Tag: Clinical-Nursing

C791 Advanced Information Management

Advanced Information Management C791

The Electronic Health Record, also known as EHR is a digital database of both past and current clinical information including everything from demographics to test results and medical conditions (Tan & Payton, 2017). Health information systems have both advantages and disadvantages surrounding their usability, interoperability, scalability and compatibility. They have a direct affect on patient care and documentation and can affect the quality and delivery of nursing care and patient outcomes. Having access to patient records using an EHR allows information to be immediately available to all providers who have access to the EHR – including co-workers in other areas of the same hospital as well as in other hospitals with the same EHR. This can be extremely beneficial to the patient and health care providers alike. Unfortunately, EHRs are very expensive to implement as well as maintain – as they require multiple levels of training as well as periodic upgrades due to changes in healthcare delivery as well as system changes.

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Health Information Systems

A1. There are advantages and disadvantages of the EHR. In the area of usability, young nurses may have only been exposed to EHRs, and in fact most or all of their education may have taken place with electronic textbooks, tests and paper submission. For them, using an EHR may be very easy and they will have an advantage over older nurses, like myself, who learned nursing on pen and paper. All of my nursing schoolwork involved writing papers by hand and testing on paper. Advantages for nurses young and old, however, are the systematic charting methods provided by an EHR. Quick templates for charting  and check-box documentation on the EHR can provide reminders for the nurse to ensure that all problems that the patient is experiencing are addressed. A disadvantage can occur when the n nurse uses only the check-boxes and fails to provide to elaborate on issues occurring which are not addressed in the boxes. Without adding a narrative or written progress note in addition to the check boxes, the nurse may not truly tell the patients’ story, allowing for important details to be omitted. In the area of interoperability, one advantage is that if multiple providers use the same EHR, the patients records may be visible by all providers. For instance, if a patient sees a primary care physician who is aligned with a hospital system, then if the patient is admitted to the hospital he/she is aligned with the notes, diagnoses, lab results and demographics will all be visible by both the office staff and the hospital staff. Additionally, interoperability with lab would ensure that test results would flow into the chart rather than allowing for the chance for human error in entering lab values or times. A disadvantage would be if the patient sees a primary care physician who uses one type of EHR and presents to a hospital with another type of EHR. Most EHRs are only compatible with like EHRs, so the only way to ensure information from a physician office would not be visible by hospital staff or if one hospital system uses one type of EHR and another hospital system uses another type of EHR, there would be no visibility of information if the patient was transferred from one hospital to another. As related to scalability, an advantage would occur if the EHR chosen by a hospital is capable of expanding as healthcare regulations change and as the hospital system grows or expands to include additional service lines. A disadvantage would occur if the EHR chosen had limits on the ability to optimize the use to fit the needs of changing healthcare regulations or if it would not allow for expansion or growth throughout the system. Compatibility of the EHR would be an advantage if the current computer system of the hospital could handle the EHR without purchasing new equipment. When patients’ blood glucose levels are tested, does the information from the glucometer flow directly into the EHR? This would definitely be an advantage. Also it would be advantageous if the EHR had the ability to run on different hardware, as many people have a preference of the system they use. It would be a disadvantage if the EHR only ran on one system, or was only able to function in one area of the hospital. It would be important to ensure that the EHR had platforms for the Emergency Department, Inpatient, Outpatient, Surgery and Testing areas. If it was not capable of crossing over to any area of the hospital the patient might experience during a stay, it would be a disadvantage. C791 Advanced Information Management.

A2. Patient care and documentation can be positively impacted by implementation of an EHR. Using an EHR provides that all patient information is recorded in the exact same manner on each patient and provides continuity of care between shifts. Reminders for labs, medications, tests, and other areas of patient care can be helpful to ensure that the nurses caring for the patient provide all of the care ordered for the patient during their shift.  Additionally, if the patients chart needs to be reviewed for quality indicators or issues, the care is documented in the same manner and in the same area for each patient. If the patient seeks care from another physician or hospital system that uses the same EHR, then their care has the potential to be more appropriate because their history will be available for physicians, nurses and other caregivers with access, resulting in a higher level of care provided.

A3. The quality and delivery of nursing care and patient outcomes can be positively affected with the implementation of the EHR. Quality reviews can take place in real time – while the patient is still a patient- rather than having to wait for paper documentation to be scanned in to a record. Additionally, with paper documentation, there is no way to mine data to measure quality across a unit or a hospital. Data mining is the process of using software to discover or establish relationships (Mastrian & McGonigle, 2017).  If patient data is entered into an EHR, reports can be run to determine what treatments are being used, if they are effective and if proper documentation is happening among many other things. Patient outcomes can be positively affected because chart audits can happen in real time. C791 Advanced Information Management.

Organizational Benefits

B1. The EHR provides the opportunity to improve efficiency and quality of patient care, resulting in better outcomes (Mastrian & McGonigle, 2017). Patients come to healthcare facilities with hopes to get better. They do not plan to get sicker or to have complications, known as Hospital Acquired Conditions or HACs, resulting from treatments that they receive (or do not receive) during their hospitalization. In the facility where I work, approximately 3 years ago, a HAC known as Catheter Associated Urinary Tract Infection or CAUTI rates were high, and we set out on a mission to decrease these rates. We tracked and trended the rates of infection and the number of catheter days for each infection, from our EHR for the previous 3 years, and came up with goals for number of catheter days and diagnoses requiring catheterization vs. catheter use for nurse convenience. Additionally, we looked at where the CAUTIs were occurring (what unit), the age of the patient, what the course of treatment was (did the patient go to surgery or other diagnostic areas) and even drilled down to what nurse(s) and aide(s) cared for the patient. Nurse(s) and tech(s) caring for patients who developed a CAUTI were counseled and education was provided to all newly hired employees. Because of the information we gathered, using the EHR our nurse leadership team created a report to run each day to determine what patients might be at greatest risk for a CAUTI. The EHR allows for reports to be very in depth and include information such as what patients have catheters and how many days the catheter has been in place. Knowing the longer the catheter is in, the higher the risk of infection, we work as an interdisciplinary team to determine if the patient needs to continue with the catheter or if it could be discontinued. This, along with other actions such as implementing the use of TheraWorx cleaning have caused a significant decrease in the amount of CAUTIs. In 2015 and 2016, our hospital had seven CAUTIs during each year. In 2018 we had three CAUTIs and year to date in 2019 we have only had two. This is because of reports run and analyzed from the EHR.  HAC rates are continually measured using data from the HER to improve patient outcomes. Another way that quality improvement data collected can lead to measurable improvement is by using the EHR to review charts of patients who have had a negative outcome during a hospital stay, such as a fall with injury or a medication error. C791 Advanced Information Management. In the case of a fall with injury, our quality department will use the EHR to perform a full chart review. Then, they will use the information from the chart review to determine what co-workers were involved in the event, what medications or treatments the patient was receiving, and what the patient was doing at the time of injury. Every patient receives a fall risk assessment at the time of admit, completed in the HER, resulting in a fall risk score which is visible by the bedside nurse and others providing care to ensure the proper precautions are in place. If the patient experiences a fall, a near miss, or a change in condition, the bedside nurse is prompted to complete a new fall risk assessment in the EHR which will result in a new fall risk score. If the event is what as known as a never event, such as a death as a result of the fall, then this is reportable and the EHR will be useful to both the quality and legal department of the hospital as well as federal or state regulatory agencies or legal counsel who obtain access to the EHR.

B2. There are federal guidelines regarding the privacy of health information for EHRs including the Health Insurance Portability and Accountability Act (HIPAA) and Health Information Technology for Economic and Clinical Health (HITECH)  (Mastrian & McGonigle, 2017). Additionally, anyone using an EHR needs to ensure information is secure and network security is managed (Mastrian & McGonigle, 2017). In the hospital where I work, we have a unit for geriatric psychiatric patients. This is a locked unit with limited access and all patients are considered private. Their names are not visible by all on house census reports or other documents. Only co-workers who have electronic access, granted by their leader, can access the records of these patients. Because it is not practical to assume that everyone a patient on this unit comes into contact with would have this electronic access, a level of security known as “breaking the glass” exists in our EHR. C791 Advanced Information Management. This allows for anyone to access their record, but in order to do so they have to “break the glass” which requires them to state the reason they need to be in the chart and agree to quality review to ensure they have the right and the access is necessary. This insures the patients in this high security area are kept as private as possible. Data back-up is also necessary. A few years ago, a Mercy Hospital in Joplin, Missouri was completely destroyed by a tornado. Many patient records were destroyed and while patients were cared for in other facilities in the area, their information was not accessible due to the other hospitals not having compatible EHRs. This data was eventually recoverable, but not in real time. As a result, each Mercy Hospital now has all of its data backed up to a computer system offsite in a database accessible to anyone at any time. The data isn’t just stored on-site, but continually backed up offsite. These measures assure compliance with HIPAA and HITECH.

