Category: Nursing

Case Study: Mr. M.

Clinical presentation of Mr. M

Mr. M. is a 70-year-old male patient. Mr. M denies any allergies. Mar M has an unsteady gain and experiences challenges in ambulating. Mr. M experiences memory lapses since he finds it difficult to remember the names of family members, the number of his room or repeating the words he has uttered. Mr. M shows fear and shows aggressiveness. Mr. M cannot bathe dress or feed without being assisted. Mr. M looks pale and tired due to lack of adequate rest and relies on Zolpidem to manage his sleep disorder. From the objective data collected from the lab tests, Mr. M has a normal body temperature hence no signs of fever. Mr. M has blood pressure of C BP 123/78 HR 93 RR 22 Pox 99%, which signifies prehypertension, which is usually asymptomatic. Mr. M shows no sign of being in any pain and denies feeling any pain. Mr. M is overweight after calculating his Body Mass Index Height: 69.5 inches; Weight 87 kg, which translates to a BMI of 28.4. Mr. M has a WBC count of 19.2 (1,000/uL) and lymphocyte count of 6700 (cells/uL).  The results from a CT scan of the head shows no alteration since the preceding scan. Mr. M Urinalysis read positive for a substantial amount of leukocytes and appeared cloudy. Mr. M protein analysis stood at 7.1 g/dL; AST: 32 U/L; ALT 29 U/L.

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Primary and Secondary diagnosis

Primary diagnosis of Mr. M would include stroke, or a heart attack since has a C BP 123/78 HR 93 RR 22 Pox 99% which signifies prehypertension. Any reading above 120 systolic pressure means prehypertension even when the diastolic pressure ranges from 60 to 79 (Mymedicalscore, 2019). The worse reading is used in the event diastolic, and systolic pressure fall into different ranges. Furthermore, people with prehypertension have increased chances of experiencing heart attacks compared to individuals with lower blood pressure (Mymedicalscore, 2019). The second primary diagnosis would be to test for urinary tract infections in Mr. M due to the presence of leukocytes in urine. An unusual elevated number of leukocytes in urine signifies swelling or infection in the urinary tract, most commonly in the bladder or kidney (Pol et al., 2017). The diagnosis is essential to Mr. M, who is undertaking medications such as Lipitor and Lisinopril, which has known side effects to the kidneys. Hence, the diagnosis of urinary tract infection is necessary.

A secondary diagnosis that needs to be carried out include liver damage due to the daily intake of Lisinopril and Lipitor, which have damaging effects on the liver (Emedicinehealth, 2019). The second diagnosis is that of the mental health condition of Mr. M. The reason is that Mr. M. experiences mental loss and cannot remember his rooms or the words he has spoken despite CT scan showing no changes (Pol et al., 2017). The other secondary diagnosis that would be necessary is to check for kidney stones since the elevated amount of leukocytes can at times, indicate the presence of kidney stones.

Expected abnormalities would you expect to find

The expected abnormalities a nurse would expect to see include changes in the vital signs of the patient. These include body temperature changes, changes in blood pressure, decreased increased respiratory rate, which may vary from time to time depending on the presence or absence of infection. Besides, Mr. M denies may pain; a nursing assessment on him would prove otherwise (Registered Nursing, 2018). The baselines of vital signs are recorded because they are vitally crucial for comparison during and after treatment. Vital signs are highly responsive to abnormalities and changes of a patient

Physical, psychological and Emotional aspects to the patient and family

Mr. M’s health condition has significantly impacted on him physically. Mr. M. experiences challenges in ambulating and does not have a steady gait. Also, Mr. M. has a tibial fracture status postsurgical repair. The condition has also lead to memory loss, and Mr. M finds it difficult even to remember his room number, names of family members, or words he had uttered.  Mr. M has also been affected psychologically and emotionally in that when he is aggressive and agitated easily. Mr. M’s unsteady mental state sees him wander at night and often get lost. The condition has also affected his family since Mr. M. has become dependent with many ADLs. Initially, Mr. M could bathe, dress, and feed on his own; however, right now, he depends on his family members to assist him doing ADLs. Besides, Mr. M becomes in approachable, especially when he is aggressive as he becomes fearful and afraid.

Interventions that can be put in place

Interventions to be implemented include mental assessment of Mr. M., and Mr. M. needs to be assigned to a therapist to help in the recovery process to minimize his aggressive behaviour. In addition, the family needs to hire a private practitioner or assistant to assist Mr. M. in his ADLs, thereby reducing the burden on the family members. Mr. M from the case study seems lonely, and that’s why he wonders alone and get lost, putting him up in a facility with other people of the same age or health conditions would undoubtedly help in his recuperation. Furthermore, he forgets the names of family members, occasional visits by family members would be helpful for bonding or otherwise arrange visits to the homes of family members away from the assisted living facility.

Potential problems faced by Mr. M. due to his condition.

Due to hypertension and hypercholesterolemia, Mr. M has a potential of developing stroke. A stroke occurs when a blood vessel transporting oxygen and nutrients in the brain is blocked or bursts. A stroke occurs when blood supply to the brain is reduced (Mayo Clinic Staff, 2019). The second potential problem Mr. M can face is the risk of cardiovascular failure. Hypertension can strain the heart leading to weakening of the heart muscles making the heart to work less efficiently, and with time, the heart gets overwhelmed and fails (Mayo Clinic Staff, 2019). Hypercholesterolemia can also increase the likelihood of Type 2 diabetes because diabetes can impact different cholesterol levels and increases the chances of developing atherosclerosis (Mayo Clinic Staff, 2019). Mr. M. is also at the verge of developing dementia. Dementia is a disease of the brain that leads to challenges of thinking, speaking vision, movement, and reasoning (Mayo Clinic Staff, 2019). There are several causes of dementia one being vascular dementia, that is caused by narrowing and blockage of arteries that supply blood to the brain.

 

References

Mayo Clinic Staff. (2019, January 09). How high blood pressure can affect your body. Retrieved from
https://www.mayoclinic.org/diseases-conditions/high-blood-pressure/in-depth/high-blood-pressure/art-20045868

 

Pol, J. G., Levesque, S., Workenhe, S. T., Gujar, S., Le Boeuf, F., Clements, D. R., … & Fucikova, J. (2018). Trial Watch: Oncolytic viro-immunotherapy of hematologic and solid tumors.
Oncoimmunology
,
7
(12), e1503032.

 

Mymedicalscore. (2019). 123/78 Blood Pressure – Good or Bad? – MyMedicalScore. Retrieved from
https://mymedicalscore.com/blood-pressure/123-78/

 

Emedicnehealth. (2019). Lipitor (atorvastatin) Side Effects, Interactions, Uses & Drug Imprint. Retrieved from
https://www.emedicinehealth.com/drug-atorvastatin/article_em.htm

 

RegisteredNursing.org. (2018, May 29). Changes and Abnormalities in Vital Signs: NCLEX-RN. Retrieved from
https://www.registerednursing.org/nclex/changes-abnormalities-vital-signs/
 Case Study: Mr. M

Tulsa Memorial Hospital Case Study

Assignment for Unit 2 – Tulsa Memorial Hospital (SoonerCare)

You are a member of the consulting firm advising Dr Wilson.  The following case study contains the instructions and requirements for the deliverable. 

Tulsa Memorial Hospital is a community hospital in Tulsa, Oklahoma.  Recently, the hospital and its affiliated physicians formed Tulsa Memorial Healthcare (TMH), a physician-hospital organization (PHO).   TMH is close to signing its first contract to provide exclusive local healthcare services to enrollees in SoonerCare (the Plan), the local Blue Cross Blue Shield of Oklahoma HMO      TMH as an alternative.  In the proposed contract, TMH will
assume full risk
for patient utilization.  In fact, the proposal calls for TMH to receive a fixed premium of $200 per member per month from the Plan, which it then can allocate to each provider component in any way it deems best using any reimbursement method it chooses.  TMH’s executive director, Dr. Randy Wilson, a cardiologist and recent graduate of the University of Oklahoma Nonresident Program in Administrative Medicine, is evaluating the Plan’s proposal.  To help do this, Dr. Wilson hired a consulting firm that specializes in PHO contracting.  The first task of the consulting firm was to review TMH’s current medical panel and estimate the number of physicians, by specialty, required to support the Plan’s patient population of 50,000, assuming aggressive utilization management.  The results in exhibit 3.1 show that TMH’s medical panel currently consists of 249 physicians, whereas the number of physicians required to support the Plan’s patient population is only 61.  Note, however, that TMH physicians serve patients other than those in the Plan.  Thus, the total number of physicians required to treat all of TMH’s patients far exceeds the 61 shown in the right column of exhibit 3.1. Tulsa Memorial Hospital Case Study

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The second task of the consulting firm was to analyze TMH’s physicians’ current practice patterns.  Clearly, utilization, and hence, cost is driven by·TMH’s physicians and that variation in practice patterns.   Results of the analysis show significant variation in practice patterns, both in the physicians’ offices and in the hospital.  For example, exhibit 3.2 contains summary data on hospital costs by physician for three common diagnosis related groups (DRGs).  Consider DRG 470 (major joint replacement).  The physician with the lowest hospital costs averaged $12,872 in costs per patient, the highest-cost physician averaged $24,638, and the average cost for all physicians was $14,999. 
The consulting firm commented that reducing this variation is important because TMH is at full risk for patient utilization. 

The third task of the consulting firm was to recommend an appropriate allocation of the premium dollars to each category of provider.  Specifically, the contract calls for TMH to receive $200 per member per month, for a total annual revenue of$200 x 50,000 members x 12 months = 120 million.  To reduce potential conflicts about how to divide the 120 million among providers, the consulting firm proposed a “status quo” allocation that would maintain the current revenue distribution percentages shown in exhibit 3.3.

The final task of the consulting firm was to recommend provider reimbursement methodologies that create appropriate incentives.  In the contract, TMH assumes full risk for patient utilization, so the consulting firm recommended that all component providers be capitated to align cost minimization incentives throughout TMH.  Furthermore, capitation of all providers would eliminate the need for risk pools, a risk-sharing arrangement that TMH has never used.  In addition to the consulting firm’s report, Dr. Wilson decided to ask TMH’s new operations committee for a short report on th;e current line of thinking among TMH’s major providers.  The committee provided the following information.

Tulsa Memorial Hospital

Historically, the profitability of Tulsa Memorial Hospital has been roughly in line with the industry.  Last year, when the hospital received about 75 percent of charges, on average, the hospital achieved an operating margin of about 3 percent.  However, hospital managers are concerned about its profitability if the Plan’s proposal is accepted.  The managers believe that controlling costs under the full-risk contract would require extraordinary efforts and that the most effective way to control costs is to create a subpanel of physicians to participate in the capitation contract.  When asked how the subpanel should be chosen, the operations committee  recommended choosing the physicians who would do the best job of containing hospital costs.

Primary Care Physicians

Many of the primary care physicians are dissatisfied.  On average, primary care physicians receive only about 60 percent of charges and are concerned about being penalized by accepting utilization risk for the Plan’s enrollees.  Primary care physicians know that they are paid less and believe that they have to work much harder than do the specialists.  Furthermore, primary care physicians believe that the specialists supplement their own incomes by overusing in-office tests and procedures.  Some primary care physicians are even talking about dropping out of TMH to form their own contracting group, taking away the entire capitation payment from the Plan and contracting themselves for specialist and hospital services.

Specialist Care Physicians

The specialists believe that the primary care physicians refer too many patients to them.  The specialists do not mind the referrals as long as their reimbursement is based on charges because, on average, they receive 90 percent of charges.  However, if they are capitated, the specialists want the primary care physicians to handle more of the minor patient problems themselves.  Also, whenever the subject of subpanels is raised, many of the specialists become incensed.  ”After all,” they say, “the whole idea behind the PHO is to protect the specialists.” Both sets of physicians-primary care and specialist-agree that the hospital is hopelessly inefficient.  Said one specialist, “No matter how much revenue the hospital receives, it still seems to barely make a profit.”

 

 

Question 1

What reimbursement method would you recommend for each of the following providers? Be sure to justify your answers.

Primary Care Physicians

Primary care physicians should be paid by capitation, which, however, encourages these physicians to shift patients to other service providers, but the sharing of risk will generate incentives to lower utilization levels of hospitals as well as specialists aligned to patient traffic. Aleternatively these physicians can also be paid service fee on discounted basis which will work as an incentive offer comprehensive preventive care thereby restricting cost escalation in the long run.

Specialists

Specialists can also be paid by capitation, but then there exist peculiar issue with respect to this mode of payment. Based on estimated patient population of 50,000, the number of physicians required for certain specialities will be relativley smaller. Given as per exhibit 3.1, the number of cardiology, neurosurgery, thoraic, and urology surgeons required is just 1.0 in each case. Around 25 specialists would be optimal, however with lower utilization levels resulting in accretion of lower capitation payments from PHO. As a result of this a small increase in high-cost patients will put physician on the losing side with lower capitation fees. Thus it is wise to pay specialists on a discounted-fee basis, however may be lower than their current reimbursement percentage of 90%.

