Category: Nursing

  • NURS 6512 Advanced Health Assessment final examination

    Which portion of the physical examination is best done with the patient standing? spinal

     

    To assess spinal levels L2, L3, and L4, which deep tendon reflex should be tested? patellar

     

    To assess a cremasteric reflex, the examiner strokes the: lightly stroking the inner thigh

     

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    Which condition is considered progressive rather than reversible? dementia

     

    When palpating breast tissue, the examiner should use the _pads of the fingers____ at each site.

     

    Palpation of a normal prostate in an older adult is likely to feel: rubbery

     

    The difference in blood pressure readings between the right and the left arms is considered normal up to _5____ mm Hg.

     

    Your 15-year-old patient is athletic and thin. Radiography of an ankle injury reveals a stress fracture. You should question this patient about her: menstrual cycles

     

    Cranial nerve XII may be assessed in an infant by: sucking and swallowing

     

    While collecting personal and social history data from a woman complaining of breast discomfort, you should question her regarding:

     

    An idiopathic spasm of arterioles in the digits is termed: Raynauds

     

    A 23-year-old white woman has come to the clinic because she has missed two menstrual periods. She states that her breasts have enlarged and that her nipples have turned a darker color. Your further response to this finding is to: pregnancy

     

    Assessing orientation to person, place, and time helps determine:

     

    The rectal past medical history of all patients should include inquiry about:

     

    To hear diastolic heart sounds, you should ask patients to:

     

    Loss of immediate and recent memory with retention of remote memory suggests: dementia

     

    Your patient’s chief complaint is repeated pencil-like stools. Further examination should include:

     

    Kawasaki disease is suspected when assessments of a child reveal:

     

    The examiner percusses for diaphragmatic excursion along the:

     

    If pitting edema is unilateral, you would suspect occlusion of a:

     

    Which medical condition would exclude a person from sports participation? fever

     

    The Mini-Mental State Examination:

     

    An ophthalmoscopic eye examination involves: Lens

     

    The Denver II is a tool used to determine:

     

    A common finding in markedly obese and pregnant women is: Lordosis

     

    When conducting a geriatric assessment, basic activities of daily living (ADLs) include: Bathing

     

    The finger-to-nose test allows assessment of: coordination

     

    Inspection of the scrotum should reveal: left lower than the right

     

    Part of the screening orthopedic component of the examination includes evaluating the person while he or she is:

     

    In the most effective percussion technique of the posterior lung fields, the patient cooperates by: crossing arms in front

     

    Normal changes of the aging brain include:

     

    Ulnar deviation and boutonniere deformities are characteristic of: Rheumatoid arthritis

     

    A cervical polyp usually appears as a:

     

    Bimanual examination of the uterus includes:

     

    If a patient cannot shrug the shoulders against resistance, which cranial nerve (CN) requires further evaluation?

     

    Electrical activity recorded by the electrocardiogram (ECG) tracing that denotes the spread of the stimulus through the atria is the: p wave

     

    Inquiry about nocturnal muscle spasms would be most significant when taking the musculoskeletal history of:

     

    The spread of the impulse through the ventricles (ventricular depolarization) is depicted on the ECG as the: QRS

     

    As Mr. B. enters the room, you observe that his gait is wide based and he staggers from side to side while swaying his trunk. You would document Mr. B.’s pattern as:

     

    The reliability of health-related findings and observations is the responsibility of the: patient and examiner

     

    The physical assessment technique most frequently used to assess joint symmetry is: inspection

     

    The presence of cervical motion tenderness may indicate:

     

    The goals of preparticipation sports evaluation include:

     

    A patient in the deepest coma would be scored a __3___ on the Glasgow Coma Scale.

     

    The adnexa of the uterus are composed of the:

     

    Montgomery tubercles are most prominent in the breasts of:

     

    Palpation of epitrochlear nodes is part of the: upper extremities

     

    During chest assessment, you note the patient’s voice quality while auscultating the lung fields. The voice sound is intensified, there is a nasal quality to the voice, and the e’s sound like a s. This sound is indicative of: bronchial obstruction

     

    When palpating joints, crepitus may occur when: irregular bony surfaces rub together

     

    Examination of the patient in the lithotomy, or knee-chest, position includes: anal sphincter

     

    The best way to ease the apprehension of a 3-year-old child before a physical examination is to: let him hold the stethoscope during the exam

     

    Recent unilateral inversion of a previously everted nipple suggests: cancer

     

    A grade IV mitral regurgitation murmur would:

     

    Breath sounds normally heard over the trachea are called: bronchial

     

    Nerves that arise from the brain rather than the spinal cord are called: cranial

     

    The checkout station for preparticipation physical evaluation (PPE) is critical because at this point: plan follow ups

     

    You are interviewing a 20-year-old patient with a new-onset psychotic disorder. The patient is apathetic and has disturbed thoughts and language patterns. The nurse recognizes this behavior pattern as consistent with a diagnosis of: schizophrenia

     

    A 12-year-old boy relates that his left scrotum has a soft swollen mass. The scrotum is not painful upon palpation. The left inguinal canal is without masses. The mass does transilluminate with a penlight. This collection of symptoms is consistent with: hydrocele

     

    Postural hypotension is defined as a ___15 mm hg decrease__ when the patient stands, compared with sitting or supine readings.

     

    While examining a 30-year-old woman, you note that one breast is slightly larger than the other. In response to this finding, you should: document in the record

     

    You are inspecting the genitalia of an uncircumcised adult male. The foreskin is tight and cannot be easily retracted. You should: ask about previous infections

     

    An examiner has rotated a brush several times into the cervical os. The brush was withdrawn and stroked lightly on a glass slide. The slide was sprayed with fixative. Which type of specimen requires this technique for collection? Cytology smear

     

    When you attempt to move a 10-month-old child from his mother’s lap to the examination table, he screams loudly. Your best action is to: let them sit on the mothers lap

     

    It is especially important to test for ankle clonus if: deep tendon reflexes are hyperactive

     

    Which one of the following is a proper technique for use of a speculum during a vaginal examination?

     

    Diabetic peripheral neuropathy will likely produce: decreased pain sensation

     

    One of the most important aspects to consider in the orthopedic screening examination is: symmetry

     

    The Mini-Mental State Examination should be administered for the patient who: get lost in their own neighborhood

     

    When the Goodenough-Harris Drawing Test is administered to a child, the evaluator principally observes the:

     

    During a routine prenatal visit, Ms. T. was noted as having dependent edema, varicosities of the legs, and hemorrhoids. She expressed concern about these symptoms. You explain to Ms. T. that her enlarged uterus is compressing her pelvic veins and her inferior vena cava. You would further explain that these findings: normal pregnancy

     

    An apical PMI palpated beyond the left fifth intercostal space may indicate: left ventricular hypertrophy

     

    Which one of the following techniques is used to detect a torn meniscus? McMurray

     

    When assessing superficial pain, touch, vibration, and position perceptions, you are testing: sensory

     

    Which of the following statements is true regarding the examination of peripheral arteries? Do not use your thumb

     

    Tarry black stool should make you suspect: upper gastrointestinal bleed

     

    A pulsation that is diminished to the point of being barely palpable would be graded as: 1

     

    Temporalis and masseter muscles are evaluated by: clenching teeth

     

    The foramen ovale should close: minutes after birth

     

    A parent is advised to restrict contact or collision sports participation for their child. An example of a sport in which this child could participate is: riflery

     

    When is the mental status portion of the neurologic system examination performed? constantly

     

    Breath odors may clue the examiner to certain underlying metabolic conditions. The odor of ammonia on the breath may signify: uremia

     

    You are conducting a preparticipation physical examination for a 10-year-old girl with Down syndrome who will be playing basketball. She has slight torticollis and mild ankle clonus. What additional diagnostic testing would be required for her? Cervical radiographs

     

    For purposes of examination and communication of physical findings, the breast is divided into: 4 quadrants and a tail

     

    A red, hot swollen joint in a 40-year-old man should lead you to suspect: gout

     

    You are examining Mr. S., a 79-year-old diabetic man complaining of claudication. Which of the following physical findings is consistent with the diagnosis of arterial occlusion? Lack of hair growth

     

    You are initially evaluating the equilibrium of Ms. Q. You ask her to stand with her feet together and arms at her sides. She loses her balance. Ms. Q. has a positive: Rombergs

     

    Anterior cruciate ligament integrity is assessed via the _____ test. Lachmans

     

    Throughout the history and physical examination, the clinician should:

     

    Your older clinic patient is being seen today as a follow-up for a 2-day history of pneumonia. The patient continues to have a productive cough, shortness of breath, and lethargy and has been spending most of the day lying in bed. You should begin the chest examination by: auscultating lung bases

     

    When assessing a 17-year-old for nuchal rigidity, you gently raise his head off the examination table. He involuntarily flexes his hips and knees. To confirm your suspicions associated with this positive test, you would also perform a test for the _____ sign.

     

    You are assessing Mr. Z.’s fluid volume status as a result of heart failure. If your finger depresses a patient’s edematous ankle to a depth of 6 mm, you should record this pitting as: 4+

    A finding that is indicative of osteoarthritis is: Herberdens

     

    To spread the breast tissue evenly over the chest wall, you should ask the woman to lie supine with: arm up over head and pillow behind one shoulder

     

    You are conducting an examination of Mr. Curtis’s heart and blood vessels and auscultate a grade III murmur. The intensity of this murmur is: moderately loud

     

    At your first meeting with a patient, it is usually best to say: Tell me about yourself

     

    Functional assessment is most important during the examination of a(n): older adult

    Nancy Walker is a 16-year-old girl who presents to the clinic with complaints of severe, acute chest pain. Her mother reports that Nancy, apart from occasional colds, Nancy is not prone to respiratory problems. What potential risk factor is most important to assess with regards to Nancy’s current problem? Cocaine

    A patient you are seeing in the emergency department for chest pain is suspected of having a myocardial infarction. During the health history interview of his family history, he relates that his father had died of “heart trouble.” The most important follow-up question you should pose is which of the following? How old was your father at the time of his death

    Which cranial nerves are usually evaluated during the examination of the eyes?

     

    While interviewing a 70-year-old female clinic patient, she tells you that she takes ginkgo biloba and St. John’s wort. You make a short note to check for results of the: MMSE

  • Problem Focus Exams: Head, Eyes, Ears, Nose, and Throat (HEENT)

    NUR 643 Topic 2: Problem Focus Exams: Head, Eyes, Ears, Nose, and Throat (HEENT)

    Topic 2: Problem Focus Exams: Head, Eyes, Ears, Nose, and Throat (HEENT)

    Read the “Procedures for Advanced Health Assessment Check-Offs” and submit your response below in this forum within the allotted timeframe for completion: Procedures for Advanced Health Assessment Check-Offs Acknowledgement I, (INSERT NAME), verify that I have read, understand, and will comply with the requirements set forth in the “Procedures for Advanced Health Assessment Check-Offs” document.

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    Objectives:

    Review the appropriate anatomy and physiology related to the HEENT systems: head, eyes, nose, ears, and throat.

    Explore basic physical examination techniques for conducting a HEENT examination for the applicable regions.

    Compile focused subjective and objective health history for the specified HEENT regions while communicating effectively with the patient.

    Prepare a competent SBAR (situation, background, assessment, and recommendations) documentation note.

    SBAR Template

    Choose an experience from your nursing practice. Using the “SBAR” template, explain the situation in detail, followed with background information. Then explain your immediate assessment and recommendations you have for the provider.

    Include the following in the “SBAR” template:

    Be sure to include three or four evidence‐based references, not older than 5 years.

    When giving your recommendation discuss how you would educate the client using evidence‐based research and guidelines. How would you deliver your recommendation in various learning environments?

    APA style is not required, but solid academic writing is expected.

    This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

    You are not required to submit this assignment to LopesWrite.

    Health Assessment Topic Reflection 2

    Complete a 250‐word reflection of what you have learned during this topic. Include the following in your reflection:

    Think about an experience you’ve encountered when viewing or completing the particular assessment.

    Discuss difficulties that could potentially arise or specific questions related to completing this type of assessment.

    Include illustrative examples of potential strategies used to overcome the difficulties encountered when completing (the particular) assessment.
                

    Describe how the Christian worldview and compassion for all plays a role in this type of assessment.

    APA style is not required, but solid academic writing is expected.

    This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

    You are not required to submit this assignment to LopesWrite.

    Course Code Class Code Assignment Title Total Points

    NUR-643E NUR-643E-O500 Health Assessment Topic Reflection 2 10.0

    Criteria Percentage 1: Unsatisfactory (0.00%) 2: Less Than Satisfactory (80.00%) 3: Satisfactory (88.00%) 4: Good (92.00%) 5: Excellent (100.00%) Comments Points Earned

    Content 85.0%

    Topic 2 DQ 1

    As an instructor, you are working with a nursing student in the second year of a 4-year nursing program. The student does not perform an ear exam correctly. How would you explain the appropriate technique to examine the ears?

    Topic 2 DQ 2

    You are working the triage desk of the ED. A client presents with sudden loss of vision of the right eye after a head collision during a volleyball game. What would your assessment include? What could be initial problems and would they warrant emergent intervention?

  • Nurs 6650 Week 4: Structural and Strategic Family Therapy

    Week 4: Structural and Strategic Family Therapy

    Individuals are born into families, grow and develop in families, and live most of their lives in families. Therefore, it makes sense that clients are best understood within the context of the family system.

    ——Dr. Candice Knight, 
    Psychotherapy for the Advanced Practice Psychiatric Nurse

    The family system is a social unit that is based on unique relationships and roles. Structural and strategic therapies are important, because they offer unique insights to the theoretical underpinnings of this system. As a psychiatric mental health nurse practitioner, a strong theoretical foundation will help you better understand the family unit and family therapy; this understanding will, in turn, improve the effectiveness of your work with clients.

    This week, as you continue exploring family therapy, you examine structural and strategic family therapies and their appropriateness for client families. You also consider your own practicum experiences involving family therapy sessions.

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    Learning Resources

    Note:
     To access this week’s required library resources, please click on the link to the Course Readings List, found in the 
    Course Materials
     section of your Syllabus.

    Required Readings

    Nichols, M. (2014).
    The essentials of family therapy
    (6th ed.). Boston, MA: Pearson.

    Chapter 5, “Bowen Family Systems Therapy” (pp. 69–88)

    Chapter 6, “Strategic Family Therapy” (pp. 89–109)

    Chapter 7, “Structural Family Therapy” (pp. 110–128)

    Gerlach, P. K. (2015). Use structural maps to manage your family well: Basic premises and examples. Retrieved from http://sfhelp.org/fam/map.htm

     

    McNeil, S. N., Herschberger, J. K., & Nedela, M. N. (2013).
    Low-income families with potential adolescent gang involvement: A structural community family therapy integration model.
    American Journal of Family Therapy, 41(2), 110–120. doi:10.1080/01926187.2011.649110

    Note:
    Retrieved from Walden Library databases.

    Méndez, N. A., Qureshi, M. E., Carnerio, R., & Hort, F. (2014). The intersection of Facebook and structural family therapy volume 1.
    American Journal of Family Therapy, 42
    (2), 167–174. doi:10.1080/01926187.2013.794046

    Note:
    Retrieved from Walden Library databases.

    Nichols, M., & Tafuri, S. (2013). Techniques of structural family assessment: A qualitative analysis of how experts promote a systemic perspective.
    Family Process, 52
    (2), 207–215. doi:10.1111/famp.12025

    Note:
    Retrieved from Walden Library databases.

    Ryan, W. J., Conti, R. P., & Simon, G. M. (2013). Presupposition compatibility facilitates treatment fidelity in therapists learning structural family therapy.
    American Journal of Family Therapy, 41
    (5), 403–414. doi:10.1080/01926187.2012.727673

    Note:
    Retrieved from Walden Library databases.

    Sheehan, A. H., & Friedlander, M. L. (2015). Therapeutic alliance and retention in brief strategic family therapy: A mixed-methods study.
    Journal of Marital and Family Therapy, 41
    (4), 415–427. doi:10.1111/jmft.12113

    Note:
    Retrieved from Walden Library databases.

    Szapocznik, J., Muir, J. A., Duff, J. H., Schwartz, S. J., & Brown, C. H. (2015). Brief strategic family therapy: Implementing evidence-based models in community settings.
    Psychotherapy Research, 25
    (1), 121–133. doi:10.1080/10503307.2013.856044

    Note:
    Retrieved from Walden Library databases.

    Required Media

    Psychotherapy.net (Producer). (2010).
    Bowenian family therapy
    [Video file]. Mill Valley, CA: Author.

     

    Note:
    You will access this media from the Walden Library databases. The approximate length of this media piece is 118 minutes.

    Triangle Productions (Producer). (2001).
    Brief strategic therapy with couples
    [Video file]. La Jolla, CA: Author.

     

    Note:
    You will access this media from the Walden Library databases. The approximate length of this media piece is 49 minutes.

    Optional Resources

    Coatsworth, J. D., Santisteban, D. A., McBride, C. K., & Szapocznik, J. (2001). Brief strategic family therapy versus community control: Engagement, retention, and an exploration of the moderating role of adolescent symptom severity.
    Family Process, 40
    (3), 313–332. Retrieved from http://www.familyprocess.org/family-process-journal/

    Golden Triad Films (Producer). (1986).
    The essence of change.
    [Video file]. Mill Valley, CA: Psychotherapy.net.

    National Institute on Drug Abuse. (2003).
    Brief strategic family therapy for adolescent drug abuse.
    Retrieved from https://archives.drugabuse.gov/TXManuals/BSFT/BSFTIndex.html

     

    Navarre, S. (1998). Salvador Minuchin’s structural family therapy and its application to multicultural family systems.
    Issues in Mental Health Nursing, 19
    (6), 557–570. doi:10.1080/016128498248845

    Psychotherapy.net (Producer). (2000b). Satir family therapy [Video file]. Mill Valley, CA: Author.

    Psychotherapy.net (Producer). (2011b). Salvador Minuchin on family therapy [Video file]. Mill Valley, CA: Author.

    Radohl, T. (2011). Incorporating family into the formula: Family-directed structural therapy for children with serious emotional disturbance.
    Child & Family Social Work, 16
    (2), 127–137. doi:10.1111/j.1365-2206.2010.00720.x

    Robbins, M. S., Feaster, D. J., Horigian, V. E., Rohrbaugh, M., Shoham, V., Bachrach, K., … Szapocznik, J. (2011). Brief strategic family therapy versus treatment as usual: Results of a multisite randomized trial for substance using adolescents.
    Journal of Consulting and Clinical Psychology, 79
    (6), 713–727. doi:10.1037/a0025477

    Santisteban, D. A., Suarez-Morales, L., Robbins, M. S., & Szapocznik, J. (2006). Brief strategic family therapy: Lessons learned in efficacy research and challenges to blending research and practice.
    Family Process, 45
    (2), 259–271. doi:10.1111/j.1545-5300.2006.00094.x

    Szapocznik, J., Schwartz, S. J., Muir, J. A., & Brown, C. H. (2012). Brief strategic family therapy: An intervention to reduce adolescent risk behavior.
    Couple & Family Psychology, 1
    (2), 134–145. doi:10.1037/a0029002

    Szapocznik, J., Zarate, M., Duff, J., & Muir, J. (2013). Brief strategic family therapy: Engaging drug using/problem behavior adolescents and their families in treatment.
    Social Work in Public Health, 28
    (3-4), 206–223. doi:10.1080/19371918.2013.774666

    Vetere, A. (2001). Therapy matters: Structural family therapy.
    Child Psychology & Psychiatry Review, 6
    (3), 133–139. Retrieved from http://www.iupui.edu/~mswd/D642/multimedia/word_doc/StructuralFamilyTherapy_Vetare.pdf

     

    Weaver, A., Greeno, C. G., Marcus, S. C., Fusco, R. A., Zimmerman, T., & Anderson, C. (2013). Effects of structural family therapy on child and maternal mental health symptomatology.
    Research on Social Work Practice, 23
    (3), 294–303. doi:10.1177/1049731512470492

    Assignment 1: Structural Versus Strategic Family Therapies

    Although structural therapy and strategic therapy are both used in family therapy, these therapeutic approaches have many differences in theory and application. As you assess families and develop treatment plans, you must consider these differences and their potential impact on clients. For this Assignment, as you compare structural and strategic family therapy, consider which therapeutic approach you might use with your own client families.

    Learning Objectives

    Students will:

    Compare structural family therapy to strategic family therapy

    Create structural family maps

    Justify recommendations for family therapy

    To prepare:

    Review this week’s Learning Resources and reflect on the insights they provide on structural and strategic family therapies.

    Refer to Gerlach (2015) in this week’s Learning Resources for guidance on creating a structural family map.

    The Assignment

    In a 2- to 3-page paper, address the following:

    Summarize the key points of both structural family therapy and strategic family therapy.

    Compare structural family therapy to strategic family therapy, noting the strengths and weaknesses of each.

    Provide an example of a family in your practicum using a structural family map. Note: Be sure to maintain HIPAA regulations.

    Recommend a specific therapy for the family, and justify your choice using the Learning Resources.

    Note: The School of Nursing requires that all papers submitted include a title page, introduction, summary, and references. The sample paper provided by the Walden Writing Center provides examples of those required elements (available at http://writingcenter.waldenu.edu/57.htm). All papers submitted must use this formatting.

     

    By Day 7

    Submit
     your Assignment.

    Submission and Grading Information

    To submit your completed Assignment for review and grading, do the following:

    Please save your Assignment using the naming convention “WK4Assgn1+last name+first initial.(extension)” as the name.

    Click the 
    Week 4 Assignment 1 Rubric 
    to review the Grading Criteria for the Assignment.

    Click the 
    Week 4 Assignment 1 
    You will also be able to “View Rubric” for grading criteria from this area.

    Next, from the Attach File area, click on the 
    Browse My Computer
    Find the document you saved as “WK4Assgn1+last name+first initial.(extension)” and click 
    Open
    .

    If applicable: From the Plagiarism Tools area, click the checkbox for 
    I agree to submit my paper(s) to the Global Reference Database
    .

    Click on the 
    Submit
    button to complete your submission.

    Grading Criteria

    To access your rubric:

    Week 4 Assignment 1 Rubric

     

    Check Your Assignment Draft for Authenticity

    To check your Assignment draft for authenticity:

    Submit your Week 4 Assignment draft and review the originality report.

     

    Submit Your Assignment by Day 7

    To submit your Assignment:

    Week 4 Assignment

     

    Assignment 2: Practicum – Week 1 Journal Entry

    By Day 7

    Submit
     your Assignment. Refer to Week 1 for additional guidance.

    Submission and Grading Information

    To submit your completed Assignment for review and grading, do the following:

    Please save your Assignment using the naming convention “WK4Assgn2+last name+first initial.(extension)” as the name.

    Click the 
    Week 4 Assignment 2 Rubric 
    to review the Grading Criteria for the Assignment.

    Click the 
    Week 4 Assignment 2 
    You will also be able to “View Rubric” for grading criteria from this area.

    Next, from the Attach File area, click on the 
    Browse My Computer
    Find the document you saved as “WK4Assgn2+last name+first initial.(extension)” and click 
    Open
    .

    If applicable: From the Plagiarism Tools area, click the checkbox for 
    I agree to submit my paper(s) to the Global Reference Database
    .

    Click on the 
    Submit
    button to complete your submission.

    Grading Criteria

    To access your rubric:

    Week 4 Assignment 2 Rubric

     

    Check Your Assignment Draft for Authenticity

    To check your Assignment draft for authenticity:

    Submit your Week 4 Assignment 2 draft and review the originality report.

     

    Submit Your Assignment by Day 7

    To submit your Assignment:

    Week 4 Assignment 2

     

    Assignment 3: Practicum – Week 2 Journal Entry

    By Day 7

    Submit
     your Assignment. Refer to Week 2 for additional guidance.

    Submission and Grading Information

    To submit your completed Assignment for review and grading, do the following:

    Please save your Assignment using the naming convention “WK4Assgn3+last name+first initial.(extension)” as the name.

    Click the 
    Week 4 Assignment 3 Rubric 
    to review the Grading Criteria for the Assignment.

    Click the 
    Week 4 Assignment 3 
    You will also be able to “View Rubric” for grading criteria from this area.

    Next, from the Attach File area, click on the 
    Browse My Computer
    Find the document you saved as “WK4Assgn3+last name+first initial.(extension)” and click 
    Open
    .

    If applicable: From the Plagiarism Tools area, click the checkbox for 
    I agree to submit my paper(s) to the Global Reference Database
    .

    Click on the 
    Submit
    button to complete your submission.

    Grading Criteria

    To access your rubric:

    Week 4 Assignment 3 Rubric

     

    Check Your Assignment Draft for Authenticity

    To check your Assignment draft for authenticity:

    Submit your Week 4 Assignment 3 draft and review the originality report.

     

    Submit Your Assignment by Day 7

    To submit your Assignment:

    Week 4 Assignment 3

     

    Assignment 4: Practicum – Week 3 Assessing Client Families

    By Day 7

    Submit
     your Assignment. Refer to Week 3 for additional guidance.

    Submission and Grading Information

    To submit your completed Assignment for review and grading, do the following:

    Please save your Assignment using the naming convention “WK4Assgn4+last name+first initial.(extension)” as the name.

    Click the 
    Week 4 Assignment 4 Rubric 
    to review the Grading Criteria for the Assignment.

    Click the 
    Week 4 Assignment 4 
    You will also be able to “View Rubric” for grading criteria from this area.

    Next, from the Attach File area, click on the 
    Browse My Computer
    Find the document you saved as “WK4Assgn4+last name+first initial.(extension)” and click 
    Open
    .

    If applicable: From the Plagiarism Tools area, click the checkbox for 
    I agree to submit my paper(s) to the Global Reference Database
    .

    Click on the 
    Submit
    button to complete your submission.

    Grading Criteria

    To access your rubric:

    Week 4 Assignment 4 Rubric

     

    Check Your Assignment Draft for Authenticity

    To check your Assignment draft for authenticity:

    Submit your Week 4 Assignment 4 draft and review the originality report.

     

    Submit Your Assignment by Day 7

    To submit your Assignment:

    Week 4 Assignment 4

     

    Assignment 5: Board Vitals

    This week you will be responding to twenty Board Vitals questions that cover a broad review of your Nurse Practitioner program courses up to this point.

    These review questions will provide practice that is critical in your preparation for the national certification exam that’s required to certify you to practice as a nurse practitioner. These customized test questions are designed to help you prepare for your Nurse Practitioner certification exam. It is in your best interest to take your time, do your best, and answer each question to the best of your ability.

    You can access Board Vitals through the link sent to you in email or by following the link below:

    https://www.boardvitals.com/

     

    By Day 7

    Complete the Board Vitals questions.

    Practicum Reminder

    Time Logs

    You are required to keep a log of the time you spend related to your practicum experience 
    and enter every patient you see each day.
     You can access your time log from the Welcome Page in your Meditrek account. You will track time individually for each patient you work with. Please make sure to continuously input your hours throughout the term.

     

    Making Connections

    Now that you have:

    Examined structural and strategic family therapies and their appropriateness for client families

    Considered your own practicum experiences involving family therapy sessions

    Next week, you will:

    Explore solution-focused and cognitive behavioral therapy and challenges related to these therapeutic approaches

    Develop diagnoses for clients receiving family psychotherapy and consider the legal and ethical implications of counseling these clients

    To go to the next week:

    Week 5

  • Designer Baby (Scalisi vs. NY Univ. Medical Center) case discussion

    Discussion is for business law 1

    Designer Baby (Scalisi vs. NY Univ. Medical Center, p. 429)

    Why was the basis of the parent’s argument that they were not bound by the written contract in the Scalisi et al. v. New York University Medical Center case? How did the court rule and what was the reasoning for that decision. Do you agree or disagree. Why or why not? Have you ever entered into an oral contract? Discuss.

    ORDER A CUSTOM-WRITTEN, PLAGIARISM-FREE PAPER NOW

    Rubic

    For your initial post (1), you must do the following:

     Compose a post of one to two paragraphs.

     In Module One, complete the initial post by Thursday at 11:59 p.m.

    Eastern Time.

     In Modules Two through Eight, complete the initial post by Thursday at

    11:59 p.m. of your local time zone.

     Take into consideration material such as course content and other

    discussion boards from the current module and previous modules, when

    appropriate (make sure you are using proper citation methods for your

    discipline when referencing scholarly or popular resources).

  • Mind Maps—Dementia, Endocarditis, and Gastro-oesophageal Reflux Disease (GERD) Pathophysiology Essay

    Advanced practice nurses often treat patients with vein and artery disorders such as chronic venous insufficiency (CVI) and deep venous thrombosis (DVT). While the symptoms of both disorders are noticeable, these symptoms are sometimes mistaken for signs of other conditions, making the disorders difficult to diagnose. Nurses must examine all symptoms and rule out other potential disorders before diagnosing and prescribing treatment for patients. In this Assignment, you explore the epidemiology, pathophysiology, and clinical presentation of CVI and DVT.

    To Prepare

    Review the section “Diseases of the Veins” (pp. 598-599) in Chapter 23 of the Huether and McCance text. Identify the pathophysiology of chronic venous insufficiency and deep venous thrombosis. Consider the similarities and differences between these disorders.

    Select a patient factor different from the one you selected in this week’s Discussion: genetics, gender, ethnicity, age, or behavior. Think about how the factor you selected might impact the pathophysiology of CVI and DVT. Reflect on how you would diagnose and prescribe treatment of these disorders for a patient based on the factor you selected.

    Review the “Mind Maps—Dementia, Endocarditis, and Gastro-oesophageal Reflux Disease (GERD)” media in the Week 2 Learning Resources. Use the examples in the media as a guide to construct two mind maps—one for chronic venous insufficiency and one for venous thrombosis. Consider the epidemiology and clinical presentation of both chronic venous insufficiency and deep venous thrombosis.

    To Complete

    ORDER A CUSTOM-WRITTEN, PLAGIARISM-FREE PAPER NOW

    Write a 2- to 3-page paper that addresses the following:

    Compare the pathophysiology of chronic venous insufficiency and deep venous thrombosis. Describe how venous thrombosis is different from arterial thrombosis.

    Explain how the patient factor you selected might impact the pathophysiology of CVI and DVT. Describe how you would diagnose and prescribe treatment of these disorders for a patient based on the factor you selected.

    Construct two mind maps—one for chronic venous insufficiency and one for deep venous thrombosis. Include the epidemiology, pathophysiology, and clinical presentation, as well as the diagnosis and treatment you explained in your paper

  • DENTAL HYGIENE PICO RESEARCH QUESTION

    My PICO RESEARCH QUESTION
    :
     Is topical fluoride as effective in managing and reducing dentinal hypersensitivity, in comparison to the application of fluoride iontophoresis?

    > 1. You must research 
    3 articles
      that pertain to topic .

    > 2. MUST FOLLOW THE PICO FORMATTING!

    > 3. For 
    each article
    , you must follow the 
    attached outline
    . Attached is a sample of the outline to be followed for the assignment. 
    It should be followed exactly as shown
    , however it should pertain to my topic. You must reference ALL work throughout the paper and at the end of the assignment.

    4. Each article 
    must contain/discuss:
     the
     title, the purpose, methods, results, critique and conclusion
     (please do not go off topic, the goal it to answer the PICO question designed by the end of the assignment)

    Dental Hygiene

    This paper is an analytical essay that examines the issue of whether topical fluoride can be effective in the management and reduction of tooth hypersensitivity. The essay shall compare whether using this topical fluoride is more effective when compared to the application of fluoride

    iontophoresis. The PICO format shall be employed in analyzing three research papers related to this topic.

    a) Article One.

    Title

    Botzenhart, U.,Braun, A., & Frentzen, M. (2012). Laser treatment of dentine hypersensitivity : An overview Part I

    ii) Purpose

    The authors of this paper carried out this study to investigate and compare the efficiency in using topical fluoride and laser techniques in the treatment of tooth sensitivity (Botzenhart et al, 2012). This article illustrates the benefits of using fluoride treatment through topical application and how this technique is more superior and effective compared to low laser radiation. At the same time, these two techniques are compared for efficacy when it comes to the management and treatment of tooth hypersensitivity (Botzenhart et al, 2012).

    iii) Methods

    This research study employed the use of comparison where conventional methods were compared against the use of laser technology. The effects of these two techniques were rated in terms of how they managed and reduced teeth hypersensitivity.  The research article mainly employed the methodological angle of review from research already done (Botzenhart et al, 2012). Hence, it provided secondary data with regards to sampled participants who had been previously treated with a diode laser that had a low energy level on each side. These diodes were meant to monitor the hypersensitivity level of teeth after the respective individual underwent the process of root canal, root planning and scaling.

    The methodology also showed how control groups were used and administered with a different form of treatment which included  topical fluoride application. The latter contained a combination of protective varnish and fluoride that was meant to desensitize the teeth. All these sampled participants or patients were given a baseline encounter after which the pain and hypersensitivity of teeth were measured on a two-day interval. This pain was rated as either low, medium or high by each of the patients subjected to this study.

    iv) Results

    The findings of this study indicated that the occurrence of tooth hypersensitivity  was significantly reduced by a larger percentage. These results were achieved a few days after the treatment was administered to the patients. This is in contrast to the control group that was given topical fluoride for treatment of teeth hypersensitivity that did not report any decrease or changes after this medication was administered (Botzenhart et al, 2012). The complete absence of teeth hypersensitivity was only reported when the patients were given low laser treatment. In fact, the results showed that at least most of the patients who received diode laser treatment showed lesser hypersensitivity of teeth as compared to a dismal number of patients who were given topical fluoride treatment.

    v) Critique

    This research study settled for the use of a small sample size that is not representative of the entire human population that suffers from teeth hypersensitivity problems. Therefore, the findings could not be graphically drawn to indicate that the treatment regimen tested is conclusive based on the given sample size. A larger number of participants could have been sampled so as to make the study more representative and improve the validity of the findings.

    vi) Conclusion

    The authors of this paper concluded that the use of diode laser treatment of low energy is one of the successful ways of managing and treating tooth hypersensitivity (Pesevska et al, 2010).  This is in comparison to the use of topical fluoride that yields less success since it does not manage to completely eradicate tooth pain or issues of sensitivity.

    b) Article Two

    i) Title

    Hashim, N. T., Gasmalla, B. G., Sabahelkheir, A. H., & Awooda, A. M. (2014). Effect of the clinical application of the diode laser (810 nm) in the treatment of dentine hypersensitivity. BMC Research Notes, 7(1), 1-9. doi:10.1186/1756-0500-7-31

    ii) Purpose

    Hashim et al (2014) carried out this study to evaluate and determine the effect of using diode lasers as one of the fluoride iontophoresis techniques in reducing tooth hypersensitivity. This technique was mainly applied so as to gauge the tensile strength of bonds between the coronal dentine and two additional adhesive systems. Additionally, the tubule occlusion was also measured quantitatively with regards to its role in minimizing the sensitivity of teeth.

