Tag: Clinical-Nursing

Application: Taking a Stand

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

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

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

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

To prepare:

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

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

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

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

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

To complete:

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

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

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

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

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

Self Assessment results

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

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

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

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

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

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

 Course Readings

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

o   Chapter 4, “Ethical Issues”

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

o   Chapter 5, “Legal and Legislative Issues”

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

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

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

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

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

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

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

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

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

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

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

ccmh 551 week 5 client termination and evaluation reflection sample essay

Client Termination and Evaluation Reflection

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

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

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

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

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

References

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

Critiquing a Change Effort

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

To prepare:

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

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

· How did the change affect your job and responsibilities?

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

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

By Day 3

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

Learning Resources

Required Readings

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

· Review Chapter 7, “Strategic and Operational Planning”

· Chapter 8, “Planned Change”

 

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

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

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

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

Retrieved from the Walden Library databases.

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

Retrieved from the Walden Library databases.

Required Media

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

Optional Resources

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

· Chapter 9, “Time Management”

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

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

Treatment of Paranoid Personality Disorder sample essay

Treatment of a Personality Disorder

Paranoid Personality Disorder

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

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Discussion

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

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

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

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

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

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

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

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

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

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

Literature Review – Analyzing Evidence-based Interventions & Preventions

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

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

Application of Theory in Treatment

Treatment Justification

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

Interventions

Short Term Goals for Individuals with Paranoid Disorder:

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

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

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

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

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

Give referral so client can obtain a full psychiatric assessment.

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

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

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

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

Decrease allegations about other people plotting to cause harm.

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

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

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

Long Term Goals for Individuals with Paranoid Disorder:

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

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

Feel trust of significant other and stop allegations of unfaithfulness.

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

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

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

Current intervention gaps

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

Cultural & Immigrant Status

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

Socioeconomic

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

 

Gender

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

Conclusion

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

 

References

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

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

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

Dialectical Behavior Therapy for Personality Disorders (DBT)

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

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

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

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

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

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

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

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

Shadow health respiratory assessment transcript Pre Brief

Tina had an asthma episode 2 days ago. At that time she used her albuterol inhaler and her symptoms decreased although they did not completely resolve. Since that incident she notes that she has had ten episodes of wheezing and has shortness of breath approximately every four hours. Tina presents with continued shortness of breath and wheezing. Be sure to ask pertinent questions during the interview about related body systems. This case study will provide the opportunity to carefully assess lung sounds during the physical examination. Be sure to appropriately document your findings using correct medical terminology.

Reason for visit: Patient presents complaining of a recent asthma episode that is not fully resolved.

NB:
We have all the questions and documented answers as listed and attached below. All you need to do is ORDER NOW for an equivalent of 4 pages for this assignment and all other iHuman/Shadow Health Assignments.

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WE SCORE 100% AND HANDLE THE SOAP NOTE

DON’T STRESS YOURSELF,  JUST CHAT US AT THE RIGHT CORNER BELOW.

Hello my name sara an FNP student and I will be interviewing you today.

Hey.

Can you please state your name for me?

Tina Jones.

Your date of birth?

February 17th.

Year of birth please? (Clarified to What year were you born.)

I was born in . . . [Ms. Jones reports correct birth year.] [AUDIO

COMING SOON]

How old are you ms. Jones? (Clarified to how old are you.)

I’m 28.

What brings you in today?

I came in because I’ve been having breathing problems, and my

inhaler just isn’t working the way it normally does.

Why did you XXX

I XXX normally does.

BRIAN FOSTER CHEST PAIN SHADOW HEALTH ASSESSMENT

I’m XXX.

XXX  that. Shadow health respiratory assessment transcript.

What XXX?

Well. . . I’ve hadxxxx since I was really little, though for a while

there it wasn’t really much of a problem. And I have xxxx,

too.

What XXX?

It’s XXX.

ESTHER PARK ABDOMINAL PAIN SHADOW HEALTH 

How XXX?

I’ve XXX.

XXX start?

I don’t know if I’d call it an asthma attack, but XXX house. She has cats, and I’m

allergic, so I’m used to it being a problem there, but usually the

inhaler fixes it. . . it doesn’t feel totally under control, though.

I’m sorry you’re having difficulty with your breathing problems.

Thanks.

How XXX  problems?

My breathing’s been acting up off and on for the past two days.

How XXX?

DANNY RIVERA SHADOW HEALTH PEDIATRIC PHYSICAL ASSESSMENT 

Maybe XXX? It’s a lot.

And how XXX? (Clarified to

how long does an episode last.)

I haven’t had a XXX normal. .

. that’s not what’s been happening recently, though.

How xxxx?

I haven’t had a xxx, but usually once I use xxx

it only takes a minute or two for my xxxck to normal. .

. that’s not what’s been happening recently, though.

How manyxxxx

Well. . . it’s kind of hard to count because my breathing’s been at

least a little bad most of the past two days, but it’s really acted up,

like with wheezing and everything, probably every four hours or so–

like five times each day.

Is your     ?

My

How     xxx.)

My asthma used to be really scary. I haven’t had a full attack in

years, and if you had asked me before this I would have said my

asthma wasn’t that bad anymore, but the last couple days I’ve had a

lot of trouble breathing.

How xxx?

My asthma used to be really scary. I haven’t had a full attack in

years, and if you had asked me before this I would have said my

asthma wasn’t that bad anymore, but the last couple days I’ve had a

lot of trouble breathing.

Is there xxx?

There usually xxxx. . . I

guess I try to avoid things that make my breathing worse, but that’s

about it. The past couple days, though, it’s been hard to do anything.

Do you wheeze during an asthma exacerbation?

During a full attack, I would wheeze a lot, like I couldn’t breathe at all,

but until the past couple days, I would usually just wheeze a little

when I had breathing problems.

Are you having any chest tightness? Shadow health respiratory assessment transcript.

It’s not so bad right this second, but it’s been pretty tight lately, like I

can’t take in air.

Have you xxx?

I’ve been xxxxa lot, yeah.

How long have you had the xxxx?

Since my asthma acted up two days ago.

How would you describe the xxx?

Um. . . I guess I’d describe it asxxx.

What makes your xxxbetter?

Drinking some water helps a little, as long as the water isn’t too cold.

Have you tried txxx your xxx?

I haven’txxx.

Is your xxx?

It has been the past cxxx, yeah.

Does lxxx worse?

Just recently lying on my back has definitely made my breathing

worse.

To try to help your breathing you may want to elevate your head with

two pillows.

OK, I understand.

Inspected anterior chest wall

Inspected anterior chest wall

Inspected left side chest wall

Inspected anterior chest wall

Inspected right side chest wall

Inspected anterior chest wall

Palpated chest expansion: Both sides rise symmetrically

Palpated fremitus in anterior upper chest wall: Equal bilaterally,

expected vibration

Ninety-nine.

Palpated fremitus in anterior lower chest wall: Equal bilaterally,

expected vibration

Ninety-nine.

Palpated fremitus in posterior upper chest wall: Equal bilaterally,

expected vibration

Ninety-nine.

Palpated fremitus in posterior middle chest wall: Equal bilaterally,

expected vibration

Ninety-nine.

