Research the health-illness continuum and its relevance to patient care. In a 750-1,000 word paper, discuss the relevance of the continuum to patient care and present a perspective of your current state of health in relation to the wellness spectrum. Include the following:

1. Examine the health-illness continuum and discuss why this perspective is important to consider in relation to health and the human experience when caring for patients.
2. Explain how understanding the health-illness continuum enables you, as a health care provider, to better promote the value and dignity of individuals or groups and to serve others in ways that promote human flourishing.
3. Reflect on your overall state of health. Discuss what behaviors support or detract from your health and well-being. Explain where you currently fall on the health-illness continuum.
4. Discuss the options and resources available to you to help you move toward wellness on the health-illness spectrum. Describe how these would assist in moving you toward wellness (managing a chronic disease, recovering from an illness, self-actualization, etc.).

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.

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Week 6: Mental Health Clinical Presentation – Part 1

Purpose  

The purpose of this assignment is for learners to: 

1. Have the opportunity to integrate knowledge and skills learned throughout all core courses in the FNP track and previous clinical courses.
2. Demonstrate an advancing understanding of the patient with a mental health disorder in primary care.
3. Demonstrate the ability to analyze the literature/ previous patients seen in the clinical setting be able to perform an evidence-based review of their case, diagnosis, and plan, while guiding and taking feedback from peers regarding the case.
4. Demonstrate professional communication and leadership, while advancing the education of peers. 

Activity Learning Outcomes 

Through this discussion, the student will demonstrate the ability to:

1. Develop management plans based on current scientific evidence and national guidelines. (CO4)  
2. Prioritize treatment based on relevant clinical presentation. (CO6)

Requirements:  

For Week 6 of the course, there will not be a case study given to you by the faculty. Instead, you will be assigned a  mental health disorder commonly seen in primary care and you will create a case study based on that disorder.  You may create a case study either from a previous clinical patient experience or if you have not had a patient in clinical that represents your assigned topic you may research your disease using the week’s classroom material and the evidence-based literature in the field. The case should be clear and include all elements of a normal case that might be presented in class  (subjective, objective, assessment, and full 5 point plan).  The clinical practicum documentation will be helpful for this process, or notes you have taken in clinical regarding cases.  The case should be  clear, organized, and meet the following guidelines: 

Week 6 Part One: 

This part goes in part one and should begin with subjective and objective data just like we do in your weekly case study discussion.  Do not put a diagnosis until your peers respond. 

WEEK 6 Part One: The case should lead the class toward the mental health diagnosis assigned to you by your instructor. 

WEEK 6 Part One Specific Guidelines: 

If this is an actual patient from clinical- Include their actual chief complaint, demographic data, HPI,  PMHX, PSHX, medications, allergies, subjective and objective findings without identifying the patient’s name. 

If this is a fictitious case you’ve created from the literature/readings you should design an example patient and include chief complaint, demographic data, HPI, PMHX, PSHX,  medications and allergies, subjective and objective findings. Be mindful that the background data for the case should bear some relevance to the diagnosis. 

The case should not be overly simple. Like your weekly case studies, it should include subjective data that loosely represents the diagnosis you have been given, but includes some elements of the pathophysiology/presentation of the disease. 

You must include the following elements in part one: subjective: chief complaint/HPI, demographic data, HPI, PMHX,  PSHX, subjective and objective findings. 

NEXT: 

Leading the discussion in part one:   You must respond to any student who posts regarding your case with a  substantial response, either answering their questions or noting their  response and acting as leader. You also must respond to any faculty  responses to your initial posting. Use references to support your  responses. Remember: Your response to your peers is part of where you  demonstrate your knowledge of the disease you were assigned. You should  be discussing hallmark symptoms, diagnostic tools etc along with  discussing the student’s impressions and conclusions.  Once your peers  respond you can share the primary diagnosis and treatment plan that  actually occurred if it is a live patient, and the ideal treatment plan  if it is an invented case. Your treatment plan should address any  national guidelines as appropriate for the diagnosis. 

