample essay Indirect witticisms are more times than not lost on them. References to data about the client not obtained directly from their mouth will increase an excessive deal of suspiciousness. Counselors need to naturally evade trying to have the client sign a release of information (ROI) for info not vital to the present treatment. Situations in life that typically would not give the majority individuals a second thought will simply become part of the focus of attention to these patients, much care must be exerted in dialogues with these particular clients (Dombeck, 2013). An authentic, black and white tactic will more than likely advance the maximum results, concentrating on present life worries which brought the patient into treatment to begin with.

Application of Theory in Treatment

Treatment Justification

The justification of the treatment process in the peer-reviewed articles all portrayed a common theme of isolating other possible conditions before moving forward with specific treatment plans. Most of the subjects studied were in mental health institutions and were monitored over increments of time ranging from 6 months to 1 year (Cramer, 2016). All the articles stated that the building of trust between client and clinician was a first and foremost stipulation to being able to move forward with a treatment plan (Hardy, 2014). A duality of common perceptions among immigrants and minorities was noted, attributing these behaviors as normal within their contexts because of the cultural divides between their cultures and that of the majority cultural within the United States. It is normal for minority cultures to harbor suspiciousness toward the dominate white culture, and this validates their insecurities with barriers to language, culture, socioeconomic and social status in an unfamiliar context (Demarce, 2017). Treatment of Paranoid Personality Disorder sample essay.

Interventions

Short Term Goals for Individuals with Paranoid Disorder:

Client will display levels of a trusting dialogue while communicating with clinician by disclosing emotions and principles.

Classify then document the persons or entities that client distrusts then document why.

Client will show agreeability by cooperating with the clinician by exploration of feelings of susceptibility.

Classification and exploration of historical foundations for the why they feel vulnerable.

Recognize then document clients perceived principles that other people are unable to be trusted and are evil.

Give referral so client can obtain a full psychiatric assessment.

Screen any prescription meds client is prescribed and detail any observed side effects.

Complete a full psychological assessment to measure clients level of obsession.

Make a referral to have a neuro-psychological assessment to cancel out client may suffer from an biological etiology. Treatment of Paranoid Personality Disorder sample essay.

Mirror any oral assembly among fear of others and the clients own feeling of insufficiency.

Decrease allegations about other people plotting to cause harm.

Client will demarcate an improved trustworthiness in others and within the communal setting.

Demarcate trustworthiness of spouse and others, then can move toward a relaxing state while in their company.

Raise societal interactions by eradicating distress or distrust being conveyed (Verheul, 2012).

Long Term Goals for Individuals with Paranoid Disorder:

Learn to trust in others by talking positively about others and report an ease when being social.

Become involved within community and interrelate with other people without becoming self-protective or irritated.

Feel trust of significant other and stop allegations of unfaithfulness.

Decrease caution and doubt around other people, increase relaxation, trust, and be more open to interaction with others.

Achieve a sense of aptitude to think on more significant matters without any intrusion from mistrustful fixations Treatment of Paranoid Personality Disorder sample essay.

Standard suitable effectiveness at place of employment, within community relations with only nominal intrusion from suspicious preoccupations (Raza, 2017).

Current intervention gaps

The current gaps that exist within the scope of PPD are varied and numerous. Because suffers do not usually seek out treatment the study numbers are small and outdated. More research into this disorder is needed to determine if possible links between populations exists. Another area of the population that tends to display this disorder is the prison population, and link between this disorder and crime has been noted but requires further probing to result in adequate research. The link between childhood abnormal treatment and adulthood suffering of PPD is too noted but not researched enough to draw a viable conclusion.

Cultural & Immigrant Status

Cultural behavior among immigrants and minority groups does mimic PPD, but most cases are dismissed as having PPD, due to the overwhelming similarity of symptoms without etiology. It is a culture-related norm to be suspicious of the majority culture, and barriers such as language, lack of knowledge of cultural norms and rules, and political acceptance all play a part in the normal development of suspicion within these groups (Raza, 2015).

Socioeconomic

           
The research indicates a higher number of individuals from lower class to lower middle class suffer from PPD. Evidence that this occurs in upper class is relevant but these suffers tend to have family and means to suppress the diagnosis formally and therefore they are able to go undetected throughout society (Raza, 2015).

 

Gender

           
PPD tends to afflict men over women 3:1. It is inconclusive as to why, but research has shown that women are more likely to seek out help for conditions that afflict them than men are (Raza, 2015).

Conclusion

This paper included a discussion of Paranoid Personality Disorder (PPD) by applying the major theories of personality, and the problems and impacts associated with this disorder on both a normal and abnormal development scale as it pertains this personality theory. This disorder was analyzed through literary review using evidence-based counseling strategies that are related to the intervention and/or the prevention efforts accompanied by PPD. A critique of the reviewed research was discussed and what could be learned about this specific disorder as well as what should be further researched to continue the advancement of potential interventions which could sustain the symptoms and ultimately give sufferers a level of functionality. A brief discussion of how this research evolved, and how this research could advance the profession of mental health counseling, counselors and clinicians. While concluding this paper, it entailed the application of the theory in treatment by providing a justification for specific treatment models, per current research within the domain of PPD. A detailed description of interventions that are associated with PPD were demarcated, and the current shortcomings that exist in the future study arenas that may pertain to areas such as cultural, gender, race, socioeconomic and immigrant status were noted and addressed.

 

References

Ahktar, S. (2014). Paranoid personality disorder: A synthesis of developmental, dynamic and descriptive features. American Journal of Psychotherapy, 44, 5–25

Bernstein, D.P., & Useda, J. (2015). Paranoid personality disorder. In: W. O’Donohue, K. Fowler, & S. Lilienfeld (Eds). Personality disorders: Toward the DSM-V. Thousand Oaks, CA: Sage

Cramer, V., Torgersen, S., & Kringlen, E. (2016). Personality disorders and quality of life. A population study. Comprehensive Psychiatry, 47, 178–184 Treatment of Paranoid Personality Disorder sample essay.