Palpated fremitus in posterior lower chest wall: Equal bilaterally,

expected vibration

Ninety-nine.

Percussed anterior left upper lobe

Percussed anterior right upper lobe

Percussed anterior left mid-chest (upper lobe)

Percussed anterior right middle lobe

Percussed anterior left lower lobe

Percussed anterior right lower lobe

Percussed posterior right upper lobe

Percussed posterior left upper lobe

Percussed posterior right mid-back (lower lobe)

Percussed posterior left mid-back (lower lobe)

Percussed posterior right lower lobe

Percussed posterior left lower lobe. Shadow health respiratory assessment transcript.

Percussed posterior left lower lobe on side

Percussed posterior left lower lobe near spine

Percussed posterior right lower lobe near spine

Percussed posterior right lower lobe on side

Auscultated breath sounds in anterior left upper lobe

Auscultated breath sounds in anterior right upper lobe

Auscultated breath sounds in anterior right middle lobe

Auscultated breath sounds in anterior left mid-chest (upper lobe)

Auscultated breath sounds in anterior left lower lobe

Auscultated breath sounds in anterior right lower lobe

Auscultated breath sounds in posterior right upper lobe

Auscultated breath sounds in posterior left upper lobe

Auscultated breath sounds in posterior left mid-back (lower lobe)

Auscultated breath sounds in posterior right mid-back (lower lobe)

Auscultated breath sounds in posterior right lower lobe

Auscultated breath sounds in posterior left lower lobe

Auscultated breath sounds in posterior left lower lobe on side

Auscultated breath sounds in posterior left lower lobe near spine

Auscultated breath sounds in posterior right lower lobe near spine

Auscultated breath sounds in posterior right lower lobe on side

Auscultated voice sounds in anterior left upper lobe

Ninety-nine.

Ninety-nine.

Auscultated voice sounds in anterior right upper lobe

Ninety-nine.

5/11/2018 Respiratory | Completed | Shadow Health

https://chamberlain.shadowhealth.com/assignment_attempts/3498304 10/23

Exam Action

05/11/18 2:01 PM

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Exam Action

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Exam Action

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Exam Action

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Exam Action

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Exam Action

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Ninety-nine.

Ninety-nine.

Auscultated voice sounds in anterior left upper lobe

Auscultated voice sounds in anterior left mid-chest (upper lobe)

Ninety-nine.

Auscultated xxx

Auscultated xxxx

Ninety-nine.

Auscultated voice sounds in anterior left lower lobe

Ninety-nine.

Ninety-nine.

Ninety-nine.

Auscultated xxxx

Ninety-nine.

Auscultated voice sounds in posterior left upper lobe

Shadow health respiratory assessment transcript

Ninety-nine.

Auscultated voice sounds in posterior right mid-back (lower lobe)

Ninety-nine.

Auscultated voice sounds in posterior left mid-back (lower lobe)

Ninety-nine.

Auscultated voice sounds in posterior right lower lobe

Ninety-nine.

Auscultated voice sounds in posterior left lower lobe

Ninety-nine.

Auscultated voice sounds in posterior left lower lobe on side

Ninety-nine.

Auscultated voice sounds in posterior left lower lobe near spine

Ninety-nine.

Auscultated voice sounds in posterior right lower lobe near spine

Ninety-nine.

Shadow health respiratory assessment transcript

Auscultated voice sounds in posterior right lower lobe on side

Ninety-nine.

Checked pulse xxx

Check pulse xx

Checked xxxx

Checked xxx

Always make sure yourxxxx

Sure, I think I understand what you mean.

Make sure to read all instructions and store as indicated (No

matching questions found.)

Make sure to read all instructions and store as indicated

Alright, thanks for letting me know.

Always shake well before using.

Thanks for telling me.

Also after every complete use you should always rinse out your

mouth with water.

Shadow health respiratory assessment transcript.

That makes sense.

What medications do you take?

My xxx is the only prescription I always have, but I usually don’t

need it everyday, except for recently. . .

When did you last use your xxx?

I had to use it early this morning.

How is your xxx prescribed?

Yes.

How often is your xxx?

Yes.

How many times have you use xxx?

I’ve been needing my xxx about every four hours, I’d say.

How many xxxx 4 hours? (Clarified to how xxxx are you prescribed.)

I’m supposed to just do twoxxx [Nurse confirmed with Pharmacy:

xxx]

How many xxx are you doing?

I’m supposed to just do xxx. [Nurse confirmed with Pharmacy:

xxx]

Make sure to follow thexxx instructions as prescribed

Thanks for telling me.

Are you taking any other medications?

No, all I really use is xxx.

You take any over-the-counter medications?

I take xxx, but not

often.

How much xxxdo you take?

I just take a couple. I usually get them at night from reading–

squinting I guess–and so I take one and go to bed. [Nurse confirmed

with Pharmacyxxx ]

How much xxx do you take for cramps?

I take three at a time. And I’d bet I take it up to three times a day.

[Nurse confirmed with Pharmacy: xxx]

Do you have xxxx?

Yeah, I’mxxx.

Do you have axxx?

No, not that I know of.

When didxxx

This all started at my cousin’s house. Shexxxxalways goes crazy when I’m there.

Does being around dust trigger asthma?

Yeah, being around a lot of dust, especially hanging out in a really

dusty house, can make my asthma act up.

Sorry to hear that about your asthma

Thanks for understanding.

Does cxxxa?

Only when I’m in a rush and have to hurry up them.

Do you have xxxx? (Clarified to do you have

seasonal allergies.)

A little while ago, I had some seasonal allergies, but it didn’t really

bother my asthma, and it’s better now.

Does xxxe?

Well. . . sometimes when txxx often.

Do you xxx?

I used to go to Dr. Dewitt, but she moved her practice recently.

Luckily she’s still been able to call in refills of my inhaler, but I haven’t

actually been in to see her in about two years.

Since you have asthma it is important to follow up on a regular basis

with your asthma specialist

Alright, thanks for letting me know.

How xxx?

I’ve had xxxle.

How xxxx?

My xxx.

Have you everxxx?

I xxx?

I used to go to thexxxt not since I

was sixteen.

Have yoxxx?

You mean like, did they ever have to put me on a breathing machine?

No, I haven’t had an asthma attack that serious.

Do you use a xxx?

Not really. . .

Do you cxxx?

I’ve heard of that, but no, I don’t do it.

Do you use xxx

No, but I have before.

We may cxxx

That makes sense.

Also a way to track your asthma symptoms and episodes. (No

matching questions found.)

Also a way to track your     s and episodes.

OK, I understand.

BUY A PLAGIARISM-FREE PAPER HERE

Sending you home with a peak flow meter and document regularly.

I’ve heard of that, but no, I don’t do it.

We will also teach you how to use nebulizer at home.

Sure, I think I understand what you mean.

How often do you change your sheets?

I change my bedding once a week, I’d say.

5/11/2018 Respiratory | Completed | Shadow Health

https://chamberlain.shadowhealth.com/assignment_attempts/3498304 18/23

Question

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Do you have pets at home?

No. . . I’m too busy to take care of a dog, and I can’t have cats

because of my allergies.

Does    ?

No, nobody at home    .

If exposed to secondhand smoke it is definitely a Asthma trigger.

Alright, thanks for letting me know.

Have you ever had eczema?

No, I don’t have that kind of skin problem.

history of sinus problems? (Clarified to do you have a history of sinus

problems?.)

I don’t really have a problem with my sinuses.

Do you have xxx?

I don’t know what that is, so I guess probably not?

Have you ever been   xxx

Have you xxx?

Shadow health respiratory assessment transcript

No, I’ve never done that. I think it’s gross.

I’m glad you think that

Thanks for understanding.

Smoking is a known trigger for asthma

OK, I understand.

Have you xxx

Well, I used to xx. . . but I don’t do that anymore.

When was the xxx?

I haven’t sxxx.

Have you ever experimented with xxxx?

No, no way. That’s a nasty thing to do.

Have you been sick recently?

No, I’m usually healthy.

Have you had any xxx?

No, I haven’t had a xxx.

5/11/2018 Respiratory | Completed | Shadow Health

https://chamberlain.shadowhealth.com/assignment_attempts/3498304 21/23

Question

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Educate

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Have you had any nausea or vomiting?

I haven’t had thrown up, or even had an upset stomach, in a long

time.

Have you had chills?

No, I haven’t.

Are you fatigued?

I feel tired, yeah, probably because I haven’t been able to sleep very

well.

Do you have any xx?

I don’t getxxx, but sometimes I wake up hot and have to kick off

my xxx.

Sometimexxxybe an indication of being sick

That makes sense.

Have you been cxxx anything?

No, nothing’s coming up.

Have you had any problemsxxx?

Nope.

Do you have any nasal drainage?

5/11/2018 Respiratory | Completed | Shadow Health

https://chamberlain.shadowhealth.com/assignment_attempts/3498304 22/23

Question

05/11/18 3:27 PM

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Question

05/11/18 3:28 PM

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Question

05/11/18 3:29 PM

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05/11/18 3:30 PM

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No, my nose has been fine.

Has anyone been sick at home?

No, no one at home has been sick.

Does anyone in your family have asthma?

It’s just me and my baby sister that have asthma, but she really

doesn’t have problems with it.

Does anyone in your family have allergies?

My sister has hay fever, I think, and it sometimes makes her asthma

get pretty bad.

Does anyone in your family have eczema?

No. . .

Do you have a family history of sinus problems?

I don’t think anyone in the family has sinus problems.

Are you in any pain right now?

It doesn’t hurt. . . it’s just hard to breathe, but there’s no pain.

Is there pain when you wheeze? (No matching questions found.)

are you in pain when you wheeze?

5/11/2018 Respiratory | Completed | Shadow Health

https://chamberlain.shadowhealth.com/assignment_attempts/3498304 23/23

Question

05/11/18 3:36 PM

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Question

05/11/18 3:37 PM

CDT

Right now it doesn’t sound too bad, but I’ve definitely been

wheezing the past couple days.

Any changes in your appetite?

I wouldn’t say it’s changed recently, but I do feel hungry a lot.

When was your last chest x-ray?

The last time I went to the hospital for an asthma attack, when I was

still in high school, they did a chest x-ray.

Comments

If your instructor provides individual feedback on this assignment, it will appear here.

shadow health respiratory transcript

APPROACH

Overview

| 
Transcript

| Subjective Data Collection

| Objective Data Collection

| Education & Empathy

| Documentation / Electronic Health Record

| Student Pre-Survey

| Lifespan Activity

| Review Questions

| Self-Reflection Activity

SAMPLE Shadow Health Respiratory Assessment

Model Documentation

Subjective

Social History: She is not aware of any environmental exposures or irritants at her job or home……

Review of Systems:

General: Denies changes in…

Nose/Sinuses:

Gastrointestinal:

Respiratory:

Objective                   

General: Ms. Jones is a pleasant….

Respiratory: Chest expansion is….

Assessment                

Mild-persistent….

Plan

Diagnostics

Obtain office….

Education

Encourage Ms. Jones to continue t….

Referral/Consultation

Refer to…..

 Follow-up Planning

Order ….

Instruct Ms. Jones …..

Revisit….

Tina’s second cousin was diagnosed with asthma at age 5. What would be included in your treatment plan? What factors might concern you related to compliance?

The treatment plan for this child would be to….

Consider that Tina’s uncle is now 68 years old and has smoked heavily every day since he was fifteen. What would you expect to find in his respiratory assessment? How would this affect your oxygenation goals for this patient?

Common significant deviations of the chest for older adults include xxxx (Hogstel & Curry, 2005). xxxx become thinner, more rigid, and change shape, and muscles may become weakened. This results in a lower oxygen level with less carbon dioxide removed from the body, and decreased ability to cough. xxxx causes decreased xxx height. xxx also causes thexxxto lose their shape causing shortness of xxx. Due to diminishedxxxwith decreased sensitivity, large amounts of particles that are more difficult to expectorate can collect in the xxx. In addition, the xxxx is less sensitive to xxxx and xxx and higher residual volume. As a result of these changes, xxx are at increased risk for xxxx and xxxx (Minaker, 2011; Sharma & Goodwin, 2006). Shadow health respiratory assessment transcript.

In the respiratory assessment of this patient, I expect to find xxx, increased xxxx of the xxx, diminished chest expansion, and xxxx. The weakened muscles will result in xxx  levels and lower xxxx leading to decreased xxxx capacity. xxx will also will also lose their shape leading toxxx. Therefore, x goals will hxave to take in cognizance these realities and advise the patient accordingly. Consequently, efforts to increase exercise tolerance, treat complication, and relieve symptoms will be initiated.

If Tina had mentioned that she was just diagnosed with pneumonia, what would you have expected to find during percussion?

If the results of Tina’s pulse oximetry had been 97%, which of the following would have been true?

Suppose that, during your lung exam on Tina, you had heard bronchial breath sounds in the left lower lung posteriorly. What would you have suspected based on this finding?

Suppose that while auscultating, you assessed a few scattered expiratory wheezes. Why would this be an expected finding for a patient with Tina’s history

When you observe a patient like Tina throughout an exam, there are many ways to determine whether a patient is experiencing respiratory distress. Identify one indicator of respiratory distress that can be assessed through observation alone.

 

Describe how you would assess Tina for dyspnea

Dyspnea can be assessed both……

Explicitly describe the tasks you undertook to complete this exam.

The examination…..

Explain the clinical reasoning behind your decisions and tasks.

Identify how your performance could be improved and how you can apply “lessons learned” within the assignment to your professional practice Shadow health respiratory assessment transcript.

My performance could be improved by seeking more history from the patient…..

NR 509 Week 1 Shadow Health History Assignment

Pre-brief

Obtaining an accurate history is the critical first step in determining the etiology of a patient’s problem. A large percentage of the time, you will actually be able to make a diagnosis based on the history alone. The value of the history, of course, will depend on your ability to elicit relevant information. Your sense of what constitutes important data will grow exponentially as you practice your interviewing skills and through increased exposure to patients and illness…………………… Interviewing patients is an art and should remain an essential skill for successful practice.

In this activity, you will interview Tina Jones to collect data to assess Ms. Jones’ condition. You will also have the opportunity to educate and empathize with Tina to engage in effective therapeutic communication; create a problem listusing evidence from the data you collected; prioritize the identified problems to differentiate immediate from non-immediate care; plan how to best address the most important concern with further assessment, interventions, and patient education; and compare your documentation to model documentation.

Ms. Jones is a pleasant, 28-year-old obese African American single woman who presents to establish care and with a recent right foot injury. She is the primary source of the history. Ms. Jones offers information freely and without contradiction. Her speech is clear and coherent and she maintains eye contact throughout the interview.

Reason for visit: Patient presents for an initial primary care visit today complaining of an infected foot wound.

| Overview

| Transcript

| Subjective Data Collection

| Objective Data Collection

| Education & Empathy

| Documentation / Electronic Health Record

| Information Processing

| Lab Pass: Certificate of Completion

NR 509 Week 2 Alternate Writing Assignment: Respiratory Summer 2018

Purpose

As a family nurse practitioner, you must possess excellent physical assessment skills. This alternative writing assignment mirrors the discussion content of the debriefing session and will allow the student to expand their knowledge of physical health assessment principles specific to the advanced practice role. Shadow health respiratory assessment transcript.

Course Outcomes

This assignment is guided by the following Course Outcomes (COs):

Apply advanced practice nursing knowledge to collecting health history information and physical examination findings for various patient populations. (PO 1, 2)

Differentiate normal and abnormal health history and physical examination findings. (PO 1, 2)

Adapt health history and physical examination skills to the developmental, gender-related, age-specific, and special population needs of the individual patient. (PO 1, 2)

The purposes of this assignment are to: (a) identify and articulate advanced assessment health history and physical examination techniques which are relevant to a focused body system (CO 1), (b) differentiate normal and abnormal findings with regard to a disease or condition that impacts the body system (CO 2), and (c) adapt advanced assessment skills if necessary to suit the needs of specific patient populations (CO 4).

NOTE
: 
You are to complete this alternative writing assignment ONLY if you had not participated or do not plan to participate in a debriefing session for the given week.

Due Date: 
This alternative written assignment is due no later than the 
Sunday of the week in which you did not attend the weekly debriefing session
. The standard MSN Participation Late Assignment policy applies to this assignment.

Preparing the Paper:

Select a focused body system from the weekly lesson which corresponds with the week of the written assignment.

Carefully read and review the selected body system in your course textbooks.

Incorporate at least 
one
scholarly peer-reviewed journal article that relates to the body system. It may be useful to identify an article that relates to a disease that impacts the body system.

The paper must clearly articulate the relevance of advanced physical assessment skills, techniques, application of advanced practice knowledge, and assessment modification (when necessary) to accommodate for specific patient populations.

Provide concluding statements that should summarize key points of the overall assignment content.

In-text citations and reference page(s) must be written using proper APA format (6thedition).

NR 509 Week 2 Quiz

A mother brings her two month old daughter in for an examination says “my daughter rolled over against the wall and now I have noticed that she has the spot soft on the top of her head, is there something terribly wrong?” The FNP‘s best response would be:

During percussion the FNP knows that a dull percussion note elicited over a lung lobe. This most likely results from:

The patient is unable to differentiate between sharp and dull stimulation to both sides of her face. The FNP suspects Damage to:

When examining the face, the FNP is aware that the two pairs of salivary gland‘s that are accessible to examination are the _____ glands

A patient comes to the clinic complaining of neck and shoulder pain and is unable to turn her head. The FNP suspects damage to cranial nerve ____ and proceeds with the examination by____

When examining a patient’s cranial nerve function, the FNP remembers that the muscles in the neck that are innervated by CN XI are the:

The patient’s laboratory data reveal an elevated thyroxine level. The FNP would proceed with an examination of the _____ gland Shadow health respiratory assessment transcript.

A patient says that she has recently noticed a lump in the front of her neck below her “Adams apple” that seems to be getting bigger. During the assessment, the finding that leaves the FNP to suspect that this may not be a cancerous thyroid nodule is that the lump:

The FNP notices that the patient’s submental lymph nodes are enlarged. In an effort to identify the cause of the node enlargement, the FNP would assess the patient’s:

The FNP is aware that the four areas in the body were lymph nodes accessible are the:

A 52-year-old patient describes the presence of occasional floaters or spots moving in front of his eyes. The FNP should know that floaters are usually not significant and are caused by:

The FNP is preparing to assess the visual acuity of a 16-year-old patient. How should the FNP proceed?

A patient’s vision is recorded as 20/30 when the Snellen eye chart is used. The FNP interprets these results to indicate that:

A patient is unable to read even the largest letters on the Snellen chart. The FNP should take which action next:

A patient’s vision is reported as 20/80 in each eye. The FNP interprets this finding to mean that

When performing the corneal light reflex assessment, the FNP notes that the light is reflected at 2 o’clock in each eye. The FNP should

The FNP is performing the diagnostic positions test. Normal findings would be which of these results?

During an assessment of the sclera of an African-American patient, the FNP would consider which of these an expected finding?

A 60-year-old man is at the clinic for an examination. The FNP suspects that he has ptosis of one eye. How should the FNP check for this?

The FNP is doing an assessment on a 21-year-old patient and notices that his nasal mucosa appears pale gray and swollen. What would be the most appropriate question to ask the patient?

The FNP is palpating the sinus areas. If the findings are normal, then the patient should report which sensation?

During an oral assessment of a 30-year-old African-American patient, the FNP notices bluish lips and a dark line along the gingival margin. What would the FNP do in response to these findings

During an assessment of a 20-year-old patient with a three day history of nausea and vomiting the FNP notices dry mucous and deep vertical fissures on the tongue. These findings are reflective of:

The FNP is reviewing the technique of palpating for tactile fremitus with a new graduate. Which statement by the graduate FNP reflects a correct understanding of tactile fremitus?

The FNP student is reviewing physical assessment findings of the HEENT system associated with pregnancy. Which statement by the graduate FNP reflects a correct understanding of expected HEENT changes associated with pregnancy? During pregnancy:

NR 509 Week 2 Quiz Review – (Jarvis 8,9,13,14,15,16,18), (Swartz 4,6,7,8,9,10)

NR 509 Week 2 Quiz

A mother brings her two month old daughter in for an examination says “my daughter rolled over against the wall and now I have noticed that she has the spot soft on the top of her head, is there something terribly wrong?” The FNP‘s best response would be:

During percussion the FNP knows that a dull percussion note elicited over a lung lobe. This most likely results from:

The patient is unable to differentiate between sharp and dull stimulation to both sides of her face. The FNP suspects Damage to:

When examining the face, the FNP is aware that the two pairs of salivary gland‘s that are accessible to examination are the _____ glands

A patient comes to the clinic complaining of neck and shoulder pain and is unable to turn her head. The FNP suspects damage to cranial nerve ____ and proceeds with the examination by____

When examining a patient’s cranial nerve function, the FNP remembers that the muscles in the neck that are innervated by CN XI are the:

The patient’s laboratory data reveal an elevated thyroxine level. The FNP would proceed with an examination of the _____ gland

A patient says that she has recently noticed a lump in the front of her neck below her “Adams apple” that seems to be getting bigger. During the assessment, the finding that leaves the FNP to suspect that this may not be a cancerous thyroid nodule is that the lump:

The FNP notices that the patient’s submental lymph nodes are enlarged. In an effort to identify the cause of the node enlargement, the FNP would assess the patient’s:

The FNP is aware that the four areas in the body were lymph nodes accessible are the:

A 52-year-old patient describes the presence of occasional floaters or spots moving in front of his eyes. The FNP should know that floaters are usually not significant and are caused by:

The FNP is preparing to assess the visual acuity of a 16-year-old patient. How should the FNP proceed?

