Reflection in Action

 

The purpose of Reflection-in-Action is to reflect upon what one has learned or how one has performed as compared with one’s expectations or goals. This assignment will provide an opportunity for students to share their experiences, thoughts, feelings and learning moments from this course. 

Self understanding through reflection on life experiences, feelings, etc., is a core concept in Dr. Jean Watson’s Theory of Human Caring.  

The Reflection for this course must address at least three (3) of the following topics:

  • Learning moments or activities from this course
  • Thoughts on evidence-based practice
  • Evidence supporting Jean Watson’s Theory of Human Caring
  • Ethics in research
  • Protecting human subjects in quality improvement or evidence-based practice projects
  • Understanding or comfort level with statistics in nursing research and other research reports
  • Perception of MSN graduates’ role in nursing research
  • Creating and sustaining an Evidence-Based nursing environment
  • Asking compelling, clinical questions
  • Lessons learned while conducting evidence-based literature review

Expectations

  • Due: Monday, 11:59 pm PT
  • Length: four pages (excluding the title and reference pages).  Submissions not meeting the minimum and maximum page requirements will receive a grade of zero. 
  • Format: Formal paper, APA 6th ed format for body of paper and all citations. 

 

Week 8 Assignment: Evidence-Based Medicine: Research Presentation

 

For this project, you will complete a clinical case study analysis, research review, and PowerPoint video presentation about the pathophysiology of a topic of your choice. Just Make powerpoint part I will present it.

  1. Your presentation should follow a case study SBAR format (situation, background, assessment, and recommendations).
  2. You must include three (3) different medical-based evidence and/or research recommendations.
  3. You must include at least three (3) scholarly sources in your overall presentation.

Your PowerPoint presentation should include the following slides:

  • Introduction to the case or situation
  • Background detail
  • Clinical assessment
  • Recommendations
  • Application to future practice
  • Reference slide: At least three (3) scholarly references supporting your ideas.

Nursing

Leadership models and theories help define approaches for creating effective behaviors within specific situations or environments. Examine contemporary leadership models and theories and in a 1,000-1,250-word paper, explain why these models or theories are effective tools for leaders who serve in health care organizations. Include the following:

  1. Discuss the correlation between effective leadership and organizational performance in health care.
  2. Discuss why it is important for regulatory professionals to practice good leadership. Outline effective strategies for regulatory leadership and explain why these are essential in health care.
  3. Describe how the concept of stewardship from servant leadership relates to a Christian worldview. Explain how stewardship relates to professional responsibility, how it can be applied in a health care setting that serves diverse populations, and the potential benefits for stakeholders and the organization overall.
  4. Distinguish between informal and formal leadership. Explain how informal leaders influence others and how this impacts a health care organization.
  5. Select one additional theory or model that you think would be effective for a health care leader to employ. Provide an overview of the model or theory and explain what aspects would be effective and why.

A minimum of three academic references from credible sources are required for this assignment.

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. 

Knowlege check

QUESTION 1
1. A 28-year-old woman presents to the clinic with a chief complaint of hirsutism and irregular menses. She describes irregular and infrequent menses (five or six per year) since menarche at 12 years of age. She began to develop dark, coarse facial hair when she was 14 years of age, but her parents did not seek treatment or medical opinion at that time. The symptoms worsened after she gained weight in college. She got married 3 years ago and has been trying to get pregnant for the last 2 years without success. Height 66 inches and weight 198. BMI 32 kg.m2. Moderate hirsutism without virilization noted.  Laboratory data reveal CMP within normal limits (WNL), CBC with manual differential (WNL), TSH 0.9 IU/L SI units (normal 0.4-4.0 IU/L SI units), a total testosterone of 65 ng/dl (normal 2.4-47 ng/dl), and glycated hemoglobin level of 6.1% (normal value ≤5.6%). Based on this information, the APRN diagnoses the patient with polycystic ovarian syndrome (PCOS) and refers her to the Women’s Health APRN for further workup and management.  
Question 1 of 2:
What is the pathogenesis of PCOS? 
1 points   
QUESTION 2
1. A 28-year-old woman presents to the clinic with a chief complaint of hirsutism and irregular menses. She describes irregular and infrequent menses (five or six per year) since menarche at 12 years of age. She began to develop dark, coarse facial hair when she was 14 years of age, but her parents did not seek treatment or medical opinion at that time. The symptoms worsened after she gained weight in college. She got married 3 years ago and has been trying to get pregnant for the last 2 years without success. Height 66 inches and weight 198. BMI 32 kg.m2. Moderate hirsutism without virilization noted.  Laboratory data reveal CMP within normal limits (WNL), CBC with manual differential (WNL), TSH 0.9 IU/L SI units (normal 0.4-4.0 IU/L SI units), a total testosterone of 65 ng/dl (normal 2.4-47 ng/dl), and glycated hemoglobin level of 6.1% (normal value ≤5.6%). Based on this information, the APRN diagnoses the patient with polycystic ovarian syndrome (PCOS) and refers her to the Women’s Health APRN for further workup and management.  
Question 2 of 2:
How does PCOS affect a woman’s fertility or infertility? 
1 points   
QUESTION 3
1. A 20-year-old female college student presents to the Student Health Clinic with a chief complaint of abdominal pain, foul smelling vaginal discharge, and fever and chills for the past 4 days. She denies nausea, vomiting, or difficulties with defecation. Last bowel movement this morning and was normal for her. Nothing has helped with the pain despite taking ibuprofen 200 mg orally several times a day. She describes the pain as sharp and localizes the pain to her lower abdomen. Past medical history noncontributory. GYN/Social history + for having had unprotected sex while at a fraternity party. Physical exam: thin, Ill appearing anxious looking white female who is moving around on the exam table and unable to find a comfortable position. Temperature 101.6F orally, pulse 120, respirations 22 and regular. Review of systems negative except for chief complaint. Focused assessment of abdomen demonstrated moderate pain to palpation left and right lower quadrants. Upper quadrants soft and non-tender. Bowel sounds diminished in bilateral lower quadrants. Pelvic exam demonstrated + adnexal tenderness, + cervical motion tenderness and copious amounts of greenish thick secretions. The APRN diagnoses the patient as having pelvic inflammatory disease (PID).  
Question:
What is the pathophysiology of PID? 
1 points   
QUESTION 4
1. A 27-year-old male comes to the clinic with a chief complaint of a “sore on my penis” that has been there for 3 days. He says it burns and leaked a little fluid. He denies any other symptoms. Past medical history noncontributory. