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Investigate normal changes of aging related to the heart. 

Part two: Complete the project started in Part One (Educational Pamphlet) by adding factors that promote cardiovascular health to your pamphlet.

Assume you are a nurse manager on a unit where a new nursing documentation system is to be implemented. You want to ensure that the system will be usable and acceptable for the nurses impacted. You realize a nurse leader must be on the implementation team.

To Prepare:

• Review the steps of the Systems Development Life Cycle (SDLC) and reflect on the scenario presented.
• Consider the benefits and challenges associated with involving a nurse leader on an implementation team for health information technology.

The Assignment: (2-3 pages)

In preparation of filling this role, develop a 2- to 3-page role description for a graduate-level nurse to guide his/her participation on the implementation team. The role description should be based on the SDLC stages and tasks and should clearly define how this individual will participate in and impact each of the following steps:

• Planning and requirements definition
• Analysis
• Design of the new system
• Implementation
• Post-implementation support

By Day 7 of Week 10

Submit your completed Role Description.

Please see attached document.   Please answer the discussion question thoughtfully and thoroughly.  Also, The discussion questions should be answered in APA format with citations.  Please do not hesitate to contact me with any clarifying questions about the assignment.   Thank you for your time.

Write a 1 page reflection analyzing the COVID situation. 

– Include an introduction.

– Include a section called “Your Thoughts” explaining the history of the virus in our country, what caused the situation and out country’s response. How have different points of view included factual reports, inductive inferences, and evaluative judgement. Define these terms. 

– Include a conclusion explaining how perceptions and beliefs of others influence awareness of our “lenses”. 

APA style

 I NEED A RESPONSE TO THIS ASSIGNMENT

2 REFERENCES

What the practitioner did well

In this week’s media, the therapist interviewed an adolescent male referred for a mental health evaluation due to anger management issues. The therapist discussed the client’s rights and limitations in privacy and confidentiality at the beginning of the session. As part of the informed consent process, the therapist was correct to clarify confidentiality and the roles, responsibilities, and expectations at the outset of treatment (American Psychological Association [APA], 2010). Transparency in treatment helps build the foundation for a strong therapeutic alliance. The therapist briefly inquired about the reason for the visit but shifted his attention to discussing the client’s school and leisure activities. He also asked about the client’s established support system. This informs the therapist that the client has other people that he can confide in and seek support. By delaying conversations about the problem, the adolescent client and therapist can get better acquainted, which reduces the development of resistance and reluctance in the client. The “warm-up” questioning allows the young male client to become acclimated to the back-and-forth verbal exchanges of therapy before discussing deeply personal or potentially threatening topics (Barrett & Rappaport, 2011). The therapist successfully paraphrased and reflected to understand the client’s experience of and feelings towards his mother. 

Areas the practitioner could improve

The therapist had missed opportunities to gather essential details from the adolescent client. The client expressed disdain for school. Key areas that the therapist missed with that revelation are how long the client had negative feelings towards school, what led to this feeling, how his grades, and his disciplinary actions at school. The therapist was correct to inquire about the client’s understanding of the reason for his visit, but he asked in a manner that caused the client to react defensively. The statement “she must have a reason” should be omitted. After that statement, the client looked away, crossed his arms, shrugged his shoulders, and told him to “ask her.” If the adolescent client feels judged and misunderstood, he will be reluctant to engage in treatment. The therapist’s mission is to help the teen divulge as much helpful information as possible to assess, diagnose, and treat properly. This mission is most effectively accomplished when therapists build a strong therapeutic relationship that represents respect and empathy for their clients’ problems (Ucar, 2017). 

Compelling concerns 

The client began to discuss the cause of his frustration with his mother. He expressed feeling “annoyed” because she persistently “nags” to share his feelings, making him hostile and resistant. Dysfunction within the family structure creates and maintains emotional and psychological issues in individuals. Unhealthy family dynamics negatively influence the way adolescents view themselves, others, and the environment, leading to poor interpersonal interactions (Al Ubaidi, 2017). Understanding and altering the household dynamic is critical to the success of the adolescent client’s treatment. 

Next question to ask and why

The next question to ask the client would be about his major stressors and how he tries to cope. Adolescents have varying life experiences and challenges. Assessing the client’s stressors gives me insight into his cognitive, physical, and social functioning. Significant life events and stressors have been linked to mental health and behavioral problems in adolescents. How the client copes or adapts determines his experience of distress and the ability to function. Revealing the client’s previous coping skills allows me to identify emotional issues and maladaptive patterns that perpetuate his problems.