Dialectical Behavior Therapy for Personality Disorders (DBT)

SIMONE HOERMANN, PH.D., CORINNE E. ZUPANICK, PSY.D. & MARK DOMBECK, PH.D. DEC 6, 2013

Edens, J.F., Marcus, D.K., & Morey, L.C. (2013). Paranoid personality has a dimensional latent structure: Taxometric analyses of community and clinical samples. Journal of Abnormal Psychology, 118, 545–553

Fulton M, Winokur G.A comparative study of paranoid and schizoid personality disorders. Am J Psychiatry 2013; 150:1363–1367.

Hackney, H., & Cormier, L. S. (1996). 
The professional counselor: A process guide to helping
. Boston, Mass: Allyn & Bacon.

Hardy, Gillian. & Kellet, Stephen. Clinical Psychology and Psychotherapy Clinical Psychology Psychotherapy 21, 452–464 (2014) Published online 3 June 2013 in Wiley Online Library (wileyonlinelibrary.com). Treatment of Paranoid Personality Disorder sample essay.

Lenzenweger, M. F., Lane, M. C., Loranger, A. W., & Kessler, R. C. (2015). DSM-IV personality disorders in the national comorbidity replication. Biological Psychiatry, 62, 553–564. doi:10. 1016=j.biopsych.2017.04.19

RAZA GINA, DEMARCE JOSEPHINE M., LASH STEVEN J., & PARKER JEFFERSON D. Journal of Ethnicity in Substance Abuse, 13:247–257, 2014 ISSN: 1533-2640 print=1533-2659 online retrieved from http://web.b.ebscohost.com.contentproxy.phoenix.edu/ehost/pdfviewer/pdfviewer?sid=b4edf5ab-02ab-46b4-a5cc-7fe07ebdb0cb%40sessionmgr101&vid=1&hid=130

Verheul, R. (2012). Treatment of Paranoid Personality Disorder sample essay Clinical utility of dimensional models for personality pathology. Journal of Personality Disorders, 19, 283–302. doi:10.1521=pedi.2017.19.4.283

Perception of Aging Discussion Essay

Discuss your own philosophy of aging. When do you think a person becomes elderly? What do you think of older people? Are they active, senile, debilitated, etc.? Give a description of an elderly person that you know.

Perception of Aging

The aging process begins from birth and follows a predictable sigmoid curve that ultimately leads to the loss of all body functions and death. In fact, aging is linked with both cognitive and physical declines. This predictable pattern occurs if growth is allowed to progress without hindrance. The more current improvement to medical treatment approaches, research and technology allow for individuals to have longer lifespans. Perception of Aging Discussion Essay. In essence, these improvements have only managed to slow down the deteriorative physical and cognitive growth process. This implies that advancing in age does not necessarily imply becoming dependent and frail. Similar to other population identifiers, aging is not a uniform process that relies on time. That is because aging is socially diverse, and is affected by ongoing medical, economic and social changes that present different circumstances, settings and needs (Harlew, 2013). For instance, a man who ate healthy foods may appear less aged when compared to a similar aged counterpart who mostly ate junk food.

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Kamouni (2016) reports on one of the scientific advances reported to reverse aging. In fact, the online newspaper article reports on the development of an anti-ageing compound by British scientists. In this case, the scientists linked to Nottingham University stated that they had identified a cellular protein (carbonic anhydrase) located in the mitochondria and responsible for aging. The study noted that the proteins’ quantities increased with advance in age to imply that older individuals had a larger quantity of the protein when compared to their younger counterparts (Kamouni, 2016) Perception of Aging Discussion Essay.

Tangible evidence collected from experimental studies involving mice as subjects noted that the identified protein was present in the muscle cells and brain tissue thereby supporting the scientists’ assertions and reports. Also, it was observed that mice with brain deterioration reported higher amounts of the protein. This led the scientists to deduct that carbon anhydrase is linked to degeneration of the body and brain. To validate their results, the scientific researchers synthesized the protein then used it to treat nematode worms. Comparing the results between untreated and treated worms showed that the treated warms had a shorter lifespan than their untreated counterparts. Perception of Aging Discussion Essay. Following this results, they conclude that the protein’s function was to facilitate the aging process. Working with this evidence (that carbonic anhydrase is responsible for aging), they postulated that inhibiting the protein action would effectively slow or even halt the aging process. They anticipate that once these inhibitors are identified, they could then be packaged and sold as pharmaceutical drugs (Kamouni, 2016). In this respect, aging can be considered as the increased accumulation and concentration of carbon anhydrase in the body since its function is to increase cognitive and physical declines Perception of Aging Discussion Essay.

References

Harlew, G. (2013).
Ethics in Clinical Practice: An inter-professional approach
. New York: Routledge.

Kamouni, S. (2016).
Anti-Ageing Pill? Breakthrough as scientists discover how to slow down the ageing process – raising hopes of drug treatments
. Retrieved from https://www.thesun.co.uk/living/1944409/breakthrough-as-scientists-discover-how-to-slow-down-the-ageing-process-raising-hopes-of-drug-treatments Perception of Aging Discussion Essay.

Age-related changes that affect the lifestyle of the elderly essay

What do you think are the two most prevalent age-related changes that affect the lifestyle of the elderly? How would you help an elderly patient adjust to the two changes you identified?

Discussion

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As individuals age, they are faced with age-related changes that affect their lifestyle. These changes are in the form of cognitive, physical and income declines. There is a correlation between completion of cognitive tasks and age. In fact, persons of advanced age will typically underperform their younger counterparts in recall and memory tasks. The performance difference is blamed in cognitive decline, except for habitual and instinctive tasks that are conducted subconsciously and do not engage recall or memory. As such, cognitively decline makes it difficult for elderly persons to complete tasks adequately and competently, thus affecting their lifestyle. This is addressed by implementing a reminder system (such as notes and alarms) that simplifies recall and memory (Dhami, Schlottmann & Waldmann, 2012). Age-related changes that affect the lifestyle of the elderly essay. Other than cognitive declines, elderly persons also face physical declines that reduce their mobility and make them prone to injury. Although not much can be done about cognitive declines except to conduct memory exercises, physical declines can be addressed in a more direct manner. Addressing physical declines would entail actively maintaining peak physical condition as a tactic for reducing the risk of falls. This would occur by making the individuals more nimble at navigating physical obstacles and developing greater physical awareness. Exercise programs present a good opportunity for maintaining peak physical condition as well as developing greater physical awareness that improves balance, back strength, lower extremity strength and flexibility, while reducing the fear of falling. This occurs by training the muscles and bone structures to be resilient and stronger. Besides physical and cognitive declines, elderly persons also face income declines that are compounded by inflation making it difficult for them to maintain the same lifestyle. This can be addressed through better investment management (Pitta, 2015) Age-related changes that affect the lifestyle of the elderly essay. In this respect, elderly persons face physical, income and cognitive declines that affect their lifestyles.

References

Dhami, M., Schlottmann, A. & Waldmann, M. (2012).
Judgment and Decision Making as a Skill: Learning, Development, and Evolution
. Cambridge: Cambridge University Press.

Pitta, P. (2014).
Solving modern family dilemmas: an assimilative therapy model
. New Yor, NY: Routledge Age-related changes that affect the lifestyle of the elderly essay.

Older Adult Interview/Patient Questionnaire/Assessing and Planning Care for an Elderly Person

Choose an older adult to interview. This cannot be a patient in your clinical setting. You can use a friend, family member, or co-worker. The older adult should be 65 years or older. Use the format provided to record the responses. A list of questions is available for you to start with. Include 2–3 questions of your own to get a complete picture of the older adult. Summarize your findings and also contrast the responses with findings in your readings and other current literature Older Adult Interview/Patient Questionnaire/Assessing and Planning Care for an Elderly Person.

This form should be used as an example:

[Patient Questionnaire

INTERVIEW OF CHOSEN ELDER ADULT

Name:

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Age:

Brief Introduction (Background information):

1. Philosophy on living a long life:

2. Thoughts about when a person is considered “too old”:

3. Opinion on the status and treatment of older adults:

4. Beliefs about health and illness:

5. Health promotion activities he or she participates in:

6. Something special that helped the person live so long:

7. Life span of other family members:

8. Special dietary traditions in patient’s culture attributed with aiding long life:

9. Any remedies/medications that have been handed down in family/group. If yes, describe.

10. Patient’s description of current and past health status

11. The values that guided life so far Older Adult Interview/Patient Questionnaire/Assessing and Planning Care for an Elderly Person

Additional Questions

1.

2.

3.

Summary:

Contrast of client’s responses with findings in current literature:]

After gaining permission, conduct a physical and mental functional assessment of the older adult you have chosen. Review your readings for the process of functional assessment.

Make use of the tools discussed this week to complete a comprehensive assessment of your patient. Search the Internet for resources on these tools.

Tinetti Balance and Gait Evaluation

Katz Index of Activities of Daily Living

Assessment of Home Safety

The Barthel Index

Make sure the older adult is clearly identified on the tools. Do not include their name, but do include professional or other designation, and age. Your name should also be identified on the tool. (This should be a part of your Appendix.)

Compare and contrast the age-related changes of the older person you interviewed and assessed with those identified in this week’s reading assignment. During this data analysis process provide at least 4–6 preliminary issues that you have identified. Identify three alterations in health that you would propose and describe them. Identify a minimum of three comprehensive interventions for each problem. Older Adult Interview/Patient Questionnaire/Assessing and Planning Care for an Elderly Person.

Make sure that you integrate personal cultural awareness and cultural competency.

Paper should be 5–6 pages, not including the questionnaire or tools used. These should be attached as an Appendix. Remember to use headings to identify the different sections in your paper.

On a separate references page, cite all sources using APA format.

Patient Questionnaire

Name:

Age: 80

Questionnaire and the responses

What is your philosophy on longevity of life?

“Living a long life means you led or living a good life. Those who die early have a bad life”

2. What are your thoughts about when a person is considered “too old”?

“A person is considered too old when they become less functional and start depending on others. They start getting memory problems. They start having many illnesses and have less comfortable life.”

3. What is your opinion on the status and treatment of older adults?

“Treatment of elderly people should be holistic and should start from preventive stages. Diseases of old age can be predicted and so physicians must prepare to handle them”.

4. What are your beliefs about health and illness in the elderly?

“The old get sick often and their diseases are frequently more than one.”

5. Do you participate in any health promotion activities? Older Adult Interview/Patient Questionnaire/Assessing and Planning Care for an Elderly Person.

“I help young women try to lose their weight. We have a group that meets weekly to discuss progress of weight loss over the week. I mostly play passive role though but keep the younger ones in check to achieving their target.”

6. Is there anything special that has helped you live long?

“I successfully controlled my smoking and was always watching on my diet. I also have my blood pressure under control.”

7. How many years have your other family members lived?

“My wife is 60 years old and alive. My dad died at 100 years. My mother is alive and 105 years old. My siblings are 67 and 60 years old.”

8. Is there any special dietary tradition in your culture that has contributed to your long life?

“There are nothing written by the book but we always encourage vegetarian diet. We only take meet and junk foods after the church service on Sundays.”