B3. Patient privacy is protected in many ways in an EHR. In the hospital where I work, a watchdog system is in place to monitor everyone who views a patient’s chart. If at any time, an employee views a patient chart and there is a match of the last name or home address, an alert is sent to the employee’s leader. It is then the leader’s role to investigate the reason the employee viewed the chart. The EHR system we use is EPIC, and the watchdog system reveals all locations in the chart viewed by the employee. If the employee had a reason to be in the patient’s chart, such as checking in the patient in the Emergency Department, but the only part of the chart viewed by the employee was the check-in screen, then there is no reason for disciplinary action. But if that same employee, responsible for checking in the patient to the Emergency Department went on to view previous visits or lab results, then they have violated HIPAA and are disciplined according to the hospital policy for privacy which aligns with HIPAA. Patient privacy is additionally protected through the process of granting employees access to the EHR. Each employee’s leader is responsible for requesting access which aligns with their training and job duties. Kitchen employees have no reason to be in a patient’s chart, so they are not trained in the EHR and do not have access. Nurses are only given access to patients on the floor(s) or department(s) where they will be working. This assures employees are not given access to patient’s private information when not required for the completion of their duties.

B4. Organizational efficiency and productivity will improved by adopting an EHR, although there have been few studies of EHRs with very little reported data (Mastrian & McGonigle, 2017). One way that efficiency is improved is standardization of charting using the EHR. Pathways can be built for standard physician orders for patients with specific conditions such as Chronic Obstructive Pulmonary Disease or COPD. Head to toe assessments are completed by multiple nurses across multiple shifts, but using the EHR, the assessments are completed the same way every time. The same documentation on each patients provides continuity of care for patients across the continuum of care, in addition to providing the ability to view data complied over a whole hospital stay on one screen in the same place every time. Productivity will be improved because the members of the care team will all be able to document at the bedside while care is being performed. In the case of a patient in cardiac arrest, where multiple members of the care team are providing care simultaneously, EPIC EHR provides a “code narrator” allowing for one point person to document all interventions during the code in real time while the code is happening. In the absence of an EHR, this documentation would be done by hand and might not be the same way every time or might cause the nurse doing the documentation to chart after the end of the event taking up time that could be used to care for other patients or to continue care on that patient if they survive. Additionally, once the documentation is entered into the EHR in real time, there is no need to scan any documents or information into the chart which provides a streamlined method of recordkeeping. If patient information is recorded on paper rather than in an EHR, there could be waste as eventually the paper would be scanned into the chart and then shredded to ensure privacy. C791 Advanced Information Management. Efficiency can also be enhanced in the area of human and capital resources. Using an EHR, each time a procedure is performed on a patient, a medication is given or a supply is used, these are recorded in the EHR and automatically charged to the patient account. This decreases the need for someone to enter charges manually into the system, thereby increasing productivity and decreasing the number of people required for care. In addition to the data listed above, there are many other ways organizational efficiency and productivity will improve with the implementation of an EHR.

Essential Stakeholder Roles for System Implementation

There are multiple layers of leadership required for implementing an EHR within a healthcare system, including but not limited to: Implementation Manager, Physician Champion, Information Technology Lead and SuperUser Lead. The Implementation Manager may be associated with the vendor of the EHR. They are responsible for making sure the project is on schedule, monitoring the work plan, maintaining a list of problems at the hospital or vendor level that need resolution, scheduling events surrounding implementation and may include communicating updates to the implementation team. Their expertise would need to be in both the inner workings and implementation of the specific EHR to be implemented (from a vendors perspective) and also in the structure of the implementation team (from the hospital perspective). This person would need to have excellent communication and organizational skills as the success of the implementation really begins and ends with them. They will also need delegation skills, as there is no way they could be expected to accomplish all facets of their role without support. It is never recommended to implement an EHR without a physician champion. A close relationship between the physician champion and the implementation team is imperative to the success of the EHR. Physicians will need the EHR to function clinically in a way that is beneficial to them as well as the patient. The Physician Champion will serve as a liaison between the implementation team and the facility physicians, so good communication skills are also required. It is essential that physicians “buy in” to the EHR, so it will be necessary for them to have a voice in the development, optimization and implementation of the EHR. The Information Technology Lead is the person that every member of the team can go to for answers related to the operation of the software and hardware of the EHR C791 Advanced Information Management. They deploy the workstations or other hardware needed, install the appropriate software and drivers on computers, tablets, scanners, printers and other hardware. They are also responsible for the operation of the software on the deployed hardware. The IT Lead will need to work with Leads from all departments within the hospital (Nurse and other Clinical Leads, Lab and other Ancillary Service Leads) so good communication skills are necessary. They will also need to understand the EHR and how the software is installed and how the hardware is intended to work once the software is installed. They will need to have a working knowledge of all areas of the EHR and what each department can expect to be required to do to login, use, and troubleshoot issues that arise. The SuperUser Lead  creates a network of Super-Users within the organization to provide continued support during and after implementation of the EHR. These SuperUsers must be recruited and trained by the SuperUser Lead. SuperUsers must be personable and willing to help employees with various skills within the organization. They will need to be able to work with very computer savvy employees as well as those who have very little computer expertise. They will provide IT support during implementation as well as assisting with new employees hired after implementation. They will be chosen based on their knowledge of different facets of the EHR so that they can provide very specific and effective assistance to employees.

Plan for Evaluation

Once an Electronic Health Record has been implemented by a team within a hospital setting, it will be important to continually evaluate the success of the EHR in the different areas of the hospital. National professional organizations have developed position papers regarding the importance of evaluation as well as methods for evaluation. One such organization, Healthcare Information and Management System Society or HIMSS, developed a position paper titled Transforming Nursing Practice Through Technology and Informatics. In this paper, they outline the value of nursing informatics, connecting with the consumer, and implications for time and plan of care (“HIMSS,” June 16, 2011). HIMSS believes that nursing should be key stakeholders in not only the development and design of EHR, but also in the evaluation and optimization of EHR (“HIMSS,” June 16, 2011) . The position statement from HIMSS is in alignment with other professional organizations such as the American Nurses Association (ANA), and the Alliance for Nursing Informatics (ANI) (“HIMSS,” June 16, 2011). Having strong nursing informatics leadership will play a key role in evaluating the success of system implementation. These leaders will orchestrate what information will be provided, how patient care is supported by the gathering and documentation of data and what financial and business implications there are as a result of implementation (“HIMSS,” June 16, 2011). National benchmarks exist in all service areas in the hospital. The EHR should allow each service area to easily compile data to measure their area against national benchmarks as well as their peers. The ease in which data is gathered from the EHR will allow more time for changes in practice guidelines or protocols to provide for safer care for the patient and a better work environment for the employee. Continual evaluation by all service areas as well as discussions between unit service area leadership and nursing informatics leadership regarding possible optimizations to the EHR are imperative to a successful EHR implementation. C791 Advanced Information Management.

 

References

Mastrian, K. G., & McGonigle, D. (2017).
Informatics for Health Professionals
(Custom WGU ed.). [Western Governors University]. Retrieved from https://wgu.vitalsource.com/#/books/9781284155402

Position statement on transforming nursing practice through technology and informatics. (June 16, 2011). Retrieved from https://www.himss.org/sites/himssorg/files/HIMSSorg/handouts/HIMSSNIPositionStatementMonographReport.pdf

Tan, J., & Payton, F. C. (2017).
Adaptive Health Management Information Systems: Concepts, Cases, & Practical Adaptions
(Custom WGU ed.). [Western Governors University]. Retrieved from https://wgu.vitalsource.com/#/books/9781284155396 C791 Advanced Information Management

Nurs 6640 week 2 discussion – Sheehan Disability Scale (SDS) Essay examples

The Sheehan Disability Scale

Assessment tools such as the Sheehan Disability Scale (SDS) are important in helping the PMHNP in assessing the functional status and functional impairment of their clients (Wheeler, 2014). The impact of mental disorders on the clients’ life does not only depend on the diagnosis of the condition but on the disability that the disorder causes (Luciano et al., 2010, p. 896). The SDS is an assessment tool that can be done in the waiting room that focuses on three groups of activities including home management, work abilities, the ability to form and maintain relationships and social life (Luciano et al., 2010, p. 897). Nurs 6640 week 2 discussion – Sheehan Disability Scale (SDS) Essay examples.

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In the case of major depressive disorder (MDD) there are associations between the mental illness and functional impairments in the affected client (Sheehan et al., 2015). The impairment associated with MDD have strong social and economic impacts causing clients to miss work, have a reduction in quality relationships, and an increase in family disruption (Sheehan et al., 2015). The SDS is a validated and accepted measure of functional outcome in clients with MDD with higher scores indicating a greater functional impairment (Sheehan et al., 2015).

Sheehan Disability Tool and Psychopharmacology

Psychopharmacology can be an important part in the client’s recovery process. The prescribing of medications for clients with mental illness is a difficult task because medications could exacerbate symptoms or even mask symptoms. It is important to be able to use a reliable assessment tool such as the SDS to determine if the medications prescribed are effective.  It is important to monitor the client’s progress early in the course of antidepressant treatment using a functional assessment such as the SDS can help clinicians determine whether or not medication adjustments are needed (Soares, Zhang, & Boucher, 2017).  Mental health recovery does not only mean symptom remission but the restoration of functional ability and that is where SDS plays a major rule in medication management. Nurs 6640 week 2 discussion – Sheehan Disability Scale (SDS) Essay examples. The SDS is among the most commonly used function scales in clinical trials of antidepressant treatment of MDD (Soares, Zhang, & Boucher, 2017). The SDS shows great potential to enhance the quality of care for mental health clients and may help clinicians determine sooner than later whether treatment adjustments are needed.