Hospital

It is a common practice with managed care plans to pay hospitals on a per day basis and hence make it attractive for physicians to limit admissions and length of stay. This is because hospital utilization can be controlled more effectively by managed care plans than the hospital itself. As a result, payment on per day basis will keep a check on the costs over the long run for the PHO.

Other Services

The utilization levels are lower and unpredictable in this case and such services are often managed by out-of-area providers. Thus they should be reimbursed on fee-for-service basis. Services given by frequent providers can be engaged at discounted contract rates and rest should be paid at actuals.

Question 2

What allocation of premium dollars do you recommend for each provider? Be sure to justify your recommendations.

Though the case provide allocation as guided by the consultant, we have made certain changes to include consideration for risk pool, which was ignored by the consultant. According to us, PHO administration overhead and in-system physicians should be given the greater allocation than what was advised by the consultant. This is because if fixed payments needs to be made to PHO and are made accountable for healthcare needs of the covered population, it needs to be equipped with talent pool of managerial staff and adequate information system which will enable them to exercise control over its components. Further, PHO should be in a position to create reserves (surplus overheads) to cover any such payments to providers on non-capitated basis over and above those allocated.

Primary care should be given higher allocation and specialists and in-system hospital should be given lower allocation than recommended by the consultants in order to set up a risk sharing arrangements within the PHO so as to reduce the amount of specialty and inpatient services provided going ahead. While the primary care physicians’ charges can be increased above traditional rates, the total compensation of specialists and hospital must be reduced in order to run successful PHO. Under the new contract, if utilization levels of these services are reduced, the profitability of specialists and hospital can be increased but with increased pressure on the hospital and specialists under the new proposed revenue distribution. Professional and in-patient services risk pools should be encouraged to get established which will provide financial incentives for promoting more cost effective and efficient practice patterns. Given that rest of categories falls outside the purview of PHO, the recommendations given by consultant seem reasonable.

The new allocation should be phased over next two to three years, instead of pushing from year 1, in order to make hospital and specialists familiar with reduced allocation of reimbursements and understand and respond to newly introduced incentives of risk pools so as to become more productive and efficient. Tulsa Memorial Hospital Case Study

Question 3

What proportion of the premium dollar would you allocate to the professional services risk pool?

Generally, risk-sharing arrangements allocate 10% to 20% of each reimbursement amount to one or more risk pools. Since PHO has never used risk pools in the past, it is prudent to start with 10% with gradual increase in later periods one they become familiar with the risk sharing experience. Since typical allocation of premium dollar for specialists is given as 16%, the allocation to professional services risk is given as 10% x 16% = 1.6% of premium amount and rest 14.4% is allocated to specialists.

How would you split the professional services risk pool between primary care physicians and specialists?

We have taken 50% for each category in order to maintain simplicity.

What proportion of the premium dollar would you allocate to the inpatient services risk pool?

Typical allocation of premium amount for hospital is 33%. Similar to professional services risk pool, 10% x 33% or 3.3% of premium amount is allocated to inpatient services risk pool and balance 29.7% or premium amount is allocated to hospitals.

How would you split the inpatient services risk pool among primary care physicians, specialists, and the hospital?

For simplicity purpose, we have divided this equally among the three parties. Tulsa Memorial Hospital Case Study

Question 4

Conduct a sensitivity analysis. More specifically, using your allocation of the premium dollars, how does the total budgeted reimbursement compare with the total actual reimbursement to primary care physicians, specialists, and the within-system hospital.

If actual payments equal the premium allocation?

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If both specialist and hospital payments are 10 percent greater than the premium allocation?

If both specialist and hospital payments are 10 percent lower than the premium allocation?

Do the risk pools provide appropriate incentives to the primary care physicians and the specialists?

If actual payments of hospital and specialists are above 10% over the budgetary allocation, the primary care physicians failed to exercise proper control over referrals to specialists, and specialists failed to exercise proper control over hospital utilization. As a result, the actual reimbursement of both groups is less than the budget.

In case of primary care physicians, the actual payment equals the budgetary allocation given that we chose to capitate them. However, their poor specialist referral program reduces the amount they receive from professional services risk pool from $960,000 to $96,000 and hence indicates that they have incentive to reduce specialist referrals.

In case of specialists, the actual premium payment at $19,008,000 is more than the budgetary allocation given that the physicians are paid on discounted-fee service basis. However, such increase in premium payment is offset by decline in professional service risk pool (reduced from $960,000 to $96,000) amount influenced by poor specialist referral performance of primary care physicians. The amount further gets reduced by inpatient service risk pool (reduced from$1,320,000 to $132,000) due to poor performance of specialists with respect to utilization of hospital. This shows that specialists have clear incentive to reduce hospital utilization. This has also reduced primary care of physicians share of inpatient risk services pool from $1,320,000 to $132,000. v

Above analysis reveal that, the risk pools provide clear incentive for control of specialist referral and hospital utilization.

Question 5

What are some reasons in favor of forming subpanels of the PHO’s primary care physicians to handle only Plan patients?

It makes financial sense to create subpanels to handle only Plan patients.

Primary Care Physicians will have only capitated payments and thus will not have to worry about varying incentive structure based on different reimbursement methodologies.

Overheads would be reduced in absence of need to maintain staff for billing third party vendors.

Risk of each provider on the panel would be reduced given that they would have large number of capitated patients from the Plan.

Of the total 57 primary care physicians, 25 can work on Plan patients and rest on non-Plan patients.

What are some reasons against forming subpanels of the PHO’s primary care physicians to handle only Plan patients?

In reality subpanel may be difficult to create given that only those primary care physicians may be willing to join who do not have full workload of patients and hence may not give requisite numbers.

While some physicians may have lower number patients because of low traffic, others may have because of poor quality of physicians or poor bedside manners.

Voluntary formation of subpanel may create pool of less efficient and effective Team.

Because of full workload by these members, Plan patients, currently seeing other primary care physicians, may be forced to change physicians as would non-Plan patients who are seeing the physicians for the Plan. It will create problems both for the physicians, by losing patients, and for the patients, who would have to change physicians. Tulsa Memorial Hospital Case Study

As a result, keeping competitive forces in mind, restricting Plan patients to lower number of primary care physicians will impact PHO’s revenues.

Should subpanels of the PHO’s specialists be created to handle only Plan patients?

It is easy to create subpanels for specialists. Given that future reimbursements might be less than the current reimbursements, specialists could be polled to find out their interest to join subpanel to serve Plan patients. So long as sufficient numbers are recruited, subpanel may be created for each category. Since they would continue to reimbursed based on discounted-fee for service basis, billing and efforts would remain unaffected.

 

 

Question 6

Consider some other actions that the PHO could take to ensure that its contract with the Plan is successful. Specifically, comment on the advisability and feasibility of taking actions in the following areas:

Utilization Review

PHO must be in possession of adequate information system in order to ascertain individual physician referral costs and the costs and effectiveness of alternative treatment methods. Further PHO should convince providers that lower-cost treatment is equally effective compared to higher cost treatment and hence encourage providers to use lower cost methods. Further such review can be used to limit referrals and inpatients utilization to those that are clinically warranted. Tulsa Memorial Hospital Case Study

Quality Management

Better the quality lower will the costs in the long run. Hence use of correct procedure and use it in the first attempt will be crucial. Stressing on quality throughout PHO will lead to higher patient satisfaction thereby ensuring contract renewal with the Plan and a potential driver to negotiate higher payments.

Information Systems

All above actions and performance will become possible only with availability of accurate, timely and structured clinical and financial information. Lack of availability of information will lead to collapse of entire PHO. Hence creation of proper information system infrastructure will be critical for the success of PHO which will help to manage patient population and financial drivers under check. Tulsa Memorial Hospital Case Study

 

Question 7

What are three key learning points from this case

It helps to build an understanding on premium payment allocation and risk-sharing with an integrated set up – PHO.

It helps to build an understanding on impact of referrals and hospital utilization on premium payments.

It improves analytical skillset with respect to using the case information into a financial model and interpret results basis change in assumptions. Tulsa Memorial Hospital Case Study

Case Study Assignment: Assessment Tools And Diagnostic Tests In Adults And Children

This week’s discussion board was about a case study on an underweight twelve-year-old girl whose parents were also underweight and what health issues and risks should the provider lookout for pertaining to this child. This assignment will also discuss and additional information that may be needed to further assess this case and questions that should be asked to parents to gather information on the child’s development and sensitivity issues she may have. Lastly, the discussion board will mention two strategies to encourage the patient and family to get to a healthy weight and ensure her health is improving.

Health Issues

When individuals are underweight there are some health concerns and issues that can…

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Case Study Assignment: Assessment Tools And Diagnostic Tests In Adults And Children

CASE STUDY: Severely underweight 12-year-old Hispanic girl with underweight parents who has been bullied in school just recently

When seeking to identify a patient’s health condition, advanced practice nurses can use a diverse selection of diagnostic tests and assessment tools; however, different factors affect the validity and reliability of the results produced by these tests or tools. Nurses must be aware of these factors in order to select the most appropriate test or tool and to accurately interpret the results.

Not only do these diagnostic tests affect adults, body measurements can provide a general picture of whether a child is receiving adequate nutrition or is at risk for health issues. These data, however, are just one aspect to be considered. Lifestyle, family history, and culture—among other factors—are also relevant. That said, gathering and communicating this information can be a delicate process. Case Study Assignment: Assessment Tools And Diagnostic Tests In Adults And Children.

For this Assignment, you will consider the validity and reliability of different assessment tools and diagnostic tests. You will explore issues such as sensitivity, specificity, and positive and negative predictive values. You will also consider examples of children with various weight issues. You will explore how you could effectively gather information and encourage parents and caregivers to be proactive about their children’s health and weight.

To Prepare

Review this week’s Learning Resources and consider factors that impact the validity and reliability of various assessment tools and diagnostic tests. You also will review examples of pediatric patients and their families as it relates to BMI.

By Day 1 of this week, you will be assigned to one of the following Assignment options by your Instructor: Adult Assessment Tools or Diagnostic Tests (option 1), or 
Child Health
 Case (Option 2). 
Note:
 Please see the “Course Announcements” section of the classroom for your assignments from your Instructor.

Search the Walden Library and credible sources for resources explaining the tool or test you were assigned. What is its purpose, how is it conducted, and what information does it gather? Case Study Assignment: Assessment Tools And Diagnostic Tests In Adults And Children.

Also, as you search the Walden library and credible sources, consider what the literature discusses regarding the validity, reliability, sensitivity, specificity, predictive values, ethical dilemmas, and controversies related to the test or tool.

If you are assigned Assignment Option 2 (Child), consider what health issues and risks may be relevant to the child in the health example.

Based on the risks you identified, consider what further information you would need to gain a full understanding of the child’s health. Think about how you could gather this information in a sensitive fashion.

Consider how you could encourage parents or caregivers to be proactive toward the child’s health.

The Assignment

Assignment
 (3–4 pages, not including title and reference pages)
:

Assignment Option 1: Adult Assessment Tools or Diagnostic Tests:

Include the following:

A description of how the assessment tool or 
diagnostic test
 you were assigned is used in healthcare.

What is its purpose?

How is it conducted?

What information does it gather?

Based on your research, evaluate the test or the tool’s validity and reliability, and explain any issues with sensitivity, reliability, and predictive values. Include references in appropriate APA formatting. Case Study Assignment: Assessment Tools And Diagnostic Tests In Adults And Children. Case Study Assignment: Assessment Tools And Diagnostic Tests In Adults And Children.

Assignment Option 2: Child Health Case:

Include the following:

An explanation of the health issues and risks that are relevant to the child you were assigned.

Describe additional information you would need in order to further assess his or her weight-related health.

Identify and describe any risks and consider what further information you would need to gain a full understanding of the child’s health. Think about how you could gather this information in a sensitive fashion. Case Study Assignment: Assessment Tools And Diagnostic Tests In Adults And Children.

Taking into account the parents’ and caregivers’ potential sensitivities, list at least three specific questions you would ask about the child to gather more information.

Provide at least two strategies you could employ to encourage the parents or caregivers to be proactive about their child’s health and weight. Case Study Assignment: Assessment Tools And Diagnostic Tests In Adults And Children.

 

Assessment Tools and Diagnostic Test in Adults and Children

This week’s discussion board was about a case study on an underweight twelve year old girl whose parents were also underweight and what health issues and risk should the provider look out for pertaining to this child. This assignment will also discuss and additional information that maybe needed to further assess this case and questions that should be asked to parents to gather information on the child’s development and sensitivity issues she may have. Lastly, the discussion board will mention two strategies to encourage the patient and family to get to a healthy weight and ensure her health is improving.