9. Are there any remedies that have been passed down the generation that is responsible for longevity?

“There are no medications or any other remedy that is passed down the generation tree”

10. Can you kindly describe your current and past health condition/status?

“I have high blood and that is under control. I was admitted once for very high blood pressures in the recent past. I also had Chronic Obstructive Pulmonary Disease but I stopped smoking 5 years ago and I am doing well.”

11. What are the values that have guided your life so far?

“Love for my wife and family. We always are happy and happiness lengthens our lives. We are still a strong family.” Older Adult Interview/Patient Questionnaire/Assessing and Planning Care for an Elderly Person.

12. Do you believe that the elderly are useful in the society?

“The elderly, even though dependent on people, play a crucial role in society. They have experience and have good advice for the younger ones. Even though, passively, they can play other important roles for example what I do to help people lose weight”

Do you think having non-communicable diseases as you shorten life?

“I think things such as high blood pressure, diabetes take a toll on us as they are present for lifetime. They make us go to hospital many times.”

14. Why do people want to live long life?

“I do not really know. It could be because old age is associated with good life or because they want to accomplish everything they wanted to have.”

Do you think that the population of elderly people will rise in future?

“Yes. I think many people are increasingly becoming old. So yes, the older people will be many in future.” Older Adult Interview/Patient Questionnaire/Assessing and Planning Care for an Elderly Person.

Summary

Most of the interviewer’s views are in tandem with the literature. For example, it is true that most elderly are prone to getting illnesses. Their health deteriorates over time. Singh & Misra (2009) asset that the elderly experience many social, psychological and physical challenges in life that impact on their sense of capacity and self. They experience depression and loneliness (Singh &Misra, 2009). His view that the elderly population will rise in the near future is also true. Most of his family members are also elderly. The elderly population is growing due to advance in the level of care and health education. For example, the population of elderly has risen from 5 % in 1960 to 23% in 2010. It is also true that the elderly get many diseases. Non-communicable diseases are also on the rise. Social and psychosocial problems in the elderly hamper their ability to live a healthy life (Isaacowitz& Smith, 2003) Older Adult Interview/Patient Questionnaire/Assessing and Planning Care for an Elderly Person. Another research also found poor health disproportionally affects the elder although the mean-level age difference in well-being is positive or null (Arai et al., 2012).

Tinetti Balance and Gait Evaluation

Tinetti Balance and Gait score assess the chances of an elderly falling within the next one year. Each variant is given a score from 0-2 and higher scores have better outcome in terms of risk of fall.  It has a total score of 28 with values less than 19 being indicative of high risk of fall. Any value from 19 is considered to have risk of fall. Older Adult Interview/Patient Questionnaire/Assessing and Planning Care for an Elderly Person.

Tinetti Balance and Gait Evaluation

Interviewer:

Date:

BALANCE

ACTIVITY

SCORE

Balance when sitting

1

Can rise with arm support

1

He rises with single attempt

2

Standing balance is firm without support

2

Standing balance is steady with wide stance

2

Steady on nudging

2

Balance intact with eyes closed

2

Has discontinuous steps on 360 turn

0

Non-smooth motion on sitting down

1

SUB-TOTAL

13/16

 

 

GAIT

ACTIVITY

SCORE

Patient can initiate gait immediately

1

Step length and height for left and right swing foot-passes stance to the opposite

1,1

Has equal left and right step symmetry

1

Has continuous step

1

No deviation in path

2

Has no sway on trunk but slight flexion of knees

1

Heels almost touch on walking

1

SUB-TOTAL

9/12

TOTA TINNETI SCORE

22/28

INTERPRETATION

RISK FOR FALL

 

(Elsawy, & Higgins, 2011)

Katz Index of Activities of Daily Living

Interviewer:

Interviewee:

Age:

Profession:

The Katz index of independence in Activities of Daily Living was 5/6 for this patient. The points are as follows Older Adult Interview/Patient Questionnaire/Assessing and Planning Care for an Elderly Person.

 

ACTIVITY

SCORE

Baths without any help

1

Dresses without any help

1

Does toileting on his own

1

Can transfer himself without help

1

Has partial urinary incontinence

0

Feeds himself without help

1

TOTAL

5/6

INTERPRETATION

Patient is independent

 

(Elsawy, & Higgins, 2011)

Assessment of Home Safety

The assessment of home safety for this elderly person will be considered under the living room, the status of the bathroom, bedroom and outside the house

LIVING ROOM

Has doorways are appropriately wide

The living room has loose electrical cords that are unsafe

The pathways in the living room are clear

The electrical cables are not overloaded and the switch is within acceptable reach.

BEDROOM

The bed is set low enough to be freely accessible

There is no installation of night light

There are no loose area rugs and carpet sections

There is no stable chair in the room to make dressing safer and easy

There is no rolling furniture Older Adult Interview/Patient Questionnaire/Assessing and Planning Care for an Elderly Person

BATHROOM

There are no grab handles near sink, toilet or shower

The water heater temperature had not been set to less than 120 degrees

There are loose rugs on the bathroom floor

Toilet sit is raised well

No phone or waterproof medical alert device for emergency call

OUTSIDE HOME

The sidewalk is in appropriate condition

The front door is in good condition

There is adequate lighting

There are railings along the front steps

 

(Tomita et al., 2014)

Interpretation: Outside the home is safe. The bathroom is unsafe. The living room is safe. The bedroom is 50% safe.

The Barthel Index assesses functional independence.