    iii) Methods

    The researchers made use of twelve teeth that were obtained from willing individuals who were made known about the study (Hashim et al, 2014). These teeth were the third molars that were divided into four different groups.  The first group involved treatment with a total adhesive system only while the second group was treated with the same adhesive after undergoing treatment with fluoride iontophoresis (Hashim et al, 2014). The third group was treated with a different adhesive known as a self-etching system. Finally, the fourth group was treated with the same adhesive after fluoride iontophoresis was administered. These four groups were also fixed with a resin composite that was meant to produce additional beams to enhance their tensile strength.

    iv) Results

    The results of this experiment were obtained after each test was treated differently through fluoride iontophoresis. The four groups were passed through scanning electron microscopes or SEMs where the images were recorded and analyzed through a statistical software (Hashim et al, 2014). The results were analyzed through the use of analysis of variance or ANOVA, probability and significant difference tests. According to the results, there was a significant difference (P ≤0.002) among  the groups that were treated with fluoride iontophoresis (Hashim et al, 2014).  The other groups that did not undergo the latter process registered no significant difference (P=1.000) in terms of reducing the sensitivity of teeth.

    v) Critique

    This experimental research made use of different statistical tools that did not properly capture the effectiveness of using fluoride iontophoresis as a mode of treating hypersensitivity in the teeth (Hashim et al, 2014).  Moreover, the use of molar teeth extracted from patients could not be deemed as a viable way of determining the reduction of pain. The alternative approach of measuring tubule occlusion is so not very appropriate with regards to the management  this dental condition.

     

     

    vi) Conclusion

    This research study was able to conclude that the use of fluoride iontophoresis is an effective way of treating the occurrence of hypersensitivity in the teeth (Hashim et al, 2014). The significant increase in the tubule occlusion was used as the indicator of the level of effectiveness of this technique. Hence, dentists can recommend to their patients that the hypersensitivity in the teeth can be significantly reduced and managed through the implementation of fluoride iontophoresis.

    c) Article Three

    i) Title

    Hosoki, M., Bando, E., Asaoka, K., Takeuchi, H., & Nishigawa, K. (2009). Assessment of allergic hypersensitivity to dental materials. Bio-Medical Materials & Engineering, 19(1), 53-61. doi:10.3233/BME-2009-056

    ii) Purpose

    This research was conducted through a long-term study that sought to compare the efficiency in the treatment for both topical fluoride use and fluoride iontophoresis by considering whether patients had any form of allergies towards various dental materials. The study aimed at investigating how serious the cases of dental hypersensitivity can be and what would be the most appropriate form of treatment (Hosoki et al, 2009).

    iii) Method

    The study employed the use of  a total of 212 patients (n=212) who were subjected to different forms of treatment (Hosoki et al, 2009). The patients were divided into male and female groups where 45 males and 167 females took part in the study. The sampled participants were then subjected to thirteen different forms of treatment with each of them testing for the extent of dental hypersensitivity (Hosoki et al, 2009). The extent and level of teeth allergic reactions were then recorded and tabulated accordingly.

    iv) Results

    The results of this study showed that the effectiveness of the topical application of fluoride in treating tooth hypersensitivity was directly related to the extent of teeth damage as well as the composition of the allergens used in the research process. In addition, if the treatment administered was closely related to the allergen the patient suffered from, then patients who suffered from severe or acute teeth hypersensitivity had the pain reduced significantly through the use of appropriate fluoride treatments.

    v) Critique

    The duration of this research study was too long such that the patients and sampled individuals would have easily grown tired or weary. Additionally, the financial implications of this study were too high considering the extended time frame employed in the process of comparing the efficacy of these two techniques.

    vi) Conclusion

    This research was able to illustrate that fluoride iontophoresis is very effective when it comes to the management and reduction of issues of hypersensitivity in the teeth (Hosoki et al, 2009).  However, the process can be quite costly due to the technical aspects involved. On the other hand, the use of topical application of fluoride is less effective but affordable altogether. Therefore, fluoride iontophoresis should be the recommended regimen for minimizing teeth hypersensitivity for people facing a recurrent problem in their dental area.

     

     

    References

    Botzenhart, U., Braun, A., & Frentzen, M. (2012). Laser treatment of dentine hypersensitivity:     An overview Part I

    Hashim, N. T., Gasmalla, B. G., Sabahelkheir, A. H., & Awooda, A. M. (2014). Effect of the       clinical application of the diode laser (810 nm) in the treatment of dentine         hypersensitivity. BMC Research Notes, 7(1), 1-9. doi:10.1186/1756-0500-7-31

    Hosoki, M., Bando, E., Asaoka, K., Takeuchi, H., & Nishigawa, K. (2009). Assessment of            allergic hypersensitivity to dental materials. Bio-Medical Materials & Engineering, 19(1),   53-61. doi:10.3233/BME-2009-056

  • Principles of Toxicology Essay – medical agents

    Principles of Toxicology

     

    Name:

    Tutor:

    Course:

    Number:

    Date:

     

     

     

     

     

     

    Principles of Toxicology

    Conflicts in Risk Assessment: Analysis of medical agents used in health promotion and treatment.

    Question of focus for the essay: Is the use of medical agnts safe enough to prolong life or it also disrupts major biological and physiological processes and functions?

    The emergence and  discovery of modern methods and modes of treatment has been very instrumental towards the prolonging of life of most people. This directly contrasts the ancient times when people were very apt and prone to contracting illnesses due to the unsanitary techniques used in treatment (Chau et al, 2014). The modern era has witnessed a wave of revolution in health care such that an ocean of medication can now be used to remedy the same illness. However, the ethical concerns and efficacy of most medicines remains questionable owing to their adverse drug reactions in the body (Rice et al, 2015).

    Principles of toxicology dictate that agents used to treat infections, illnesses or diseases should have minimal effect on the human host and maximum effect on the causative agent of the disease (Pavey et al, 2015). There are many queries and concerns that have been raised when certain chemicals are introduced as remedies into a health issue. For instance, fluorine is commonly used to treat water and eliminate pathogenic microflora that may easily establish infections in the human body (Kadiyala and Tan, 2013). However, the same fluorine is also dangerous since if used in excess, it can lead to teeth discoloration or bring about hormonal imbalance in the body.

    These side effects can be dangerous to a person who suffers from a hormonal disorder such as poor serotonin absorption. Another example is where the use of hydrocortisone is prescribed as an anti-inflammatory drug (Zhang et al, 2014). However, the same chemical is known to damage the melanin pigment of the skin that is very important in protecting the body from harmful radiation. Therefore, an equilibrium point should be established and agreed at what level is it safe to use certain chemicals so that toxicological effects are minimized.

    Policies and Regulations That Can Help in Revising the Principles of Toxicology

    The best and most suitable approach that can be recommended in this case is the introduction of a policy or act of  law that would govern the use of toxic agents and chemicals. For instance, an Act of Law would define the chemical or agent in question and then go ahead to outline its benefits to the human body (Zhang et al, 2014). Additionally, this act would also include the hazards or side effects of using this agent on a continued basis or in excess. At the same time, the policy would also oversee the use of controversial chemicals and dictate their application within various situations. This information can be communicated to the larger public through a gazette notice that would outline them in meticulous detail.

    The introduction of a policy that strictly or solely deals with toxic agents would easily capture the attention of the public. If  a person is made away that cortisone as a chemical can inhibit or impair the melanin pigment, then they would become more concerned about it. This would mean gathering information on how this chemical works in the body and at what point it is bound to elicit an adverse drug reaction (Zhang et al, 2014). Additionally, the policy should be deliberated  within a public forum such that people are included in the official process of reducing toxicological effects of controversial chemical agents.

    Conclusively, medicines and treatment agents have highly transformed human lives by prolonging it for a couple of years. However, some of them introduce toxic effects in the body and that is why policies and government acts should be implemented to mitigate such negative effects.