References

Al Ubaidi, B. A. (2017). Cost if growing up in dysfunctional family. Journal of Family 

     Medicine and Disease Prevention, 3(3), 1-6.

American Psychological Association. (2010). Ethical principles of psychologists and code 

     of conduct. Retrieved on 11-30-20, from http://www.apa.org/ethics

Barrett, J., & Rappaport, N. (2011). Keeping it real: Overcoming resistance in adolescent 

     males mandated into treatment. Adolescent Psychiatry, 1, 28-34.

Ucar, S. (2017). Reluctance and resistance: Challenges to change in psychotherapy. Journal 

The U.S. Preventive Services Task Force (USPSTF) is an independent, volunteer group of national experts in prevention and evidence-based medicine that makes recommendations about clinical preventive services such as screening tests, counseling services, and preventive medications.The U.S. Preventive Services Task Force (USPSTF) is an independent, volunteer group of national experts in prevention and evidence-based medicine that makes recommendations about clinical preventive services such as screening tests, counseling services, and preventive medications. The USPSTF is made up of 16 volunteer members who come from the fields of preventive medicine and primary care, including internal medicine, family medicine, pediatrics, behavioral health, obstetrics/gynecology, and nursing. All members volunteer their time to serve on the USPSTF, and most are practicing clinicians (Oyola, 2020).

Cervical cancer screening recommendations by the USPSTF: The USPSTF recommends screening for cervical cancer every 3 years with cervical cytology alone in women aged 21 to 29 years. For women aged 30 to 65 years, the USPSTF recommends screening every 3 years with cervical cytology alone, every 5 years with high-risk human papillomavirus (hrHPV) testing alone, or every 5 years with hrHPV testing in combination with cytology (cotesting). The USPSTF found convincing evidence that screening with cervical cytology alone, primary testing for high-risk HPV types (hrHPV testing) alone, or in combination at the same time (cotesting) can detect high-grade precancerous cervical lesions and cervical cancer (Curry, 2018).

References:

Curry SJ, Krist AH, Owens DK, Barry MJ, Caughey AB, Davidson KW, Doubeni CA, Epling JW Jr, Kemper AR, Kubik M, Landefeld CS, Mangione CM, Phipps MG, Silverstein M, Simon MA, Tseng CW, Wong JB. Screening for Cervical Cancer: US Preventive Services Task Force Recommendation Statement. JAMA. 2018 Aug 21;320(7):674-686. doi: 10.1001/jama.2018.10897. PMID: 30140884.

This is a Collaborative Learning Community (CLC) assignment. 

The purpose of this assignment is to assess leadership styles, traits, and practices as a nursing professional, establish the importance of effective interprofessional communication as a leader in nursing, and to explore the role of servant leadership in nursing practice.

Read the study materials on leadership and complete the topic quiz activities to better understand your leadership qualities.

Upon completion, summarize and share with your group what you learned about your specific leadership qualities, so you can become familiar with how you are similar and different from your peers when it comes to being a leader.

As a group, review the study materials related to servant leadership. Using what you have learned about the tenets of servant leadership and traits and practices of successful leaders, create a 10-12 slide PowerPoint presentation with speaker notes. Add an additional slide for references at the end of your presentation.  

Include the following in your presentation:

1. Each group member: Create a slide that summarizes your leadership style, traits, and practices.
2. Compare the personal leadership styles of your group members, including commonalities between group members’ strengths and weaknesses.
3. Explain why it is important for nursing professionals to be aware of their personal leadership style, traits, and practices.
4. Discuss what leadership traits and styles are necessary to be an effective communicator. Explain the importance of leaders adapting communication approaches when working interprofessionally (across ancillary departments, vendors, community members).
5. Discuss how nursing professionals can benefit from integrating the tenets of servant leadership to empower and influence others as they lead.
6. Discuss how leaders who practice servant leadership and have a strong understanding of their personal leadership traits can successfully lead others and navigate the unique challenges that are part of nursing and health care. Provide two examples that illustrate your main ideas.

You are required to cite to a minimum of three 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. 

Refer to the resource, “Creating Effective PowerPoint Presentations,” located in the Student Success Center, for additional guidance on completing this assignment in the appropriate style. 

While APA style is not required for the body of this assignment, solid academic writing is expected, and documentation of sources should be presented using APA formatting guidelines, which can be found in the APA Style Guide, located in the Student Success Center. 

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

You are required to submit this assignment to LopesWrite. Refer to the LopesWrite Technical Support articles for assistance. 