THE BARTHEL INDEX SCORE

ACTIVITY

SCORE

INTERPRETATION

Feeding

10

Independent

Grooming

5

Independent

Toileting

10

Independent

Bowel Control

10

Has continence

Dressing

10

Independent

Transfers

15

Independent

Bladder control

5

Occasional accident

Bathing

5

Independent

Mobility on flat surface

15

Independent

Stair case movement

5

Needs help

TOTAL SCORE

95

Fully independent

MINI-COGNITIVE ASSESSMENT INSTRUMENT

Assesses for presence of dementia

ITEMS RECALLED

DRAWING OF CLOCK

INTERPRETATION

0

A

P

1

n

N

1

A

P

2

n

N

2

A

P

3

n

N

3

A

N

KEY

ITEMS RECALLED-the number of three unrelated items that the interviewee recalls

DRAWING-ability to draw clock

A-abnormal

n-Normal

P-Positive

N-negative

INTERPRETATION

The patient is at the red line where he recalls only two unrelated words (dog and table) and has abnormal clock drawing and therefore tests positive for dementia

Whole Analysis-comparison

The patient tested positive for dementia. He was able to recall two unrelated words; dog and table. His clock drawing result was abnormal and therefore he tested positive for dementia on the mini-cognitive assessment. Dementia refers to progressive decline in the cognitive functions of an individual. Symptoms such as apathy, depression, agitation and other neuropsychiatric symptoms are common. With this loss of function, the patient looses independence and may require placement in home care. Older Adult Interview/Patient Questionnaire/Assessing and Planning Care for an Elderly Person. The age-standardized prevalence of dementia from 11 European countries based on population studies was at 6.4% for all cases and 4.4 % for Alzheimer’s disease. The prevalence is higher in women than in men and nearly doubled every five-year increase in age.  For the population above 90 years, close to 30% of them had dementia. Alzheimer’s disease was present in 54% of the patients who have dementia. Thus, it is normal for the interviewee to have some form of cognitive impairment. Another important finding is the occasional loss of bladder control. This is also an expected finding in male patients of that age. Most times it can be from bladder outlet obstruction secondary to Benign Prostatic Enlargement. Other symptoms of Benign Prostatic Enlargement should be sought. The levels of the PSA will also be valuable in the further assessment of the patient. The patient should be seen by the urologist for further assessment. If enlargement is found he can be given medications or have urinary catheter in situ for symptomatic relief before prostatectomy is carried out. On physical evaluation, it was also found that, the interviewer had difficulty in climbing stairs. He has strong balance control for his age and his gait is normal for the age. Home safety found the bathroom is unsafe. To make his home safer for his age, there is need to install grab handles near the sink, toilet and the shower. The water heater also needs to be set to less than 120-degree for the maximum temperature. Further, there is need to eliminate loose throw rugs on the bathroom floor. Lastly, there is need to install a phone in the bathroom or have a waterproof medical alert device for emergency calls. The patient has Chronic Obstructive Pulmonary Disease that he has acquired due to long-standing cigarette smoking. It is commendable that he has quit smoking. However, COPD is a chronic disease and elderly patient are at risk of developing acute exacerbations. He has to be taught appropriate inhaler technique. His role in helping others lose weight is also recommendable. He plays a passive role despite being overweight. Moderate exercise is advisable for him. Apart from weight loss, it will also help him to control his blood pressures well. He is a vegetarian. DASH diet will be recommendable for him. Residential nursing care is not recommended for him as he has fairly good physical and mental functions. Further, he has a fairly young and supportive wife who can take good care of him Older Adult Interview/Patient Questionnaire/Assessing and Planning Care for an Elderly Person.

.

References

Arai, H., Ouchi, Y., Yokode, M., Ito, H., Uematsu, H., Eto, F., … & Tsubota, K. (2012). Toward the realization of a better aged society: messages from gerontology and geriatrics. 
Geriatrics & gerontology international
, 
12
(1), 16-22.

Elsawy, B., & Higgins, K. E. (2011). The geriatric assessment. 
Am Fam Physician
, 
83
(1), 48-56.

Isaacowitz, D. M., & Smith, J. (2003). Positive and negative affect in very old age. 
The Journals of Gerontology Series B: Psychological Sciences and Social Sciences
, 
58
(3), P143-P152.

Singh, A., & Misra, N. (2009). Loneliness, depression and sociability in old age. 
Industrial psychiatry journal
, 
18
(1), 51. Older Adult Interview/Patient Questionnaire/Assessing and Planning Care for an Elderly Person.

Tomita, M. R., Saharan, S., Rajendran, S., Nochajski, S. M., & Schweitzer, J. A. (2014). Psychometrics of the Home Safety Self-Assessment Tool (HSSAT) to prevent falls in community-dwelling older adults. 
American journal of occupational therapy
, 
68
(6), 711-718 Older Adult Interview/Patient Questionnaire/Assessing and Planning Care for an Elderly Person.

PICO analysis of depression essay

A PICO analysis is used to pose a focused clinical question to which you find appropriate evidence-based answers. The PICO question should include the patient or population (P), anticipated intervention (I), comparison group or current standard (C), and outcome desired (O). In this Assignment, you develop a question related to dementia, delirium, or depression. Through your PICO analysis, you explore various resources and examine current evidence to answer the question you develop.

To prepare:

Select one of the following disorders as your topic: dementia, delirium, or depression.

Review the guidelines in the “Literature Review Matrix” document in this week’s Learning Resources.

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Think about a research question around your issue as indicated in Part I: PICO Analysis of Research Topic. PICO analysis of depression essay.

Consider the resources you will use, search terms and criteria, and Boolean search strings as indicated in Part II: Search Strategy.

Using the Walden Library and other appropriate databases, locate five articles related to your PICO question. At least one article must be a systematic review. All of the articles should be primary sources.

Reflect on the five articles you selected as indicated in Part III: Analysis of Literature. Consider the conceptual framework/theory, main finding, research method, strengths of study, weaknesses, and level of evidence for each article PICO analysis of depression essay.