It is important for the PMHNP to understand the assessment tools that are used and their limitations. SDS may help clinicians determine sooner than later whether treatment adjustments are needed (Soares, Zhang, & Boucher, 2017). The SDS can not only be used as a primary assessment tool but can also be used to determine the efficacy of the medications being prescribed. Nurs 6640 week 2 discussion – Sheehan Disability Scale (SDS) Essay examples.

Reference

Luciano, J. V., Bertsch, J., Salvador-Carulla, L., Tomás, J. M., Fernández, A., Pinto-Meza, A., … Serrano-Blanco, A. (2010). Factor structure, internal consistency and construct validity of the Sheehan Disability Scale in a Spanish primary care sample.
Journal of Evaluation in Clinical Practice
,
16
(5), 895-901. doi:10.1111/j.1365-2753.2009.01211.x

Sheehan, D. V., Mancini, M., Wang, J., Berggren, L., Cao, H., Dueñas, H. J., & Yue, L. (2015). Assessment of functional outcomes by Sheehan Disability Scale in patients with major depressive disorder treated with duloxetine versus selective serotonin reuptake inhibitors.
Human Psychopharmacology: Clinical and Experimental
,
31
(1), 53-63. doi:10.1002/hup.2500

Soares, C. N., Zhang, M., & Boucher, M. (2017). Categorical improvement in functional impairment in depressed patients treated with desvenlafaxine.
CNS Spectrums
, 1-11. doi:10.1017/s1092852917000633

Wheeler, K. (2014).
Psychotherapy for the Advanced Practice Psychiatric Nurse, Second Edition
. Springer Publishing Company. Nurs 6640 week 2 discussion – Sheehan Disability Scale (SDS) Essay examples.

 

NURS 6640 Week 2: Assessment and Diagnosis in Psychotherapy Assignment

“A sensitively crafted intake assessment can be a powerful therapeutic tool. It can establish rapport between patient and therapist, further the therapeutic alliance, alleviate anxiety, provide reassurance, and facilitate the flow of information necessary for an accurate diagnosis and appropriate treatment plan.”

—Pamela Bjorklund, clinical psychologist

Whether you are treating patients for physical ailments or clients for mental health issues, the assessment process is an inextricable part of health care. To properly diagnose clients and develop treatment plans, you must have a strong foundation in assessment. This includes a working knowledge of assessments that are available to aid in diagnosis, how to use these assessments, and how to select the most appropriate assessment based on a client’s presentation. Nurs 6640 week 2 discussion – Sheehan Disability Scale (SDS) Essay examples.

This week, as you explore assessment and diagnosis in psychotherapy, you examine assessment tools, including their psychometric properties and appropriate use. You also develop diagnoses for clients receiving psychotherapy and consider legal and ethical implications of counseling these clients. NURS 6640 – Assessment and Diagnosis in Psychotherapy Essay Assignment Papers.

NURS 6640 Week 2: Assessment and Diagnosis in Psychotherapy Assignment

NURS 6640 – Assessment and Diagnosis in Psychotherapy Essay Assignment Papers Learning Resources

NURS 6640 Week 2: Assessment and Diagnosis in Psychotherapy Assignment Required Readings

Wheeler, K. (Ed.). (2014). 
Psychotherapy for the advanced practice psychiatric nurse: A how-to guide for evidence-based practice
 (2nd ed.). New York, NY: Springer Publishing Company.

Chapter 3, “Assessment and Diagnosis” (pp. 95–168)

Chapter 4, “The Initial Contact and Maintaining the Frame” (pp. 169–224)

American Psychiatric Association. (2013). 
Diagnostic and statistical manual of mental disorders
(5th ed.). Washington, DC: Author. NURS 6640 – Assessment and Diagnosis in Psychotherapy Essay Assignment Papers. Nurs 6640 week 2 discussion – Sheehan Disability Scale (SDS) Essay examples

 

Note:
 It is highly recommended that you use this resource as a reference guide throughout the course. You will access this text from the Walden Library databases.

American Academy of Child and Adolescent Psychiatry. (1995). 
Practice parameters for the psychiatric assessment of children and adolescents
. Washington, DC: Author. Retrieved from https://www.aacap.org/App_Themes/AACAP/docs/practice_parameters/psychiatric_assessment_practice_parameter.pdf

American Psychiatric Association. (2016). 
Practice guidelines for the psychiatric evaluation of adults
 (3rd ed.). Arlington, VA: Author. Retrieved from http://psychiatryonline.org/doi/pdf/10.1176/appi.books.9780890426760

Walden Library. (2017). NURS 6640 week 2 discussion guide. Retrieved from http://academicguides.waldenu.edu/nurs6640week2discussion

Walden University. (n.d.). Tests & measures: Home. Retrieved February 6, 2017, from http://academicguides.waldenu.edu/library/testsmeasures

Note:
This database may be helpful in obtaining assessment tool information for this week’s Discussion. Nurs 6640 week 2 discussion – Sheehan Disability Scale (SDS) Essay examples

NURS 6640 Week 2: Assessment and Diagnosis in Psychotherapy Assignment Required Media

Laureate Education (Producer). (2015a). Counseling competencies—The application of ethical guides and laws to record keeping [Video file]. Baltimore, MD: Author.

Provided courtesy of the Laureate International Network of Universities.

 

Note:
 The approximate length of this media piece is 23 minutes.

NURS 6640 Week 2: Assessment and Diagnosis in Psychotherapy Assignment Discussion: Assessment Tools

Assessment tools have two primary purposes: 1) to measure illness and diagnose clients, and 2) to measure a client’s response to treatment. Often, you will find that multiple assessment tools are designed to measure the same condition or response. Not all tools, however, are appropriate for use in all clinical situations. You must consider the strengths and weaknesses of each tool to select the appropriate assessment tool for your client. For this Discussion, as you examine the assessment tool assigned to you by the Course Instructor, consider its use in psychotherapy. Nurs 6640 week 2 discussion – Sheehan Disability Scale (SDS) Essay examples.

Learning Objectives

Students will:

Analyze psychometric properties of assessment tools

Evaluate appropriate use of assessment tools in psychotherapy

Compare assessment tools used in psychotherapy

Note:
 By Day 1 of this week, the Course Instructor will assign you to an assessment tool that is used in psychotherapy.

To prepare:

Review this week’s Learning Resources and reflect on the insights they provide.

Consider the asessment tool assigned to you by the Course Instructor.

Review the Library Course Guide in your Learning Resources for assistance in locating information on the assessment tool you were assigned.

Note:
 For this Discussion, you are required to complete your initial post before you will be able to view and respond to your colleagues’ postings. Begin by clicking on the “Post to Discussion Question” link and then select “Create Thread” to complete your initial post. Remember, once you click Submit, you cannot delete or edit your own posts, and cannot post anonymously. Please check your post carefully before clicking 
Submit! Nurs 6640 week 2 discussion – Sheehan Disability Scale (SDS) Essay examples

By Day 3

Post
 an explanation of the psychometric properties of the assessment tool you were assigned. Explain when it is appropriate to use this assessment tool with clients, including whether the tool can be used to evaluate the efficacy of psychopharmacologic medications. Support your approach with evidence-based literature. NURS 6640 – Assessment and Diagnosis in Psychotherapy Essay Assignment Papers.

Read
 a selection of your colleagues’ responses.

By Day 6

Respond
 to at least 
two
 of your colleagues by comparing your assessment tool to theirs.

Submission and Grading Information

Grading Criteria

To access your rubric:

Week 2 Discussion Rubric

Post by Day 3 and Respond by Day 6

To participate in this Discussion:

Week 2 Discussion

 

The assessment tool that I will use for assessing my client will be the Sheehan Disability Scale (SDS). This tool important for the PMHNP to assess the functional status and functional impairment for the clients during assessment (Wheeler, 2014). In client’s life, the impact that the mental illness cause does not just depend on the diagnosing of the condition but also on the disorder that causes disability. This tool can also be useful in the waiting room for assessment which depends on three different groups of programing such as management at home, abilities to work, and ability for a client to have a relationship and maintain it and social life. With clients with major depressive disorder (MDD), the client is effected by the mental illness and functional impairments (Sheehan et al., 2015). These impairments are associated client with MDD have impact on their social and economic affecting their work, having low quality of friendship, and has an increase in disrupting their family.