Participating in part one: As a student you will be required to respond to at least one other student, whom has no responses to their posting**. In your response to your peer you must include the  following: Your top three (3) differentials based on the information  provided, the primary diagnosis you are leaning toward, and first line  treatment for how you would treat that diagnosis. Use references to  support your response. *DEADLINE – YOUR ONE REPSONSE TO A STUDENT IN DISCUSSION #1 IS DUE BY THURSDAY AT 11:59 p.m. MT SO THAT THE STUDENT CAN INTERACT WITH YOU AS WE DO IN OTHER CASES.  **If all students have a response, then choose the student with the least responses to their posting. 

**To  see view the grading criteria/rubric, please click on the 3 dots in the  box at the end of the solid gray bar above the discussion board title  and then Show Rubric.

DISCUSSION CONTENT 

Description 

Application of Course Knowledge  

Post contributes clinically accurate perspectives/insights applicable to the results from the physical exam and diagnoses. Initial post includes the most likely diagnosis/specific treatment plan given case study information supported by rationale  and answers all questions presented in the case. Demonstrates course  knowledge/assigned readings by: linking tests/interventions accurately to diagnoses, applies learned knowledge specifically to the symptoms and patient information using original dialogue i.e., little to no direct quotes.  

Evidence Based resources 

Discussion post supported by  evidence from appropriate sources published within the last five years.  Focus of journal articles represents a logical link between the article  content and the case study information.  In-text citations and full  references are provided. 

Organization  

Discussion post presented in a  logical, meaningful, and understandable sequence. Headings reflect  separation of criterion outlined in assignment guidelines.  

**Direct quote should not exceed 15 words & must add substantively to the discussion 

APA/Grammar/Spelling 

Discussion post has minimal  grammar, spelling, syntax, punctuation and APA* errors. Direct quotes  (if used) is limited to 1 short statement** which adds substantively to  the post.  

* APA style references and in text  citations are required; however, there are no deductions for errors in  indentation or spacing of references. All elements of the reference  otherwise must be included. 

          Week 6: Mental Health Final Treatment Plan/Analysis – Part 2         

Purpose  

The purpose of this assignment is for learners to: 

1. Have the opportunity to integrate knowledge and skills learned  throughout all core courses in the FNP track and previous clinical  courses.
2. Demonstrate an advancing understanding of the patient with a mental health disorder in primary care.
3. Demonstrate the ability to analyze the literature/ previous patients  seen in the clinical setting be able to perform an evidenced-based  review of their case, diagnosis, and plan, while guiding and taking  feedback from peers regarding the case.
4. Demonstrate professional communication and leadership, while advancing the education of peers.

Activity Learning Outcomes  

Through this discussion, the student will demonstrate the ability to:

1. Interpret  subjective and objective data to develop appropriate diagnoses and  evidence based management plans for patients and families with complex  or multiple diagnoses across the lifespan. (CO 1)  
2. Develop management plans based on current scientific evidence and national guidelines. 

Part 2- Turning in your final treatment plan and Analysis  

The final treatment plan will include the  primary diagnosis, diagnostic testing recommended by National  Guidelines. Medications, interventions, education, labs, follow up,  referrals. After completing the treatment plan include the following  sections in a large area called ANALYSIS:

1. Pathophysiology and Pharmacology: For the  primary diagnoses in the case, write a brief summary of the underlying  pathophysiology and tie pharmacological treatment chosen in the reversal  or control of that pathology. 
2. Additional analysis of the case: This includes national guidelines  that were or should have been used to make diagnosis or treatment and  review how they applied or how care was unique but based in guidelines.
3. Follow-up/Referrals: This means how the patient was doing when seen a  second time if this applies. This would be their response to your plan  of care. OR when Follow up will occur and what actions will be taken on  the follow up visit. Referrals if indicated.
4. Quality: Include anything that should have been considered in  hindsight or changes you would make in seeing similar patients in the  future with the same complaint, history, exam, or diagnosis. Add  anything you learned from discussion in the class that shed new light on  this patient.
5. Coding and Billing. Any or all CPT and ICD-10 codes that should have been used (List them and name them only.

Written in a word document and submitted in the Week 6 case study summary submission box.

DISCUSSION CONTENT 

Description 

Application of Course Knowledge  

Post contributes clinically accurate perspectives/insights applicable to the results from the physical exam and diagnoses. Initial post includes the most likely diagnosis/specific treatment plan given case study information supported by rationale  and answers all questions presented in the case. Demonstrates course  knowledge/assigned readings by: linking tests/interventions accurately to diagnoses, applies learned knowledge specifically to the symptoms and patient information using original dialogue i.e., little to no direct quotes.  