Consider how to use the summaries in Part III to create an evidence table. Use this evidence table to determine appropriate treatment options for patients who present with the disorder you selected as your topic.

To complete:

Formulate a question around the disorder you selected as indicated in Part I: PICO Analysis of Research Topic. PICO analysis of depression essay.

Identify the resources you will use, search terms and criteria, and Boolean search strings as indicated in Part II: Search Strategy.

Summarize the five articles you selected as indicated in Part III: Analysis of Literature. Describe the conceptual framework/theory, main finding, research method, strengths of study, weaknesses, and level of evidence for each article.

Create an evidence table based on the article summaries in Part III. Describe appropriate treatment options for patients based on this evidence table.

Managing Depression among Pregnant Women

Part I and II

This study investigated the need and strategies to manage depression cases among pregnant women. For this study, five sources were selected from varying databases after entering several search terms and search strings. The key search term deployed for the study included pregnancy, prenatal, depression, exercise. Consequently, the search strings for the study included maternal depression, pregnancy depressive symptoms, child outcomes, pregnancy and prenatal depression, and pregnancy depressive disorder. PICO analysis of depression essay. The resources selected were all primary sources and had a time range of not more than five years. Moreover, two of the articles were systematic reviews.

Part III: Analysis of Literature.

Gentile (2017) conducted a systematic review investigating the effect of Untreated depression during pregnancy with emphasis on both the Short-and long-term effects to the offspring. In the study, Forty-three articles were selected from varying databases since August 2015. This studies revealed that untreated depression during pregnancy had adverse effects on the developing fetus, newborns and young children, a factor which facilitated including hyperactivity, and irregular fetal heart rate, and resulted to premature deaths PICO analysis of depression essay. Consequently, untreated depression during pregnancy had a significant effect on children in later development ranging from “increased salivary cortisol levels, internalizing and externalizing problems, and central adiposity.” The study highlighted a controversy on the correlation between gestational depression and an increase in prematurity and low birth weight.

Another study by Glover, (2014) investigating on the measures that should be enacted to address “Maternal depression, anxiety and stress during pregnancy and child outcome” from the study Results revealed that even though other factors such as genetics and postnatal care were at play, prenatal anxiety and depression played a significant role facilitating the child’s behavioral and psychological outcomes PICO analysis of depression essay.

The study by Perales, Refoyo, Coteron, Bacchi, and Barakat. (2015) was a randomized controlled trial investigating whether “Exercise during pregnancy attenuates prenatal depression.” the sample for this study was 184 pregnant women selected from Fuenlabrada Hospital. Two groups EG supervised exercise and CG control group were developed and 90 women from the sample were allocated to the EG while the other 77 women were included in the control group (CG). From this study, it was observed that “supervised physical exercise during pregnancy curbed depression and its incidence in pregnant women.”(Perales et al., 2015)

The other study selected was a systematic review conducted by Staneva, Bogossian, Pritchard, and Wittkowski, (2015) investigating “The effects of maternal depression, anxiety, and perceived stress during pregnancy on preterm birth” in this study Four databases were searched in a bid to select articles “focusing on the association between antenatal depression, anxiety, and stress, and preterm birth published in English between 1980 and 2013.” The study result highlighted a strong correlation between antenatal distress during the pregnancy and preterm birth.

The article by Woolhouse, Gartland, Mensah and Brown (2015) “Maternal depression from early pregnancy to 4 years postpartum in a prospective pregnancy cohort study: implications for primary health care” sort to highlight the prevalence and the underlying  risk factors for depressive symptoms employing a cohort study for a 4 years nulliparous women as the study design. The sample was 1507 women whereby the resultant data highlighted a mean gestation of 15 weeks PICO analysis of depression essay. From the study 1 in every three women reported a case of depression symptom in the first four months and the resultant depression prevalence in this study was at 14.5%.

Appropriate treatment options

From the analyzed literature its evident that prevalence of depressive symptoms among pregnant women is high. Moreover, Woolhouse et al. (2015) observed that depression symptoms were also likely to extend to the early years of postpartum heightening the negative impact of depression. Consequently, the articles recommend several interventions to curb the depression symptoms and manage stress and depression cases related to pregnancy PICO analysis of depression essay. However, Gentile’s study also cautions the medical practitioners to weigh out possible effects of some intervention strategies especially the antidepressants which have been highlighted as harbouring utero exposure risks (Gentile, 2017). In this regard, following the literature analysis, this study has highlighted four interventions strategies as adequate to manage pregnancy depression cases.

Notably, depression symptoms in women are high in pregnancy and early years of parenting and pose a significant risk to both the mother and the child (Woolhouse et al., 2015). As such, healthcare services should scale up surveillance of depressive symptoms to all women in this categories. In this regard, this study suggests that free depression medical checkups should be enacted in health centres to cater for the pregnant women and those in early years of postpartum.

Consequently, psychological distress manifest in varying ways including anxiety and stress was shown to be highly correlated with depression (Staneva et al., 2015). As such, this paper proposes that any form of psychological distress evident in pregnant women should be handled with heightened caution and curbed adequately. The Health practitioners especially those engaged perinatal care to women should be adequately informed to work in corroboration and share information amongst them self to ensure that all symptoms have been assessed and adequate intervention measures enacted as deemed appropriate (Glover, 2014). This intern will improve outcomes for both mothers and infants.

Lastly, a notable intervention strategy that had a significant positive outcome in the reduction of depression in pregnant women was evident in Perales et al. (2015) study. According, to the study, supervised physical exercise during pregnancy was shown to significantly lower the level of depression and probability of depression incidence in the pregnant women (Perales et al., 2015). The efficacy of the approach was also heightened by the possibility of negative effect both to the mother and the fetus accrued with depressants PICO analysis of depression essay.