Sheehan Disability Scale and Psychopharmacology

Psychopharmacology is necessary during client’s process of recovery as a part of treatment for mental illness. For providers to prescribe medications for a mental illness client is very difficult because some medications can cause the illness to be worst or even mask the symptoms. SDS tool plays a very important part in making sure the medications prescribed by the provider will be effective. The provider needs to monitor the progress of the client’s antidepressant regimen by using the functional assessment such as the SDS to find out if the medication is working or need to be adjusted (Soares, Zhang, & Boucher, 2017). SDS plays an important role in medication management for mental illness recovery not only to symptom remission but also to restore the functional ability of the client. This tool is the only tool used in clinical trials for function scales of the antidepressant regimen and it showed a great potential in enhancing the quality of care the providers care for mental illness clients and helps the clinician in determining treatment sooner if it needs to be adjusted or not than waiting for later.

The PMHNP needs to know the and understand the assessment tools used, also know their limit but can be used the primary tool use to determine the efficacy of the medications that the provider is prescribing.

 

References;

Hodgins, D. C. (2013). Reliability and validity of the Sheehan Disability Scale modified for pathological gambling. BMC Psychiatry, 13177. doi:10.1186/1471-244X-13-177

 

Luciano, J. V., Bertsch, J., Salvador-Carulla, L., Tomás, J. M., Fernández, A., Pinto-Meza, A., … Serrano-Blanco, A. (2010). Factor structure, internal consistency and construct validity of the Sheehan Disability Scale in a Spanish primary care sample. Journal of Evaluation in Clinical Practice, 16(5), 895-901. doi:10.1111/j.1365-2753.2009.01211.x

Sheehan, D. V., Mancini, M., Wang, J., Berggren, L., Cao, H., Dueñas, H. J., & Yue, L. (2015). Assessment of functional outcomes by Sheehan Disability Scale in patients with major depressive disorder treated with duloxetine versus selective serotonin reuptake inhibitors. Human Psychopharmacology: Clinical and Experimental, 31(1), 53-63. doi:10.1002/hup.2500

Soares, C. N., Zhang, M., & Boucher, M. (2017). Categorical improvement in functional impairment in depressed patients treated with desvenlafaxine. CNS Spectrums, 1-11. doi:10.1017/s1092852917000633

Wheeler, K. (2014). Psychotherapy for the Advanced Practice Psychiatric Nurse, Second Edition. Springer Publishing Company. Nurs 6640 week 2 discussion – Sheehan Disability Scale (SDS) Essay examples

SHEEHAN, D. V., GASIOR, M., MCELROY, S. L., RADEWONUK, J., HERMAN, B. K., & HUDSON, J. (2018). Effects of Lisdexamfetamine Dimesylate on Functional Impairment Measured on the Sheehan Disability Scale in Adults With Moderate-tosevere Binge Eating Disorder: Results from Two Randomized, Placebo-controlled Trials. Innovations In Clinical Neuroscience, 15(5/6), 22-29. Nurs 6640 week 2 discussion – Sheehan Disability Scale (SDS) Essay examples

Nurs 6551 Week 1 Discussion – Political, Social, and Sociocultural Influences on Women’s Health Sample Essays

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

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

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To prepare:

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

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

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

·        Reflect on how the personal perceptions of providers might influence their ability or willingness to care for women in relation to this issue.

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

1.     pick on subject from above

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

3.     social factors of this women’s health issue

4.     sociocultural factors on this women’s health issue

5.     Explain how personal perceptions of providers might influence their ability or willingness to care for women in relation to this issue. Nurs 6551 Week 1 Discussion – Political, Social, and Sociocultural Influences on Women’s Health Sample Essays

Resource

Schuiling, K. D., & Likis, F. E. (2013).
Women’s gynecologic health
(2nd ed.). Burlington, MA: Jones and Bartlett Publishers

 

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

To prepare FOR NURS 6551 Week 1 Discussion:

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

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

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

Reflect on how the personal perceptions of providers might influence their ability or willingness to care for women in relation to this issue.

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

1.     pick on subject from above

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

3.     social factors of this women’s health issue

4.     sociocultural factors on this women’s health issue

5.     Explain how personal perceptions of providers might influence their ability or willingness to care for women in relation to this issue.

NURS 6551 Week 1 Discussion Resource

Schuiling, K. D., & Likis, F. E. (2013). 
Women’s gynecologic health
 (2nd ed.). Burlington, MA: Jones and Bartlett Publishers

NURS 6551 Week 9 Discussion

To prepare Assignment 1: Application – Comprehensive Patient Assessment ON Abnormal Uterine Bleeding

Reflect on your Practicum Experience and select a female patient whom you have examined with the support and guidance of your Preceptor. Nurs 6551 Week 1 Discussion – Political, Social, and Sociocultural Influences on Women’s Health Sample Essays

Think about the details of the patient’s background, medical history, physical exam, labs and diagnostics, diagnosis, treatment and management plan, as well as education strategies and follow-up care.

To complete

Write an 8- to 10-page comprehensive 
soap Note paper on
 
Abnormal Uterine Bleeding
 , that addresses the following:

Age, race and ethnicity, and partner status of the patient

Current health status, including chief concern or complaint of the patient

Contraception method (if any)

Patient history, including medical history, family medical history, gynecologic history, obstetric history, and personal social history (as appropriate to current problem)

Review of systems

Physical exam

Labs, tests, and other diagnostics

Differential diagnoses

Management plan, including diagnosis, treatment, patient education, and follow-up care.

References

Schuiling, K. D., & Likis, F. E. (2013). 
Women’s gynecologic health
 (2nd ed.). Burlington, MA: Jones and Bartlett Publishers.

Chapter 5, “Gynecologic Anatomy and Physiology” (pp. 81–101)

Chapter 6, “Gynecologic History and Physical Examination” (pp. 103–131)

Tharpe, N. L., Farley, C., & Jordan, R. G. (2013).
 Clinical practice guidelines for midwifery & Women’s health
 (4th ed.). Burlington, MA: Jones & Bartlett Publishers.

Chapter 6, “Care of the Well Woman Across the Life Span

“Preventive Health Care for Well Women” (pp. 263–265)

. Retrieved from 
http://www.womenshealth.gov/screening-
tests-and-vaccines/screening
-tests-for-women/
Screening tests and vaccines
U.S. Department of Health and Human Services. (2012b). Care of the Well Woman: Health Assessment and Screening” (pp. 265–270)

Society for Reporoductive Endocrinology and Infertility. (2012). Abnormal uterine bleeding. Retrieved from 
http://www.socrei.org/BOOKLET_abnormal_uteine_bleeding/
Taran, F. A., Stewart, E. A., & Brucker, S. (2013). Adenomyosis: Epidemiology, risk factors, clinical phenotype and surgical and interventional alternative to hysterectomy. 
Geburtshilfe Frauenheilkunde, 73
(9), 924-931. Nurs 6551 Week 1 Discussion – Political, Social, and Sociocultural Influences on Women’s Health Sample Essays

Nurs 6640 week 1 discussion Post Response

Great post Daniel on the cultural beliefs effect psychotherapy. I agree when you said that it is important that the PMHNP needs to be culturally competent and aware of the different stigmas that culture can play on the perception of psychotherapy. The concept of cultural competence is especially true when dealing with the Navajo nation because even the use of the word “belief’ can cause problem because of the way their culture interprets its meaning. The Navajo regard psychotherapy as a practice pertaining to illness and healing and the terminology used becomes important (Lewis-Fernández, 2011, p. 5). When the word belief is applied to aspects of therapy it carries the connotation of falsehood, instead of saying what is your belief on mental illness and psych therapy one should use the terms values, attitudes on, view, but never beliefs (Lewis-Fernández, 2011, p. 6). Nurs 6640 week 1 discussion Post Response

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The feeling of shared cultural beliefs and values plays an important role in psychotherapy. If a client feels that you do not understand where they are coming from because of cultural differences, it can cause negative effects. There are some studies that show that ethnically similar clients and therapists can result in more favorable outcomes. The increase in more favorable outcomes could be because the ethnic minority clients may view ethnically similar psychotherapists as a more credible source of help because the assume a shared culture or values (Meyer & Zane, 2013, p. 3).

Through your research have you found any data that supports racial matching of clients causing more favorable outcomes? Do you think that racial matching is appropriate in todays society? Nurs 6640 week 1 discussion Post Response. Again Daniel this was a very informative post and I look forward to reading more from you in the future.

