All posts by : chebby

  Hello i need a Briefly, Good and Positive Comment for this Post.Thank you.  I need at least two references.

Week 6 Main post

RP is a 30 y/o female baker-acted to the hospital after an attempt to overdose on Tylenol. She was medically cleared from the ER and sent to the psychiatric hospital for an inpatient evaluation. She reported that she has been depressed and hopeless about a relationship she had just gotten broken up. She felt there was no reason to live. As an adult, they will see the psychiatrist and be evaluated for competency. Once deemed competent they will have the ability to sign a voluntary form. Being competent allows them to make their own decisions about treatment options. Patient was started on Lexapro 10 mg daily and Vistaril 50 mg at bedtime to help her sleep. Group therapy and therapeutic milieu ordered. Upon discharge she was set up with out- patient services such as therapy and follow-up with a psychiatrist to monitor her medication. She gave consent for her treatment and medications.

Child/Adolescent

A child would have been treated the same way, but the parent or guardian would be more involved in the decisions for the child. The medication choice would be started at a lower dose or a different antidepressant. The child would be medically cleared before sending to psych. Because this is a minor, parents need to be involved in every aspect of the transaction. A child is considered vulnerable as opposed to a competent adult. Another difference is the separation of adults and children in a psychiatric facility. There is no blending of the two. Chapter 36 of the Code of Practice to the Mental Health Act specifies that children and adolescents receiving in-patient care for mental illness should have: appropriate physical facilities; staff with the right training, skills and knowledge to understand and address their needs as children and young people; a hospital routine that will allow their personal, social and educational development to continue as normally as possible; and equal access to educational opportunities as their peers, in so far as that is consistent with their ability to make use of them, considering their mental state (Hazel, Sprague, & Sharpe, 2016) .

Ethical/Legal

Decision-making in child and adolescent psychiatry brings with it a variety of challenges for children, parents/guardians, and child and adolescent psychiatrists. It relies on the concepts of assent and consent by proxy, which is the focus of Principle IV of the AACAP Code of Ethics (2014). Assent recognizes that minors might not, due to their developmental level, be capable of giving completely reasoned consent; however, minors might be capable of having preferences and communicating their preference. Assent recognizes the importance of the involvement of minors in the decision-making process, while also recognizing that a minor’s level of participation is less than completely competent. Parents/guardians and child and adolescent psychiatrists should not exclude minors from decision-making without clear and convincing reasons (“American Academy of Child and Adolescent Psychiatry,” 2020). Some feel that the baker-act is being abused when it comes to children and adolescents. “They want to use (the) Baker Act for any behavioral problem — anything that they don’t like,” Hilary Caskey said. “If you have any kind of outburst, if you have any kind of emotion whatsoever and you are not just an order-following automaton, they will Baker Act you.” Law enforcement officers, who have limited training in mental health issues, are usually the ones deciding whether a child should be sent to a psychiatric facility for an evaluation. This is especially true in the schools, which may or may not have an on-site psychologist (Gluck, 2019). So, for an adult to be baker-acted, it is straight forward. For a child to be baker-acted is a bit more complicated as they typically get baker-acted from school and the parents may not get notified which they are the guardians of the child. Some schools averaged multiple Baker Acts a month per school year. Many happen even at the elementary school level. The rule for the schools needs to be followed. A parent or guardian must be contacted before the baker act process.

References

Ethical Issues in Clinical Practice. (2020). Retrieved from https://www.aacap.org/AACAP/Member_Resources/Ethics/Ethics_Committee/Ethical_Issues_in_Clinical_Practice.aspx

Gluck, F. (2019). Florida kids are getting sent to psychiatric units under the Baker Act in record numbers. Retrieved from https://www.news-press.com/in-depth/news/2019/08/21/florida-children-baker-act-record-numbers-mental-health/3247904002/

Hazel, P., Sprague, T., & Sharpe, J. (2016, January 8, 2016). Psychiatric hospital treatment of children and adolescents in New South Wales, Australia: 12-year trends. US National Library of Medicine, 1-5. https://doi.org/ doi: 10.1192/bjpo.bp.115.000

Assignment Prompt

This course is designed to prepare investigators involved in the design and/or conduct of research involving human subjects to understand their obligations to protect the rights and welfare of subjects in research. The course material presents basic concepts, principles, and issues related to the protection of research participants. 

