Discuss the Nursing care of age-related Physiologic or Psychologic Disorder.

1. Present the age-related Physiologic or Psychologic Disorder
   Choose from one: Integumentary function, Urinary function, Musculoskeletal function or Endocrine function.
2. Describe the age-related changes and common problems and conditions.
3. Summarize the nursing management appropriate for your Physiologic or Psychologic Disorder chosen

Submission Instructions:

• Presentation is original work and logically organized. 
• Followed current APA format including citation of references.
• Power point presentation with 4-6 slides were clear and easy to read. Speaker notes expanded upon and clarified content on the slides.
• Incorporate a minimum of 4 current (published within last five years) scholarly journal articles or primary legal sources (statutes, court opinions) within your work.
• Journal articles and books should be referenced according to current APA style.

Identify two operating indicators and explain how they may supplement a ratio analysis using financial data.  How would you interpret the operating indicators? 

2 paragraphs

two discussion same topic different words

Using resources such as the CDC, state and county health department websites, and various local resources, identify an opportunity for improved health behavior in an individual client. Your paper should be 1 – 2 pages in length in addition to the cover page and reference page. You should use a minimum of three references to support your work.

Be sure to cover the following:

• Identify an opportunity to for improved health behavior in an individualized client.
• Identify short and long term goals for the achievement of the overall health goal.
• Using Healthy People 2020, identify which problem you are working on improving.
• Recognize local resources to aid in the resolution of the identified problem.
• Assist in the evaluation in the response to interventions.

4 replies base in the PowerPoint slice

In your role, you must understand group processes and stages of formation, as this will help you develop groups and determine an individual’s appropriateness for group therapy. Whether you are at the beginning stages of group formation or facilitating a session for a developed group, it is important to consider factors that may influence individual client progress. For this Assignment, as you examine the video Group Therapy: A Live Demonstration in this week’s Learning Resources, consider the group’s processes, stages of formation, and other factors that might impact the effectiveness of group therapy for clients.

Learning Objectives

Students will:

• Analyze group processes and stages of formation
• Analyze curative factors of groups
• Analyze the impact of curative factors on client progress
• Recommend strategies for managing intragroup conflict

To prepare:

• Review this week’s Learning Resources and reflect on the insights they provide on group processes.
• View the media, Group Therapy: A Live Demonstration, and consider the group dynamics.

The Assignment

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

• Explain the group’s processes and stage of formation.
• Explain curative factors that occurred in the group. Include how these factors might impact client progress.
• Explain intragroup conflict that occurred and recommend strategies for managing the conflict. Support your recommendations with evidence-based literature.

 HA3300D – Healthcare Policy and Ethics

Discussion 08: Harassment

Discussion 

In Chapter 10 of your textbook, you explored the relationship between organizational culture and ethics. Keep this reading in mind as you respond to the following case study:

You are the director of a radiology department. During a routine individual meeting with one of your male staff, the employee tells you that a female employee has been making suggestive remarks to him, and occasionally grabbed and fondled him in a sexual manner. He said he asked her several times to stop this behavior as he was married and did not appreciate the behavior, particularly in a work setting. The behavior continued anyway. The male employee asks you not to report this further because he did not want to get the female employee in trouble and he brought it up only for ideas how to make her stop it.

Consider these questions in your 8 – 10 sentence discussion board post:

.What are your ethical obligations?

.What ethical theories apply to your situation, and why?

.Does the work of Carol Gilligan change how we should respond in this scenario? Why or why not?

Your initial post should be a minimum of 8 – 10 sentences and include an APA-style references list to ensure full credit.

 PLEASE FOLLOW THE INSTRUCTION BELOW

5 REFERENCES

ZERO PLAGIARISM

earning Objectives

Students will:

• Assess progress for clients receiving psychotherapy
• Differentiate progress notes from privileged notes
• Analyze preceptor’s use of privileged notes

To prepare:

• Reflect on the client you selected for the Week 3 Practicum Assignment.
• Review the Cameron and Turtle-Song (2002) article in this week’s Learning Resources for guidance on writing case notes using the SOAP format.