Health Issues

When individuals are underweight there are some health concern and issues that can impact their overall health and life span. This patient is underweight which causes concern for poor nutrition which will impact her growth and development, inability to fight off infections and illnesses as well as high risk for heart attacks and impaired thinking such as deceased concentration (Semba & Bloem, 2017). Another concern is that her parents are underweight as well which could suggest that their socioeconomic status is poor where they are not able to buy food or some form of genetic and diseases that affect the endocrine and digestive systems (Russo, 2017). Another factor that could contribute to her being underweight could be her mental health. She may have had a traumatic event take place to where she is ashamed of her body and controls her life through her weight, and eating disorder or she may be bullied at school and is depressed (Martin, et al., 2014).

Additional Information Needed

       
When realizing the health concerns and issues the information that is going to be needed is the nutritional factors for the family. What they eat, how often do they buy food and if they believe this is a healthy weight. The provider will need to gather the body mass index (BMI) for the patient as well as her family to gauge if they are healthy or underweight (Ball, et al., 2015). The formula for calculating BMI is to take the patients weight and divide it by her height. If the number is under 19.5 the patient is consider to have poor nutrition (Ball et al., 2015). Case Study Assignment: Assessment Tools And Diagnostic Tests In Adults And Children.

Three Targeted Questions

         
 Looking at the case study and the information that is going to be needed to further investigate into the patient’s health history certain question will need to be asked. The three targeted questions the provider should ask the patient and parents are:

How would you describe your weight? (CDC, 2017). This question will allow the provider to asses her mental health status on how she sees herself.

Are your family member very slim as well? (Russo, 2017). This question will gather information on genetics being the possible factor to the provider (Russo, 2017).

What do you typically eat within a 24 hour period?

Two Strategies to Encourage Proactivity

In order to promote an individual’s health, the first strategy is to educate the patient on their health and management. If the patient is not aware of the risk factors associated with their health history, family history and habits they will not succeed in positive outcomes regarding their health Case Study Assignment: Assessment Tools And Diagnostic Tests In Adults And Children. In this scenario nutrition education is needed (Gibbs & Chapman-Novakofski, 2012). This can include a nutrition consult, information about my plate which tells you the amount of servings needed for fruit, veggies and meat as well as what can happen when the body is not meeting the nutritional requirements. In order to promote education, the provider needs to know the health literacy of the patient. Most people read at a third grade level so understanding how your patient learns is essential in preparing a treatment or plan of care that the patient will follow and understand (Gibbs & Chapman-Novakofski, 2012).

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            The second strategy to promote healthy eating is to advocate for the patient and supply her with resources that can help her acquire food if she is having a hard time meeting the need due to finances. Many government offices have WIC programs that can give the family vouchers to buy food that is needed to keep the body healthy and meet the plate guidelines for what percentage of carbs, protein and fats for healthy growth (Ball, et al., 2015) Case Study Assignment: Assessment Tools And Diagnostic Tests In Adults And Children.

Summary

In order to help your patient have a healthy lifestyle and know how to prevent health problems from occurring, the provider needs a detailed history and physical of the patient. Asking the right questions and understanding the patient’s background can also help the provider choose the correct treatment and medications. Establishing a good rapport with patients and their families are important so that they are open, honest and not fear judgement.

References

Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2015).
Seidel’s guide to physical examination (8th ed.).
St. Louis, MO: Elsevier Mosby. Case Study Assignment: Assessment Tools And Diagnostic Tests In Adults And Children

CDC. (2017).
Youth Risk Behaviors Surveillance System (YRBSS) Overview.
Retrieved from https://www.cdc.gov/healthyyouth/data/yrbs/overview.htm

Gibbs, H., & Chapman-Novakofski, K. (2012).
Exploring nutritin literacy: Attention to assessment and the skills clients need.
Retrieved from Health, 4(3), 120-124: http://dx.doi.org/10.4236/health.2012.43019

Martin, B. C., Dalton, W. T., Williams, S. L., Slawson, D. L., Dunn, M. S., & Johns-Wommack, R. (2014).
Weight Status Misperception as Related to Selected Health Risk Behaviors Among Middle School Students.
Retrieved from Journal of School Health, 84(2), 116-123: doi:10.1111/josh.12128

Russo, J. (2017).
What are the Causes of Underweight Children?
Retrieved from http://www.livestrong.com/article/198981-what-are-the-causes-of-underweight-children/

Semba, R. D., & Bloem, M. W. (2017).
Nutrition and Health in a Developing World (2nd ed.).
Retrieved from https://www.researchgate.net/profile/Barry_Popkin/publication/225833386_The_Nutrition_Transition_and_Its_Relationship_to_Demographic_Change/links/54c7b36a0cf289f0cecd96c8/The-Nutrition-Transition-and-Its-Relationship-to-Demographic-Change.pdf#page=137 Case Study Assignment: Assessment Tools And Diagnostic Tests In Adults And Children

Stages Of Life Essay and Interview

Write a 500‐750‐word essay on the Stages‐of‐Life and the influence of age in health care from a patient’s perspective. Interview a friend or family member about that person’s experiences with the health care system. You may develop your own list of questions.

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Suggested questions:

Do you feel that your stage‐of‐life had any effect on your interaction with health care professionals?

Which areas of the hospital or clinic were most concerned with your well‐being and feelings?

Was your family with you during this hospital stay or outpatient visit?

Was your family included in your treatment, such as post‐procedure instructions? Stages Of Life Essay and Interview

Asthma And Stepwise Management Essay Assignment Paper

Asthma is a chronic inflammatory respiratory disease of the airways characterized by airway obstruction, inflammation and hyperresponsiveness (Arcangelo and Peterson, 2013).  The principal objective to treating asthma is to control the disease.  Asthma control focuses on preventing problematic symptoms such as shortness of breath, wheezing, extreme coughing and/or frequent respiratory infections.  In order to treat and control asthma, the advance practice nurses must be able to recognize and distinguish life-threatening symptoms and understand the stepwise management approach for treatment.  There are two treatment choices that are utilized to treat asthma, long-term control and quick relief treatment.  Asthma And Stepwise Management Essay Assignment Paper. The purpose of this paper is to describe the long-term control and quick relief treatment and explain the stepwise approach to asthma treatment and management.  Finally, the paper will also explain how stepwise management assist health care providers and patients in gaining and maintaining control of the disease.

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Long-Term Control and Quick Relief Treatment

Long-Term Control

The goal of long-term control asthma pharmacotherapy is to prevent symptom flair ups and control asthma.  According to Arcangelo and Peterson (2013), long-term control medications must be taken every day to achieve and maintain control in persistent cases.  Long-term asthma medication is the most effective medication when preventing asthma attacks and controlling chronic symptoms.  According to Drugs.com (2012), long-term medication includes inhaled corticosteroids, long-acting beta-agonists (LABAs), leukotriene modifiers, theophylline, and combination inhalers containing both LABAs and corticosteroids.  One of the most important and effective long-term control medication is inhaled corticosteroid.  This long-term medication is considered to be the most effective anti-inflammatory medication because it prevents the passage and stimulation of inflammatory cells.  In return it prevents airway hyperresponsiveness, improves symptoms, and the function of the respiratory system.  According to Arcangelo and Peterson (2013), the impact of inhaled corticosteroids includes oral fungus known as “thrush”, coughing, hoarseness, osteoporosis and easy bruising.  In children one of the most crucial side effect is delayed or suppressed growth.  It is important for advance practice nurses and physicians to monitor the effects of the medication and educate patients on the possible side effects Asthma And Stepwise Management Essay Assignment Paper.

Quick-Relief Treatment

Quick relief medications also known as “rescue medications” are used to…

 

To Prepare

Reflect on drugs used to treat asthmatic patients, including  long-term control and quick relief treatment options for patients. Think  about the impact these drugs might have on patients, including adults  and children.

Consider how you might apply the stepwise approach to address the health needs of a patient in your practice.

Reflect on how stepwise management assists health care providers and patients in gaining and maintaining control of the disease

Create a  5- to 6-slide PowerPoint presentation that can be used in a staff  development meeting on presenting different approaches for implementing  the stepwise approach for asthma treatment. Be sure to address the  following:

Describe  long-term control and quick-relief treatment options for the asthma  patient from your practice as well as the impact these drugs might have  on your patient.

Explain the 
Stepwise Approach
 to asthma treatment and management for your patient.

Explain  how stepwise management assists health care providers and patients in  gaining and maintaining control of the disease. Be specific.

Please review the rubric for this assignment..

 

Grid View

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Excellent   Good   Fair   Poor       Describe the long-term control and quick relief treatment options for  the asthma patient from your practice, as well as the impact these drugs might have on your patient.          Points Range:     27 (27%) – 30 (30%)   The presentation clearly and  accurately describes in detail the long-term control and quick relief  treatment options for the asthma patient from their practice.

The presentation clearly and accurately describes in detail the impact these drugs might have on their patient.        Points Range:     24 (24%) – 26 (26%)   The presentation accurately describes the long-term control and quick relief options for the asthma patient from their practice.

The presentation accurately describes the impact these drugs might have on their patient.        Points Range:     21 (21%) – 23 (23%)   The presentation inaccurately or  vaguely describes the long-term control and quick relief options for the  asthma patient from their practice.

The presentation inaccurately or vaguely describes the impact these drugs might have on their patient.        Points Range:     0 (0%) – 20 (20%)   The presentation inaccurately and  vaguely describes the long-term and quick relief options for the asthma  patient from their practice, or is missing.

The presentation inaccurately and vaguely describes the impact these drugs might have on their patient, or is missing.     Explain the stepwise approach to asthma treatment and management for your patient.          Points Range:     27 (27%) – 30 (30%)   The presentation clearly and  accurately explains in detail the stepwise approach to asthma treatment  and management for their patient.        Points Range:     24 (24%) – 26 (26%)   The presentation accurately explains the stepwise approach to asthma treatment and management for their patient.        Points Range:     21 (21%) – 23 (23%)   The presentation inaccurately or vaguely explains the stepwise approach to asthma treatment and management for their patient.        Points Range:     0 (0%) – 20 (20%)   The presentation inaccurately and vaguely explains the stepwise approach to asthma treatment and management for their patient.     Explain how stepwise management assists health care providers and  patients in gaining and maintaining control of the disease. Be specific.          Points Range:     27 (27%) – 30 (30%)   The presentation clearly and  accurately explains in detail how stepwise management assists health  care providers and patients in gaining and maintaining control of the  disease.

The presentation provides accurate and detailed examples to support the explanation provided.        Points Range:     24 (24%) – 26 (26%)   The presentation accurately  explains how stepwise management assists health care providers and  patients in gaining and maintaining control of the disease.

The presentation provides accurate examples to support the explanation provided.        Points Range:     21 (21%) – 23 (23%)   The presentation inaccurately or  vaguely explains how stepwise management assists health care providers  and patients in gaining and maintaining control of the disease.

The presentation provides inaccurate or vague examples to support the explanation provided.        Points Range:     0 (0%) – 20 (20%)   The presentation inaccurately and  vaguely explains how stepwise management assists health care providers  and patients in gaining and maintaining control of the disease, or is  missing. Asthma And Stepwise Management Essay Assignment Paper.

The presentation provides inaccurate and vague examples to support the explanation provided, or is missing.     Written Expression and Formatting – Paragraph Development and Organization:

Paragraphs  make clear points that support well developed ideas, flow logically,  and demonstrate continuity of ideas. Sentences are carefully  focused–neither long and rambling nor short and lacking substance.          Points Range:     5 (5%) – 5 (5%)   Paragraphs and sentences follow writing standards for flow, continuity, and clarity.        Points Range:     4 (4%) – 4 (4%)   Paragraphs and sentences follow writing standards for flow, continuity, and clarity 80% of the time.        Points Range:     3.5 (3.5%) – 3.5 (3.5%)   Paragraphs and sentences follow writing standards for flow, continuity, and clarity 60%–79% of the time.        Points Range:     0 (0%) – 3 (3%)   Paragraphs and sentences follow writing standards for flow, continuity, and clarity less than 60% of the time.     Written Expression and Formatting – English writing standards:

Correct grammar, mechanics, and proper punctuation          Points Range:     5 (5%) – 5 (5%)   Uses correct grammar, spelling, and punctuation with no errors        Points Range:     4 (4%) – 4 (4%)   Contains a few (1–2) grammar, spelling, and punctuation errors        Points Range:     3.5 (3.5%) – 3.5 (3.5%)   Contains several (3–4) grammar, spelling, and punctuation errors        Points Range:     0 (0%) – 3 (3%)   Contains many (≥ 5) grammar, spelling, and punctuation errors that interfere with the reader’s understanding          Total Points: 100 Asthma And Stepwise Management Essay Assignment Paper

 

Asthma and Stepwise Management

Asthma is a chronic inflammatory respiratory disease of the airways characterized by airway obstruction, inflammation and hyperresponsiveness (Arcangelo and Peterson, 2013).  The principal objective to treating asthma is to control the disease.  Asthma control focuses on preventing problematic symptoms such as shortness of breath, wheezing, extreme coughing and/or frequent respiratory infections.  In order to treat and control asthma, the advance practice nurses must be able to recognize and distinguish life-threatening symptoms and understand the stepwise management approach for treatment.  There are two treatment choices that are utilized to treat asthma, long-term control and quick relief treatment.  The purpose of this paper is to describe the long-term control and quick relief treatment and explain the stepwise approach to asthma treatment and management. Asthma And Stepwise Management Essay Assignment Paper.  Finally, the paper will also explain how stepwise management assist health care providers and patients in gaining and maintaining control of the disease.