     

    References

    Chau, M. M., Kong, D. M., Hal, S. J., Urbancic, K., Trubiano, J. A., Cassumbhoy, M., & … Worth, L. J. (2014). Consensus guidelines for optimising antifungal drug delivery and monitoring to avoid toxicity and improve outcomes in patients with haematological malignancy, 2014. Internal Medicine Journal, 44(12b), 1364-1388. doi:10.1111/imj.12600

    Kadiyala, I., & Tan, E. (2013). Formulation approaches in mitigating toxicity of orally administrated drugs. Pharmaceutical Development & Technology, 18(2), 305-312. doi:10.3109/10837450.2012.734516

    Pavey, R. A., Kambil, S. M., & Bhat, R. M. (2015). Dermatological adverse reactions to cancer chemotherapy. Indian Journal Of Dermatology, Venereology & Leprology, 81(4), 433. doi:10.4103/0378-6323.15995

    Rice, H., Dalton, C. H., Price, M. E., Graham, S. J., Green, A. C., Jenner, J., & … Timperley, C. M. (2015). Toxicity and medical countermeasure studies on the organophosphorus nerve agents VM and VX. Proceedings Of The Royal Society A: Mathematical, Physical & Engineering Sciences, 471(2176), 1-14. doi:10.1098/rspa.2014.0891

    Zhang, J. D., Berntenis, N., Roth, A., & Ebeling, M. (2014). Data mining reveals a network of early-response genes as a consensus signature of drug-induced in vitro and in vivo toxicity. Pharmacogenomics Journal, 14(3), 208-216. doi:10.1038/tpj.2013.39

  • Bisphenol A Essay – Principles of Toxicology

    Topic

    Name

    Date

     

     

    Bisphenol A also known as BPA has for a long time been a chemical with contradicting issues. BPA is a chemical that for many years has been used in the hardening of plastics. This chemical is found in almost everything, like some medical device, dental sealants, water bottles, water discs, the lining of canned food and drinks as well as many other products. According to studies over 90% of people use BPA in their bodies (Vaughn, 2010).  Most of it gets in the body while we eat foods that have been in containers that are made of BPA. It is possible to pick this chemical through dust, water and air.

    This chemical is also common in Sippy cups, baby bottles, beauty formula cans and other products that are used in infants and young children. According to the report given by the health departments, children toys do not have BPA. On the same note the outer shield of some pacifiers have BPA. However, his chemical is not found on the nipple that the baby sucks. For a long time, people used BPA without thinking of the risks and the harm it can bring especially to children. According to studies, there are some concerns about the use of BPA. These products can affect the prostate glands in fetus and children, brain and the way a person behaves (Gibert, 2015).

    On the other hand, there is the benefit that is brought by using BPA. For instance, BPA is used in the making of some critical components of the numerous medical device as well as their housings. BPA has an optical clarity that is used for direct observation of fluids in the body including the blood (Vogel, 2012). By observing the liquids, the health caregivers can be able to monitor the flow. The health care gives depended on the equipment as well as medical devices that have been made with BPA so that they can be able to have a transparent view of the body of a human (Hayes & Laudan, 2009). This view makes it easy for them to check for the presence of air bubbles or any other obstructions during the procedure.

    Note that numerous different things that can be said about BPA, but in my opinion, this chemical should continue to be used due to the benefits that it brings. For instance without this chemical, there could have been many deaths that could rise from obstructions in the body fluids when a patient is undergoing medication (Rosenfeld & Feng, 2011).. Unless there is a100% prove of damages that this medicine brings, and then it should continue to be used. Science comes up with theories that are challenged every day. The theory behind BPA is one of such. They have not produced clear prove that shows the product is poisonous.

    By burning BPA there are so many areas that will be affected, this chemical makes a broad range of things like receipt of the store sales, police shield, reading glasses, bullet prove glass, LED lights and many more. This is some of the things that are used on daily basis; some of them are even used to aid day to day living. This is the reason that cutting BPA out of the market will mean bringing a lot of things to a standstill. To avoid this, scientist, should continue with their study and come up with something that is concrete. A point that should be considered is that for a long time BPA has been used, even on infants and little or no harm came on their way.

    In conclusion, there are so many chemicals that have the benefit on humans, and yet it also causes serious damage. BPA, if any at all causes low harm on humans and should not be banned.

     

     

     

    References

    Gibert, Y. (2015). 
    Bisphenol A: Sources, risks of environmental exposure and human health

    effects
    . New York: Nova Publishers.

    Hayes, D., & Laudan, R. (2009). 
    Food and nutrition
    . New York: Marshall Cavendish Reference.

    Rosenfeld, P. E., & Feng, L. G. H. (2011). 
    Risks of hazardous wastes
    . Amsterdam:

    Elsevier/William Andrew.

    Vaughn, B. C. (2010). 
    Bisphenol A and phthalates: Uses, health effects and environmental risks
    .

    New York: Nova Science Publishers.

    Vogel, S. A. (2012). 
    Is It Safe?: BPA and the Struggle to Define the Safety of Chemicals
    .

    Berkeley: University of California Press.

  • Hypersensitivity Therapy PICO – immunotherapy and medication Essay

    HYPERSENSITIVITY

     

     

     

     

     

    Name:

    Course:

    Tutor:

    College:

    Date:

     

    Hypersensitivity

    The human immune system is often tasked with the physical obligation of protecting the body from foreign pathogens that may invade it. The instigation or onset of a hypersensitivity reaction is often as a result of an abnormal reaction of the immune system towards a foreign pathogen or antigen. Hypersensitivity is often used to describe allergies, which arise out of the body detecting the presence of a foreign object that the body is not used to normally. There are various methods of treatment and therapy that have been devised to tackle the diverse types of hypersensitivity reactions or conditions. This paper is a brief essay that compares two therapeutic measures for hypersensitivity and which one works best for research.

    Therapeutic Measures for Hypersensitivity.

    There many different methods that are employed in the treatment of hypersensitivity or allergic reactions. The mode of treatment that is chosen depends on the extent of the hypersensitivity as well as the causative agent (Legendre et al 2014, p. 145). The two therapeutic measures that can be adopted for both hypersensitivity and research purposes are immunotherapy and use of medication (Karnoub et al 2015, p. 2). The latter is the most common method that is used to treat hypersensitivity. However, the medicine that is administered to the patient depends on the nature of the allergic reaction they have (Jones et al 2015, p. 198). Both immunotherapy and medications can be evaluated as a treatment regimen for allergies based on the PICO approach.

    PICO deals with the patient or population receiving the treatment, the intervention used, control and the resultant outcome. In this case, PICO can be used to ascertain if these two therapeutic methods are effective for the patient, the nature of their intervention, the control measures employed and whether there are any side effects from their usage (Medical Literature, 2015). The medication approach is often used for the control of hypersensitivity reactions which are mostly allergens. Antihistamines and decongestants are the most common medicines prescribed for patients with allergic symptoms (Stone et al 2014, p. 12). Decongestants are known to control allergies such as asthma or stuffy noses. Likewise, antihistamines and corticosteroids are also prescribed when a patient has a hypersensitivity inflammation. On the other hand, immunotherapy is a different form of hypersensitivity treatment that makes use of small doses of the allergen to which the patient is allergic to presently (Berroa et al 2014, p. 276).

    Immunotherapy is mainly used to treat allergies such as pollen, dust, bee venom or even flower and coffee pheromones. The use of minimal or small doses of the allergen is meant to trigger the immune system into becoming less sensitive to this foreign substance (Legendre et al 2014, p. 145).   Consequently, the immunity of the person responds by hindering the release of antibodies, which means that allergic reactions with then be avoided. Immunotherapy is very effective in treating conditions such as rhinitis, anaphylaxis and other frequently occurring allergies. Both medication and immunotherapy are effective because they are able to minimize the production of antibodies within the immune system (Legendre et al 2014, p. 145).

    Additionally, both of these therapeutic interventions are known to have very minimal side effects or adverse drug reactions that can at times be acute. Instead, they usually restore the health of the patient with little damage to the physiological functioning of the body (Medical Literature, 2015). The success of these forms of treatment lies in first establishing the factors that strongly trigger the hypersensitivity reactions. Blood tests as well as skin tests are known to give the main allergens that cause one to be hypersensitive. Hence, after this is diagnosed, it then becomes easier to decide whether to use medication or immunotherapy interventions.           Conclusively, both medication and immunotherapy are effective therapeutic measures for treating hypersensitivity and research into both modes of treatment has revealed their numerous advantages to the affected patient.