The Assignment

Part 1: Progress Note

Using the client from your Week 3 Assignment, address the following in a progress note (without violating HIPAA regulations):

• Treatment modality used and efficacy of approach
• Progress and/or lack of progress toward the mutually agreed-upon client goals (reference the Treatment plan—progress toward goals)
• Modification(s) of the treatment plan that were made based on progress/lack of progress
• Clinical impressions regarding diagnosis and/or symptoms
• Relevant psychosocial information or changes from original assessment (i.e., marriage, separation/divorce, new relationships, move to a new house/apartment, change of job, etc.)
• Safety issues
• Clinical emergencies/actions taken
• Medications used by the patient (even if the nurse psychotherapist was not the one prescribing them)
• Treatment compliance/lack of compliance
• Clinical consultations
• Collaboration with other professionals (i.e., phone consultations with physicians, psychiatrists, marriage/family therapists, etc.)
• Therapist’s recommendations, including whether the client agreed to the recommendations
• Referrals made/reasons for making referrals
• Termination/issues that are relevant to the termination process (i.e., client informed of loss of insurance or refusal of insurance company to pay for continued sessions)
• Issues related to consent and/or informed consent for treatment
• Information concerning child abuse, and/or elder or dependent adult abuse, including documentation as to where the abuse was reported
• Information reflecting the therapist’s exercise of clinical judgment

The Occupational Safety and Health Administration (OSHA), the Centers for Medicaid and Medicare Services (CMS), and the Joint Commission (JC) require that health care organizations maintain risk management programs to address infection control. Detail three measures that your health care organization (or any health care organization) could implement, beyond what is currently in practice, to support the delivery of safe health care services and avoid the spread of infection (e.g., placing hand washing devices at all of the public entrances of the health care facility). Support your response with a minimum of two peer-reviewed references.

Your responses should be in a well-developed paragraph (300-350 words) to each peer. Integrating an evidence-based resource that is different than the one you used for the initial post.

Respectfully agree and disagree with your peers’ responses and explain your reasoning by Including your rationales in your explanation.

The described expectations meet the passing level of 80%. Students are directed to review the Discussion Grading Rubric for criteria, which exceed expectations.

APA format references , atleast 2 each.

Response 1 

1. What lifestyle modifications do you recommend for CF?

It is crucial to educate and reassure CF. Perhaps if he understood how his choices affect the discomfort he is having, he would be more likely to adhere to the suggested treatment plan. Gastroesophageal reflux disease (GERD) can be prevented and cured by making straightforward lifestyle and dietary modifications (Cao et. al, 2019). First of all, I would recommend CF consider eliminating his nightly intake of wine as alcohol decreases lower esophageal sphincter (LES) tone; thus allowing for the contents of the stomach to flow back into the esophagus (Woo & Robinson, 2017). Additionally, eating smaller meals, and avoiding caffeine, chocolate, peppermint, and fatty foods can help prevent the acid reflux (Smith, 2018). Furthermore, I would inform CF that his choice to stop smoking was advantageous to his overall health. In relation to GERD, smoking inhibits the production of saliva causing a reduction of saliva in the mouth/throat; saliva helps to counteract the acidity of gastric secretions, thus avoiding smoking is best (Smith, 2018).

1. Describe a rational drug choice for this patient. Be specific regarding what factors you would consider. Include pharmacokinetic and dynamic considerations for the pharmacological choices made. Also consider interactions and side effects.

The entire class of proton pump inhibitors (PPI) are approved for treatment of GERD since they decrease gastric acid by over 90% (Woo & Robinson, 2017). Omeprazole (Prilosec) 20mg capsule by mouth once daily for a trial period of 4 weeks would be my rational drug choice for CF. Due to his age, negative physical exam, and the fact that he does not take daily medications, omeprazole would not interact with any current medications or put him at a concerning risk for osteoporosis. The benefits of omeprazole include rapid absorption of less than one hour and peak effect within 2 hours (Lexicomp, 2017). I would inform CF about common side effects such as dizziness, headaches, skin rash, constipation, diarrhea, flatulence, and nausea/vomiting (Lexicomp, 2017).