Long-Term Control and Quick Relief Treatment

Long-Term Control

The goal of long-term control asthma pharmacotherapy is to prevent symptom flair ups and control asthma.  According to Arcangelo and Peterson (2013), long-term control medications must be taken every day to achieve and maintain control in persistent cases.  Long-term asthma medication is the most effective medication when preventing asthma attacks and controlling chronic symptoms.  According to Drugs.com (2012), long-term medication includes inhaled corticosteroids, long-acting beta-agonists (LABAs), leukotriene modifiers, theophylline, and combination inhalers containing both LABAs and corticosteroids.  One of the most important and effective long-term control medication is inhaled corticosteroid.  This long-term medication is considered to be the most effective anti-inflammatory medication because it prevents the passage and stimulation of inflammatory cells.  In return it prevents airway hyperresponsiveness, improves symptoms, and the function of the respiratory system.  According to Arcangelo and Peterson (2013), the impact of inhaled corticosteroids includes oral fungus known as “thrush”, coughing, hoarseness, osteoporosis and easy bruising.  In children one of the most crucial side effect is delayed or suppressed growth.  It is important for advance practice nurses and physicians to monitor the effects of the medication and educate patients on the possible side effects.

Quick-Relief Treatment

Quick relief medications also known as “rescue medications” are used to control flair ups such as wheezing, shortness of breath, and extreme or severe coughing during an asthma attach.  These medications are known as bronchodilators because they relax the airway muscles by eliminating the symptom.  It is crucial that the asthmatic patient knows and understands the importance of keeping a rescue inhaler with them at all times.  These medications have a faster onset to improve breathing and treat attacks versus the long-term control medications.  These medications are Metaproterenol, Pirbuterol, Bitolterol, Terbutaline, Levalbterol, and Albuterol (Drugs.com, 2012).  The advance practice nurse or physicians must establish an asthma action plan in regards to when the drug must be used and the amount to use during an attack with the patient (Bousquet, 2000).  Although these medications eliminate symptoms during an attack, it is important to know the impact of the medication could cause tremors, headaches, anxiety, restlessness, and fast and uneven heartbeats in both adults and children (Arcangelo & Peterson, 2013) Asthma And Stepwise Management Essay Assignment Paper.

Stepwise Approach to Treatment and Management

When asthma is diagnoses and the severity of disease is assessed, the advance practice nurse or physician will then utilize the stepwise approach to decide which step of therapy should be considered to coincide the proper level of asthma severity.  The Expert Panel Report 3 from the National Asthma Education and Prevention Program (NAEPP EPR-3) (2007) recommends a stepwise approach to the implementation and adjustment of pharmacotherapy in asthma management.  The purpose of the stepwise approach is to initiate a more intensive therapy to attain rapid control, and then step down to the least possible therapy.  There are six steps outlined in the stepwise approach.  Step one involves using a short acting beta-agonist to treat intermittent asthma.  Steps two through six includes treating individuals with persistent asthma utilizing daily medication.  According to the  National Asthma Education and Prevention Program (NAEPP EPR-3) (2007), the following doses are recommended for each step; step two low-dose inhaled corticosteroids (ICS), step three a medium-dose ICS or low-dose LABA plus ICS, step four LABA and medium-dose ICS, step five a LABA and high-dose ICS, and step six an oral corticosteroid plus a LABA plus a high-dose ICS.

Stepwise Management Assist Health Care Providers and Patients

The stepwise approach is a tool that both the health care provider and patient can benefit from utilizing.  When the approach is used the health care provider can utilize questionnaires to help determine if the level of control has been achieved (Osman et al., 1993).  This provides an opportunity to determine if the current treatments are beneficial to the patient and the impact of the medication.  The stepwise approach is critical in the management and prescribing of medication based on the stage of the disease and provides alternative medications.  Comorbidities management, environmental control, and patient education accompany each stage of the stepwise approach, which is important in managing and treating asthma Asthma And Stepwise Management Essay Assignment Paper.

Conclusion

The main objective of asthma care is the accomplishment and maintenance of asthma control.  This is achieved by decreasing the impairment and risk by utilizing pharmacotherapy and the stepwise approach.  It is critical that health care providers and patients collaborate closely to identify the needs of the patients early.  A thorough health history should be established to identify individual triggers for easier management and identifying the proper medications.  Although there is no cure for asthma it can be controlled properly by the health care provider and patient.

 

Reference

Arcanglo, V.P., & Peterson, A.M., (Eds). (2013).
Pharmacotherapuetics for advanced

            practice: A practical approach
(3
rd
). Ambler, PA: Lippincott Williams & Wilkins

Bousquet, J. (2000). Global initiative for asthma (GINA) and its objectives. Clinical and Experimental Allergy, 30(6; SUPP/1), 2-5.

Drugs.com., (2012). Asthma. Retrieved from
https://www.drugs.com/asthma.html

Expert Panel Report 3: Guidelines for the diagnosis and management of asthma. National Heart, Lung, and Blood Institute; National Institutes of Health; U.S. Department of Health and Human Services. Published August 28, 2007. Retrieved from
www.nhlbi.nih.gov/health-pro/guidelines/current/asthma-guidelines/full-report

Osman, L. M., Russell, I. T., Friend, J. A., Legge, J. S., & Douglas, J. G. (1993). Predicting patient attitudes to asthma medication. Thorax, 48(8), 827-830. Asthma And Stepwise Management Essay Assignment Paper

Professional Identity and Stewardship – Part II: Leadership Interview

Professional Identity and Stewardship Interview Essay examples

 

Interview a person in a formal position of leadership within your organization (e.g., a supervisor, a manager, a director). Begin your interview with the following questions:

What is your role as a health care team member?

How do you define professionalism and how does professional responsibility influence your work?

Do you consider yourself a steward of health care? Why or Why not?

Is it important to you that leaders exercise professional advocacy and authenticity as well as power and influence when working with colleagues? Why or why not?

Professional Identity and Stewardship Interview Essay examples

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In 500-750 words, summarize your interview and share your impressions of the leader’s responses.

Compare and contrast responses provided by your peer (in Professional Identity and Stewardship – Part I: Peer Interview assignment) with those provided by the leader. Share your impressions of their differences and similarities.

Prepare this assignment according to the APA guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

This assignment uses a grading rubric. Instructors will be using the rubric to grade the assignment; therefore, students should review the rubric prior to beginning the assignment to become familiar with the assignment criteria and expectations for successful completion of the  Professional Identity and Stewardship Interview Essay examples

 

Professional Identity & Stewardship Leadership Interview

This week we are conducting interviews with various leaders both in the class and in leadership roles at a place of employment.  We will be discussing their opinions on the necessary characteristics one must possess to be a leader, whether they are a steward of healthcare and how, as well as the professional responsibilities a leader is to hold. Professional Identity and Stewardship Interview Essay examples.

ROLE

J.L is a registered nurse that holds the position of Patient Care Manger.  He manages a 24 bed trauma intermediate care unit at a Level 1 Trauma Center.  He worked as a PCT while pursuing his RN degree and upon completion of his schooling he transitioned to a 20 bed unit that was a trauma/surgical/oncology floor.  The hospital was experiencing a lot of growth at this time and expanding services.  Three years into his career a new unit was created for trauma patient’s only. Professional Identity and Stewardship Interview Essay examples He transitioned to that unit in the Clinical Leader role.  He worked as a CL for 5 years and then applied for the PCM position.  He has held that position since (J. Loya, personal communication, March 16, 2018).

PROFESSIONALISM/PERSONAL RESPONSIBILITY

J.L. was given the question of defining professionalism and his personal responsibility to influence others.  He defined professional as a means of working hard on the behalf of his staff using past experience as well as evidence based practice.  He sees his role and responsibility as being the collective voice of the whole when they don’t have the access or means to do so themselves. He has strived to accomplish this through creating a specific culture on his unit of teamwork and inspiring the staff to think outside the box for problem solving.  J.L. has brought unit specific education to the staff to build confidence and experience.  He fosters an open door policy and bi-monthly does a “check-in” individually with each employee to ask specific questions about what is working and what needs improvement with everything from fellow peers to supplies and workflow, etc. (J. Loya, personal communication, March 16, 2018) Professional Identity and Stewardship Interview Essay examples.

STEWARDSHIP

When asked about whether J.L. views himself as a steward of healthcare, he responds with an emphatic yes.  His greatest accomplishment in his current position was assisting in the creation of a burn program here in Tucson.  The closest services for any burn (8% and over) was at Maricopa Burn Center.  J.L. worked together with the Chief of Trauma to fill the need locally.  Burns average a hospital stay of 21 days and can exceed 6 months.  When the patient isn’t local to a burn center it can be a heavy burden on the family to be close during the hospital stay.  It also poses challenges for follow up care.  The hospital can now serve patient’s all the way from New Mexico and Nevada and have even had several patients from Mexico. Professional Identity and Stewardship Interview Essay examples. There are now 2 dedicated burn surgeons as well as a “burn team”.  The fact that the hospital is a teaching facility as well as a level one trauma center, the burn program is a perk in that it draws candidates here looking for the training as well.  (J. Loya, personal communication, March 16, 2018)

AUTHENTICITY

When asked about authenticity, J.L. believes is imperative to any leadership role.  Not only among the people you are leading, but your peers as well.  If you have demonstrated authenticity though strong core values, it shows strength and enables you to have a solid foundation of trust.  And with that comes an ability to influence, advocate and affect change.  (J. Loya, personal communication, March 16, 2018).

CONCLUSION

The differences between my peer and my manager were not that stark.  I don’t know if it has to do with the nursing foundation or not.  As a nurse you are expected to lead in so many different ways that the transition between those of us at bedside and our managers aren’t always that far apart.  At least not when you are dealing with a good manager! Professional Identity and Stewardship Interview Essay examples

 

Professional Identity and Stewardship- Part I: Peer Review

This paper will give a summary of the interview between author and critical care nurse Samantha Claudio. Samantha agreed to meet for a one-on-one interview to discuss a series of questions pertaining to her professional identity and stewardship as a staff nurse in the critical care unit. The questions asked were related to her role as a healthcare team member, what her definition of professionalism is and how it influences her work, if she considers the leaders in the organization stewards, and lastly if she feels it is important that the leaders exercise professional advocacy, authenticity, power and influence. If given the opportunity, professionalism has the capacity to influence one’s work ethic. It is important for all members of the health care team to show professionalism and stewardship.

Role

Samantha’s role as a health care team member is to ensure collaborative and high-quality care to not only her patients, but to their families, her coworkers, and the profession itself. She feels that her role is to provide the essential care to her patients and help facilitate communication between all disciplines involved Professional Identity and Stewardship Interview Essay examples.

Professionalism

Samantha defined professionalism as the ability to hold the competence and expected skill set as desired in nursing. She went on to explain that this competence is not just what she was taught to be a successful bedside nurse. This is also the strength and understanding on how to present oneself to her patients in times of desperation or agony. The professional responsibility influences her work by holding her accountable. With this she sees it her responsibility to hold the appropriate knowledge to adequately care for the patients that walk through the door. She feels nursing is held at a higher standard of professionalism due to having to handle so many situations with life and death. Professional Identity and Stewardship Interview Essay examples.

Stewards of Healthcare

It was expressed that she felt the leaders in her organization show great signs of stewards of health care. Including the patient care managers, hospital administration, and physicians Samantha explains that these leaders are active members in portraying their responsibility in upholding the organizations mission statement. The leaders take on the great battle of managing the staff and providing the wisdom needed to keep the facility operating appropriately. They are supportive, encouraging, and offer guidance to all workings members of the team.

Professional Advocacy, Authenticity, Power, & Influence

Samantha replied that is of the upmost importance to her that the leaders exercise professional advocacy, authenticity, power, and influence, especially in health care. When caring for people they deserve nothing less than everything we are able to offer them. It is because of this that Samantha feels strongly that leaders should not only encourage this behavior, but also show exemplary examples of this when working. Professional Identity and Stewardship Interview Essay examples. Respect towards her leaders is more important than some people realize. With respect, the followers are able to hold their own encouragement and continue to grow. Without respect, colleagues can often times lose their drive and force to better themselves and provide the best care.

Thesis

Samantha has been a registered nurse for 10 years. She prides herself on the ability to maintain a fulfilling home life, as well as a successful career. This interview offered the insight that professionalism is important in every position of nursing. It isn’t just for the managers and leaders of the organization. Professionalism and stewardship have a great influence for every member of the health care team Professional Identity and Stewardship Interview Essay examples.