 

Reference

Lewis-Fernández, R. (2011). Commentary on “Elements of Psychotherapy in Navaho Religion”: A Perspective from Contemporary Cultural Psychiatry.
Psychiatry: Interpersonal and Biological Processes
,
74
(4), 293-300. doi:10.1521/psyc.2011.74.4.293

Meyer, O. L., & Zane, N. (2013). THE INFLUENCE OF RACE AND ETHNICITY IN CLIENTS’ EXPERIENCES OF MENTAL HEALTH TREATMENT.
Journal of Community Psychology
,
41
(7), 884-901. doi:10.1002/jcop.21580. Nurs 6640 week 1 discussion Post Response

Human papilloma virus (HPV) vaccine Essay – Nurs 6551 Week 1 Discussion – Political, Social, and Sociocultural Influences on Women’s Health

NURS 6551

Week 1 Discussion

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

Human papilloma virus (HPV) vaccine

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

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Political impact

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

Social impact

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

Sociocultural factors

In todays society there is a movement that is supportive of greater involvement by teens in their health and wellness. However, there are still large groups of  parents that appear to make the decision about receiving the vaccine. Some parents do discuss the vaccine with their children, and there has been evidence that a higher number of teens are being vaccinated when given the choice themselves (Gilkey,  Moss, Coyne-Beasley, Hall, Shah, & Brewer, 2015). Parents understanding benefits of the HPV vaccine and decreasing the risk of cervical cancer was limited. There are government sponsored programs that  have increased awareness and helped society to understand the medical and preventative benefits of receiving the vaccine. Human papilloma virus (HPV) vaccine Essay – Nurs 6551 Week 1 Discussion – Political, Social, and Sociocultural Influences on Women’s Health

Providers influence

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

Reference

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

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

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

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

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

Sussman, A. L., Helitzer, D., Bennett, A., Solares, A., Lanoue, M., & Getrich, C. M. (2015).        Catching Up With the HPV Vaccine: Challenges and Opportunities in Primary Care.  
Annals Of Family Medicine,
13(4), 354-360. doi:10.1370/afm.1821 Human papilloma virus (HPV) vaccine Essay – Nurs 6551 Week 1 Discussion – Political, Social, and Sociocultural Influences on Women’s Health

 

Human Papilloma Virus

Human Papilloma Virus (HPV) is transmitted through close intimate contact with another individual carrying the disease and is known as the most common sexually transmitted disease according to the Centers for Disease Control and Prevention (CDC). (CDC, 2016).  Unfortunately, this condition can remain asymptomatic permitting the spread of the virus to others (Shuiling & Likis, 2017).  The virus is transmitted via sexual intercourse with a person having infected genitals, oropharynx, as well as anal.  HPV  is found during routine screening with Papanicolaou (PAP) smear which determines abnormal cells present to the cervix (CDC, 2016).  These abnormal cells frequently return to normal over a period of time, however, with some persons these cells may turn into cancer (CDC, 2016).  Unresolved lesions can lead to cancer of the cervix, vagina, penis, anus, and the oropharynx (Sasaki et al., 2017).  Nearly 70% of cervical cancer is caused by HPV 16 and 18 along with HPV 6 and 11 have been determined to cause genital warts and laryngeal papillomatosis (Sasaki et al., 2017).

Political Impact

In 2006 the U. S. Food and Drug Administration (FDA) approved the first HPV vaccine to prevent or reduce the incidence of cervical, vaginal, vulvar, penile, anal, and oropharyngeal related cancers (Keim-Malpass et al., 2017).  Unfortunately, the completion of the three-vaccination series lags far behind the Healthy People 2020 goal of 80% of males and females aged 13-15 years of age (Office of Disease Prevention and Health Promotion, 2016).

Social and Sociocultural Factors

According to Rossi, Baldacchini, and Ronco (2014), women from lower socioeconomic status along with others in disadvantaged groups had less knowledge regarding HPV and cervical cancer risks than more affluent women.  Rossi et al. (2014) also found that unvaccinated women are also underscreened for HPV.  Furthermore, Rossi et al. (2014) felt the introduction of the HPV self-testing may increase screening however inequalities continue to exist as the cost is prohibitive with some groups of at-risk women.  Rossi et al. (2014), felt HPV self-screening would increase population coverage, participation, and compliance to preventing disease transmission along with the development of newer technology in self-sampling innovation. Rossi et al. (2014) go on to say in population-based randomized trials have indicated that screening with an HPV test has greater effectiveness than the Pap test in decreasing the incidence of cervical cancer along with mortality.   There are many government-sponsored programs to increase HPV awareness to assist the public in understanding the medical and preventative benefits of utilizing vaccines to prevent cancer. Human papilloma virus (HPV) vaccine Essay – Nurs 6551 Week 1 Discussion – Political, Social, and Sociocultural Influences on Women’s Health

Provider Influence

The conversation between the provider, parent, and adolescent can be tricky.  Clark et al. (2016) found in a national study that communication and support for the HPV vaccine were not consistently recommended due to long and in-depth conversations.  A recent personal experience during a pediatric practicum, the pediatrician, routinely did not routinely recommend the HPV vaccine to adolescents unless it was felt the family and patient exhibited ‘at risk’ behaviors.  To increase the national goal of HPV vaccination, it will be essential to eliminate provider barriers to recommending vaccination in the clinical setting (Warner et al., 2017).

References

Centers for Disease Control and Prevention (CDC).  (2016).  Human Papillomavirus (HPV).

Retrieved from cdc.gov/hpv/parents/whatishpv.html

Keim-Malpass, J., Mitchell, E. M., DeGuzman, P. B., Stoler, M. H., & Kennedy, C. (2017).

Legislative activity related to the human papillomavirus (HPV) vaccine in the United States (2006-2015): A need for evidence-based policy. 
Risk Managed Healthcare Policy, 10,
29-32. doi: 10.2147/RMHP.S128247

Office of Disease Prevention and Health Promotion.  (2016).  HPV vaccine, adolescents 2008-

(2016). In
Healthy People 2020.
Retrieved from https://www.healthypeople.gov/ 2020/topics-objectives/topic/hpv/vaccines.

Rossi, P. G., Baldacchini, F., & Ronco, G. (2014).  The possible effects on socio-economic

inequalities of introducing HPV testing as primary test in cervical cancer screening programs. 
Frontiers in Oncology, 4
, 20. doi: 10.3389/fronc.2014.00020 Human papilloma virus (HPV) vaccine Essay – Nurs 6551 Week 1 Discussion – Political, Social, and Sociocultural Influences on Women’s Health

Sasaki, Y., Iwanari, O., Arakawa, I., Moriya, T., Mikami, Y., Iihara, K., & Konno, R. (2017).

Cervical cancer screening with human papillomavirus DNA and cytology in Japan. 
International Journal of Gynecological Cancer, 27
(3), 523-529. doi: 10.1097/IGC. 000000000000000898

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

Jones and Bartlett Publishers

Warner, E. L., Ding, Q., Pappas, L., Bodson, J., Fowler, B., Mooney, R., Kirchhoff, A. C., &

Kepka, D. (2017).  Health care providers’ knowledge of HPV vaccination, barriers, and strategies in a state with low HPV vaccine receipt:  Mixed-methods study. 
JMIR Caner, 3
(2), e12.  doi: 10.2196/cancer.7345 Human papilloma virus (HPV) vaccine Essay – Nurs 6551 Week 1 Discussion – Political, Social, and Sociocultural Influences on Women’s Health

NURS 6512 Week 1 Discussion

Understanding the Individual

The provider who can build a rapport and earn the trust of a patient will meet less resistance when gathering information for a health history.  It is important to look at the whole person, considering factors that could influence the patient’s overall health such as occupation, culture, ethnicity, and socioeconomic status (Ball, Dains, Flynn, Solomon, & Stewart,2015).  The purpose of this discussion is to identify techniques in building a health history for a 76-year-old Black man, with disabilities that lives in an urban area.

Factors for Consideration

At 76, even with known disabilities, the patient has probably outlived many in his community as the life expectancy of the American Black male, is just over 72 years of age (Arias, Heron & XU,2016).  The African-American patient might not trust health care providers based on a history of isolation and exploitation (Watts, 2003).  Until the middle of the last century, health care was often segregated, and those of African heritage were not afforded the same consideration as those of European descent (Watts,2003). The construction of a health history requires the provider to be sensitive to patient feelings and perceptions related to health care. NURS 6512 Week 1 Discussion

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The Assessment

The collection and analysis of information regarding an individual’s current and overall health is a health assessment (Ball, Dains, Flynn, Solomon, & Stewart,2015). The information provided by the individual is subjective (Ball, Dains, Flynn, Solomon, & Stewart,2015).  Due to the personal nature of the information, a patient provides it is crucial a practitioner observes and completes a physical examination providing objective data to the health assessment and the completion of the individual’s health history.  Physical exams should include inspection, auscultation, percussion, and palpation of the patient to verify the patients report objectively (Ball, Dains, Flynn, Solomon, & Stewart,2015).  A functional assessment helps to provide an understanding of an individual’s ability to perform activities of daily living (Ball, Dains, Flynn, Solomon, & Stewart,2015).  A functional assessment is particularly useful in elderly patients and those with documented disabilities. The presence of physical, cognitive and emotional limitations may restrict independence and identify areas where assistance is needed (Ball, Dains, Flynn, Solomon, & Stewart,2015). NURS 6512 Week 1 Discussion

Targeted Questions

Asking appropriate questions and avoiding stereotypes is essential to providing care that is tailored to the individual (Ball, Dains, Flynn, Solomon, & Stewart,2015).   Questions should be open ended and asked in a manner that is easily understood.  Possible targeted questions are: What brought you in to be seen today?  What kind of problems have been caused by your illness or condition?  Has this illness limited your ability to do things in your home?  Have you experienced any falls?  Do you have help available if you need it?  The questions should be relevant to the patient’s situation, so knowing if they live alone, with family or in a facility affects the types of questions asked.

Conclusion

Providing quality individualized care requires a provider to understand factors outside of the pathophysiology of illness, disease or condition. NURS 6512 Week 1 Discussion A successful interview develops the patient- provider relationship and builds trust.  Take the time to listen to your patients, and they will do the same for you.