Evidence based research involving human subjects requires that researchers be cognizant of and adhere to the important tenets necessary to protect subjects from abuse, harm, injury, and/or other undesirable outcomes resulting from the research process.  Based on this fact, write a minimum of 2 pages (Title page and Reference not included in page count) of an APA formatted paper answering the following questions with a minimum of 3 “short” sentences for each question:

1. Historical background of human subjects protection? (10 points)
2. Find and discuss at least one historical incident of human subjects abuse in research and what human right was violated. (10 points)
3. What steps will you take to minimize risks on human subjects? (10 points)
4. What populations are considered vulnerable populations and why? (10 points)
5. What are appropriate ways to recruit subjects? (10 points)
6. How would you properly obtain consent? (10 points)
7. What are the elements of a properly executed consent? (10 points) 
8. What committees are responsible for monitoring the protection of human subjects? (10 points)

Scoring Scheme:

• Total points for questions/content: 80 points
• Title page and a minimum of 2 References: 10 points
• Minimum of 3 “short” sentences to answer each question: 10 points
• TOTAL POINTS: 100 (the gradebook will re-weight this total as 50 points or 5% of the course grade)

NOTE: This is a written APA formatted assignment and “NOT” a YES or NO answer assignment. You are expected to answer each question with at least 3 short sentences, points will be deducted for using a single sentence. Title and Reference pages are required. There is no template/outline for this assignment.

It is necessary for an RN-BSN-prepared nurse to demonstrate an enhanced understanding of the pathophysiological processes of disease, the clinical manifestations and treatment protocols, and how they affect clients across the life span.

Evaluate the Health History and Medical Information for Mr. M., presented below.

Based on this information, formulate a conclusion based on your evaluation, and complete the Critical Thinking Essay assignment, as instructed below.

Health History and Medical Information

Health History

Mr. M., a 70-year-old male, has been living at the assisted living facility where you work. He has no know allergies. He is a nonsmoker and does not use alcohol. Limited physical activity related to difficulty ambulating and unsteady gait. Medical history includes hypertension controlled with ACE inhibitors, hypercholesterolemia, status post appendectomy, and tibial fracture status postsurgical repair with no obvious signs of complications. Current medications include Lisinopril 20mg daily, Lipitor 40mg daily, Ambien 10mg PRN, Xanax 0.5 mg PRN, and ibuprofen 400mg PRN.

Case Scenario

Over the past 2 months, Mr. M. seems to be deteriorating quickly. He is having trouble recalling the names of his family members, remembering his room number, and even repeating what he has just read. He is becoming agitated and aggressive quickly. He appears to be afraid and fearful when he gets aggressive. He has been found wandering at night and will frequently become lost, needing help to get back to his room. Mr. M has become dependent with many ADLs, whereas a few months ago he was fully able to dress, bathe, and feed himself. The assisted living facility is concerned with his rapid decline and has decided to order testing.

Objective Data

1. Temperature: 37.1 degrees C
2. BP 123/78 HR 93 RR 22 Pox 99%
3. Denies pain
4. Height: 69.5 inches; Weight 87 kg

Laboratory Results

1. WBC: 19.2 (1,000/uL)
2. Lymphocytes 6700 (cells/uL)
3. CT Head shows no changes since previous scan
4. Urinalysis positive for moderate amount of leukocytes and cloudy
5. Protein: 7.1 g/dL; AST: 32 U/L; ALT 29 U/L

Critical Thinking Essay

In 750-1,000 words, critically evaluate Mr. M.’s situation. Include the following:

1. Describe the clinical manifestations present in Mr. M.
2. Based on the information presented in the case scenario, discuss what primary and secondary medical diagnoses should be considered for Mr. M. Explain why these should be considered and what data is provided for support.
3. When performing your nursing assessment, discuss what abnormalities would you expect to find and why.
4. Describe the physical, psychological, and emotional effects Mr. M.’s current health status may have on him. Discuss the impact it can have on his family.
5. Discuss what interventions can be put into place to support Mr. M. and his family.
6. Given Mr. M.’s current condition, discuss at least four actual or potential problems he faces. Provide rationale for each.