 

Course Code

Class Code

Assignment Title

Total Points

AMP-450V

AMP-450V-O500

Professional Identity and Stewardship – Part II: Leadership Interview

50.0

Professional Identity and Stewardship Interview Essay examples

Criteria

Percentage

Unsatisfactory          0-71% (0.00%)

Less Than Satisfactory          72-75% (75.00%)

Satisfactory          76-79% (79.00%)

Good          80-89% (89.00%)

Excellent          90-100% (100.00%)

Content

80.0%

Detailed Summary of  Leader Interview

70.0%

Summary of leader interview is not provided or is incomplete.

Summary of leader review is unclear or inconsistent with professionalism and the role of stewardship.

Summary of leader interview is clear but one of the four components of the interview is lacking.

Summary of leader interview is provided with detailed explanation of each component of professionalism, stewardship, advocacy and authenticity.

Comprehensive summary of leader interview is provided with detailed explanations of each component of professional identity and a thoughtful discussion of the interviewer’s perceptions of the interview experience.

Compares and contrasts the peer responses, from Professional Identify and Stewardship-Part 1, with those provided by the leader. Shares impression of differences and similarities.

10.0%

No comparison and contrast of peer responses with those provided by the leader are provided.

Comparison and contrast of peer responses with those provided by the leader and student’s impression of those differences and similarities are not adequately addressed.

Comparison and contrast of peer responses with those provided by the leader and student’s impression of those differences and similarities meet the basic expectations of the assignment as indicated by the assignment instructions.

Comparison and contrast of peer responses with those provided by the leader and student’s impression of those differences and similarities demonstrate a clear understanding of roles, professionalism, stewardship, and advocacy as it applies to leadership.

Comparison and contrast of peer responses with those provided by the leader and student’s impression of those differences and similarities demonstrate a clear understanding of roles, professionalism, stewardship, and advocacy as it applies to leadership, while demonstrating higher level thinking as indicated by evidence of reflective thought.

Professional Identity and Stewardship Interview Essay examples

Organization and Effectiveness

15.0%

Thesis Development and Purpose

5.0%

Paper lacks any discernible overall purpose or organizing claim.

Thesis and/or main claim are insufficiently developed and/or vague; purpose is not clear.

Thesis and/or main claim are apparent and appropriate to purpose.

Thesis and/or main claim are clear and forecast the development of the paper.  It is descriptive and reflective of the arguments and appropriate to the purpose.

Thesis and/or main claim are comprehensive; contained within the thesis is the essence of the paper.  Thesis statement makes the purpose of the paper clear.

Paragraph Development and Transitions

5.0%

Paragraphs and transitions consistently lack unity and coherence.  No apparent connections between paragraphs are established. Transitions are inappropriate to purpose and scope.  Organization is disjointed.

Some paragraphs and transitions may lack logical progression of ideas, unity, coherence, and/or cohesiveness.  Some degree of organization is evident.

Paragraphs are generally competent, but ideas may show some inconsistency in organization and/or in their relationships to each other.

A logical progression of ideas between paragraphs is apparent.  Paragraphs exhibit a unity, coherence, and cohesiveness.  Topic sentences and concluding remarks are appropriate to purpose.

There is a sophisticated construction of paragraphs and transitions.  Ideas progress and relate to each other.  Paragraph and transition construction guide the reader.  Paragraph structure is seamless.

Mechanics of Writing (includes spelling, punctuation, grammar, language use)

5.0%

Surface errors are pervasive enough that they impede communication of meaning. Inappropriate word choice and/or sentence construction are used.

Frequent and repetitive mechanical errors distract the reader. Inconsistencies in language choice (register), sentence structure, and/or word choice are present.

Some mechanical errors or typos are present, but are not overly distracting to the reader. Correct sentence structure and audience-appropriate language are used.

Prose is largely free of mechanical errors, although a few may be present. A variety of sentence structures and effective figures of speech are used.

Writer is clearly in command of standard, written, academic English.

Format

5.0%

Paper Format (Use of appropriate style for the major and assignment)

5.0%

Template is not used appropriately or documentation format is rarely followed correctly.

Template is used, but some elements are missing or mistaken; lack of control with formatting is apparent.

Template is used, and formatting is correct, although some minor errors may be present.

Template is fully used; There are virtually no errors in formatting style.

All format elements are correct.

Total Weightage

100%

Professional Identity and Stewardship Interview Essay examples

The purpose of this Personal teaching philosophy statement essay example assignment is to develop your personal teaching philosophy statement. This will be included in your e-portfolio to be submitted at the end of this course.

Begin by researching a developed teaching philosophy and use the information to shape your own philosophy.

In 250-500 words, develop a personal teaching philosophy statement that includes your beliefs on the purpose of education, how students learn, how your beliefs facilitate learning, the role of the nurse educator, and how you plan to implement this philosophy to grow as an educator as you seek to integrate the nurse educator competencies into your professional practice.

APA style is not required, but solid academic writing is expected. Personal teaching philosophy statement essay example.

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

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Statement of Teaching Philosophy

The purpose of a Statement of Teaching Philosophy is not only to put your individual goals as an educator on paper, but to also enhance your likelihood of commandeering a job as an educator. First and foremost, the main goal behind putting your philosophy on paper is to remind you why you want to be an educator. Sometimes we have outside interference in our lives that can affect our goals and passions and this would serve as a little reminder as to why we want to be educators Personal teaching philosophy statement essay example. In other words, a teaching philosophy is a goal-oriented statement. Included in a statement of teaching philosophy should be your own personal goals as an educator, what methods you plan to use while teaching, why you plan to use those methods and how you will evaluate yourself and your methods. Overall, your personal statement of teaching philosophy will change as you do over time. As you learn more and more through experience, you will end up altering your views and goals on being an educator.

When I take a minute to jot down my fundamental beliefs about both learning and teaching, I see a direct correlation between the two. The commonality is that students need to be engaged in any lesson in the greatest capacity possible in order for the teaching to be effective. As for my beliefs about learning, I believe that students have a much higher success rate when they are in more of a “hands-on” learning environment. For example, from my own experience in an elementary setting; students who are lectured and then told to do an exercise tend to be less interested or do not know what to do when given the paper to do their work. However, when the students “learn” along with the teacher during the lesson, students have a much higher success rate when left on their own to do the activity. As for my beliefs about teaching, I have a hard time believing that educators enjoy lecturing students instead of working with them to help them understand a specific topic and or exercise. Personal teaching philosophy statement essay example. Personally, I believe in order to keep teaching fresh and prevent from getting in a routine considering education changes daily, I would constantly be looking for new ways to convey information and skills to students.

The fundamental values I would want to pass along to my students would be positive attitudes and their purpose for learning. First and foremost, conveying positive attitudes can do nothing but create an encouraging atmosphere around the classroom. If students are encouraged to be positive, this could lead into the successfulness of the “hands-on” learning environment. How these two go together is quite simple. If a student doesn’t understand even with the “hands-on” learning strategy, there will not only be the educators to help the child, but they would not feel embarrassed or ashamed asking a peer to help them better understand the material. When it comes to letting them know the purposes for learning, I would instill that in them by teaching them life skills along with educational skills. Those two types of skills essentially go hand in hand throughout life. Personal teaching philosophy statement essay example. As a student, I learned the English language and then eventually learned speech and people skills as I went on throughout my education.

Teaching to me means educating the younger generations in order to facilitate as successful of a future planet as possible. I understand that I will not be on this planet forever; therefore I feel the need to convey as much positive educational information to our younger generations as possible. Teaching also means shaping the minds of these children to become the best possible people they can be and enable them to make the biggest contribution they can to this planet as well. Personally working with a child one on one right now I can not only see the differences that one person can make in another’s life and this is the main reason why teaching means what it does to me. I honestly believe that without teaching or education this world would be a disaster. Education has been the one solid constant throughout the history of our country and it takes a special person to be a teacher. Personal teaching philosophy statement essay example.

In conclusion, education is full of different theories and philosophies, however the key factor in all of them is whether or not they are successful for you. This is the reason why creating your own philosophy of teaching is most ideal. There is no benefit from using other educator’s ideas and beliefs. We are all different therefore all share different views on education and how things should be taught. While we may get ideas from certain places, our philosophy should be our own without much if any influence. Education is an ever changing part of life in which there is ever changing educators educating our youth. These youth will one day go on and take our place, it is a never ending cycle that will forever evolve and it’s our duty to do our part and give what we can to our younger generations. Personal teaching philosophy statement essay example.

Formulating Your Philosophy of Education

Philosophy is in everything that we do. Dealing with parents and other.

Attitudes in life reflects your philosophy

Philosophy in Education includes this concepts:

–        Human person

–        True and good that needs to be taught

 

I believe that every child has a natural interest in learning and is capable of learning is an embodied spirit can be influenced but not totally by his/her environment is unique and so comparing a child to other children has no basis. I believe that my task as a teacher is to facilitate the development of every child to optimum and to the maximum. I believe that education is an individual, unique experience for every student who enters a classroom. In order for children to benefit from what schools offer, I think that teachers must fully understand the importance of their job. First, I believe that teachers must consider teaching to be a lifestyle, not a mere forty-hour-a-week job, because a teacher’s goals for his/her students encompass much more than relaying out-of-context facts to passive students. As professionals entrusted with the education of young minds, teachers must facilitate learning and growth academically, personally, and ethically. By providing a quality education to each individual in one’s classroom, a teacher equips children with the tools necessary for success in life.  I think that teaching and learning are a reciprocal processes. Personal teaching philosophy statement essay example. When teachers nurture individual talents in each child, educators can build self-esteem and may encourage a lifelong skill. By supporting these special abilities, teachers can, for example, guide students’ research, and students can, in turn, enlighten teachers about subjects in which they may not be as knowledgeable. This mutual respect for individual skills cultivates a professional academic relationship, leading to a give-and-take educational alliance. This liaison allows students to feel that they are on equal intellectual ground with their teachers, thus creating a strong academic atmosphere. In choosing to become a teacher, I have made the commitment to myself and my future students to be the best academic, personal, and ethical role model I can be Personal teaching philosophy statement essay example. It is my goal to have a mutually enriching teaching career by keeping an open mind and continually communicating with my peers and students. I am prepared to rise to the challenges of teaching in the 21st century, and I promise to try to provide an honest, well-rounded education to every student I encounter.

The Foundational Principles of Morality and You

 

“Even on your worst day on the job, you are still some children’s best hope.”

Morality- “The quality of human acts by” The quality of human acts by which we call them right or which we call them right or wrong, good or evil“ wrong, good or evil“

 

–        Your human action is right when it conforms with the norm, rule or, law of morality, otherwise it is said to be wrong.

 

 

PRINCEPS – a beginning a source

 

PRINCIPLES – is that on which something is based

founded originated initiate

The term “morality” can be used either

–        descriptively to refer to some codes of conduct put forward by a society or, some other group, such as a religion, or accepted by an individual for her own behavior or

–  normatively to refer to a code of conduct that, given specified conditions, would be put forward by all rational persons

 

Moral Principles of Education

–        The teacher needs to understand public opinion and the social order, as much as the public needs to comprehend the nature of expert educational service. – John Dewey

Teachers as Role Models

Teachers were expected to be morally upright individuals who displayed good character

They were expected to teach and discipline students

The public expects teachers to display behaviors such as

Fairness

Honesty

Adherence

 

 

7 Philosophies of Education

What are your beliefs about teaching?

 

Behind every school and every teacher is a set of related beliefs–a philosophy of education–that influences what and how students are taught. A philosophy of education represents answers to questions about the purpose of schooling, a teacher’s role, and what should be taught and by what methods. Personal teaching philosophy statement essay example.

Essentialism focuses on teaching the essential elements of academic and moral knowledge. Essentialists urge that schools get back to the basics; they believe in a strong core curriculum and high academic standards.

 

Perennialism focuses on the universal truths that have withstood the test of time. Perennialists urge that students read the Great Books and develop their understanding of the philosophical concepts that underlie human knowledge.

 

Progressivism is based largely on the belief that lessons must be relevant to the students in order for them to learn. The curriculum of a progressivist school is built around the personal experiences, interests, and needs of the students Personal teaching philosophy statement essay example.

 

Social Reconstructionist separated from progressivism because they desired more direct and immediate attention to societal ills. They are interested in combining study and social action, and believe that education can and should go hand in hand with ameliorating social problems.

 

Existentialism is derived from a powerful belief in human free will, and the need for individuals to shape their own futures. Students in existentialist classrooms control their own education. Students are encouraged to understand and appreciate their uniqueness and to assume responsibility for their actions.