References:

Arias E, Heron M, Xu JQ. (2016). United States life tables, 2012. National vital statistics reports;

vol 65 no 8. Hyattsville, MD: National Center for Health Statistics.

Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2015). Seidel’s guide to

physical examination (8th ed.). St. Louis, MO: Elsevier Mosby. NURS 6512 Week 1 Discussion

 

Watts, R., (January 31, 2003). “Race Consciousness and the Health of African

Americans”. Online Journal of Issues in Nursing. Vol. 8 No. 1.  Retrieved from:

http://www.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/

OJIN/TableofContents/Volume82003/No1Jan2003/RaceandHealth.html NURS 6512 Week 1 Discussion

NURS 6050 week 1 discussion

Patient Scenario

A 30-year-old, Caucasian female presented to the emergency room complaining of severe epigastric and right upper quadrant (RUQ) pain, nausea, vomiting, and fever. Her medical history is only significant for irritable bowel syndrome and endometriosis. The only medication the patient takes is a birth control pill daily. The patient stated that the pain started about four hours ago, but has steadily increased. She denies any significant changes in her diet or recent abdominal injuries but says she has eaten a lot more over the past week because of the Thanksgiving holiday. The patient says she is very busy between working and taking her kids to after school activities, so they often eat fast food and she requires a lot of caffeine throughout the day, so she doesn’t drink much water. Upon physical examination, bowel sounds present in all four quadrants, RUQ guarding, tenderness noted to entire abdomen upon palpation, no rebound tenderness, but Murphy’s sign was positive.

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Impacting Factors

This patient is suffering from cholelithiasis (gallstones) with an influencing factor of behavior, specifically because of dietary habits. Cholelithiasis is the process of gallstones forming (Pak & Lindseth, 2016). “Gallstones are hardened deposits of digestive fluid that can form in your gallbladder” (Mayo Clinic, 2013). Some impacting factors to this disorder are: being female, eating a high-fat, high cholesterol, low-fiber diet, and taking medications that contain estrogen (Mayo Clinic, 2013). The patient admits to eating fast food frequently which typically means the food she is eating is high in fat, high in cholesterol, and low in fiber. She also said she took a birth control pill daily. A majority of birth control pills contain estrogen and progesterone to prevent pregnancy. NURS 6050 week 1 discussion

Pathophysiology and Associated Alterations

There are two common types of gallstones: cholesterol and pigmented. “Most are composed largely of cholesterol with or without calcium deposits” (Hammer & McPhee, 2014). Cholesterol gallstones form when the cholesterol concentration in the bile is greater than its solubility percentage (Hammer & McPhee, 2014). Having a higher percentage of cholesterol causes cholesterol crystals to form called “microstones” (Huether & McCance, 2012). More crystals collect on the microstones, growing “macrostones” (Huether & McCance, 2012). This process occurs in the gallbladder because of decreased motility. “The stones may lie dormant or become lodged in the cystic or common duct, causing pain when the gallbladder contracts and cholecystitis” (Huether & McCance, 2012). If cholecystitis occurs and is left untreated, it can progress to acute pancreatitis “if a stone travels down the common bile duct but fails to clear the sphincter of Oddi, thereby blocking the pancreatic duct” (Hammer & McPhee, 2014). An infection and necrosis may also occur if the gallbladder is left untreated, putting the patient at risk of becoming septic (Hammer & McPhee, 2014). NURS 6050 week 1 discussion

References

Hammer, G. D., & McPhee, S. J. (2014).
Pathophysiology of Disease: An Introduction to Clinical Medicine
(Seventh ed.). New York, NY: McGraw Hill Education.

Huether, S. E., & McCance, K. L. (2012).
Understanding Pathophysiology
(Fifth ed.). St. Louis, Missouri: Elsevier.

Mayo Clinic. (2013, July 23).
Diseases and Conditions: Gallstones
. Retrieved from Mayo Clinic: http://www.mayoclinic.org/diseases-conditions/gallstones/basics/definition/con-20020461

Pak, M., & Lindseth, G. (2016). Risk Factors for Cholelithiasis.
Gastroenterology Nursing, 39
(4), 297-309. NURS 6050 week 1 discussion

Nurs 6501 Week 1 Discussion – Factors That Influence Disease – Cancer Essay example

Factors That Influence Disease

In clinical settings, some of the most common questions that patients ask are Why do I have this? What caused this disorder? Will it ever go away? These emotional questions can be difficult to ask and to answer. However, for patients to come to terms with their diagnoses and adhere to treatment plans, they must have an understanding of factors that might have caused, or continue to impact, their disorders. As an advanced practice nurse, it is important that you are able to explain disorders, associated alterations and symptoms, and changes that might occur within your patients’ bodies. Nurs 6501 Week 1 Discussion – Factors That Influence Disease – Cancer Essay example

To prepare:

1.      Review this week’s media presentation with Dr. Terry Buttaro. Reflect on the importance of developing an in-depth understanding of pathophysiology.

2.      Select a disorder from the following list:

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a.      Cholelithiasis (gallstones)

b.      Colon cancer

c.      Cystic fibrosis

d.      Hemophilia

e.      Nephrolithiasis (kidney stones)

f.       Osteoporosis

g.     Parkinson’s disease

h.      Tuberculosis

3.      Select one of the following patient factors: genetics, gender, ethnicity, age, or behavior. Reflect on how that factor might impact your selected disorder, as well as potential associated alterations and symptoms.

4.      Identify the pathophysiology of the associated alterations, including the normal and altered cellular function. Consider both intra- and extra-cellular changes that occur. Nurs 6501 Week 1 Discussion – Factors That Influence Disease – Cancer Essay example

Post a 1 page APA format-  (at least 2 references)

1.      A brief description of a patient scenario involving the disorder and the factor you selected.

2.      Explain how the factor might impact your selected disorder, as well as potential associated alterations and symptoms.

3.      Finally, explain the pathophysiology of the associated alterations, including changes in cellular function.

 

Class Resources

·        Huether, S. E., & McCance, K. L. (2012). 
Understanding pathophysiology
 (Laureate custom ed.). St. Louis, MO: Mosby.

o   Chapter 1, “Cellular Biology”

This chapter reviews cellular biology to establish a foundation for exploring the pathophysiology of disease. It also covers the structure and function of cellular components, cell-to-cell adhesions, cellular communication, cellular metabolism, membrane transport, the cell cycle, and tissues.

o   Chapter 2, “Genes and Genetic Diseases”

This chapter explores genetic disorders and factors that impact genetic disorders. It also examines how mutations and chromosomal abnormalities lead to transmission of genetic disorders.

o   Chapter 3, “Altered Cellular and Tissue Biology”

This chapter examines disorders related to cell adaptation, injury, and death. It also explores disorders associated with altered cellular and tissue function as a result of aging. Nurs 6501 Week 1 Discussion – Factors That Influence Disease – Cancer Essay example

·        McPhee, S. J., & Hammer, G. D. (2012). 
Pathophysiology of disease: An introduction to clinical medicine
 
(Laureate Education, Inc., custom ed.). New York, NY: McGraw-Hill Medical.

o   Chapter 2, “Genetic Disease”

This chapter reviews the clinical manifestations, pathophysiology, and genetic principles of genetic diseases. It also explores different types of genetic diseases and the mechanisms involved.

o   Chapter 5, “Neoplasia”

This chapter explores various disorders associated with neoplasia. It also covers causes and effects of common cancers and tumors resulting from neoplasia.

Media

·        Laureate Education, Inc. (Executive Producer). (2012d). 
Introduction to advanced pathophysiology
. Baltimore, MD: Author.

 

Week 1 Discussion

NURS

6501

A 60-year-old male presents to the office complaining of a change in bowel habits, and blood noted in his stool.  The patient is overweight, a smoker, and drinks alcohol on a regular basis.  The patient states he has been having abdominal cramps recently and feels as if he is bloated.  At his last office visit, the patient was recently diagnosed as pre-diabetic.  A family history reveals his sister has breast cancer, and his father died of colon cancer at the age of 57. Nurs 6501 Week 1 Discussion – Factors That Influence Disease – Cancer Essay example

Colon Cancer

Colon cancer is a cancer of the large intestine.  Most diagnosed cases start out as benign adenomatous polyps that produce little to no symptoms ( Mayo Clinic, 2017).  Colorectal cancer (CRC) is the third most common cancer and the fourth leading cause of cancer death worldwide and is diagnosed more frequently in men than women (Majek, Gondos, Jansen, & Emrich, 2013).  Because CRC usually starts out as polyps, it is recommended that patients have a colonoscopy at the age of fifty and regular screenings to obtain a baseline and to identify and remove noted polyps before they turn cancerous (American Cancer Society, 2016).