You are required to cite to a minimum of two sources to complete this assignment. Sources must be published within the last 5 years and appropriate for the assignment criteria and relevant to nursing practice.

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

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

  This is a discussion….please make sure it is understandable when it is read

One example of a measurement tool is the Healthcare Effectiveness Data and Information Set (HEDIS) comprehensive care measures. Review the components of HEDIS comprehensive diabetes care; then consider the following scenario.

You are a staff nurse working in a private primary care practice. It is a small practice with 2 MDs (internists), 2 nurses, 1 medical assistant, and an office staff for billing. There are approximately 1,000 patients in the practice. You have had no EHR until the last year, but all charts are manual, historically. Your physicians are starting to inquire about quality incentives, particularly regarding patients with diabetes. 

Take on the role of the staff nurse in the scenario, and post an explanation of how you would go about finding out how many diabetics are in your practice and how many meet all components of HEDIS comprehensive diabetes care.

https://www.ncqa.org/hedis/measures/

I also attached another resource from this week

Support your response with references from the professional nursing literature. Your posts need to be written at the capstone level (see checklist).

Notes Initial Post: This should be a 3-paragraph (at least 350 words) response. Be sure to use evidence from the readings and include in-text citations. Utilize essay-level writing practice and skills, including the use of transitional material and organizational frames. Avoid quotes; paraphrase to incorporate evidence into your own writing. A reference list is required. Use the most current evidence (usually ≤ 5 years old). (Refer to AWE Checklist, Capstone)

 Using the Week 5 research template identify the research components, listed on the template. Select a nursing research article from the list below and address each of the following criteria:

If a component is not present in the article, its absence should be discussed.

• Identify the research problem.
• Identify the research purpose.
• Summarize the review of literature.
• Identify the nursing framework or theoretical perspective. 
• Identify the research questions and hypotheses.
• Identify the variables.
• Identify and discuss the appropriateness of the design.
• Describe the procedures for data collection
• Discusses the validity and reliability of the instruments, tools, or surveys.
• Describe the final sample.
• Summarize the results including statistical analysis used or other method of analysis.
• Discuss the significance of the study. Did it resolve the question?
• Discuss the legal and ethical issues of the study. Include the use of human subjects and their protection.
• Describe any cultural aspects of the study.
• Describe how the results of the research may affect future nursing practice.
• Apply the research to your nursing practice.
• NOTE: If a component is not addressed, the student receives a zero for that component.

Articles

Sousa, J.P., & Santos, M. (2019). Symptom management and hospital readmission in heart failure patients. A qualitative study from Portugal. Critical Care Nurse Quarterly 42(1), 81-88.

NOTE: Once accessing the article above, you will need to click on the Full Text link in the left navigation bar.

Nurses’ Preparedness and Perceived Competence in Managing Disasters

The Lived Experiences of People with Chronic Obstructive Pulmonary Disease: A Phenomenological Study

NOTE: Once accessing the article above, you will need to click on the Full Text link in the left navigation bar.

Zaken, Z.B, Maoz, E., Raizman, E. (2018). Needs of relatives of surgical patients: Perceptions of relatives and medical staff. MEDSURG Nursing 27(2), 110-116.

As a future advanced practice nurse, it is important that you are able to connect your classroom experience to your practicum experience. By applying the concepts you study in the classroom to clinical settings, you enhance your professional competency. Each week, you complete an Assignment that prompts you to reflect on your practicum experiences and relate them to the material presented in the classroom. This week, you begin documenting your practicum experiences in your Practicum Journal.