 

The 21st Century Teacher

The 21
st
 century educator looks forward to the future. They are aware of the ever-changing trends in technology and are in tune of what the future may bring to education. A good 21
st
century teacher is aware of the career opportunities that will be in the coming years for their students, and are always advocating towards forward thinking and planning to ensure all students will not be left behind. Lastly, the 21
st
 century educator must use 
teaching strategies
 to ensure that the focus in education is on preparing today’s children for the future of where they will live and where they will work, not for our current world. The 21st century teacher is one that moves right along with it. Technology in the classroom, whether it’s for lessons, assignments, or grading, can help students learn better and faster, and help make a teacher’s time more effective. Personal teaching philosophy statement essay example. A 21st century teacher does not have to have a class set of tablets in every child’s hand, or the latest smart board. But they can have a nice balance of educational tools in their classroom. An effective teacher knows what technology in the classroom can truly help transform their students’ education. They know what the best tools are, and how and when to use them. An effective 21st century educator must be able to collaborate and work well in a team. Working with others is an important 21st century skill. Over the past few years, being able to collaborate effectively in the workplace has grown quite rapidly. Learning is deemed to be more effective when you can share your ideas and knowledge with others. Sharing your expertise and experience, communicating and learning from others, and being able to self-reflect is an important part of the learning and teaching process. The 21
st
century educator is a lifelong learner Personal teaching philosophy statement essay example. They don’t just expect their students to be lifelong learners, but they too stay current and on top of what’s new in education. Even though they may still use the same lesson plan from years before, they know how to change it to keep up-to-date with what is current. A great educator will not only embrace technology, but be willing to learn more about it. It’s a critical time in education and how it and teachers are being perceived. With the common core being implemented and judged, the teaching profession is being met with a close eye now more than ever before. Instead of sitting back, a 21
st
 century takes a stand for themselves and advocates for their profession. Personal teaching philosophy statement essay example. They pay close attention to the important issues and talk about them with their community. They keep parents and students informed on what’s going on in education and address on issues head on.

21st Century learning means teaching just as you have done in the past centuries, but with way better tools.  Today’s teachers have a great advantage, they have powerful learning tools at their disposal that they didn’t have before. 21st Century technology is an opportunity for students to acquire more knowledge. Teachers have the ability to move away from being the dispenser of information to someone who can guide them and prepare them for their future Personal teaching philosophy statement essay example. Ultimately, the 21
st
 century learner will be “learner-driven,” where they choose how and what they want to learn. The teacher will serve as a facilitator and guide to help embrace 21
st
century learning.

The National Competency-Based Teacher

An integrated theoretical framework that defines the different dimensions of effective teaching

Where effective teaching means being able to help all types of students learn the different learning goals in the curriculum.

all aspects of a teacher’s professional life and in all phases of teacher development

Standardizes the definition of what effective teaching is.

It provides a better guide for all teacher development programs and projects from school level up to the national level.

Various stakeholders and institutions use the NCBTS in their roles to maintain quality education through effecting teaching and learning. Personal teaching philosophy statement essay example.

Nurse Educator Nursing Plan

As a nurse educator, you will be responsible for creating effective lessons for various settings. Choose a teaching and learning experience from your clinical setting. You may use the clinical experience from your Topic 4 discussion response.

Based on the experience you chose, use the engagement, student learning, and creating effective learning environment strategies that you have learned in this course to develop a lesson plan on similar content for two additional settings (such as an asynchronous online session and teaching a nursing student in the clinical setting, etc.). Nurse Educator Nursing Plan Use the lesson plan examples found in the topic materials to assist you in creating your lesson outlines.

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This assignment will be used as an artifact for your electronic portfolio at the end of the course.

Include the following in your outline:

Lesson Objectives

Timeframe and target environment

Three to four teaching strategies-based on Evidence-Based Practice.

Activities

A summary of the types of assessments you would use in your lesson and why?

Provide rationale for the teaching strategies you implemented into each lesson and why they differ.

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center.

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

You are required to submit this assignment to LopesWrite

This assignment benchmarks the following competency:

Master of Science in Nursing with an Emphesis in Education

6.1: Apply instructional strategies grounded in evidence-based practice and learning theory that meet the unique needs of learners in diverse environments. Nurse Educator Nursing Plan.

NURS 6551 Week 1 Discussion – Human papilloma virus (HPV) vaccine Essay

NURS 6551

Week 1 Discussion

Political, Social, and Sociocultural Influences on Women’s Health

Human papilloma virus (HPV) vaccine

Human papillomavirus (HPV) is the most commonly sexually transmitted infection. People who are infected remain asymptomatic but continue to spread the virus (Shuiling & Likis, 2017). Some HPV infections result in no symptoms and resolve spontaneously. Exposure to the virus can occur during intercourse, contact with infected genitals, mouth, or throat. Routine screening should be completed during Papanicolaou (PAP) smears. In people where the HPV virus persists can result in warts or precancerous lesions.  This leads to an increased risk of cancer of the cervix, vagina, penis, anus, mouth, or throat. HPV 16 and HPV18 account for 70% of cervical cancer. HPV6 and HPV 11 have been found to cause genital warts and laryngeal papillomatosis (Arnheim-Dahlstrom, Pasternak, Svanström, Sparén, Hviid, 2013). NURS 6551 Week 1 Discussion – Human papilloma virus (HPV) vaccine Essay.

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Political impact

When the HPV vaccine hit the market, it became a heated discussion in political circles. Many states proposed legislation to mandate the vaccine for school attendance (www.ncsl.org, 2015). The World Health Organization (WHO) recommends the HPV vaccine as part of routine vaccines. If all young girls received the vaccine, it would protect against 10,000 new cases of cervical cancer every year. Despite these findings, progressive and conservative groups still to this day argue the merit and intent of this vaccine.

Social impact

Research studies have proven the safety of the vaccine, but opposition still remains in regards to the sexual implications. Conservative groups are against making vaccine mandatory reporting it is a violation of parental rights and could lead to early sexual activity. The groups believe giving the vaccine to a pre-adolescent girl would give a false sense of immunity to sexually transmitted diseases resulting in having sex at a younger age (Sussman, Helitzer, Bennett, Solares, Lanoue, & Getrich, 2015).  The American Academy of Pediatrics has disagreed with the though process of the vaccine will increase sexual activity among teens. Parents have expressed concern on making the vaccine mandatory for admission to public schools. Their concerns are with the HPV vaccine is to prevent STD’s. Whereas other vaccines are given to prevent diseases passes through social contact.

Sociocultural factors

In todays society there is a movement that is supportive of greater involvement by teens in their health and wellness. However, there are still large groups of  parents that appear to make the decision about receiving the vaccine. Some parents do discuss the vaccine with their children, and there has been evidence that a higher number of teens are being vaccinated when given the choice themselves (Gilkey,  Moss, Coyne-Beasley, Hall, Shah, & Brewer, 2015). Parents understanding benefits of the HPV vaccine and decreasing the risk of cervical cancer was limited. There are government sponsored programs that  have increased awareness and helped society to understand the medical and preventative benefits of receiving the vaccine.

Providers influence

The conversation between the parent and provider about receiving the HPV vaccine can be a difficulty one. A 2016 study of national physician communication and support for the vaccine found the HPV vaccine not routinely being recommended (Clark, Cowan, Pilippp, Fisher, & Stokley, 2016). The physicians in the study reported the discussion with parents about the HPV vaccine was long and taxing. Parents who have refused to have the vaccine given were more likely to not have  had a discussion with the provider regarding the benefits of the vaccine. One provider who was surveyed said he would discuss preventing cervical cancer and would not address the sexual aspects surrounding the vaccine. Another study describing HPV vaccination among adolescent girls in high-risk communities found that parent awareness of the vaccine, belief in vaccine effectiveness, and doctor recommendation were positively associated with vaccine initiation. They also found that negative attitudes toward the vaccine and needing more information about the vaccine were negatively associated with vaccine being administered. NURS 6551 Week 1 Discussion – Human papilloma virus (HPV) vaccine Essay

Reference

Arnheim-Dahlstrom, L.; Pasternak, B.; Svanström, H.; Sparén, P.; Hviid, A. (2013).                                  Autoimmune, neurological, and venous thromboembolic adverse events after                     immunization of adolescent girls with quadrivalent human papillomavirus vaccine in             Denmark and Sweden: Cohort study”.
BMJ.
    347: f5906. doi:10.1136/bmj.f5906

Clark, S. J., Cowan, A. E., Filipp, S. L., Fisher, A. M., & Stokley, S. (2016). Parent Perception of             Provider Interactions Influences HPV Vaccination Status of Adolescent Females. 
Clinical               Pediatrics
, 
55
(8), 701-706. doi:10.1177/0009922815610629

Gilkey, Melissa B.; Moss, Jennifer L.; Coyne-Beasley, Tamera; Hall, Megan E.; Shah, Parth D.;    Brewer, Noel T. (2015). “Physician communication about adolescent vaccination: How is                 human papillomavirus vaccine different?”.
Preventive Medicine
. 77: 181–185.         doi:10.1016/j.ypmed.2015.05.024

“HPV Vaccine: State Legislation and Statutes.” Www.ncsl.org, 15 Nov. 2018, www.ncsl.org.

Schuiling, K. D., & Likis, F. E. (2017). Women’s  gynecologic health (3rd ed.). Burlington, MA:              Jones and Bartlett  Publishers.

Sussman, A. L., Helitzer, D., Bennett, A., Solares, A., Lanoue, M., & Getrich, C. M. (2015).        Catching Up With the HPV Vaccine: Challenges and Opportunities in Primary Care.  
Annals Of Family Medicine,
13(4), 354-360. doi:10.1370/afm.1821

 

 

Discussion: Political, Social, and Sociocultural Influences on Women’s Health

As an advanced practice nurse, you must remain current on health issues that commonly impact women such as birth control, abortion, family planning, the human papillomavirus (HPV) vaccine, and human immunodeficiency virus (HIV). Many of these women’s health issues are heavily influenced by political, social, and sociocultural factors. These influences might not only affect a woman’s ability or desire to receive care, but also a provider’s ability or willingness to offer care. How might political, social, and sociocultural factors influence your personal perceptions of these women’s health issues? NURS 6551 Week 1 Discussion – Human papilloma virus (HPV) vaccine Essay

To prepare:

·        Review this week’s media presentation, as well as Chapter 1 of the Schuiling and Likis text.

·        Select and research one of the following women’s health issues: birth control, abortion, family planning, human papillomavirus (HPV) vaccine, human immunodeficiency virus (HIV) in women, or another issue approved by the course Instructor.

·        Consider the impact of political, social, and sociocultural factors on the women’s health issue you selected.

·        Reflect on how the personal perceptions of providers might influence their ability or willingness to care for women in relation to this issue. NURS 6551 Week 1 Discussion – Human papilloma virus (HPV) vaccine Essay

 

Post
 at least 250 words APA format (no introduction or conclusion)

1.     pick on subject from above

2.     explain the political impact of this women’s health issue,

3.     social factors of this women’s health issue

4.     sociocultural factors on this women’s health issue

5.     Explain how personal perceptions of providers might influence their ability or willingness to care for women in relation to this issue. NURS 6551 Week 1 Discussion – Human papilloma virus (HPV) vaccine Essay

Resource

Schuiling, K. D., & Likis, F. E. (2013). 
Women’s gynecologic health
(2nd ed.). Burlington, MA: Jones and Bartlett Publishers. NURS 6551 Week 1 Discussion – Human papilloma virus (HPV) vaccine Essay

Assessing and Treating Clients with With Bipolar Disorder Case study Assignment

Introduction

In this paper, we examine the case study regarding bipolar disorder in Asian American Woman. A number of Asian American woman face this disorder. Conferring suicide in numerous Asian societies is viewed as a corrupt and insolent act to one’s folks and predecessors. Numerous Asian American women with despondency will express uninvolved self-destructive musings when addressed delicately. The Bipolar disorder refers to outrageous emotional instability through honest to goodness comes about for ordinary living of patients and their gatekeepers. The brain as ordinary primarily involves pharmacotherapy and solid treatment. Assessing and Treating Clients with With Bipolar Disorder Case study Assignment.

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Regardless, countless shows a defective response to treatment and still experience the evil impacts of unending scenes, symptoms and poor social working. Both psychiatric and…

Examine Case Study: An Asian American Woman With Bipolar Disorder. You will be asked to make three decisions concerning the medication to prescribe to this client. Be sure to consider factors that might impact the client’s pharmacokinetic and pharmacodynamic processes.

At each decision point stop to complete the following:

Decision #1

Which decision did you select?

Why did you select this decision? Support your response with evidence and references to the Learning Resources.

What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources. Assessing and Treating Clients with With Bipolar Disorder Case study Assignment.

Explain any difference between what you expected to achieve with Decision #1 and the results of the decision. Why were they different?

Decision #2

Why did you select this decision? Support your response with evidence and references to the Learning Resources.

What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.

Explain any difference between what you expected to achieve with Decision #2 and the results of the decision. Why were they different?

Decision #3

Why did you select this decision? Support your response with evidence and references to the Learning Resources.

What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.

Explain any difference between what you expected to achieve with Decision #3 and the results of the decision. Why were they different?

Also include how ethical considerations might impact your treatment plan and communication with clients.

Finally: 1. Complete the decision tree (keep track of what you selected. come up with a rational reason why you chose it. Come up with patient specific rational reason behind not choosing the other two options not chosen).