     

     

     

    References

    Berroa, F, Lafuente, A, Javaloyes, G, Ferrer, M, Moncada, R, Goikoetxea, M, Urbain, C, Sanz, M, & Gastaminza, G 2014, ‘The usefulness of plasma histamine and different tryptase cut-off points in the diagnosis of peranaesthetic hypersensitivity reactions’, Clinical & Experimental Allergy, 44, 2, pp. 270-277, Academic Search Premier, EBSCOhost, viewed 14 September 2015

    Jones, J, Richter, L, Alonto, A, & Leedahl, D 2015, ‘Desensitization To Ceftaroline In a patient with multiple medication hypersensitivity reactions’, American Journal Of Health-System Pharmacy, 72, 3, pp. 198-202, Academic Search Premier, EBSCOhost, viewed 14 September 2015

    Karnoub, M, Zairi, F, Aboukais, R, & Assaker, R 2015, ‘Delayed Hypersensitivity Reaction: An Increasingly Recognized Complication of Metal-on-Metal Total Disc Replacement’, Case Reports In Orthopedics, 2015, pp. 1-3, Academic Search Premier, EBSCOhost, viewed 14 September 2015

    Legendre, D, Muzny, C, Marshall, G, & Swiatlo, E 2014, ‘Antibiotic Hypersensitivity Reactions and Approaches to Desensitization’,Clinical Infectious Diseases, 58, 8, pp. 140-148, Academic Search Premier, EBSCOhost, viewed 14 September 2015

    Medical Literature. (2015).
    PICO formula
    . Retrieved on 14 Septermber 2015 from http://learntech.physiol.ox.ac.uk/cochrane_tutorial/cochlibd0e84.php

    Stone, S, Phillips, E, Wiese, M, Heddle, R, & Brown, S 2014, ‘Immediate-type hypersensitivity drug reactions’, British Journal Of Clinical Pharmacology, 78, 1, pp. 1-13, Academic Search Premier, EBSCOhost, viewed 14 September 2015

  • Ontario health care system Essay- Primary Care Research Paper Assignment

    TOPIC: Primary Care

    Research Paper Assignment

     

    Primary care has been touted as the answer to real transformational change

    and improved integration of 
    Ontario’s health care system
    .

    –    Discuss the definitions of primary (health) care and primary medical

        care and the similarities and differences between them.

    –    Describe the rationale behind the belief that primary care is a critical component of improved integration.

    –    Discuss the key roadblocks that must be addressed and what can/should be done

    Evaluation Criteria

    .Application of the concepts and frameworks from lectures and readings

    .Ability to synthesize and incorporate course ideas

    .Ability to construct a coherent and well-informed argument based on a review of the literature (new articles beyond the course readings are required).

    .Clarity of the research paper

    .Note that descriptive papers are not sufficient as the teaching team wants to see an understanding and not merely a regurgitation of information.

     

     

     

     

     

     

    PRIMARY CARE

     

     

     

     

     

     

     

    Name:

    Course:

    Tutor:

    College:

    Date:

     

    Primary Care

    The state of complete mental, physical and social well being of a person combined with the absence of disease and infirmity is what constitutes good human health. The health care sector is mandated with the task of overseeing that its citizens are able to remain in a state of complete physical health. There are different departments and sections within the health care department that serve these functions at a variable level. One of these departments is the primary care sector that forms the core foundation of most health care systems. Primary care is one of the sections within health care that serves the umbrella function of providing very basic care to patients. This care is often  provided on a daily basis by either a physician, health worker or a nurse. The person offering this kind of care is usually the first person of contact with the patient and they are supposed to coordinate all other involvements with this sick person. Due to the basic nature of primary health care, many countries and states have put in place measures to improve the service delivery.

    In Ontario, primary care has been touted as the answer to real transformational change and improved integration of its health care system. This is because primary care is regarded as one of its fundamental pillars in the health system. Therefore, this state thrives to foster the improvement of quality medical and health care to its people. It does this by providing the appropriate and adequate resources, strategies and initiatives to help primary care to become more efficient. The primary care providers such as the nurse practitioners and the physicians are also given additional training so that they can be competent at what they do. In any case, the core aim of primary care is to make sure that patients receive the most basic treatment and care in a quality and effective manner. This paper is an incisive and descriptive essay that discusses the importance of primary care by focusing on Ontario’s health care system.

    Discuss the definitions of primary (health) care and primary medical care

    Primary health care or PHC is a segment of health care that deals with scientific and socially accepted methods of providing health care to individuals. This type of care is tasked with the duty of ensuring that health care is accessible to everyone within the community, society or even country (Chrystal et al, 2015). As such, primary health care strives to become universal, so that every person can at least have access to a medical facility. PHC is also an approach that strives to see that health is achieved through additional medical and social policies. This bracket of health care includes all the areas that play a very instrumental role in health (Phillips et al, 2014).

    This means that primary health care is intertwined with the individual’s lifestyle, their environment and how they access health care. Consequently, primary health care can be considered as a cornerstone that can be used to achieve the ideal health system on a universal scale. The ultimate goal and objective of primary health care is to improve health accessibility and ensure that all people can be able to visit a health facility (Pype et al, 2014). PHC is able to do this by reducing the gap that exists between social classes and disparities in the health care sector. Secondly, PHC also strives to organize and deliver health services that are within the needs and expectations of the people. This is normally considered as part of service delivery reform. Thirdly, primary health care aims at integrating health into all the available sectors of the economy (Thomas et al, 2015).

    This includes both the public and private policies of reforms. In addition, PHC also pursues the collaborative models of policy and dialogue so that it can increase the participation of the respective stakeholders (Thomas et al, 2015). On the other hand, primary medical care aims at providing the highest quality of medical care to all sick people and patients. In addition, primary medical care or PMC endeavors to prevent illnesses, diseases and health conditions in the patients themselves. The overall aim of PMC is to work together with the health professionals to provide quality care that is also comprehensive and integrated as well (Giltenane et al, 2015). The practice of PMC includes the promotion of health, prevention of diseases, maintaining health and diagnosis of diseases. In addition, primary medical care also deals with counseling and educating the patient, providing in-patient and out patient care as well as offering other medical forms of care such as home care and day care.

    Primary medical care is performed and provided by a personal physician, doctor or health practitioner. This person works with the collaboration of other important parties such health professionals (Jenstad and Donnelly, 2015). This ensures that the provision of PMC is such that there is a total utilization of the appropriate processes so that medical care is of utmost quality. In addition, PMC strives to become cost-effective so that virtually all people can afford it. Primary medical care is a practice that is considered as the first point of entry of the patient to the health care system. What’s more, it also serves as a continuing focal point for the medical care services that are needed (Mundt et al, 2015).

    This means that primary medical care also has a mission of providing patients with the access to the physician or doctor that they want to treat them.  In overall, primary medical care is generally structured to provide medical attention to the larger majority. The state of Ontario is striving hard to provide quality primary medical and health care. ­Presently, Ontario does not have a well coordinated or comprehensive approach  that deals with the performance of this medical sector. In fact, statistics show that Ontarios primary medical and health care compare quite poorly with other states and cities (Ngiap et al, 2014).

    This means that the health care sector in Ontario also falters if it is compared to other states on the same level. As such, a lot of effort is being placed towards the primary care sector in Ontario so that areas and loopholes of possible improvement are identified. This began when the health quality unit in Ontario saw the dire need to have a large-scale approach that can measure the performance of both primary medical and health care (Ngiap et al, 2014).

    This measurement can be done at the practice and system levels where specific programs are usually launched. These performance initiatives are undertaken together with the collaborative efforts of key stakeholders in the medical fraternity. The end product of these efforts is to ensure that health care is available and affordable for all.

    Similarities and differences between primary (health) care and primary medical care

    Both primary medical care and primary health care are perceived to be the most comprehensive rationale behind the provision of health and medical services. However, the two fields of care have a number of similarities and differences. Primary medical care and primary health care are two terms that are used interchangeably on a very regular basis. However, it should be noted that the two terms are used to denote and refer to very different concepts. These two terms describe very distinct and unique entities that relate to aspects within the medical field. Primary medical care deals with approaches that include policies and regulations that can reform the sector. One of the similarities between PMC and PHC is that both of these terms deal with the process of providing medical attention in the best way possible (Chrystal et al, 2015).

    Both of these disciplines strive to ensure that medical attention is available to people at an affordable cost. Additionally, both PMC and PHC are governed by some policies and rules, some of which are formulated by the World Health Organization. If the focus is placed on Ontario, the PHC sector supports families and individuals so that they can make the best and informed decision concerning their health. In addition, PHC in Ontario includes the provision of advice on the best and suitable strategies of promoting health and preventing diseases (Phillips et al, 2014). In as much as there are similarities between PMC and PHC, There are also a couple of differences that exist between primary health care and primary medical care. To begin with, primary medical care is often used in describing a family practice where a small number of individuals are given urgent attention. On other other hand, primary health care is a broader term that usually encompasses the wider selection of people such as providers of health care (Phillips et al, 2014). PHC also includes the function and services of other stakeholders and how they aspire to achieve these goals. Sometimes, primary health care is regarded as a bracket of health care that is founded on the principles of offering fair and accessible to almost all people.            Secondly, PHC endeavors to remain relevant to the people by ensuring that their medica needs are met (Pype et al, 2014). Primary health care differs from primary medical care in that it is more cost effective and uses various forms of technology to provide quality care to patients. The World Health Organization plays a very instrumental role in ensuring that all children and adults can be able to access quality and affordable health care (Pype et al, 2014).  This is achieved by following their policies and rules that are part of their mission. PHC also takes into account the demographics and population index of various places so that it can know how best to serve people in a given area (Jenstad and Donnelly, 2015).  There are numerous explanations that continue to be given for both primary medical or health care. The fact remains that both are distinctly different and they should not be used interchangeably.