A patient’s vision is recorded as 20/30 when the Snellen eye chart is used. The FNP interprets these results to indicate that:

A patient is unable to read even the largest letters on the Snellen chart. The FNP should take which action next:

A patient’s vision is reported as 20/80 in each eye. The FNP interprets this finding to mean that

When performing the corneal light reflex assessment, the FNP notes that the light is reflected at 2 o’clock in each eye. The FNP should

The FNP is performing the diagnostic positions test. Normal findings would be which of these results?

During an assessment of the sclera of an African-American patient, the FNP would consider which of these an expected finding?

A 60-year-old man is at the clinic for an examination. The FNP suspects that he has ptosis of one eye. How should the FNP check for this?

The FNP is doing an assessment on a 21-year-old patient and notices that his nasal mucosa appears pale gray and swollen. What would be the most appropriate question to ask the patient?

The FNP is palpating the sinus areas. If the findings are normal, then the patient should report which sensation?

During an oral assessment of a 30-year-old African-American patient, the FNP notices bluish lips and a dark line along the gingival margin. What would the FNP do in response to these findings

During an assessment of a 20-year-old patient with a three day history of nausea and vomiting the FNP notices dry mucous and deep vertical fissures on the tongue. These findings are reflective of: Shadow health respiratory assessment transcript.

The FNP is reviewing the technique of palpating for tactile fremitus with a new graduate. Which statement by the graduate FNP reflects a correct understanding of tactile fremitus?

The FNP student is reviewing physical assessment findings of the HEENT system associated with pregnancy. Which statement by the graduate FNP reflects a correct understanding of expected HEENT changes associated with pregnancy? During pregnancy:

Identifying and Reliability:

Ms. Jones is an obese 28-year-old female who is

presenting to the office today with an athma

exacerbation. She is the primary and only source of

personal and medical data. Pleasent, cooperative

and readily open to freely dissiminate health

information. Good eyeye contact, well-groomed,

good posture, and comunicates clearly with logical

flow of ideas.

General Survey:

Upon entering the patient’s examination room,

patient was found to be sitting straight and erect,

good posture, well-groomed, well nourished with a

pleasent demeanor and manner of communicating.

Reason for Visit:

“Breathing problems and my inhaler just isn’t

working the way it normally does.”

HPI: Ms. Tina Jones is a 28-year-old African

American woman who walked in to the clinic

complianing of SOB and wheezing after nearly

haveing a “bad” asthma attack two days ago. Pt.

Overview

Transcript

Subjective Data Collection

Objective Data Collection

Education & Empathy

Documentation

Student Pre-Survey

Lifespan

Review Questions

Self-Reflection

reports xxx which triggered her asthma

symptoms while she was visitn her cousins house.

Initially, at the time of the climax of her near asthma

attack, xxx It lasted for 5 minutes,

following the use of her rescuexxx . Pt.

reports only chest tightness at the time, which has

continued to the present with no increase in

tightness. Pt. denies all other allergic symptoms

during the exaccerbation of her asthma. The inhalor

had amild to moderate effect, not fully resolving the

asthma symptoms. Pt. reports that since the initial

exacerbation, she has had ten similar asthma

episodes consisting of SOB, “not able to get

enough air in” to her lungs, chest tightness all occur

every 4 hours, even through the night, awakinging

her from sleep. Her symptomsare worsoned when

laying supine, including coughing fits each time she

lays down, which easily resolves once sitting

backup. Instead of using the xxx, pt. has been using xxxx with minimal to moderate relief. Most

recent episode was this morning prior to her arrival.

xxx are aggrevated by exposure

to cats, perhaps dust, and currently exacerbated by

exertion and laying supine with a subsequent

coughing fit. occur Cough is non-productive.

Pt. concerned her new albuterol inhaler is ineffective

compared to previous device. Her asthma has been

slowly interferring with her life the past year or so,

while still being manageable. Over the past 2 days,

her asthma has interferred with her daily life,

including her response that if she had not had these

past two days off of work, she “would have called in

sick for sure.” Pt. feels minimal asthma symptoms

curretly, following her xxx over an hour

ago.

Diagnosed with asthma at 2.5-years-old, She

frequented hospital visits and including five

hospitalizations before she was 16-years-old. Since

then she hasn’t been hospitalized. Pt. xxxx. Pt. doesn’t keep

asthma record of exacerbations and triggers; denies

asthma medication usage excet for albuterolresuce

inhaler. Pt. not currrently beingmanaged by a

pulmonologist or someone for her allergies. Pt.

denies using a vaporizer or nebulizer at home.

PMH:

Pt. reports Type 2 Diabetes, possible borderline

hypertension (no actual dx).

Allergies:

Cats: Develops itchy, watery eyes; an itchy, “runny

nose”; an itchy, sometimes a sore throat, and often

an asthma exacerbation – SOB, DOE, wheezing,

coughing, and chest tightness.

Dust: Develops a rash, no tiching.

Penicillin: “Rash, like, hives.”

HPI: Ms. Jones is a pleasant 28-year-old African

American woman who presented to the clinic with

complaints of xxxxx attack that she had two

days ago. She reports that she was xxxx and was exposed to cats which triggered her

asthma symptoms. At the time of the incident she

notes that her wheezes were a 6/10 severity and her

shortness of breath was a 7-8/10 severity and

lasted five minutes. She did not experience any

chest pain or allergic symptoms. At that time she

used her albuterol inhaler and her symptoms

decreased although they did not completely resolve.

Since that incident she notes that she has had 10

episodes of wheezing and has shortness of breath

approximately every four hours. Her last episode of

shortness of breath was this morning before coming

to clinic. She notes that her current symptoms seem

to be worsened by lying flat and movement and are

accompanied by a non-productive cough. She

awakens with night-time shortness of breath twice

per night. She complains that her current symptoms

are beginning to interfere with her daily activities

Medications:

Rx: xxx.

OTC: xxxfor occasional

xxxx related to readingfor prolonged periods

of . xxxx

Social History:

Pt. reports fairly severe xxx (xxx);

A moderate allergic reaction to excessive dust

accumulation (axxx); and Penicillin (report from

mom when pt.was a child, mother reports

development of a rash only; unknown if xxx and axx

occured as well. Pt. is meticullus about dust,

allergins, mildew accumulation; using hypoallergenic

practices with bed, sheets, pillows and spead.

Mattress is 12 months old. Pt. denies ever using

tabacco in any form, as well as illicit drugs and

prescription medicaton abuse. Pt. does report that

from 15-16-years old she smoked marijuana, but

hasn’t partaken in it since 21-years-old. Pt. states

she doesn’t exercise, eats “whatever”, with some

restrint in high sugar beverages and treats.