• In preparation for this course’s practicum experience, address the following in your Practicum Journal:
• Select one nursing theory and one counseling theory to best guide your practice in psychotherapy.
  Note: For guidance on nursing and counseling theories, refer to this week’s Learning Resources.
• Explain why you selected these theories. Support your approach with evidence-based literature.
• Develop at least three goals and at least three objectives for the practicum experience in this course.
• Create a timeline of practicum activities based on your practicum requirements.

If you were to ask 10 people what they believe to be the most significant issue facing healthcare today, you might get 10 different answers. Escalating costs? Regulation? Technology disruption?

These and many other topics are worthy of discussion. Not surprisingly, much has been said in the research, within the profession, and in the news about these topics. Whether they are issues of finance, quality, workload, or outcomes, there is no shortage of changes to be addressed.

In this Discussion, you examine a national healthcare issue and consider how that issue may impact your work setting. You also analyze how your organization has responded to this issue.

To Prepare:

• Review the Resources and select one current national healthcare issue/stressor to focus on.
• Reflect on the current national healthcare issue/stressor you selected and think about how this issue/stressor may be addressed in your work setting.

By Day 3 of Week 1

Post a description of the national healthcare issue/stressor you selected for analysis, and explain how the healthcare issue/stressor may impact your work setting. Then, describe how your health system work setting has responded to the healthcare issue/stressor, including a description of what changes may have been implemented. Be specific and provide examples.

By Day 6 of Week 1

Respond to at least two of your colleagues on two different days who chose a different national healthcare issue/stressor than you selected. Explain how their chosen national healthcare issue/stressor may also impact your work setting and what (if anything) is being done to address the national healthcare issue/stressor.

SWOT Analysis – SWOT is an acronym that stands for Strengths, Weaknesses, Opportunities, and Threats which is an analysis tool that assists organizations in strategic planning. 

Instructions:

1. Read through Reducing Fertility in Bangladesh PPT that provides details of a successful program. Read until you feel comfortable with the explanation of the program.
2. Write down aspects of the program that fits into each part of the SWOT analysis.
3. Your paper should be:
   • Typed according to APA style for margins, formatting and spacing standards

 Mention one of the therapeutic options use as intervention for child sexual abuse. How does it work? (explain it) 

This week, we will serve to use the class as a preliminary area of interest and support for our topic selection for the upcoming Informational speeches that will be due in the following weeks. It is always important to grasp what people know about your topic, how they feel about it, and allow yourself the opportunity to ask questions and receive feedback when possible before preparing a public speech.

The Blog this week will operate as a live proposal of your speech topic, consideration of research that you will locate and evaluate, and a sense of the audience, analysis to prepare your presentation to your peers. I want you to use the chapter readings to demonstrate the language of research as you propose what research you need and how you plan to integrate evidence.

To help, I want to provide some suggestions for your response:

• Topic (choose a conspiracy theory)
• Come up with a title (thesis) that clearly states your topic and is informative and descriptive
• Create an abstract/ summary (150-250 words)
• Discuss keywords central to your research topic or understanding the topic (consider groups, dates, events, historical foundations, and background, news sources, social media, and hashtags)
• Include a review of sources (Literature Review) you are looking at or intend to review for research/ Describe the proposed research (Methodology)
• Ask any questions to see how familiar your audience is with the proposed topics and clarify areas that may need more attention and those you can review in your presentation more quickly because they are well known by your audience.

Again, work on the blog entry with the idea that you need to contribute until you feel you have adequately represented yourself clearly in addressing the prompt. This should not be a final draft but a start to how you will approach your topic and what you are looking to include and where you will look more than having the answers and writing a research paper for submission.

Do not forget to respond and help others with planning their speeches through comments.

 Locate 5 varied sources for your speech assignment. Remember you are choosing a conspiracy theory as your topic.

You need to include both scholarly research and Internet research.

Write an annotated bibliography using APA style of five (5) sources.