Directions for Reflection Paper

Objective

This assignment will promote student introspection and development as a graduate nurse by delving into the role and responsibilities of the nurse and the legal/ethical issues in professional nursing practice. 

Instructions

Compose a one to one and a half page APA formatted paper describing the role of the nurse; integrating the legal and ethical responsibilities of the professional nurse. The paper must also integrate nursing values and accountability. 

 I NEED A REPONSE TO THIS ASSIGNEMNT

2 REFERENCES

Therapy for Patients with Personality Disorder

            Personality disorder can be described as a set of behaviors where individuals can identify themselves with and relate to the environment. Most mental health disorders are difficult to diagnose since there is no lab point out for sure what it is. Bipolar personality disorder like most mental health disorder have similar symptoms that are subjective, and so the clinician depends on what the person tells them how they feel. According to the American Psychiatric Association. (, 2013).  A personality disorder is an enduring pattern of inner experience and behavior that deviates markedly from the expectations of the individual’s culture, is pervasive and inflexible, has an onset in adolescence or early adulthood, is stable over time, and leads to distress or impairment. For this paper, I will be discussing borderline personality disorder, its treatment, both psychotropic and psychotherapy.

            Borderline personality disorder (BPD) is a pattern of instability in interpersonal relationships, self-image, and affects, and marked impulsivity as defined in Diagnostic and statistical Manual-5 (DSM-5) American Psychiatric Association. (, 2013).   BPD symptoms are characterized by the inability of the patient to maintain stable relationships, excessive worrying, feeling lonely, or thinking no one loves them, having problems of being able to regulate their emotions leading to frequent irritability, and feeling depressed and injurious behaviors. Borderline personality disorder (BPD) is a severe mental disorder with symptoms such as affective instability, impulsivity, and self-harm according to Beck, E., et al. (2016). Proper treatment depends on properly identifying the correct personality disorder since many behaviors exist with similar symptoms and comorbid disorders. This comorbidity makes it difficult for a PMHNP who is just beginning difficulty and challenging to treat. In this case, monotherapy is usually not very effective, and hence use of psych pharmacology and psychotherapies should be encouraged, targeting each symptom described or observed by the clinician. BPD may co-occur with substance use disorder (SUD). Research has indicated that chronic, excessive use of substances and problems due to excessive use are potential indicators of the BPD diagnosis that is the BPD impulsivity criterion, according to Trull, T. J., et al. (2018).

            Evidence-based practice research has shown that Mentalization-based behavior group (MBT) therapy and dialectical behavioral therapy (DBT) effectively treat BPD. As for the MBT, the primary goal is to strike a balance between the authority and structure of each session with an open mind to explore the curious stance of the patient. The patients’ profound difficulties with interpersonal functioning and affect regulation require therapeutic techniques potent enough to counteract the difficulties that can arise during sessions. According to Beck, E., et al. (2016). MBT is based on attachment theory and psychodynamic principles and has a high degree of structure and a clear treatment goal of improving patients’ mentalizing skills and may last up to a year. DBT, on its part, focuses on the patient’s inability to control their emotions. It is based on the fact people with BPD are especially sensitive in their reactions and the difficulties to control their tempers either due to their environment they grew up in or due to trauma during childhood or adolescence. The goal here is to train the mind to manage their emotions when exposed to uncomfortable situations. DBT is a good research psychosocial treatment that has been found effective for treating BPD. DBT helps them avoid being so judgmental and critical about themselves as good for nothing person leading to suicidal thoughts.

            Treating BPD with psychopharmacology drugs focuses on the priority symptoms that the person is most concerned about or display as destroying his/her life. Psychotic symptoms such as irritability, suicide ideation, or attempt or self-injurious behaviors might begin with psychotic medications such as Depakote, topiramate, Lamictal, which are anticonvulsants drugs, use off label to treat this disorder. Also, lithium and atypical antipsychotics such as Olanzapine and Abilify that have proven effective in decreasing this disorder. Patients might benefit from antidepressants if they exhibit depression symptoms too. Care must be taken in selecting this medication as their side effects might lead to medication non-compliant. Depakote and lithium levels need to be monitored to avoid toxicity. One will have to assess for insomnia as people with this condition might express irritability and emotional instability.

            Diagnosing BPD, like most mental health illnesses, must be done with care, empathy but at At the same time setting professional boundaries. These patients often take offense when told about their diagnosis as they are often in denial, attentional seeking behaviors, for instance, stating that they were going to hurt themselves. The diagnosis, therefore, must be presented in a manner that validates them with offers to assist them in overcoming their difficulties in controlling like their depression, irritability, suicide ideations, not feeling loved or abandoned by their loved ones.