Family History: Pt. states sister has history of

asthma and hayfever.

Surgical History: Pt. denies previous surgeries.

ROS:

General: Pt. states recent changes in appetite as

she is “always hungry” even after she has eaten a

large meal. Reports exercise intolerance, usually

feels fatigued. Pt. denies recent weight changes,

fevers, chills. body aches, sweats. feels she is

generally a healthy person.

Skin: Pt. reports skin color and pigment changes

localized only around her neck – which has been

changeing the past couple of years now. Pt. reports

that moles on her back have not changed in size or

color.Skin is dryer than usual and feels dehydrated

and always thirsty. Denies sores, lesions, scabs.

Pulmonary: Pt. states that she has coughing fits

when exposed to allergens like dust adn especially

cats. Coughing also occurs when asthma “acts up”

and anytime she lays down in the past month she

begins to cough. Lately she will wake up twice a

night because of uncontrolable coughing which

resolves after she has been in a sitting or upright

position for a few minutes. Denies productive cough

or coughing up blood. Denies being exposed to

anyone sick, has not traveled.

Reports SOB when she has to hurry somewhere or

whan she climbs a large flight of stairs. Has

orthopnea twice a night with coughing fits. xxxx and denies OSA.

xxx: Pt. state she may have borderline

and she is concerned that her xxxx

seems to be less effective than previous. Currently

she states that her breathing is normal. Diagnosed

with asthma at age 2.5 years. She has no recent use

of spirometry, does not use a peak flow, does not

record attacks, and does not have a home nebulizer

or vaporizer. She has been hospitalized five times

for asthma, last at age 16. She has never been

intubated for her asthma. She does not have a

current pulmonologist or allergist.

xxx: She is not aware of any

environmental exposures or irritants at her job or

home. She changes her sheets weekly and denies

dust/mildew at her home. She uses a hypoallergenic

pillow cover and her mattress is one year old. She

denies current use of tobacco, alcohol, and illicit

drugs. She did smoke marijuana for 5 or 6 years,

her last use was at age 21 years. She does not

exercise.

Review of Systems: General: Denies changes in

weight, fatigue, weakness, fever, chills, and night

sweats.

• xxx: Denies rhinorrhea with this episode.

Denies stuffiness, sneezing, itching, previous allergy,

epistaxis, or sinus pressure.

• Gastrointestinal: No changes in appetite, no

nausea, no vomiting, no symptoms ofxxx

• xxx: Complains of shortness of breath and

cough as above. Denies sputum, xxx,

pneumonia, bronchitis, emphysema, tuberculosis.

She has a history of asthma, last hospitalization was

age 16, last chestxxxx.

hypertension. Pt. denies xxxx,

palpitations, tachycardia or racing heart, orthostatic

changes, edema, heart arrythmias and denies

sickle-cell disease.

Endocrine: Pt. reports having previous diagnosis of

diabetesxxxx, xxx,

lethargy. Pt. reposrts having xxx, dxxx,

being overweight. Pt. denies changes in hair

pattern, weight changes, node enlargement, breast

changes, galactorhea, never been pregnant,

tremors. Shadow health respiratory assessment transcript.

GI: Pt. denies N/V, anorexia, diarhea, GERD, ulcers,

colonoscopy, constipation, hematamesis,

hematechezia, recent changes in bowel evacuation

habits, dysphagia, flatulance.

GU: Pt. reports xxxx, feels

thirsty all the time now, drinks a lot of fluids which

doesn’t seem to quench thirst. She has now been

experiencing nocturia 2-3 times per night. Denies

xxx, chronic or recent xxxx, history

of or knowlingly being xxxx. Reports

haveing three sexual partners in her life, all of which

are men. Has been absinent for over a year now.

Denies incontinence.

Neurologic: Pt. denies changes in sensation,

weakness, light-headedness, dizziness, chronic

xxxxchanges in mentation,

long or short term memory, concussions,xxxx

HEENT: Pt. denies history of xxx, except for

occassionally occuring when she reads too long xxx

changes, except for “blurry eyes” after reading for

too long. Denies other visions problems, hearing

issues, nasal discharge, epistaxis, gingivitis, mouth

sores. Pt. doesn’t see dentist annually nor teetch

professionally cleaned – hasn’t been to the dentist

for “years.”

Objective

Tina is an obese 28-year-old African American

woman who does not seem to be in any acute

distress. Alert and oriented, sitting upright, ,

maintains appropriate eye contact, is

conversational, and answers questions approprietly.

Respiratory: Respiratory examination found Tina’s

chest expansion to be symetrical with respiration.

Bilaterally symetrical tactile fremitous, negative

broncophony anteriorly and posteriorly in all lung

fields. Chest resonent when percussed, devoid of

any dullness. Bilateral lower lxxxx. All other

lung fields clear to auscultation. No crackles,

rhonchi, coarseness noted in lung auscultation.

Muffled words bilaterally with prominent expiratory

wheezes in the posterior lower lobes only.

Spirometry yielded xxxxon room air, xxxx, BP

General: Ms. Jones is a pleasant, xxx 28-year-old

African American woman in no acute distress. She

is alert and oriented and sitting upright on exam

table. She maintains eye contact throughout

interview and examination.

• Respiratory: Chest expansion is symmetrical with

respirations. Normal fremitus, symmetric bilaterally.

Chest resonant to percussion; no dullness. Bilateral

expiratory wheezes in posterior lower lobes.

Bilateral muffled words with notable expiratory

wheezes in posterior lower lobes. No crackles. In

office xxx%.

x

140/81, Temperature xxxdegrees Farenhiet.

Assessment

Mild-Persistent Asthma with Exacerbation. Mild-persistent asthma with exacerbation

Plan

Diagnostics: Obtain oxygen saturation and baseline

spirometry and peak flow readings.

Medication: NMI at office one time. Continue

albuterol rescue inhalor. Initiate step up inhaled

corticosteroid.

Education: Encourage Tina to log her asthma

symptoms and episodes of exacerbation every day

and bring log in to next visit. Monitor trigger

exposures adn resultant asthma symptoms and

severity of exacerbations. Encourage Tina to

remove and/or clean all possible harborers of

allergens, including bedding, seats, pillows carpet.

Change air filters in home and car to incrased

allergiin removal from the air. Encourage an incrase

in fluid consumption, especially water. Help guide

pt. indeveloping an asthma action plan and assess

effectiveness and apropriateness of plan in next

visit.

Orders: xxxx

after each exacerbation for purposes of comparison

and establishing pt. trends.

Instruct Tina to return to clinic if ongoing symptoms.

Also inform xxx if

worsoning asthma symptoms, xxxx that is

unresolved by a short rest. Also go to xxxis

unresolved xxx, wheezing not allevaited

xxx and xxx.

Follow-Up: Return to clinic in 3 weeks for follow-up

evaluation regarding coarse of illness, medication

use and needs, as well as medication effectivenss.