Pathophysiology

Cancer is the abnormal growth and division of cells that invade other tissues and organs in the body.  A benign tumor can easily turn into a malignant tumor.  Malignant tumors are characterized by rapid cell growth rate, the loss of cell differentiation, and the absence of normal tissue organization.  CRC is thought to have an association with a family history of cancer, environmental factors, and the mutation of tumor suppression genes.  The polyps that are associated with CRC are a protrusion from the mucosal lining of the epithelium and once defined as cancerous, called adenomatous polyps.  The polyps undergo multiple genetic changes that lead to the carcinoma.  CRC has a long pre-invasive timeframe. Tumors grow slowly and have to invade several layers of the epithelium before entering the bloodstream and lymphatic system to metastasize throughout the body (Huether & McCance, 2017). Nurs 6501 Week 1 Discussion – Factors That Influence Disease – Cancer Essay example

Associated Factors

Factors associated with CRC include age (greater than 50), family history, history of colon polyps, obesity, physical inactivity and a diet high in red meats or processed meats.  Smoking, heavy alcohol use, a history of inflammatory bowel disease or Crohn’s disease, diabetes or a previous history of cancer are also risk factors for CRC (American Cancer Society, 2016).  The patient in this scenario is over the age of 50, has a family history of cancer, smokes, and drinks alcohol, and is overweight and pre-diabetic. The patient’s behavioral risk factors put him at higher risk for CRC.  Being overweight, especially in the abdominal girth, and male, greatly increase the chances of developing CRC (American Cancer Society, 2016).  The patient has several preventable modifiable behaviors he can change.

The patient presented with a change in bowel habits, blood in his stool and abdominal discomfort.  The symptoms of CRC usually are seen later in the progression of the disease.  Besides the presented symptoms, other associated symptoms are weakness, fatigue, sudden weight loss, and a feeling of the bowel not emptying completely ( Mayo Clinic, 2017).

Diagnosis and Treatment

Regular screenings should be obtained at the age of 50 for CRC.  Changing modifiable risk factors such as starting a high fiber diet, exercising, smoking cessation, and reduction of alcohol intake decreases potential risk ( Mayo Clinic, 2017).  The staging of CRC is done through imaging and surgical exploration.  Surgery is the recommended treatment in all four stages.  Chemotherapy and radiation may be given to reduce tumor size before surgery. Nurs 6501 Week 1 Discussion – Factors That Influence Disease – Cancer Essay example

It is imperative to have an innate understanding of the disease process and the pathophysiology to correctly diagnose or refer a patient to the correct specialization (Education, 2012).  Many diseases have similar signs and symptoms, if the basic disease process is not understood, a patient could be misdiagnosed.  An advanced practice nurse should be able to differentiate between symptoms, and know why the symptoms occur during the disease process.

References

Mayo Clinic
. (2017, October 31). Retrieved from Mayo Clinic: https://www.mayoclinic.org/diseases-conditions/colon-cancer/…causes/syc-20353669

American Cancer Society
. (2016, October 15). Retrieved from American Cancer Society: http://www.cancer.org

Education, L. (Director). (2012).
Introduction to Advanced Pathophysiology
[Motion Picture].

Huether, S., & McCance, K. (2017).
Understanding Pathophysiology.
St. Louis: Elsevier.

Majek, O., Gondos, A., Jansen, L., & Emrich, K. (2013). Sex Differences in Colorectal Survival.
Plos One, 8
(7), 1-7. Retrieved from http://www.plosone.org Nurs 6501 Week 1 Discussion – Factors That Influence Disease – Cancer Essay example

NURS 6501 Week 3 Discussion Acute, Chronic, and Referred Pain

NURS 6501 Week 3 Discussion Pain

Pain: NURS 6501 Week 3 Discussion examines pain as related to the neurological system. Our expert writers will examine the pathophysiology of acute, chronic, and referred pain as well as their differences and similarities. Further, the impact of genetics, gender, ethnicity, age, or behavior on the the pathophysiology, diagnosis, and prescription of treatment for acute, chronic, and referred pain will also form part of the discussion.So, ORDER NOW for our erudite writers to produce a paper that comprehensively captures the instructions below!

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Pain: NURS 6501 Week 3 Discussion

The neurological system affects all parts and functions of the body through nerve stimulation. Nerves also control the sensation and perception of pain.While pain can be described in a variety of ways, it is essentially labeled according to its duration and source. As an advanced practice nurse evaluating a patient, you need to consider the following questions: Does the pain quickly come and go, or is it persistent and ongoing? Does the pain arise at the source of injury or in another location? In this Discussion, you compare three common types of pain—acute, chronic, and referred. NURS 6501 Week 3 Discussion Acute, Chronic, and Referred Pain

To prepare for Pain: NURS 6501 Week 3 Discussion:

Review this week’s media presentation on the neurological system, as well as Chapter 13 in the Huether and McCance text.

Identify the pathophysiology of acute, chronic, and referred pain. Consider the similarities and differences between these three types of pain.

Select two of the following patient factors: genetics, gender, ethnicity, age, or behavior. Reflect on how the factors you selected might impact the pathophysiology, diagnosis, and prescription of treatment for acute, chronic, and referred pain.

By Day 3  of Pain: NURS 6501 Week 3 Discussion

Post a description of the pathophysiology of acute, chronic, and referred pain, including similarities and differences between them. Then, explain how the factors you selected might impact the pathophysiology, diagnosis, and prescription of treatment for acute, chronic, and referred pain.

Read a selection of your colleagues’ responses.

By Day 6 of Pain: NURS 6501 Week 3 Discussion

Respond to at least two of your colleagues on two different days who selected different factors than you, in the following ways:

Share insights on how your colleague’s factors impact the pathophysiology of pain.

Suggest alternative diagnoses and treatment options for acute, chronic, and referred pain.

Click on the Reply button below to reveal the textbox for entering your message. Then click on the Submit button to post your message. NURS 6501 Week 3 Discussion Acute, Chronic, and Referred Pain

NURS 6501 Week 6 Discussion

Respiratory Alterations

In clinical settings, patients often present with various respiratory symptoms such as congestion, coughing, and wheezing. While identifying a symptom’s underlying illness can be challenging, it is essential because even basic symptoms such as persistent coughing can be a sign of a more severe disorder.Advanced practice nurses must be able to differentiate between moderate and severe respiratory disorders, as well as properly diagnose and prescribe treatment for their patients. For this reason, you must have an understanding of the pathophysiology of respiratory disorders.

Consider the following three scenarios:

Scenario 1:

Ms. Teel brings in her 7-month-old infant for evaluation. She is afraid that the baby might have respiratory syncytial virus (RSV) because she seems to be coughing a lot, and Ms. Teel heard that RSV is a common condition for infants. A detailed patient history reveals that the infant has been coughing consistently for several months. It’s never seemed all that bad. Ms. Teel thought it was just a normal thing, but then she read about RSV. Closer evaluation indicates that the infant coughs mostly at night; and, in fact, most nights the baby coughs to some extent. Additionally, Ms. Teel confirms that the infant seems to cough more when she cries. Physical examination reveals an apparently healthy age- and weight-appropriate, 7-month-old infant with breath sounds that are clear to auscultation. The infant’s medical history is significant only for eczema that was actually quite bad a few months back. Otherwise, the only remarkable history is an allergic reaction to amoxicillin that she experienced 3 months ago when she had an ear infection. NURS 6501 Week 3 Discussion Acute, Chronic, and Referred Pain

Scenario 2:

Kevin is a 6-year-old boy who is brought in for evaluation by his parents. The parents are concerned that he has a really deep cough that he just can’t seem to get over. The history reveals that he was in his usual state of good health until approximately 1 week ago when he developed a profound cough.His parents say that it is deep and sounds like he is barking. He coughs so hard that sometimes he actually vomits. The cough is productive for mucus, but there is no blood in it. Kevin has had a low-grade temperature but nothing really high. His parents do not have a thermometer and don’t know for sure how high it got. His past medical history is negative. He has never had childhood asthma or RSV. His mother says that they moved around a lot in his first 2 years and she is not sure that his immunizations are up to date. She does not have a current vaccination record.

Scenario 3:

Maria is a 36-year-old who presents for evaluation of a cough. She is normally a healthy young lady with no significant medical history. She takes no medications and does not smoke. She reports that she was in her usual state of good health until approximately 3 weeks ago when she developed a “really bad cold.” The cold is characterized by a profound, deep, mucus-producing cough. She denies any rhinorrhea or rhinitis—the primary problem is the cough.She develops these coughing fits that are prolonged, very deep, and productive of a lot of green sputum. She hasn’t had any fever but does have a scratchy throat. Maria has tried over-the-counter cough medicines but has not had much relief. NURS 6501 Week 3 Discussion Acute, Chronic, and Referred Pain. The cough keeps her awake at night and sometimes gets so bad that she gags and dry heaves.

To prepare:

Review the three scenarios, as well as Chapter 26 and Chapter 27 in the Huether and McCance text.

Select one of the scenarios and consider the respiratory disorder and underlying alteration associated with the type of cough described.

Identify the pathophysiology of the alteration that you associated with the cough.

Select two of the following factors: genetics, gender, ethnicity, age, or behavior. Reflect on how the factors you selected might impact the disorder.

By Day 3

Post a description of the disorder and underlying respiratory alteration associated with the type of cough in your selected scenario. Then, explain the pathophysiology of the respiratory alteration. Finally, explain how the factors you selected might impact the disorder.