Evidence-Based resources 

Discussion post supported by  evidence from appropriate sources published within the last five years.  Focus of journal articles represents a logical link between the article  content and the case study information.  In-text citations and full  references are provided. 

APA/Grammar/Spelling 

Discussion post presented in a  logical, meaningful, and understandable sequence. Headings reflect  separation of criterion outlined in assignment guidelines.  

**Direct quote should not exceed 15 words & must add substantively to the discussion 

Discussion post has minimal grammar, spelling, syntax, punctuation and APA* errors. Direct quotes (if used) is limited to 1 short statement** which adds substantively to the post.  

* APA style references and in text  citations are required; however, there are no deductions for errors in  indentation or spacing of references. All elements of the reference  otherwise must be included. 

PLEASE FOLLOW THE INSTRUCTION BELOW

ZERO PLAGIARISM

FIVE REFERENCES

Psychiatric mental health nursing practice is one of the newest disciplines to be licensed to provide psychotherapy As such, the majority of psychotherapy research is centered on other disciplines such as psychology, social work, marriage/family therapy, art therapy, psychiatry, and mental health counseling. This makes it essential for you to be able to translate current literature from other disciplines into your own clinical practice. For this Assignment, you practice this skill by examining literature on group work and group therapy and considering its applicability to your own clients.

Learning Objectives

Students will:

• Evaluate the application of current literature to clinical practice

To prepare:

• Review this week’s Learning Resources and reflect on the insights they provide on group work and group therapy.
• Select one of the articles from the Learning Resources to evaluate for this Assignment.

Note: In nursing practice, it is not uncommon to review current literature and share findings with your colleagues. Approach this Assignment as though you were presenting the information to your colleagues.

The Assignment

In a 5- to 10-slide PowerPoint presentation, address the following:

• Provide an overview of the article you selected, including answers to the following questions:
  • What type of group was discussed?
  • Who were the participants in the group? Why were they selected?
  • What was the setting of the group?
  • How often did the group meet?
  • What was the duration of the group therapy?
  • What curative factors might be important for this group and why?
  • What “exclusion criteria” did the authors mention?
• Explain the findings/outcomes of the study in the article. Include whether this will translate into practice with your own client groups. If so, how? If not, why?
• Explain whether the limitations of the study might impact your ability to use the findings/outcomes presented in the article.

 Migrant Workers

The health issues that face migrant and other mobile underserved populations are similar to those faced by the general population but are often magnified or compounded by their migratory lifestyle. Mobility results in poor continuity of care and simultaneously increases the need for care (Migrant Health Network, 2015).  Health care access is a struggle as barriers of mobility, language, cultural differences and lack of familiarity with local health care services.  Work hazards for immigrant and migrant populations include some of the riskiest industries such as agriculture, forestry and construction.  There is a higher rate of injury and fatality compared to workers in other sectors.  Farm workers and their families are exposed to pesticides.  Other hazards include housing and sanitation, food insecurity and climate changes.

 Some recommendations for the migrant population would include ways to ensure their safety while at work whether construction or on the farm.  Pesticides exposure is a significant risk when working on the farm. It is important for them to recognize the signs and symptoms of exposure so they can have early medical treatment.  Exposure can happen by inhalation, touch or swallowing.  Signs can be very subtle like tiredness, headache, sore throat, nausea or vomiting and dizziness.  Protection from exposure includes wearing proper clothing (long sleeve shirts and pants), washing hands prior to eating and before drinking or going to the bathroom.

 When discussing the types of contraceptive methods available to young adults, it is important to provide all pertinent information for each.  Options range from daily pills, monthly injections or intrauterine devices.  If the patient is not complaint on a daily medication regime is would be best to suggest another option so that it is most effective.  In my short five years as a nurse, I have quickly learned to keep my personal feelings and/or beliefs aside.  Working with women that have difficulty conceiving naturally, I have been in situations that are uncomfortable for me but I must keep an empathetic face and mind to be the best for my patient.  It is important to be able to provide all information but as well to be able to have a comfortable conversation with your patient.