     

     

    Describe the rationale behind the belief that primary care is a critical component of improved integration.

    The Ontario health care system is amid one of the best medical systems in the world. Residents who qualify for this health system have the privilege  to access various kinds of health care facilities in their community (Jenstad and Donnelly, 2015).  In Ontario, citizens are given a medical health cover insurance that will cater for their medical needs during emergencies. There are various ways of getting non-emergency medical care in Ontario. One of them is by trained medical staff answering the patients’ questions via phone (Giltenane et al, 2015). Family doctors, nurses and other health care providers are usually the ones in most cases concerned with checking out and attending to patients’ medical complications. Primary health care is a necessity for an improved medical integration, and an example can be seen in treatment for chronic diseases like cancer, heart complications, kidney failures, and many other diseases.

    In most countries, primary health care is practiced by nurses, and other health providers (Thomas et al, 2015).  In preventing chronic diseases, multiple guidelines have been developed to help general physicians in the avoidance of Chronic diseases. The prospective role of general practice comprises the identification and delivery of brief interventions to avert chronic disease and also the referral to other facilities and programs. A number of industrialized nations have introduced and embarked on healthcare reforms, these reforms is aimed at improving their systems of delivering primary health care (Jenstad and Donnelly, 2015). With the introduction of medical reforms, many people are able to access primary medical care and the rate of their attendants increased.

    Launching a more rational basis for referrals and taming the coordination between primary care and specialist doctors making primary care practice more interesting and rationally fulfilling. Nations should embrace the distribution of both primary care and specialists by modifying their authorizing rules to health requirements in different areas or by providing financial enticements for practicing in harsh areas, as is done in some other nations. Primary care is a necessity and so ways of improving it must be incorporated (Mundt et al, 2015).  Allocating more funds to facilitate research in primary health care will be of great help in the expansion of this service, as this will benefit many people in the community.

    Discuss the key roadblocks that must be addressed and what can/should be done

    Delivering worthy patient care is aim number one for most medical practices, but good objectives are not constantly enough if your management progressions keep falling apart (Ngiap et al, 2014).  Fort Wayne Medical Education Program (FWMEP),  family health program in Indiana came up with several road blocks that hindered the administration of primary health care, and possible ways on how to overcome them  Some of these roadblocks that must be addressed within the Ontario health and reform system are presented below:

    Scheduling visits more effectively

    As a busy practice seeing 100 patients a day, FWMEP has to quickly look for possible solutions on how to attend to patients and especially those with acute health problems. First, and foremost, WMEP created fifteen appointment slots, each taking place morning and afternoon hours (Jenstad and Donnelly, 2015).  Secondly, The exercise established two brochures that focus on the need for preventive  care, one for young teenagers and the other for adults (Ngiap et al, 2014). Usually, these services were offered to patients and parents during their  appointment periods, and the exercise plans to widen delivery services to patients who are not planning on performing preventive exams frequently.

     

    Providing two visits in one

    One major obstacle to executing a double visit procedure was the absence of coding and reimbursement skills amid the medical practice. To curb this, doctors were taught how to clearly deal with both services in the patient’s electronic health record and correctly code them with the use of modifier 25 to show that a major, separately distinguishable service was delivered on the same day (Jenstad and Donnelly, 2015). At first, this resulted to consternation, but after few weeks of practice, a careful evaluation discovered that adding ten minutes to accommodate well-child checks was not troublesome and in fact improved the treatment time.

    Reducing missed appointments

    To handle the  roadblock of missed appointments, the practice should take a detailed overview of mails sent by patients to their physicians for those who did not make for their ideal appointment day.  For instance, FWMEP found out that though they requested patients to reorganize for their appointments, the mails did not have any information on how to contact these patients (Mundt et al, 2015).  The practice came up with a new mail highlighting the practice’s contact numbers and e-mail address, so that the doctors could communicate with patients and know why they missed their appointments. FWMEP also got the support of AmeriHealth Mercy of Indiana, which promised to handle communications when patients missed three or more appointments (Mundt et al, 2015). The practice also reviewed its method for appointment approval phone calls. Even though patients will get appointment notices from an automated system two days before their planned appointment, they must be reminded on that specific day their appointment will occur, and most patients will be contacted in the morning.

     

     

    Increasing newborn care

    To avoid postpartum and preliminary newborn care from subsiding through the cracks, the doctors deliver hospital care to moms and children (Thomas et al, 2015). In addition, they have to use the discharge paperwork for each of their patients to one of the two triage nurses employed by the practice. The nurse follows up straight with the patient to program the newborn and postpartum appointment (Ngiap et al, 2014). Patients get an automated an approval call two days prior these appointments. The practice is making an allowance for the emergence of a postpartum and nursery standing-order sheet to train hospital ward workers to review the exercise earlier before the patient is cleared from the hospital to plan for the postpartum and newborn check-ups (Ngiap et al, 2014).

    Positive results

    The new scheduling conventions which include welcome calls to new patients, approval calls for all well-child checks and postpartum follow-up calls, were tabled in by earlier staff after reshuffling and relocating jobs. Using a system that makes enhanced utilization of  providers’ time, instead of the addition of more hours, the practice’s volume and revenue both improved (Chrystal et al, 2015). Most significantly, kids are getting the preventive, primary care they require. This advantage has proved that refining outcomes may contain much more than revising what goes on in the exam room (Phillips et al, 2014). Enhanced aftermaths may well depend upon uncovering and eradicating the barriers a practice makes, and  how it succeeds in accessing it.

    Conclusion

    Primary care is vital for building a durable health care system that warrants positive health outcomes, usefulness and competence, and health impartiality. It is the first interaction in a health care system for people and is embracing coordination and completeness. It offers  individual, community-oriented and family-focused  care for treating, preventing, or improving common infections and disabilities, and supporting health. In both developed and developing countries, primary care has been proven to be connected with enriched access to health care services, improved health aftermaths, and a reduction in hospitalization and use of emergency unit visits. Primary care can also aid in offsetting the negative effect of poor economic conditions on health. Thus, the research recommends the necessity to intensify the supply of primary care physicians globally.

    Alternatively, research has pointed out that nations and regions more focused on the primary care have lesser healthcare expenses, but improved health outcomes, though advance studies using formal cost-effectiveness ways need to be piloted. Cost-effectiveness of primary care has been purposely recognized through a limited interventions performed in primary care settings, and embracing of health information systems in primary care settings may lead to improved  financial achievements.

     

    References

    Chrystal, J. G., Glover, D. L., Young, A. S., Whelan, F., Austin, E. L., Johnson, N. K., &             Kertesz, S. G. (2015). Experience of Primary Care among Homeless                                               Individuals with Mental Health Conditions. Plos ONE, 10(2), 1-14.                                       doi:10.1371/journal.pone.0117395

    Giltenane, M., Kelly, M., & Dowling, M. (2015). Public health nurses’ (PHNs) experiences of                   their role as part of a primary care team (PCT) in Ireland. Australian Journal Of             Advanced Nursing, 32(3), 6-15.

    Jenstad, L. M., & Donnelly, M. (2015). Hearing Care for Elders: A Personal Reflection on                        Participatory Action Learning With Primary Care Providers. American Journal Of Audiology, 24(1), 23-30. doi:10.1044/2014_AJA-14-0051

    Mundt, M. P., Gilchrist, V. J., Fleming, M. F., Zakletskaia, L. I., Tuan, W., & Beasley, J. W.                     (2015). Effects of Primary Care Team Social Networks on Quality of Care and Costs for Patients With Cardiovascular Disease. Annals Of Family Medicine, 13(2), 139-148.          doi:10.1370/afm.1754

    Ngiap Chuan, T., Chirk Jenn, N., Rosemary, M., Wahid, K., & Lee Gan, G. (2014). Developing               a primary care research agenda through collaborative efforts — a proposed      “6E” model.     Asia Pacific Family Medicine, 13(1), 1-13. doi:10.1186/s12930-014-0017-9

    Phillips, J. P., Petterson, S. M., Bazemore, A. W., & Phillips, R. L. (2014). A Retrospective           Analysis of the Relationship Between Medical Student Debt and Primary Care Practice in             the United States. Annals Of Family Medicine, 12(6), 542-549. doi:10.1370/afm.1697

    Pype, P., Peersman, W., Wens, J., Stes, A., Van den Eynden, B., & Deveugele, M. (2014). What,             how and from whom do health care professionals learn during collaboration in palliative       home care: a cross-sectional study in primary palliative care. BMC Health Services        Research, 14(1), 247-266. doi:10.1186/s12913-014-0501-9

    Thomas, K., Krevers, B., & Bendtsen, P. (2015). Implementing healthy lifestyle promotion in                   primary care: a quasi-experimental cross-sectional study evaluating a team initiative.            PMC Health Services Research, 15(1), 650-669. doi:10.1186/s12913-015-0688-4