The Application of xyz Middle Range Theory to Practice scientific poster includes:
How has the U.S.A risen to the top internationally to decrease abuse amongst pregnant women?
I just want to copy and paste from the attached chapter, and put it into PowerPoint I mean copying the important things, in other words I mean abbreviate the chapter. Because I don’t have the time to figure out the important things in the chapter and copy and paste them
Competing needs arise within any organization as employees seek to meet their targets and leaders seek to meet company goals. As a leader, successful management of these goals requires establishing priorities and allocating resources accordingly.
Within a healthcare setting, the needs of the workforce, resources, and patients are often in conflict. Mandatory overtime, implementation of staffing ratios, use of unlicensed assisting personnel, and employer reductions of education benefits are examples of practices that might lead to conflicting needs in practice.
Leaders can contribute to both the problem and the solution through policies, action, and inaction. In this Assignment, you will further develop the white paper you began work on in Module 1 by addressing competing needs within your organization.
To Prepare:
The Assignment (4-5 pages):
Developing Organizational Policies and Practices
Add a section to the paper you submitted in Module 1. The new section should address the following:
1.Discuss the professional nurse’s role in health-promotion activities
2. Examine theories and concepts related to health-promotion behaviors.
3. Discuss health promotion, illness prevention, health maintenance, health restoration, and rehabilitation in relation to the nurse’s role in working with various populations.
4. Discuss the influences of moral, ethical, and legal principles on professional nursing practice.
5. Identify effective communication with clients and other healthcare providers.
Discuss attitudes and actions that influence personal, educational, and professional development. (PO 5) 7. Identify health-promotion strategies throughout the life span. (POs
Review the Institute of Medicine’s 2010 report “The Future of Nursing: Leading Change, Advancing Health.” Write a 750‐1,000 word paper discussing the influence of the IOM report on nursing practice. Include the following:
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.
You are required to submit this assignment to LopesWrite. Refer to the LopesWrite Technical Support articles for assistance.
Respond to your colleagues by recommending at least one additional way you would treat a child or adolescent client differently than you would an adult and at least one additional way you would address the legal and ethical issues involved.
NOTE: Positive Comment
Main Discussion
Psychiatric emergencies are severe behavioral changes that may result from worsening mental illness. Psychiatric emergency is any disturbance in thoughts, feelings, or actions that require immediate therapeutic intervention (Stahl, S. M., 2014). The providers approach, attitudes and work environment may escalate the situation and interfere with the quality of care. Certain therapeutic measures can reduce the intensity of the situation and provide a more dignified way for patients to recover from the crisis. It is thus important that the PMHNP understand how to assess patient’s emergency status and address their unique needs while maintaining safety.
Case selected.
Patient is a 25-year-old AA male who presents to the emergency department with psychotic behavior in believing he should kill his mother which led to his attempt to stab his mother. Patient is admitted for inpatient psychiatric stabilization. Patient has a history of schizoaffective disorder and major depression that was managed with use of clozapine 150mg twice a day and Zoloft 100mg daily. Family reported that patient has a history of medication non-compliant and had been on different psychiatric medications in the past but were not working for him. Additional reports by his parents shows that patient had missed several doses of his medication, decompensated and they had notices some changes recently including increase agitation, delusional believes that he is the savior in the family and God had directed him to cast the demon in his mother. Reports also that he had drawn a picture of himself with knives cutting a woman he portrayed as a demon with blood flowing with a man standing to the side, laughing. Patient currently stated that he participates in a meeting with angels from which he gets directives on how to attack his mother which led to his attempt to stab his mother. Because of this, patient was considered dangerous to his mother per admitting physician. Patients symptoms include psychosis, extreme agitation, paranoia, verbal outburst, combative and very difficult to redirect. Patient has no known drug allergies per parents. Verbal restraint was used including letting patient know what will happen if he does not comply, respecting his autonomy, empathetic listening, decrease environmental stimulation, reassure patient that they will be safe, and maintain a safe environment. The patient was given emergency medications including haloperidol lactate 5mg, lorazepam 2mg, and diphenhydramine 50mg all IM for severe agitation and danger to others. To prevent re-hospitalization within 12-24 hours of discharge, the physician ordered outpatient therapy and continued use of clozapine and Zoloft along with necessary lab work.
How I would treat the client differently if he or she were a child or adolescent
Children and adolescent are usually brought for treatment when their behavior or thoughts come to the attention of parents, teachers, social workers, or school. For pediatric patients in a mental health crisis, the typical chaotic nature of the situation may easily further exacerbate an already traumatized state of the patient. Just like in adults, as a PMHNP I would perform an evaluation to determine the type of emergency and contributing factors in child and adolescent emergency by assessing not just the child but also the entire family. Additionally, safety and protection are essential mandate in psychiatric emergency evaluation especially when the patient pose imminent threat to self or others. What I will do different when interviewing children especially younger children is to assess the underlying cause of the violent behavior and delusional symptoms within a developmental context. Specifically, I would clarify that “bizarre thinking ” or accounts of seeing or hearing things that others do not see or hear are different from developmentally appropriate fantasy or difficulty while distinguishing inner voices from distressing hallucinations. On like in adults where they can provide information during the interview, when it comes to younger children, I would need to obtain information from parents or guardian. For adolescents, I would obtain information from the patient first then talk to their parent or guardian if the adolescent is able to tell most of their own story. This may also help to give a sense of autonomy and control to the adolescent which promote cooperation with the interview process. However, information from family is very crucial particularly for a child who is psychotic, frightened, unable, or unwilling to corporate with the provider to help understand how the situation occurred and the severity of the behavior.