 Smoking cessation is different for every individual but overall some of the same important steps apply.  It is essential to mark your calendar and give yourself a realistic goal to achieve.  Triggers must be identified to know how to approach them in a productive manner.  You want to tell someone or multiple people your plans, this way you can be held accountable by them and they can help give you positive reinforcement.  There is pharmacological methods that can help curve the nicotine cravings.  It is I important to take these steps once they are committed one hundred percent to quitting. 

 Poverty has a negative impact on older adult’s health.  Poverty can significantly affect their access to food.  While they may have access to food some of the time, they often don’t know where, when, or how they will get their next meal.  Health care access can be affected as healthcare cost is continuously rising.

References

Migrant Health Network. (2015, September 15). Migrant Health Issues. Retrieved October 08, 2020, from https://www.migrantclinician.org/issues/migrant-info/health-problems.html

A patient is admitted with chest pain following a visit with her family health care provider. Using the “OLD CART” method of gathering pertinent data, discuss the type of questions you will be asking this patient in relation to her chest pain.

design health policies that address local and global population health issues 

Week 2 Case 2: Alzheimer’s

Ms. Washington is a 67-year-old African American female who is brought to your office by her daughter with concerns of “forgetfulness.” She has lived with her daughter for 4 years now, and her daughter reports noticing she asks the same questions even after they have been answered. She even reports her mom getting lost in Walmart recently. Ms. Washington has lived with her daughter since losing her husband of 57 years, about 4 years ago. Her daughter states her mother is a retired teacher and usually very astute but notices more forgetfulness. 

According to Ms. Washington’s daughter, Angela, her mom has been demonstrating increased forgetfulness of more recent things but can easily recall historical moments and events. She also reports that sometimes her mom has difficulty “finding the right words” in a conversation, and then will shift to an entirely different line of conversation. She also said her mother will “laugh off” things when she forgets important appointments and/or become upset or critical of others who try to point these things out. 

Note: Be sure to review the Mini-Mental State Exam (MMSE) and how to interpret results. Use the MMSE, in the attached document, to determine the patient’s MMSE score in the video. Make sure you document the patient’s score in your SOAP note document: Mental State Assessment Tests.

Ms. Washington is a 67-year-old female who is alert, cooperative with today’s clinical interview. Her eye contact is fair. Speech is clear and coherent but tangential at times. She makes no unusual motor movements and demonstrates no tics. She denies any visual or auditory hallucinations. She denies any suicidal thoughts or ideations. She is alert and oriented to person, partially oriented to place but is disoriented to time and place. (She reported that she thought was headed to work but “wound up here,” referring to your office, at which point she begins to laugh it off.) She denies any falls or pain. 

All other Review of System and Physical Exam findings are negative other than stated.

PMH: Hypertension, Hyperlipidemia, Osteoporosis 

Allergies: Penicillin, Lisinopril

Medications:

• Amlodipine 10mg daily
• HCTZ 12.5mg daily
• Multivitamin daily
• Atorvastatin 40mg daily
• Alendronate 70mg orally once a week

Social History: As stated in Case Study

ROS: As stated in Case study

Diagnostics/Assessments done: 

1. CXR—no cardiopulmonary findings. WNL
2. CT head—diffuse Cerebral Atrophy
3. MMSE—Ms. Washington scores 18 out of 30 with primary deficits in orientation, registration, attention and calculation, and recall. The score suggests moderate dementia. 

The Assignment:

Complete the Focused SOAP Note Template provided for the patient in the case study. Be sure to address the following:

• Subjective: What was the patient’s subjective complaint? What details did the patient provide regarding their history of present illness and personal and medical history? Include a list of prescription and over-the-counter drugs the patient is currently taking. Compare this list to the American Geriatrics Society Beers Criteria®, and consider alternative drugs if appropriate. Provide a review of systems.
• Objective: What observations did you note from the physical assessment? What were the lab, imaging, or functional assessments results? How would you interpret and address the results of the Mini-Mental State Examination (MMSE)?
• Assessment: Provide a minimum of three differential diagnoses. List them from top priority to least priority. Compare the diagnostic criteria for each, and explain what rules each differential in or out. Explain you critical thinking process that led you to the primary diagnosis you selected. Include pertinent positives and pertinent negatives for the specific patient case.
• Plan: Provide a detailed treatment plan for the patient that addresses each diagnosis, as applicable. Include documentation of diagnostic studies that will be obtained, referrals to other healthcare providers, therapeutic interventions, education, disposition of the patient, caregiver support, and any planned follow-up visits. Provide a discussion of health promotion and disease prevention for the patient, taking into consideration patient factors, past medical history (PMH), and other risk factors. Finally, include a reflection statement on the case that describes insights or lessons learned.
• Provide at least three evidence-based peer-reviewed journal articles or evidenced-based guidelines, which relate to this case to support your diagnostics and differentials diagnoses. Be sure they are current (no more than 5 years old) and support the treatment plan in following current standards of care. Follow APA 7th edition formatting. 