References.

American Psychiatric Association. (, 2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.

Beck, E., Bo, S., Gondan, M., Poulsen, S., Pedersen, L., Pedersen, J., & Simonsen, E. (2016). Mentalization-based treatment in groups for adolescents with borderline personality disorder (BPD) or subthreshold BPD versus treatment as usual (M-GAB): study protocol for a randomized controlled trial. Trials, 17(1), 1-13.

Rizvi, S. L., Hughes, C. D., & Thomas, M. C. (2016). The DBT Coach mobile application as an adjunct to treatment for suicidal and self-injuring individuals with borderline personality disorder: A preliminary evaluation and challenges to client utilization. Psychological services, 13(4), 380.

Trull, T. J., Freeman, L. K., Vebares, T. J., Choate, A. M., Helle, A. C., & Wycoff, A. M. (2018). Borderline personality disorder and substance use disorders: an updated review. Borderline personality disorder and emotion dysregulation, 5(1), 15.

Impact on nurses, nursing care, healthcare organizations, and quality of care.

          The problem of obesity in Florida has a significant impact on nurses and nursing care. The first impact which is there on nursing is that patients who are obese tend to stay in the hospital longer compared to normal weight patients. The patients need more care during this period from the nurses and the majority of them are highly unstable (Osondu et al., 2016). The nurses also face challenges because the patients who are obese are more difficult to transport. Moving them around even on the hospital beds is a significant challenge. For the healthcare organization, there is increased utilization of their medical services. The obese patients attend the healthcare facilities more compared to the normal weight patients. The healthcare organizations also have to be ready to deal with an increase in the risk of injury of the people. The healthcare organizations have to be ready to deal with more problems that can arise even during medical attention such as urinary tract infections. The obese patients also require to visit emergency room services more often and the healthcare organizations need to be ready to handle the increase of patients who regularly visit the emergency services department. When it comes to quality of care, obese patients are a risk to quality because it is associated with infections and other complications which can, for example, lead to poorer surgical outcomes (Aziz et al., 2017). It is difficult to give these patients good care because of the various conditions they face such as high blood pressure and diabetes.

Local Key Stakeholders.

          There are various key stakeholders that are there when it comes to the issue of obesity. The first stakeholder are the government at all levels. It is important to note that the government is in charge of the health system and it is critical to ensure that it is efficiency. The government has worked to provide the best care but obesity is a challenge because of the complications that it brings. The state and local government need to make sure that they have more emergency rooms, for example. The next local stakeholder are healthcare organizations (Osondu et al., 2016). The healthcare organizations today need to have more capacity to handle the increase in citizens of Florida who are obese. The next important stakeholders in this issue are the media. It is important for the media to build on responsible advertising especially when it comes to the products that lead to obesity. There are high fat and high sugar foods and drinks advertised that need to be removed or should come with disclaimers. The media has the ethical duty to communicate messages to encourage people to exercise and observe their diets.

Intervention.

          One local approach that can be used is encouragement of physical exercise. One of the interventions that can deal with the problem of obesity is ensuring that the local citizens are regularly exercising. There should be a culture of going to exercise at thrice a week (Musich et al., 2016). Physical activity can lead to people living healthier lives. The lives of people improve when they engage in physical exercise and they can drive the obesity. In Florida, getting people outside more is an intervention that has worked particular for those who are in their middle ages (Aziz et al., 2017). This intervention works because there are quality and enjoyable physical exercise which are there for younger generations such as parkour.

References

Aziz, M., Osondu, C. U., Younus, A., Malik, R., Rouseff, M., Das, S., & Agatston, A. S. (2017). The association of sleep duration and morbid obesity in a working population: The Baptist Health South Florida employee study. Metabolic syndrome and related disorders, 15(2), 59-62.

Osondu, C. U., Aneni, E. C., Salami, J., Valero-Elizondo, J., Rouseff, M., Das, S., & Agatston, A. S. (2016). Obesity is associated with Significantly Higher Healthcare Expenditures in a Large US Employee Population: The Baptist Health South Florida Employee Study. Circulation, 134(suppl_1), A19792-A19792.

Musich, S., MacLeod, S., Bhattarai, G. R., Wang, S. S., Hawkins, K., Bottone Jr, F. G., & Yeh, C. S. (2016). The impact of obesity on health care utilization and expenditures in a Medicare supplement population. Gerontology and Geriatric Medicine, 2, 2333721415622004.