Diagnostics

• Obtain office oxygen saturation

Medication

• xxxin office x 1

• Initiate step-up medication therapy with xxxx

• Continue xxx

Education

• Encourage Ms. Jones to continue to xxx

symptoms and wheezing with associated factors

and bring log to next visit

• Encourage to wash xxx and consider xxx to decrease axxe

symptoms

• Educate to increase intake of water and other

fluids

• Create Axxx

Referral/Consultation

• Refer to allergy specialist for evaluation and testing

Follow-up Planning

• Order PFTs to be completed after exacerbation to

have baseline available for future comparison

• Instruct Ms. Jones on when to seek emergent care

including episodes of chest pain or shortness of

breath unrelieved by rest, worsening asthma

symptoms or wheezing, or the sense that rescue

inhaler is not helping

• Revisit clinic in 2-4 weeks for follow up and

evaluation

Comments

If your instructor provides individual feedback on this assignment, it will appear here.

NR 509 Week 2 Quiz Review – (Jarvis 8,9,13,14,15,16,18), (Swartz 4,6,7,8,9,10)

1.       What does dullness when percussing lung fields: Jarvis pg 427

2.       Facial sensation controlled by which CN: Jarvis 283,

3.       Know what two salivary glands are accessible during exam

4.       What CN is being … when pt shrugs shoulders Jarvis 646

5.       What muscles are being …. when …. CN 11 (spinal accessory nerve)

6.       Concern for malignant nodules versus benign lymph nodule

7.       Know what you’d do next if you palpated a submental lymph node: Jarvis pg 253

8.       Define visual acuity

9.       Know what to do if your patient can’t read the largest number on the Snellen chart: Jarvis 289

10.   Example of good visual acuity : Jarvis 289

11.   Example of poor visual acuity: Jarvis 289

12.   What is …. with corneal light reflex-

13.   Know normal variances of sclera : Jarvis 283

14.   Know how to check for Ptosis: Jarvis 292

15.   What does ptosis indicate: Jarvis 292

16.   Nasal fissure of pt with chronic allergies : Jarvis 271

·         Acute allergies : Jarvis p 363 .

17.   What is an abnormal palpation of sinuses: Jarvis 362

·         Normal palpation of sinuses

18.   Know normal variations in gingival margin

19.   Know what a dehydrated oral cavity will look like: Jarvis 387

20.   What is tactile fremitus, how do you test for it and what does it indicate. Jarvis 425

N 518 Module 2: THE GENERAL SURVEY AND HEENT

Module 2: Discussion Question

Start by reading and following these instructions:

You are responsible for minimally at least 3 posts for each question in your discussion boards; your initial post and reply to two of your classmates. 
Your initial post(s) should be your response to the questions posed in the discussion question. You should research your answer and cite at least one scholarly source when appropriate, and always use quality writing.The discussion board is never a place to use text language or emoticons. You will also be asked to respond to your classmates. This is designed to enhance the academic discussion around the topic. It is all right to disagree with something posted by another, however your responses should always be thoughtful and respectful and reflect your opinions professionally.

Discussion Question:

In your professional opinion, what is the difference between chronic and acute pain? How is the assessment for each type of pain different? What must you keep in mind when assessing acute pain? What must you keep in mind when assessing chronic pain?  Reflect upon a time when you assessed a patient in pain. What did you do well? What points could you have improved upon? How did the pain impact the patient? What specific treatments could have lessened the impact of the pain on the patient?

Your initial posting should be 200 to 300 words in length and utilize at least one scholarly source other than the textbook. Please reply to at least two classmates. Replies to classmates should be at least 100 words in length. To properly “thread” your discussion posting, please click on REPLY.

When you are ready for the discussion, do the following:

Click on the discussion link above.

Start your answer by clicking “Start a New Thread” button with the title of your answer and the body of text following the guidance above.

To properly post your answer, please click on the “Post” button.

After posting your contribution, you must read what others have posted, reply to at least two of those posts, and respond (when appropriate) to those you have responded to you.

To reply to a classmate’s post:

Click on the title of another student’s post.

Click “Reply to Thread” and type your response to the student.

Click the “Post” button to post your reply.

N 581 Module 2: Assignment

Remember to submit your work following the file naming convention FirstInitial.LastName_M01.docx. For example, J.Smith_M01.docx. Remember that it is not necessary to manually type in the file extension; it will automatically append.

Start by reading and following these instructions:

1. Quickly skim the questions or assignment below and the assignment rubric to help you focus.

2. Read the required chapter(s) of the textbook and any additional recommended resources. Some answers may require you to do additional research on the Internet or in other reference sources. Choose your sources carefully.

3. Consider the discussion and the any insights you gained from it.

4. Create your Assignment submission and be sure to cite your sources, use APA style as required, check your spelling.

Assignment:

Exercises
: 

Complete the Shadow Health HEENT assessment.

Professional Development

Write a reflection essay of your experience with the Shadow Health virtual assessment. At least two scholarly sources in addition to your textbook should be utilized. Please be sure to address each of the following prompts:

What went well in your assessment?

What did not go so well? What will you change for your next assessment?

What findings did you uncover?

What questions yielded the most information? Why do you think these were effective?

What diagnostic tests would you order based on your findings?

What differential diagnoses are you currently considering?

What patient teaching were you able to complete? What additional patient teaching is needed?

Would you prescribe any medications at this point? Why or why not? If so, what?

How did your assessment demonstrate sound critical thinking and clinical decision making? What could you change to make it better?

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Shadow Health Physical Assessment Rubric

Shadow Health Physical Assessment Rubric

Criteria

Ratings

Pts

This criterion is linked to a Learning Outcome
Subjective Data, Organization, Communication, and Summary (DCE Score or transcript)

25.0
 pts

Above Average- DCE Score greater than or equal to 93; Comprehensive introduction with expectations of exam verbalized; questions worded in a non-judgmental way; professional language exercised; questions well-organized; appropriate closing with summary of findings verbalized to patient.

21.0
 pts

Average- DCE Score greater than or equal to 86-92; Adequate introduction; some questions worded in a non-judgmental way; professional language mostly exercised; questions generally organized; somewhat complete closing.

10.0
 pts

Below Average- DCE Score greater than or equal to 80-85; Incomplete introduction; many questions worded in a judgmental way; some professional language exercised; questions somewhat organized; incomplete closing.

0.0
 pts

Unsatisfactory- DCE Score less than or equal to 79; Introduction missing; questions worded in a judgmental way; little professional language; questions unorganized; closing missing.

25.0
 pts

This criterion is linked to a Learning Outcome
Objective Data, Physical Examination, Interpretation of Findings, Assessment, and Documentation

20.0
 pts

Above Average- Physical assessment documentation includes all relevant body systems; all pertinent normal and abnormal findings identified; documentation reflects professional language; treatment plan includes each of the following components: diagnostics, medication, education, consultation/referral, and follow-up planning.

16.0
 pts

Average- Physical assessment documentation lacks sufficient details pertaining to one or two relevant body systems; or identifies ≥ 50% of the pertinent normal and abnormal findings; or documentation lacks professional language; or treatment plan lacks one or two components (diagnostics, medication, education, consultation/referral, or follow-up planning).