1. What counseling points about this medication do you give CF?

First of all, I would tell CF I wish to see him back in four weeks to discuss his potential experience with side effects, symptom relief including his being awakened at night with symptoms. Should he report his symptoms are controlled during the day and reappear before bed, I would consider adding either a second dose of omeprazole daily or an H2 receptor antagonist before bed (Woo & Robinson, 2017). It is important for CF to understand the efficiency of omeprazole is greatly decreased if not taken on an empty stomach (Lexicomp 2017). Adherence to taking PPI is crucial to attain the optimal gastric acid secretion; therefore, I would reinforce how important it is to stay consistent with his medication regimen (Smith, 2018).

Responsec 2

 Modifying lifestyle is the golden management strategy for GERD. Some of the lifestyle modification that could help CF reduce his frequency of GERD includes maintaining a healthy weight as more weight puts pressure on the abdomen causing acid to come out from the stomach to esophagus it is important to maintain a healthy BMI. Stopping smoking, drinking alcohol. Elevating the head of the bed to help him with the heart burn experienced at night using bed wedge decreases significantly the backing of acid from the stomach to esophagus (Johnson, 2016). To wait at least three hours before lying down or sleeping, chew food more slowly and thoroughly to help digest better. Stay away from foods that trigger acid reflux such as spicy foods, caffeine, chocolate high fat and fried foods (Joel E. Richter, 2009). Avoid tight fitting cloths in the waist and to be more physically active, to exercise and avoid sedentary lifestyle.
Patients with GERD empirically treated with protein pump inhibitor are well managed with the medication without further diagnostic tests (Dalbir S. Sandhu, 2018). There are about four PPI that he can easily purchase over the counter. To improve the effectiveness and compliance of PPI it is important to tell the patient when to take the medication. Considering the fact that he is having symptoms of heart burn and had tried H2RA’s. There are some factors that ensures the effectiveness on the treatment such as how easily can the patient get the medication, how definite are we with the GERD diagnosis ruling our other causes, how the patient accepts the treatment and how they use their treatment in correct way (such as taking it 30 minutes prior to a meal. Factors that helps us chose the first line of treatment would be his knowledge regarding on how to take the medication and how he continuous to use it and his adherence to the lifestyle changes he is going to make. If his symptoms are not well managed with a PPI two timed daily dose, we consider adding H2RA (Dalbir S. Sandhu, 2018).
When choosing PPI Lansoprazole is more effective than Omeprazole in reducing the acidity in the esophagus indicating different PPI affect the clearance of esophagus and esophageal sphincter differently (Janczewska I et al, 1998). Considering this and lansoprazole having a quick onset improves patients adhering to the treatment. The other thing to keep in mind is metabolism of pantoprazole CYP450 system making it safer (Bordin DS, 2010). We have to be cautious if we are using other drugs that interact with PPI such as clopidogrel it can decrease the effect of the blood thinner increasing the chance of heart attack.
As long-term use of PPI can increase the chances of bone fracture, hypomagnesemia causing tremor, muscle pain and dysrhythmia, pneumonia and increase the risk of C-diff infection we have to be monitor for this side effects. CF need to be counseled on lifestyle change, using the medication correctly and as prescribed, looking out for the side effects and seek medical advice if symptoms worsen. 

RUBRIC:

Discussion Question Rubric

Note: Scholarly resources are defined as evidence-based practice, peer-reviewed journals; textbook (do not rely solely on your textbook as a reference); and National Standard Guidelines. Review assignment instructions, as this will provide any additional requirements that are not specifically listed on the rubric.

Note: The value of each of the criterion on this rubric represents a point range. (example: 17-0 points)

Discussion Question Rubric – 100 PointsCriteriaExemplary
Exceeds ExpectationsAdvanced
Meets ExpectationsIntermediate
Needs ImprovementNovice
InadequateTotal PointsQuality of Initial PostProvides clear examples supported by course content and references.

Cites three or more references, using at least one new scholarly resource that was not provided in the course materials.

All instruction requirements noted.