Review the IOM report, “The Future of Nursing: Leading Change, Advancing Health,” and explore the “Campaign for Action: State Action Coalition” website. In a 1,000-1,250 word paper, discuss the influence the IOM report and state-based action coalitions have had on nursing practice, nursing education, and nursing workforce development, and how they continue to advance the goals for the nursing profession.

Include the following:

1. Describe the work of the Robert Wood Johnson Foundation Committee Initiative that led to the IOM report, “Future of Nursing: Leading Change, Advancing Health.”
2. Outline the four “Key Messages” that structure the IOM Report recommendations. Explain how these have transformed or influenced nursing practice, nursing education and training, nursing leadership, and nursing workforce development. Provide examples.
3. Discuss the role of state-based action coalitions. Explain how these coalitions help advance the goals specified in the IOM report, “Future of Nursing: Leading Change, Advancing Health.”
4. Research the initiatives on which your state’s action coalition is working. Summarize two initiatives spearheaded by your state’s action coalition. Discuss the ways these initiatives advance the nursing profession.
5. Describe barriers to advancement that currently exist in your state and explain how nursing advocates in your state overcome these barriers.

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.  

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. 

The Role of the RN/APRN in Policy Evaluation

 Respond to TO THIS POST by suggesting additional opportunities or recommendations for overcoming the challenges described by your colleagues.  

  This is the post to respond to.

There are opportunities that exist for RNs and APRNs to actively participate in policy review.. One opportunity that exists for RNs and APRNs is to become a member of a professional nursing organization such as the American Nurses Association or the American Cancer Society. Often times, nurses are not motivated to participate in policy because there are many individuals writing policies that do not have health care knowledge and it can be intimidating to work with them. According to Matthews (2012), “Members and experts from many specialty organizations work with ANA lobbyists in the U.S. Congress and the various state legislatures to inform and persuade legislators concerning the needs of nursing and the general public regarding healthcare issues and quality care. 

               Another opportunity that exists to become involved in policy review for RNs and APRNs is to become a member of your state nurses association. Many state nurses associations hold positions for nurses to be a part of reviewing different health care policies. The challenge that is posed by this type of involvement in policy review is that it is a time consuming position and it can be difficult to balance that and a full time RN or APRN job. According to the Delaware Nursing Association (n.d), “DNA takes appropriate action whenever necessary to recommend and/or promote legislation (including statutory and administrative laws, executive policies standards, regulations, rulings, and legal decisions) which affect the interest of healthcare consumers, the nursing professional and support the mission and goals of DNA. The advocacy committee is charged with monitoring and participating in policy related to health care, the workplace, patient care, and many other areas where nurses are engaged”. 

               I believe that the opportunities that are available for RNs and APRNs to become more involved in policy review should be advocated by employers and by state boards of nursing. Employers should promote and foster the relationship of its nursing staff becoming more involved in health care policy making and review. After all, nurses are on the front lines and have a great deal of knowledge to share when it comes to policies in health care. According to Burke (2016), “More than ever, nurses are present in every healthcare setting and possess a unique role in formulating policy”.  

References 

Burke, S. (2016). Influence through policy: Nurses have a unique role. Retrieved October 23, 2020 from https://nursingcentered.sigmanursing.org/commentary/more-commentary/Vol42_2_nurses-have-a-unique-role

Delaware Nurses Association (n.d). Advocacy Committee. Retrieved October 23, 2020 from https://www.denurses.org/Committees

Matthews, J., (January 31, 2012) “Role of Professional Organizations in Advocating for the Nursing Profession” OJIN: The Online Journal of Issues in Nursing Vol. 17, No. 1, Manuscript 3.