According to Gentile (2017), several studies have pointed out on the possibility of negative outcome associated with in utero exposure to antidepressants. However, the study also emphasizes that if untreated dare consequences are likely to befall the mother and the child extending to later years in life. According to the study possible effects of depression in pregnancy to the child in later years include “increased salivary cortisol levels, internalizing and externalizing problems, and central adiposity” (Gentile, 2017, p 157). As such, this study proposes that healthcare institutions should enact programs or collaborate with professional physical exercise providers to ensure the pregnant patients get supervised physical exercise sessions as a means to curb depression cases and symptoms

References

Gentile, S. (2017). Untreated depression during pregnancy: Short-and long-term effects in offspring. A systematic review. 
Neuroscience
, 
342
, 154-166.

Glover, V. (2014). Maternal depression, anxiety and stress during pregnancy and child outcome; what needs to be done. 
Best practice & research Clinical obstetrics & gynaecology
, 
28
(1), 25-35.

Perales, M., Refoyo, I., Coteron, J., Bacchi, M., & Barakat, R. (2015). Exercise during pregnancy attenuates prenatal depression: a randomized controlled trial. 
Evaluation & the health professions
, 
38
(1), 59-72 PICO analysis of depression essay.

Staneva, A., Bogossian, F., Pritchard, M., & Wittkowski, A. (2015). The effects of maternal depression, anxiety, and perceived stress during pregnancy on preterm birth: a systematic review. 
Women and Birth
, 
28
(3), 179-193.

Woolhouse, H., Gartland, D., Mensah, F., & Brown, S. J. (2015). Maternal depression from early pregnancy to 4 years postpartum in a prospective pregnancy cohort study: implications for primary health care. 
BJOG: An International Journal of Obstetrics & Gynaecology
, 
122
(3), 312-321 PICO analysis of depression essay.

Social Challenges of Aging Essay

Conduct in-depth analysis of a pertinent topic related to aging. Define the problem, specific population affected, cultural implications, and financial/legal/ethical implications. What interventions can be used to improve the problem? What resources are available? What are the associated costs? Is this idea sustainable? Social Challenges of Aging Essay.

Submit your paper in a 6–7-page Microsoft Word document.

Support your responses with examples.

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References must be within 3 years.

Social Challenges of Aging

Introduction

The subject of aging garners greater debate when it concerns the elderly and aged persons who are often considered unproductive but requiring a large proportion of the health resources to maintain a high-quality life, health education and long-term care plans. In fact, the attention focus on the gaps in income, housing and other relevant social and community elements. The reality is that elderly persons require input from multiple stakeholders before these gaps can be addressed (von Homboldt, 2016). Social Challenges of Aging Essay. This then leaves us with the question of what consequences will be faced by both the present and future populations with regards to the existing gaps as pertains a population composed of elderly persons. The present paper explores these notions by talking of the implications of aging and associated social challenges of an aging population.

Discussion

Social challenges of aging

The elderly population has far-reaching implications for any country. This is because it presents direct challenges to the medical system to include the increasing cost of healthcare, rising demand for medical services use, and shifting health profiles. This can be presented as a rapidly increasing group of elderly persons with a larger burden of lifestyle-related medical conditions (such as diabetes) and typical age-based medical issues (that include cancer, dementia, arthritis, and so on) when compared to preceding generations. In addition, the social variations that the next generation of elderly persons will experience (to include an enhanced awareness and understanding of medical issues, as well as greater expectations of medical services) poses added challenges. These challenges are likely to have an effect on future health care engagement and delivery models (Tomczyk & Klimczuk, 2015). Social Challenges of Aging Essay.

The major social challenge is shifting health profiles, with the issue being how medical systems will meet the health needs of the aging population that is increasingly impacted by chronic ailments. The prevalence of many medical conditions is greater for older age groups. Besides that, it is noted that elderly persons are more likely to report multiple long-term medical disorders. Despite the rising incidence of ill health and disease among elderly persons with the condition worsening with age, most persons in that age group believe that they are in good health Social Challenges of Aging Essay. The implication of these awareness is that older individuals have a higher prevalence of chronic self-reported health conditions, terminal conditions, and high risk of injury, thereby showing that they are prone to shifting health profiles requiring greater medical care (Tomczyk & Klimczuk, 2015).

Another challenge is the rising demand for medical services. It is increasingly apparent that the demand for medical services is affected by a range of social factors, but elderly persons are typically higher users of medical services when compared to their younger counterparts. As such, medical services demand is anticipated to rise with the aging population. The increased use of medical services and facilities by elderly populations has implications for medical personnel that is diverse and large, encompassing many occupations that range from volunteers to support staff and highly qualified professions Social Challenges of Aging Essay. The aging population needs an adequate medical labour force to handle its needs (to include skill set, distribution, and numbers) to meet the heightened demand and shifting needs. The future scarcity of appropriately skilled health workers is also anticipated to be a particular challenge (Tomczyk & Klimczuk, 2015).

Yet another challenge is the rising cost of health care. With elderly persons being high users of medical services and facilities, and medical costs being higher for the same population subset, it is prudent to have concerns about the possibility of elderly persons placing an unsustainable strain on available resources. The relationship between medical costs and aging is complex. Still, there is considerable evidence to show that growth in health care spending (both current and projected) are attributable to aging. As such, there is little doubt that medical policies and systems should be adapted in response to the significant shift in population demographics. Part of this understanding includes the awareness that health care funding is collected from a range of sources to include private individuals, insurers, government, and non-governmental sources (Michel et al., 2018).