8.0
 pts

Below Average- Physical assessment documentation lacks sufficient details pertaining to three or more relevant body systems; or identifies < 49% of the pertinent normal and abnormal findings; or documentation includes unprofessional language; or treatment plan lacks three or more components (diagnostics, medication, education, consultation/referral, or follow-up planning). 0.0  pts Unsatisfactory- No physical assessment documentation or no treatment plan. 20.0  pts This criterion is linked to a Learning Outcome Self-Reflection 5.0  pts Above Average- Responds to three of the three reflection post questions; and provides analysis of performance; and reflection posts written using professional language; and reflection posts demonstrate insight. 3.0  pts Average- Responds to two of the three reflection post questions; or provides limited self-analysis of performance; or reflection posts are somewhat unclear related to the assignment and the student’s experience; or reflection posts lack insight. 2.0  pts Below Average- Responds to one of the three reflection post questions; or does not provide self-analysis of performance; or reflections are not related to the assignment and the student’s experience; or does not provide insight 0.0  pts Unsatisfactory- No reflection posts for the assignment. 5.0  pts Total Points:  50.0

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

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

Discussion

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

References

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

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

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

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

This form should be used as an example:

[Patient Questionnaire

INTERVIEW OF CHOSEN ELDER ADULT

Name:

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Age:

Brief Introduction (Background information):

1. Philosophy on living a long life:

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

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

4. Beliefs about health and illness:

5. Health promotion activities he or she participates in:

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

7. Life span of other family members:

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

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

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

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

Additional Questions

1.

2.

3.

Summary:

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

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

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

Tinetti Balance and Gait Evaluation

Katz Index of Activities of Daily Living

Assessment of Home Safety

The Barthel Index

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

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

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

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

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

Patient Questionnaire

Name:

Age: 80

Questionnaire and the responses

What is your philosophy on longevity of life?

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

14. Why do people want to live long life?

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

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

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

Summary

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

Tinetti Balance and Gait Evaluation

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

Tinetti Balance and Gait Evaluation

Interviewer:

Date:

BALANCE

ACTIVITY

SCORE

Balance when sitting

1

Can rise with arm support

1

He rises with single attempt

2

Standing balance is firm without support

2

Standing balance is steady with wide stance

2

Steady on nudging

2

Balance intact with eyes closed

2

Has discontinuous steps on 360 turn

0

Non-smooth motion on sitting down

1

SUB-TOTAL

13/16

 

 

GAIT

ACTIVITY

SCORE

Patient can initiate gait immediately

1

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

1,1

Has equal left and right step symmetry

1

Has continuous step

1

No deviation in path

2

Has no sway on trunk but slight flexion of knees

1

Heels almost touch on walking

1

SUB-TOTAL

9/12

TOTA TINNETI SCORE

22/28

INTERPRETATION

RISK FOR FALL

 

(Elsawy, & Higgins, 2011)

Katz Index of Activities of Daily Living

Interviewer:

Interviewee:

Age:

Profession:

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

 

ACTIVITY

SCORE

Baths without any help

1

Dresses without any help

1

Does toileting on his own

1

Can transfer himself without help

1

Has partial urinary incontinence

0

Feeds himself without help

1

TOTAL

5/6

INTERPRETATION

Patient is independent

 

(Elsawy, & Higgins, 2011)

Assessment of Home Safety

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

LIVING ROOM

Has doorways are appropriately wide

The living room has loose electrical cords that are unsafe

The pathways in the living room are clear

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

BEDROOM

The bed is set low enough to be freely accessible

There is no installation of night light

There are no loose area rugs and carpet sections

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

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

BATHROOM

There are no grab handles near sink, toilet or shower

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

There are loose rugs on the bathroom floor

Toilet sit is raised well

No phone or waterproof medical alert device for emergency call

OUTSIDE HOME

The sidewalk is in appropriate condition

The front door is in good condition

There is adequate lighting

There are railings along the front steps

 

(Tomita et al., 2014)

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

The Barthel Index assesses functional independence.

THE BARTHEL INDEX SCORE

ACTIVITY

SCORE

INTERPRETATION

Feeding

10

Independent

Grooming

5

Independent

Toileting

10

Independent

Bowel Control

10

Has continence

Dressing

10

Independent

Transfers

15

Independent

Bladder control

5

Occasional accident

Bathing

5

Independent

Mobility on flat surface

15

Independent

Stair case movement

5

Needs help

TOTAL SCORE

95

Fully independent

MINI-COGNITIVE ASSESSMENT INSTRUMENT

Assesses for presence of dementia

ITEMS RECALLED

DRAWING OF CLOCK

INTERPRETATION

0

A

P

1

n

N

1

A

P

2

n

N

2

A

P

3

n

N

3

A

N

KEY

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

DRAWING-ability to draw clock

A-abnormal

n-Normal

P-Positive

N-negative

INTERPRETATION

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

Whole Analysis-comparison

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

.

References

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

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

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

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

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

PICO analysis of depression essay

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

To prepare:

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

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

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

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

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

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

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

To complete:

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

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

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

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

Managing Depression among Pregnant Women

Part I and II

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

Part III: Analysis of Literature.

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

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

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

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

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

Appropriate treatment options

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

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

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

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

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

References

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

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

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

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

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

Social Challenges of Aging Essay

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

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

Support your responses with examples.

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References must be within 3 years.

Social Challenges of Aging

Introduction

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

Discussion

Social challenges of aging

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

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

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

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

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

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

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

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

Responding to the social challenges

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

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

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

Conclusion

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

References

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

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

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

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

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

Develop a Wellness Program Essay with a holistic approach for the older adult you identified, using resources available in your community (Thomasville, GA). Discuss how this approach will prove an optimum level of well-being.

Citations should conform to APA guidelines.

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Teleadult program has been proposed as a wellness program that makes it conceivable for older adults to access health care in the face of outwardly overwhelming obstructions that comprise isolation, limited movement, and being invalids. The program makes use of phone messaging services to a dedicated site that has medical personnel on standby to offer health care advice to include taking vital readings at regular intervals to be accompanied by customized questions and graphics. In this case, the program would involve using communication technologies to expedite healthcare delivery without regard for distance Wellness Program Essay. This occurs even as communication between medical personnel and the population is enabled. For that matter, the program assigns priority to advance treatment, prevention and ensuring wellness. In fact, the program would be applied to carry out patient evaluation, offer interventions (health and psychological), caregiver education, and real-time monitoring of the patients. This occurs even as it creates a feedback mechanism that guarantees an efficient flow of information between the medical personnel and patient (Harris, 2015). The program can be considered as a multidimensional treatment model that focuses on older adults who are homebound and frail. It evaluates issues that influence the quality of care and their connection with care outcomes thus guaranteeing that the population receives the recommended care with enhanced participation from all stakeholders. Even as the program is applied, a likely obstacle to its implementation is meaningful use by the older adult population. The obstacle will be preempted through offering detailed tutorials to the population explaining what the program entails before its implementation. Also, verbal prompts would be included to allow the patient make good use of the program (Harris, 2015). In this respect, Teleadult program is a wellness program that presents an opportunity for older adults to addresses the communication concerns of health care delivery. Wellness Program Essay.

Reference

Harris, M. (2015).
Handbook of Home Health Care Administration
(6
th
ed.). Burlington, MA: Jones & Bartlett Learning Wellness Program Essay.