40 pointsComponents are accurate and thoroughly represented, with explanations and application of knowledge to include evidence-based practice, ethics, theory, and/or role. Synthesizes course content using course materials and scholarly resources to support importantpoints.

Meets all requirements within the discussion instructions.

Cites two references.

35 pointsComponents are accurate and mostly represented primarily with definitions and summarization. Ideas may be overstated, with minimal contribution to the subject matter. Minimal application to evidence-based practice, theory, or role development. Synthesis of course content is present but missing depth and/or development.

Is missing one component/requirement of the discussion instructions.

Cites one reference, or references do not clearly support content.

Most instruction requirements are noted.

31 pointsAbsent application to evidence-based practice, theory, or role development. Synthesis of course content is superficial.

Demonstrates incomplete understanding of content and/or inadequate preparation.

No references cited.

Missing several instruction requirements.

Submits post late.

27 points40Peer Response PostOffers both supportive and alternative viewpoints to the discussion, using two or more scholarly references per peer post. Post provides additional value to the conversation.

All instruction requirements noted.

40 pointsEvidence of further synthesis of course content. Provides clarification and new information or insight related to the content of the peer’s post.

Response is supported by course content and a minimum of one scholarly reference per each peer post.

All instruction requirements noted.

35 pointsLacks clarification or new information. Scholarly reference supports the content in the peer post without adding new information or insight.

Missing reference from one peer post.

Partially followed instructions regarding number of reply posts.

Most instruction requirements are noted.

31 pointsPost is primarily a summation of peer’s post without further synthesis of course content.

Demonstrates incomplete understanding of content and/or inadequate preparation.

Did not follow instructions regarding number of reply posts.

Missing reference from peer posts.

Missing several instruction requirements.

Submits post late.

27 points40Frequency of DistributionInitial post and peer post(s) made on multiple separate days.

All instruction requirements noted.

10 pointsInitial post and peer post(s) made on multiple separate days.

8 pointsMinimum of two post options (initial and/or peer) made on separate days.

7 pointsAll posts made on same day.

Submission demonstrates inadequate preparation.

No post submitted.

6 points10OrganizationWell-organized content with a clear and complex purpose statement and content argument. Writing is concise with a logical flow of ideas.

5 pointsOrganized content with an informative purpose statement, supportive content, and summary statement. Argument content is developed with minimal issues in content flow.

4 pointsPoor organization and flow of ideas distract from content. Narrative is difficult to follow and frequently causes reader to reread work.

Purpose statement is noted.

3 pointsIllogical flow of ideas. Prose rambles. Purpose statement is unclear or missing.

Demonstrates incomplete understanding of content and/or inadequate preparation.

No purpose statement.

Submits assignment late.

2 points5APA, Grammar, and SpellingCorrect APA formatting with no errors.

The writer correctly identifies reading audience, as demonstrated by appropriate language (avoids jargon and simplifies complex concepts appropriately).

Writing is concise, in active voice, and avoids awkward transitions and overuse of conjunctions.

There are no spelling, punctuation, or word-usage errors.

5 pointsCorrect and consistent APA formatting of references and cites all references used. No more than two unique APA errors.

The writer demonstrates correct usage of formal English language in sentence construction. Variation in sentence structure and word usage promotes readability.

There are minimal to no grammar, punctuation, or word-usage errors.

4 pointsThree to four unique APA formatting errors.

The writer occasionally uses awkward sentence construction or overuses/inappropriately uses complex sentence structure. Problems with word usage (evidence of incorrect use of thesaurus) and punctuation persist, often causing some difficulties with grammar. Some words, transitional phrases, and conjunctions are overused.

Multiple grammar, punctuation, or word usage errors.

3 pointsFive or more unique formatting errors or no attempt to format in APA.

The writer demonstrates limited understanding of formal written language use; writing is colloquial (conforms to spoken language).

The writer struggles with limited vocabulary and has difficulty conveying meaning such that only the broadest, most general messages are presented.

Grammar and punctuation are consistently incorrect. Spelling errors are numerous.

Submits assignment late.

2 points5Total Points100