The government is the principal source of health funding, accounting for as much as 70% of funding needs. It is important to note that the high expenditure has been matched by increasing tax revenue. Whether the same trend will be noted in the future is difficult to predict since labour productivity and supply patterns are likely to undergo change even as education levels rise and diversification occurs in the economy (von Homboldt, 2016). Social Challenges of Aging Essay Private individuals account for 17% of medical funding, with the elderly who tend to have lower incomes and greater wealth also reporting higher costs and spending although these figures are distributed unevenly. More than 50% of their personal wealth (for the elderly) constitutes property. Although it would be logical to assume that elderly persons can easily access their wealth (such as property through reverse mortgage), this wealth is not readily accessible to fund medical needs. Besides that, elderly persons who do not own their accommodation end up having to rent and spend a large proportion of their income on housing thereby leaving a very small proportion for medical costs and other expenditures (von Homboldt, 2016).

The next generation of elderly persons (the baby boomer cohort) is anticipated to have higher levels of wealth and income when compared to past generations. However, the unequal distribution of wealth and income will continue whereby 25% of the wealthy elderly persons will account for 60% of the income and wealth while the poorer 25% will account for 4% of the income and wealth for that age group (von Homboldt, 2016). In addition, the elderly are also increasingly becoming active in the labour force, thereby helping to offset their expenditure growth and bring about better retirement balances (Paltasing & Tyagi, 2015) Social Challenges of Aging Essay. On the other hand, a large number of elderly persons have never contributed to retirement schemes or have only made minimal contributions for a limited time. Increased retirement savings is not anticipated to have an impact in decreasing the number of persons who receive pensions, but it is anticipated to cause a greater shift away from full pensions and towards partial pensions. This means that this population will be unable to meet their health care costs even as they age (Michel et al., 2018).

It is important to note that the challenge presented by an elderly population is acute for certain demographic groups, thereby explaining why the demand for medical service types and locations vary. The higher incidence of disability and life expectancy reported among elderly women (when compared to their male counterparts), along with differences in workforce participation and earnings means that women are more vulnerable to economic uncertainties. Although retirement payment coverage is rising, there remains a significant disparity between superannuation coverage for both male and female elderly persons (Rajan & Balagopal, 2017). Social Challenges of Aging Essay.

At the core of the focus on social factors and pressures is the awareness that socioeconomic factors, including their related handicaps, are important health determinants. In general, there is a tendency for health status to improve with a rise in the economic data. This phenomenon is typically referred to as the socioeconomic gradient of health. Rajan and Balagopal, (2017) puts the issue into perspective by reporting that health inequalities impose costs on any country, both regarding losing productivity and medical care. The very existence of such inequalities is an indication that there is room for health gains to be realized (Rajan & Balagopal, 2017).

Responding to the social challenges

As has been established, an aging population presents some social challenges. This implies that the combination of medical services needed and offered, as well as the way in which they are delivered and funded needs to undergo some radical changes in response to the aging population. At the core of this awareness is the knowledge that aging is linked to heightened risk of dependency, disability and plethora of medical conditions, although the situation is variable since most of the chronic conditions can be postponed or even prevented thereby determining that they are not an inevitable consequence of aging (von Humboldt, 2016). The postponement and prevention to promote good health across the lifespan occur through reduction of morbidity from diseases, disease prevention after the onset, reducing risk factors prevalence before disease onset, and prevention of disease risk factors (Paltasing & Tyagi, 2015) Social Challenges of Aging Essay. Overall, encouraging wellbeing across the different age groups is intended as a strategy for ensuring that future generations of elderly persons are healthy.

Another response is enabling healthy aging, which involves improving and maintaining quality of life and health of elderly persons through the management of multi-morbidity and chronic conditions to enable active and healthy aging (Rajan & Balagopal, 2017). The medical sector plays a principal role in supporting and promoting healthy aging, with medical professionals being instrumental in averting or avoiding disease complications, managing the risks of diseases, and offering advice on lifestyle. Care programs for aged persons also offer a setting for preventive medical care, particularly in avoiding the occurrence of fractures and falls since they are common among elderly persons and are associated with high costs (von Humboldt, 2016).

Supporting and better enabling the social and economic participation of elderly persons within their communities is anticipated to mitigate the challenges of an aging population. This is because health is positively linked to engagement in paid employment (Paltasing & Tyagi, 2015). As a result, promoting good health among elderly persons presents the possibility of triggering health gains and increasing the capacity to actively participate in both the community and workforce.

Conclusion

One must accept that aging attracts debate since the population is linked to heightened risk of dependency, disability and plethora of medical conditions. Also, the population is considered unproductive and yet require considerable resources to maintain. In addition, one must acknowledge that this population faces significant social challenges. Social Challenges of Aging Essay To be more concise, aging population faces social challenges in terms of shifting health profiles, rising demand for medical services, rising cost of health care, funding sources, and unfavorable socioeconomic gradient of health. There is a need to respond to these social challenges through postponement and prevention to promote good health across the lifespan, enabling healthy aging, and supporting increased social and economic participation of elderly persons. In this respect, an aging population introduces unique social challenges that should be addressed.

References

Michel, J., Beattie, L., Martin, F. & Walston, J. (2018).
Oxford Textbook of Geriatric Medicine. Oxford Textbook of Geriatric Medicine
(3
rd
ed.). Oxford: Oxford University Press.

Paltasing, T. & Tyagi, R. (2015).
Caring for the elderly: social gerontology in the Indian context
. New Delhi: SAGE Publications India Pvt Ltd.

Rajan, I. & Balagopal, G. (2017).
Elderly care in India: societal and state responses
. Singapore: Springer Nature.

Tomczyk, L. & Klimczuk, A. (2015).
Aging in the social space
. Bialystok-Krakow: The Association of Social Gerontologists. Social Challenges of Aging Essay.

von Humboldt, S. (2016).
Conceptual and methodological issues on the adjustment to aging: perspectives on aging well
. Dordrecht: Springer.