2. Write paper addressing all section listed based on the decision tree.

Case Study: Bipolar Therapy for Client of Korean Descent/Ancestry:

BACKGROUND INFORMATION

The client is a 26-year-old woman of Korean descent who presents to her first appointment following a 21-day hospitalization for onset of acute mania. She was diagnosed with bipolar I disorder. Assessing and Treating Clients with With Bipolar Disorder Case study Assignment.

Upon arrival in your office, she is quite “busy,” playing with things on your desk and shifting from side to side in her chair. She informs you that “they said I was bipolar, I don’t believe that, do you? I just like to talk, and dance, and sing. Did I tell you that I liked to cook?”

She weight 110 lbs. and is 5′ 5″

SUBJECTIVE

Patient reports “fantastic” mood. Reports that she sleeps about 5 hours/night to which she adds “I hate sleep, it’s no fun.”

You reviewed her hospital records and find that she has been medically worked up by a physician who reported her to be in overall good health. Lab studies were all within normal limits. You find that the patient had genetic testing in the hospital (specifically GeneSight testing) as none of the medications that they were treating her with seemed to work.

Genetic testing reveals that she is positive for CYP2D6*10 allele.

Patient confesses that she stopped taking her lithium (which was prescribed in the hospital) since she was discharged two weeks ago.

MENTAL STATUS EXAM

The patient is alert, oriented to person, place, time, and event. She is dressed quite oddly- wearing what appears to be an evening gown to her appointment. Speech is rapid, pressured, tangential. Self-reported mood is euthymic. Affect broad. Patient denies visual or auditory hallucinations, no overt delusional or paranoid thought processes readily apparent. Judgment is grossly intact, but insight is clearly impaired. She is currently denying suicidal or homicidal ideation.

The Young Mania Rating Scale (YMRS) score is 22

RESOURCES

§ Chen, R., Wang, H., Shi, J., Shen, K., & Hu, P. (2015). Cytochrome P450 2D6 genotype & affects the pharmacokinetics of controlled-release paroxetine in healthy Chinese subjects: comparison of traditional phenotype & activity score systems. European Journal of Clinical Pharmacology, 71(7), 835-841. doi:10.1007/s00228-015-1855-6 Assessing and Treating Clients with With Bipolar Disorder Case study Assignment.

Decisions Made and Outcomes (Needed to formulate the paper) 

Choices for Decision 1:
 Select what the PMHNP should do: Begin Lithium 300 mg orally BID, Begin Risperdal 1 mg orally BID, or Begin Seroquel XR 100 mg orally at HS.

My decision:
I chose to begin Lithium 300 mg orally BID.

Outcome: RESULTS OF DECISION POINT ONE:
Client returns to clinic in four weeks

Client informs the PMHNP that she has been taking her drug “off and on” only when she “feels like she needs it”

Today’s presentation is similar to the first day you met her

Choices for Decision 2:
Select what the PMHNP should do:Increase Lithium to 450 mg orally BID, Assess rationale for non-compliance to elicit reason for non-compliance and educate client re: drug effects, and pharmacology, or Switch to Depakote ER 500 mg orally at HS.

My decision:
I chose to switch to Depakote ER 500 mg orally at HS.

Outcome: RESULTS OF DECISION POINT TWO:
Client returns to clinic in four weeks

Client reports that she has been compliant and you notice a marked reduction in manic symptoms. Young Mania Rating Scale was 11 (50% reduction from first office visit)

Client reports that she has gained 6 pounds over the last 4 weeks and wants to stop the medication because of this  Client returns to clinic in four weeks

Choices for Decision 3:
Decision Point Three Select what the PMHNP should do next: Educate client regarding diet/weight loss and continue client on the same drug/dose, Decrease Depakote ER to 250 mg orally at HS, or Switch medication to Zyprexa 15 mg orally daily at HS

My decision:
I choose to educate client regarding diet/weight loss and continue client on the same drug/dose

Outcome:
Guidance to Student Assessing and Treating Clients with With Bipolar Disorder Case study Assignment

The PMHNP should begin by educating the client regarding weight loss/and importance of diet/exercise while taking Depakote which can cause weight gain. Decreasing the dose of Depakote would not be appropriate as she still has symptoms and decreasing dose of Depakote may result in some weight loss, it may result in a return of manic symptoms. The PMHNP can switch to Zyprexa but if weight gain is the issue, then this will be compounded by Zyprexa which is associated with significant weight gain (up to 20 kg over a 24 month period).

 

Assignment: Assessing and Treating Clients with With Bipolar Disorder

Bipolar disorder is a unique disorder that causes shifts in mood and energy, which results in depression and mania for clients. Proper diagnosis of this disorder is often a challenge for two reasons: 1) clients often present as depressive or manic, but may have both; and 2) many symptoms of bipolar disorder are similar to other disorders. Misdiagnosis is common, making it essential for you to have a deep understanding of the disorder’s pathophysiology. For this Assessing and Treating Clients with With Bipolar Disorder Case study Assignment, as you examine the client case study in this week’s Learning Resources, consider how you might assess and treat clients presenting with bipolar disorder.

Learning Objectives

Students will:

Assess client factors and history to develop personalized plans of bipolar therapy for clients

Analyze factors that influence pharmacokinetic and pharmacodynamic processes in clients requiring bipolar therapy

Evaluate efficacy of treatment plans

Assessing and Treating Clients with With Bipolar Disorder Case study Assignment

Analyze ethical and legal implications related to prescribing bipolar therapy to clients across the lifespan ..

 

The Assignment

Examine Case Study: An Asian American Woman With Bipolar Disorder.
 You will be asked to make three decisions concerning the medication to prescribe to this client. Be sure to consider factors that might impact the client’s pharmacokinetic and pharmacodynamic processes.

At each decision point stop to complete the following:

Decision #1

Which decision did you select?

Why did you select this decision? Support your response with evidence and references to the Learning Resources.

What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.

Explain any difference between what you expected to achieve with Decision #1 and the results of the decision. Why were they different?

Assessing and Treating Clients with With Bipolar Disorder Case study Assignment

Decision #2

Why did you select this decision? Support your response with evidence and references to the Learning Resources.

What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.

Explain any difference between what you expected to achieve with Decision #2 and the results of the decision. Why were they different?

Decision #3

Why did you select this decision? Support your response with evidence and references to the Learning Resources.

What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.

Explain any difference between what you expected to achieve with Decision #3 and the results of the decision. Why were they different? Assessing and Treating Clients with With Bipolar Disorder Case study Assignment

 you can use my sample/ edit or do a new assignment.

you can edit or use my sample with same medication therapy.

Walden University .. 6630n

2 Assessing and Treatment for Bipolar Disorder Patient Introduction Bipolar disorder is not an uncommon illness. It is a very chronic and severe mental disorder, affecting approximately 1-2% of the adult population. The signs and symptoms of bipolar disorder are different depending on the type of episode (i.e., manic or depressive). Each episode marks a critical change from the way a person usually acts and their typical mood, and can be characterized by a sudden change in the general attitude of the patient, the way the patient thinks and the behavior. 1 The changes will be sudden that it will be noticed by people around (Robert et al., 2017). This dangerous demonstrative unpredictability mood disorder can be found in all area of life, that is, from the poor to the rich, this disorder affects millions of people in all facets of life (Robert et al., 2017). Bipolar disorder can be seen mostly in the age starting at 25years or older, but it is not totally absent in the teenage age. It shows that about 2.6 percent of the population are diagnosed as bipolar. 3 (National Alliance on Mental Illness, 2017). Assessing and Treating Clients with With Bipolar Disorder Case study Assignment

If not well treated ,Bipolar disorder can be critical; 1 early identification of symptoms with an appropriate treatment plan may include psychotherapy, medications, a healthy lifestyle and a regular schedule will keep the patient healthy (National Alliance on Mental Illness. (2017). 1 The NP should have a good understand of this disorder to be able to take care of this the patient because of its long-term management and how it affects the health in totality (National Alliance on Mental Illness. (2017). 1 My focus of this paper will look into an Asian American Woman with a bipolar disorder, symptoms management, diagnosing the symptom, and the complete treatment. The paper will consider the most safe and appropriate options of treatment and the outcome as the treatment, and care.

Decision Selected My patient is an Asian American woman age 39 years with 4 children and 3 ground children. The husband notices that sometimes she will be singing loud to the top of her voice and dancing not to the music she sang. In another time she will just fill like not doing anything and nothing will interest her, and she will lay on the bed for hours without going to the business she spent her years building and love so much.Patient is withdrawn and non-interactive. 4 She is diagnosed Bipolar disorder.

1 Decision # 1 Reason Selected My best treatment of choice for this disorder will be to begin Risperdal 2 mg orally twice a day. Risperdal is the best choice to treat bipolar disorder. (Lee et al., 2011). Risperdal called risperidone is in the chemical class benzisoxazole derivatives which are antipsychotic. It is an effective medication for bipolar disorder (Lee et al., 2011). The reasons of choosing Risperdal is because it is used to treat schizophrenia and the risperidone works with the brain to stabilize the brain (Lee et al., 2011). Risperidone rebalances dopamine and serotonin to improve thinking, mood, and behavior. Risperidone belongs to a class of drugs called atypical antipsychotics approved by U.S. Food and Drug Administration (FDA) The drug is also used to treat symptoms of bipolar disorder and irritability (NAMI, 2017).

Expected Results We will need to have some subjective and objective changes. 1Patient should be able to verbalize changes within the first month of the treatment.

During the next visit with the patient after one month, she is expected to express changes in the clarity of her brain. The freedom from indistinctness or ambiguity because of the medicine will help her to balance certain natural substances in her brain.She should also notice a change in her ability to concentrate on her activities (Lee et al., 2011). No side effects. Assessing and Treating Clients with With Bipolar Disorder Case study Assignment

Differences between Expected outcome and Actual outcome Patient came back after a month (4 WEEKS) and report that she experiences some improvement in the symptom including some improvement with concentration. My patient reported some drowsiness. 1 Drowsiness is one of the side effect of high dose of Risperdal. The genetic testing, reveals that she is positive for CYP2D6. Asians are more likely to have decreased CYP2D6 activity compared to Caucasians (Lee et al., 2011). I will reduce the dosage of this medication. 1 A positive outcome should be that there was a little bit of improvement in symptoms, patient able to sleep, more concentration. Patient and family report drowsiness during the day time which is one the side effect of high dose Risperdal.

Decision Point Two Reason Selected The next best option is not to discontinue Risperdal, but to lower dose to Risperdal 1 mg orally at hours of sleep (HS) since expected outcome was not achieved based on decision one. My patient and , her family reported that patient has been drowsy during the day because of Risperdal 2mg. I will continue on Risperdal because the patient confirm improvement on the symptoms and the side effect observed was a regular adverse reaction because of her descendant background (American Psychiatric Association, 2017). The reduction to Risperdal 1mg BID to Risperdal 1 mg will be closely monitor.

Expected Results Risperdal 1mg orally at bedtime is a reduced dosage from the 2mg which is expected to eliminate the drowsiness and toxicity in the patient Stahl, (2013).The patient is expected to continue to have decrease in the bipolar symptom. The effect of the medication should be observable and notice by the family member as a testimony (American Psychiatric Association, 2017).

Differences between Expected outcome and Actual outcome During the patient four weeks follow up examination shows that the bipolar disorder symptom dissipated to noticeable level. This indicate a therapeutic effect of Risperdal 1mg at night brought about the therapeutic effect on the patient and patient is tolerating and adjusting to the medication in a positive way (Dean, 2017). The patient did not experience the drowsiness and there was no toxicity, therefore the expected result and the actual result were the same. Risperdal therapy will continue with this medication and the dosage, and a close monitoring will still be needed until the next four weeks appointment (Dean, 2017).

Decision Point Three Decision Selected Risperdal 1mg orally at HS will be continued Reason for Selection The decision to continue with the medication was because the desire result, and the actual result are in pari-passu. To change the current medication or tamper with the dosage may offset the patient and thereby destabilize the rate of her healing (Dean, 2017). The patient is still under assessment and close monitoring continue until the next appointment date. Assessing and Treating Clients with With Bipolar Disorder Case study Assignment.

Expected Results It is expected that the patient will increase in good mental stability and continue to maintain reduction in bipolar disorder symptom with the dosage of Risperdal 1mg at night (Robert et al., 2017). The patient is anticipated to having good sleep at night and well improve in her interaction with relatives and friends, with ability to concentrate on matters that concern her and carrier (Robert et al., 2017).

Differences between Expected outcome and Actual outcome The therapeutic decision is working in this patient in accordance to the expectation. The treatment agrees with the standard way of treatment of an Asian descendant, the starting procedural treatment for bipolar disorder to the maintaining of such patient that are been positive for CYP2D6.The side effect of drowsiness in the day and toxicity is agreement with Asian descent (Robert et al., 2017). The patient will have to be place on the same medication till the next visit for examination. The actual result is that the medication is achieving the therapeutic effect that is needed by the patient (Dean, 2017).