Same interviewing strategies used in adult may be used including speaking in a soft voice respecting patients’ autonomy, assuring safety, validating feelings, offering distractions (like video games) especially with very young children, and clear limit-setting can be helpful. However, children should be evaluated in a carefully planned setting with doors closed for limiting access, and be sure appropriate backup is available (Margret, C. P., & Hilt, R., 2018).
In violent situations children may require a different approach in deescalating the situation than adults. Safety is the essential mandate in an aggression evaluation, with the interviewer specifically looking for imminent threats, plans, targeted people, and access to means of harm (Margret, C. P., & Hilt, R., 2018). Because adults are much stronger, they may require physical restrain specially to administer medication to calm the patient. Verbal restrain such as providing verbal directions in a nonthreatening manner, setting limits, and assuring the child that treatment may help them calm may be used for children first. However, if the child is dangerously out of control and aggressive, they may need medication to keep them calm and safe.
Legal or ethical issues I would consider when working with a child or adolescent emergency case
The ethical issue I will consider when working with children and adolescent is respect for their autonomy, privacy, and confidentiality. For very young children parents must consent to treatment and the health care provider treating the child should make every reasonable effort to obtain and document informed consent. (American Academy of Pediatrics, 2015). Just like adults, maintaining a patient’s confidentiality is an important ethical consideration when providing care to children and adolescents. However, when a PMHNP is concerned that the patient may be at imminent risk for harm to self or others, confidentiality requirements no longer apply (Chun, T. H., Katz, E. R., & Duffy, S. J., 2013). This means that the PMHNP in this situation may disclose information collected from patient to caregivers or others as needed and may obtain information from others such as friends, family members, school personnel, employers and other without obtaining consent from the patient or guardians (Chun, T. H., Katz, E. R., & Duffy, S. J., 2013. Patient autonomy is a major principle in making decisions about an individual’s health, and as a PMHNP we are obligated to respect this right and allow patients to practice their autonomy in the course of their treatment (Parsapoor, A., Parsapoor, M. B., Rezaei, N., & Asghari, F., 2014). However, a psychiatric emergency and age may limit a child’s ability to make such decisions. Regardless, it is always important to involve the child in informed decision making even if the consent is signed by the parents or guardian.
References
Chun, T. H., Katz, E. R., & Duffy, S. J. (2013). Pediatric mental health emergencies and special
health care needs. Pediatric clinics of North America, 60(5), 1185–1201. Retrieved from,
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3792398/
Da Silva, A. G., Baldaçara, L., Cavalcante, D. A., Fasanella, N. A., & Palha, A. P. (2020). The
Impact of Mental Illness Stigma on Psychiatric Emergencies. Frontiers in psychiatry, 11,
573. https://doi.org/10.3389/fpsyt.2020.00573
Margret, C. P., & Hilt, R. (2018). Evaluation and Management of Psychiatric Emergencies in
Children. Pediatric Annals, 47(8), e328–e333. https://doi-
org.ezp.waldenulibrary.org/10.3928/19382359-20180709-01
Parsapoor, A., Parsapoor, M. B., Rezaei, N., & Asghari, F. (2014). Autonomy of children and
adolescents in consent to treatment: ethical, jurisprudential and legal considerations.
Iranian journal of pediatrics, 24(3), 241–248. Retrieved from,
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4276576/
Stahl, S. M. (2014). Prescriber’s Guide: Stahl’s Essential Psychopharmacology (5th ed.). New
York, NY: Cambridge University Press.
A 42-year-old male reports pain in his lower back for the past month. The pain sometimes radiates to his left leg. In determining the cause of the back pain, based on your knowledge of anatomy, what nerve roots might be involved? How would you test for each of them? What other symptoms need to be explored? What are your differential diagnoses for acute low back pain? Consider the possible origins using the Agency for Healthcare Research and Quality (AHRQ) guidelines as a framework. What physical examination will you perform? What special maneuvers will you perform?
Please read the following case study thoroughly and then answer the following questions:
Case Study
Luis is a 9-year-old Hispanic Latino male who presents to the Pediatric Clinic. His mother explains to you that she observes that Luis sleeps with his mouth open, she hears him snoring loudly at night, and sometimes he stops breathing for a few seconds which wakes him up. She notices he looks tired and he is cranky when he wakes up in the morning. When he comes home from school he wants to take a nap. Yesterday his teacher called his mother about him falling asleep in class. He does not engage in any physical activities because he is too tired.
Your initial assessment reveals that Luis is obese. His height is within normal limits for his age at 4’8”, but his weight is 102 lbs. His ideal body weight for his age and height is 62 lbs. His body mass index (BMI) is 22.9 which places him in the 97th percentile indicating that he has obesity.
1. Discuss the statistical data for childhood obesity in the United States.
2. There are a number of aspects that play a significant role in the development of childhood obesity. Please discuss how the following factors contribute to childhood obesity:
3. Luis was diagnosed with obstructive sleep apnea secondary to obesity and physical inactivity.
4. Discuss other health consequences for a child who is obese.
5. What recommendations would you provide to Luis and his mother as a focus for nutritional and behavioral treatment of Luis’s obesity?
6. Your patient education for Luis and his mother includes healthy, nutritional meal and snack planning. You will teach them how to use MyPlate on the ChooseMyPlate.gov website https://www.choosemyplate.gov/kids
1. Describe the role of the community health nurse in providing quality end-life-care for seriously ill persons and their families.
2. Identify and discuss the diverse settings for end-of-life care and the role of the nurse in each setting.
APA format word document, with in-text citations and references
A minimum of 3 evidence-based references no older than 5 years must be used.
A minimum of 800 words not to exceed 1,000 are required without counting the first and last page.