Read a selection of your colleagues’ responses.

By Day 6

Respond to at least two of your colleagues on two different days who selected a different scenario than you, in one or more of the following ways:

Share insights on how the factor you selected impacts the disorder your colleague identified.

Ask a probing question regarding the disorder that your colleague identified.

Suggest an alternative disorder for the scenario your colleague selected.

Click on the Reply button below to reveal the textbox for entering your message. Then click on the Submit button to post your message.

NURS 6501 Week 3 Quiz (2018): Advanced Pathophysiology -Walden University (Verified answers, Scored A)

NURS 6501 Week 3 Quiz (2018): Advanced Pathophysiology -Walden University • Question 1 A 65-year-old male recently suffered a cerebral vascular accident. He is now unable to recognize and identify objects by touch because of injury to the sensory cortex. How should the nurse document this finding? 
• Question 2 A 15-year-old male is brought to the ER for treatment of injuries received in a motor vehicle accident. An MRI reveals spinal cord injury, and his body temperature fluctuates markedly. The most accurate explanation of this phenomenon is that: • Question 3 A 60-year-old female with a recent history of head trauma and a long-term history of hypertension presents to the ER for changes in mental status. MRI reveals that she had a hemorrhagic stroke. What does the nurse suspect caused this type of stroke? • Question 4 A nurse should document on the chart that chronic pain is occurring when the patient reports the pain has lasted longer than: • Question 5 A 40-year-old male complains of uncontrolled excessive movement and progressive dysfunction of intellectual and thought processes. He is experiencing movement problems that begin in the face and arms that eventually affect the entire body. The most likely diagnosis is: • Question 6 A patient has memory loss of events that occurred before a head injury. What cognitive disorder does the nurse suspect the patient is experiencing? • Question 7 Parents of a 3-month-old infant bring him to the emergency room (ER) after he has had a seizure. He has muscle rigidity, and the parents report they are of Jewish ancestry. For what genetic disease should this infant be screened? • Question 8 When a patient has a fever, which of the following thermoregulatory mechanisms is activated? • Question 9 A 50-year-old male suffers a severe head injury when his motorcycle hits a tree. His breathing becomes deep and rapid but with normal pattern. What term should the nurse use for this condition? • Question 10 A 20-year-old male was at the supermarket when he fell to the ground. NURS 6501 Week 3 Discussion Acute, Chronic, and Referred Pain. Bystanders reported that he lost consciousness and his body tensed up then relaxed, then tensed and relaxed several times. He most likely was experiencing a(n): • Question 11 A teenage boy sustains a severe closed head injury following an all-terrain vehicle (ATV) accident. He is in a state of deep sleep that requires vigorous stimulation to elicit eye opening. How should the nurse document this in the chart? • Question 12 A 15-month-old child from Pennsylvania was brought to the ER for fever, seizure activity, cranial palsies, and paralysis. Which of the following diagnosis will be documented in the chart? • Question 13 A 33-year-old male is brought to the ER for treatment of injuries received in a motor vehicle accident. An MRI reveals an injury of the cervical cord. Cord swelling in this region may be life threatening because: • Question 14 A 72-year-old male demonstrates left-sided weakness of upper and lower extremities. The symptoms lasted 24 hours and resolve with no evidence of infarction. The patient most likely experienced a(n): • Question 15 Which finding indicates the patient is having complications from heat stroke? • Question 16 A 20-year-old male was brought to the emergency room (ER) for severe burns. He requested something for the excruciating pain he was experiencing. Blocking which of the following neurotransmitters would reduce his pain? • Question 17 A nurse thinks a patient may be experiencing dementia. Which assessment finding will most help support this diagnosis? • Question 18 An initial assessment finding associated with acute spinal cord injury is _____ the injury. • Question 19 The nursing student would correctly identify the most common symptom of brain abscess as: • Question 20 An older adult is admitted to the ER following a fall. The patient complains of pain in the back. The patient has a history of osteoporosis. The nurse would expect the patient’s injury and subsequent pain is most likely due to: • Question 21 A 16-year-old male took a recreational drug that altered his level of arousal. Physical exam revealed a negative Babinski sign, equal and reactive pupils, and roving eye movements. Which of the following diagnosis will the nurse most likely see on the chart? • Question 22 A 20-year-old male suffers a severe closed head injury in a motor vehicle accident. He remains in a vegetative state (VS) 1 month after the accident. Which of the following structures is most likely keeping the patient alive? • Question 23 A 23-year-old female begins having problems with tiredness, weakness, and visual changes. Her diagnosis is multiple sclerosis (MS). What is occurring in the patient’s body? • Question 24 A 69-year-old male with a history of alcohol abuse presents to the emergency room (ER) after a month-long episode of headaches and confusion. Based on his alcoholism, a likely cause of his neurologic symptoms is: • Question 25 When planning care for a child in pain, which principle should the nurse remember? The pain threshold in children is _____ that of adults. NURS 6501 Week 3 Discussion Acute, Chronic, and Referred Pain

NURS 6501 – Advanced Pathophysiology Week 1 Quiz

A 12-year-old male is diagnosed with Klinefelter syndrome. His karyotype would reveal which of the following?

XXY

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The nurse is teaching staff about the most common cause of Down syndrome. What is the nurse describing?

Maternal nondisjunction

 

A nurse is discussing the movement of fluid across the arterial end of capillary membranes into the interstitial fluid surrounding the capillary. Which process of fluid movement is the nurse describing?

Hydrostatic pressure

 

What principle should the nurse remember when trying to distinguish aging from disease?

It is difficult to tell the difference because both processes are believed to result from cell injury.

 

What causes the rapid change in the resting membrane potential that initiates an action potential?

Sodium gates open, and sodium rushes into the cell, changing the membrane potential from negative to positive.

 

During childhood, the thymus decreases in size, and this is referred to as _____ atrophy.

Physiologic NURS 6501 – Advanced Pathophysiology Week 1 Quiz

 

Sodium and water accumulation in an injured cell are a direct result of:

Decreased ATP production

 

A 50-year-old male was recently diagnosed with Huntington disease. Transmission of this disease is associated with:

Delayed age of onset

 

 

What is the diagnosis of a 13-year-old female who has a karyotype that reveals an absent homologous X chromosome with only a single X chromosome? Her features include a short stature, widely spaced nipples, reduced carrying angle at the elbow, and sparse body hair.

Turner Syndrome

 

What is the role of cytokines in cell production?

Provide growth factor for tissue growth and development

 

A eukaryotic cell is undergoing DNA replication. In which region of the cell would most of the genetic information be contained?

Nucleolus

 

A patient has severe mental retardation caused by a deletion of part of chromosome 5. What genetic disorder will the nurse see documented in the chart?

Cri du chat syndrome NURS 6501 – Advanced Pathophysiology Week 1 Quiz

 

The student is reviewing functions of the cell. The student would be correct in identifying the primary function of the nerve cell as:

Communication

 

How are potassium and sodium transported across plasma membranes?

By adenosine triphosphate enzyme (ATPase)

 

After a geneticist talks to the patient about being a chromosomal mosaic, the patient as the nurse what that means. How should the nurse respond?  You may ____ genetic disease(s).

Have a mild form of the

 

A runner has depleted all the oxygen available for muscle energy. Which of the following will facilitate his continued muscle performance? NURS 6501 – Advanced Pathophysiology Week 1 Quiz

Anaerobic glycolysis

 

A patient who has diarrhea receives a hypertonic saline solution intravenously to replace the sodium and chloride lost in the stool. What effect will this fluid replacement have on cells?

Cells will shrink

 

A patient has a heart attack that leads to progressive cell injury that causes cell death with severe cell swelling and breakdown of organelles. What term would the nurse use to define this process?

Necrosis

 

A nurse reading the chart and sees the term oncotic pressure. The nurse recalls that oncotic pressure (colloid osmotic pressure) is determined by:

Plasma proteins

 

An aide asks the nurse why people who have neurofibromatosis will show varying degrees of the disease. Which genetic principle should the nurse explain to the aide?

Expressivity

 

A cell is isolated, and electrophysiology studies reveal that the resting membrane potential is -70 millivolts. The predominant intracellular ion is Na+, and the predominant extracellular ion is K+.  With voltage change, which of the following would result in an action potential?

Na+ rushing into the cell

 

A 13-year-old girl has a karyotype that reveals an absent homologous X chromosome with only a single X chromosome present. What medical diagnosis will the nurse observe in the chart?

Turner syndrome

 

A 15-year-old female is diagnosed with Prader-Willi syndrome. This condition is an example of:

Gene imprinting

 

A 55-year-old male with a 30-year history of smoking is examined for respiratory disturbance. Examination of his airway (bronchial) reveals that stratified squamous epithelial cells have replaced the normal columnar ciliated cells.  This type of cellular adaptation is called:

Metaplasia

 

A group of prison inmates developed tuberculosis following exposure to an infected inmate. On examination, tissues were soft and granular (like clumped cheese).  Which of the following is the most likely cause?

Caseous necrosis NURS 6501 – Advanced Pathophysiology Week 1 Quiz