Ethical Considerations for Treatment plan Ethics demand that a patient should agree to treatment before it could be administering unto the patient. The law concerning patient’s preferences for treatment are overlook when the patient is in jeopardy of life threatening or severe psychiatric illness. Psychiatric advance directives are employing to make decision on the patient (Srivastava, 2011). When a practitioner treating a patient with bipolar is confronted with ethical conflicts of helping the patient to attain best result or their autonomy. Assessing and Treating Clients with With Bipolar Disorder Case study Assignment. The autonomy will be the choice of the practitioner (Srivastava, 2011). The law clearly stipulate that practitioners should always carefully consider what moral weight should be given to the values of doing well and avoiding harm (U.S. Food and Drug Administration, 2017).

2 Conclusion Psychiatric nurses should assess the function of the client not only during admission even during remission period and plan for rehabilitation services since functioning is a complex and demanding task. However, it is very important to bring back the client to his fullest possible level to normal life by planning effective psychoeducation about illness, communication training and teaching problem solving skills to client and family. 1 Many drugs are available for the treatment of bipolar disorder, but the professional will have to carefully select a medication that will be the best treatment for the patient. It is worth knowing that genetics influences the absorption of drugs, metabolism, excretion, and distribution. In the case study the Asian woman with positive CYP2D6 will exhibit a certain side effect which will not be in a patient with negative CYP2D6 (Dean, 2017). Therefore, the dosage and frequent of dispensing of drugs be based on the genetic testing (National Alliance on Mental Illness, 2017). The treatment of bipolar disorders in Asian descent must be handled carefully and in accordance with the Food and Drug Administration set guidelines (U.S. Food and Drug Administration, 2017). In conclusion the safety of the patient and the life of family and friends should be the paramount concern of the practitioners. Assessing and Treating Clients with With Bipolar Disorder Case study Assignment.

References American Psychiatric Association. (2017). 1 Treatment of Patients with Bipolar Disorder.

Retrieved from: 1http://psychiatryonline.org/pb/assets/raw/sitewide/practice_guidelines/guidelines/bipolar.pdf Dean, L. (2017). 1 Risperidone Therapy and CYP2D6 Genotype. Retrieved from:

1 https://www.ncbi.nlm.nih.gov/books/NBK425795/ Lee, S. Y., Martins, S. S., Keyes, K. M., & Lee, H. B. (2011). 1 Mental Health Service Use by Persons of Asian Ancestry With DSM-IV Mental Disorders in the United States. Psychiatric Services (Washington, D.C.), 62(10), 1180–1186.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3698479/ Nami National Alliance on Mental Illness. (2017). 1 What Is Risperdal and What Does It Treat? Assessing and Treating Clients with With Bipolar Disorder Case study Assignment.

Retrieved from: 1 https://www.nami.org/learn-more/treatment/mental-health-medications/risperidone (Risperdal).

Robert, M., Keck, P., & David Solomon, D. (2017). 1 Bipolar disorder in adults:Choosing maintenance treatment. Retrieved from: 1https://www.uptodate.org/contents/bipolar-isorder-in-adults-choosing-maintenance-treatment Srivastava, S. (2011). Ethics Commentary: Bipolar Disorder: 1 Ethical Considerations in the Treatment of Bipolar Disorder. Retrieved from:

1 https://focus.psychiatryonline.org/doi/abs/10.1176/foc.9.4.foc461?journalCode=foc Stahl, S. M. (2013). 1 Stahl’s essential psychopharmacology: Neuroscientific basis and practical applications (4th ed.). New York, NY: Cambridge University Press.

U.S. 1 Food and Drug Administration. (2017). 1 The Facts on Bipolar Disorder and FDA- Approved Treatments. Retrieved from: 1https://www.fda.gov/ForConsumers/ConsumerUpdates/ucm530107.htm

 

Bipolar Disorder

Introduction

In this paper, we examine the case study regarding bipolar disorder in Asian American Woman. A number of Asian American woman face this disorder. Conferring suicide in numerous Asian societies is viewed as a corrupt and insolent act to one’s folks and predecessors. Numerous Asian American women with despondency will express uninvolved self-destructive musings when addressed delicately. The Bipolar disorder refers to outrageous emotional instability through honest to goodness comes about for ordinary living of patients and their gatekeepers. The brain as ordinary primarily involves pharmacotherapy and solid treatment. Assessing and Treating Clients with With Bipolar Disorder Case study Assignment.

Regardless, countless shows a defective response to treatment and still experience the evil impacts of unending scenes, symptoms and poor social working. Both psychiatric and physical comorbid issue visits, especially personality issue, substance misuse, cardiovascular diseases, and diabetes. The multidisciplinary composed exertion of specialists is required to join all ability with a particular true objective to finish awesome consolidated treatment. A couple of audits have exhibited promising effects of composed treatment programs for patients with bipolar issue. We also present an ethical consideration to the decision regarding Bipolar disorder (Tondo L, 2013).

Decision 1.

My Decision

My first decision is to begin “Risperdal one mg orally Bis In Die (BID)”

 

Reason

Risperdal, whose logical name is risperidone, is a moment era or atypical antipsychotic whose utilizations incorporate treatment of the bipolar issue. It attempts to rebalance the dopamine and serotonin and along these lines enhancing inclination, considering and conduct. Since the patient was determined to have bipolar confusion, Risperdal is the best alternative considering the accessible prescriptions. In the past treatment, the patient defaulted in lithium. Thus it may not be a smart thought to start lithium 300 mg as chances are the patient may not go along. Seroquel XR might be a decent alternative yet its reactions may incorporate putting on of weight and obstruction (Martha Sajatovic, 2006). It may not be gotten well by the patient who defaulted in utilizing lithium that is the comparable reaction in stoppage. Assessing and Treating Clients with With Bipolar Disorder Case study Assignment.

Hope to Achieve

Inside the initial four weeks, patient ought to have the capacity to progress. The manifestations should diminish essentially incorporating a change in the state of mind. The patient ought to have the capacity to begin having great rest and getting a charge out of it. Risperdal is a powerful solution for adjusting mental action ought to have the capacity to re-establish rational soundness in the way the patient considers and responds to matters (Fountoulakis, 2014). The self-destructive practices should diminish, and also tension responds to matters. The self-destructive practices should diminish and also tension.

Real and Expected Outcomes

Following four weeks, the patient went to the doctor’s facility, and she was calmed and dormant. Truly, her mother needed to escort her and help her into the workplace. It accounted for that these indications ejected following one week of the drug. It is in opposition to the foreseen consequences of lessened bipolar side effects.

It was normal that the patient will have enhanced the state of mind and appropriate considering (Stahl, 2013). The distinction in the outcomes is because of the reactions of the medication. A high measure of Risperdal in the blood prompts sedation. The way that the patient is of Korean plunge and positive for “CYP2D6*10 allele” implies that she might not have quick freedom of Risperdal from the blood promoting aggregation.

Decision 2.

My Decision

My second decision is to reduce the “Risperdal to one mg at HS.”

Reason

The second visit does not demonstrate that the Risperdal 1 mg orally BID has neglected to work; it just gives the reactions. It is savvy to change the dose to deal with the symptoms instead of end the medicine for another. Changing Risperdal to 2 mg at HS may, in any case, turn out to be a great deal, and the reactions may not sufficiently oversee. A choice to change back to lithium is as yet not great as the patient still has a demeanor towards it (Chen R, 2015). Moreover, it may befuddle the patient and make her vibe that all medicine is terrible. Helping her adapt to an alternate dose of a similar medication will support her trust in drugs and comprehend that it is about the direction of the measurements. Assessing and Treating Clients with With Bipolar Disorder Case study Assignment.

Hope to Achieve

As said before, Risperdal effective in adjusting dopamine and serotonin in the brains and subsequently treating mind-set, conduct, and thought issues. The reactions have credited to the amassing of Risperdal in the blood of the patient. Diminishing the measurements to Risperdal 1 mg at HS will guarantee there is no collection of the medication in the blood of the patient as the body will have the capacity to discharge it effectively.

By changing the measurements, the patient should begin being less quieted and less dormant. The patient ought to likewise begin encountering a change in the disposition, have legitimate practices and also think well. It is the work of Risperdal when taken in the correct amounts. Assessing and Treating Clients with With Bipolar Disorder Case study Assignment.

Real and Expected Outcomes

Following four weeks, the patient went to, and she was less calmed and less lazy. Also, the Young Mania Rating Scale had diminished from 22 to 16. The patient revealed herself that she was not encountering whatever other reactions. These outcomes are fundamentally the same as the foreseen comes. Indeed, the reactions cleared very quicker than it thought and this the main distinction and fortunately in the positive bearing. Assessing and Treating Clients with With Bipolar Disorder Case study Assignment. The outcomes are comparative because similarly as specified before, Risperdal is a powerful solution for bipolar turmoil (Miklowitz, 2012). The reactions couldn’t utilize as a reason for dumping the medication for this situation.

Decision 3.

My Decision

My third decision is to “continue at the same dose of the Risperdal.”

Reason

Now, the patient is reacting great to the present prescription. It is more prudent to endure with the dose as the evaluation keeps on taking note of any requirement for changing the medicine in any capacity. Besides, Risperdal I mg orally BID officially turned out to be heinous by the patient’s framework. Going back toward it, prompt the symptoms saw before. Changing to Latuda then again is not appropriate since FDA just affirms it for the treatment of bipolar 1. The patient’s condition is not steady with bipolar 1.

The medication is additionally extremely costly and may not be moderate to the patient. In this manner, it is insightful to proceed with a similar measurement of Risperdal and just change when it is vital.

Hope to Achieve

Since a patient has reacted decidedly to the treatment by Risperdal, it is normal that nonstop utilization of this medication will bring about much further lessening of the bipolar manifestations. The principal moment yielded a more than twenty-five rate diminishment in side effects; in this way, the lessening ought to be around 50% by the fourth week (Vitiello, 2013). The patient ought to have great rest, an enhanced state of mind, ordinary conduct and legitimate manner of thinking. The symptoms experienced in the main measurements not anticipate that would happen once more.

Real and Expected Outcomes

As indicated by exhortation given after the third choice, the ordinary outcomes will be that the patient will accomplish a critical dynamic lessening of the side effects. It will prompt the cure of bipolar issue if the Risperdal keeps on working adequately at this measurement. These are comparative outcomes to those expected when the dose was directing. Given consistency in the pharmacodynamics and pharmacokinetics, these ought to be the outcomes, and the objectives of treatment will accomplish.

Ethical Consideration

In healthcare, the ethical considerations assume a major part in treatment arrange. When managing patients having bipolar confusion, moral contemplations come midway to the way the PMHNP approaches the treatment. For the most part, the patient is temperamental rationally, and in this manner, the PMHNP needs to know the best approach to introduce any data to them and an opportunity.

For this situation, moral contemplations influenced the way the patient was directed to keep utilizing Risperdal in an alternate measurement after the first had caused sedation and dormancy (Roger D. Weiss, 2011). While picking between the medications to utilize, moral contemplations were at the center since a few medications are known for certain reactions to various drops of individuals. For example, Seroquel XL is known for stoppage and drying of mouth. The patient had whined of comparable reactions when she utilized lithium in her past medicine. Moral contemplations request that the PMHNP considers the long haul impacts this may realize; like harm of the teeth. Assessing and Treating Clients with With Bipolar Disorder Case study Assignment.

Conclusion

The bipolar issue is a dubious condition to analyze due to the numerous indications that look like manifestations for another mental issue. In the treatment of this condition, due contemplations should make with regards to the reactions of the medications utilized. Moral contemplations are likewise fundamental to the treatment anticipate bipolar confusion given the mental flimsiness of the patient. There are drugs known for the treatment of bipolar issue; in any case, the PMHNP should know about which tranquilize is appropriate and the measurement for each particular bipolar issue persistent. Assessing and Treating Clients with With Bipolar Disorder Case study Assignment.

 

References

Chen R, W. H. (2015). Cytochrome P450 2D6 genotype affects the pharmacokinetics of controlled-release paroxetine in healthy Chinese subjects: comparison of traditional phenotype and activity score systems.
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Fountoulakis, K. N. (2014).
Bipolar Disorder: An Evidence-Based Guide to Manic Depression.
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Martha Sajatovic, M. S. (2006). Risperidone in the treatment of bipolar mania.
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Miklowitz, D. J. (2012). Integrated Group Therapy for Bipolar Disorder and Substance Abuse.
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Roger D. Weiss, H. S. (2011).
Integrated Group Therapy for Bipolar Disorder and Substance Abuse.
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Stahl, S. M. (2013).
Stahl’s Essential Psychopharmacology: Neuroscientific Basis and Practical Applications.
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Tondo L, I. G. (2013). Suicidal behaviour in bipolar disorde.
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Vitiello, B. (2013). How effective are the current treatments for children diagnosed with manic/mixed bipolar disorder.
CNS Drugs
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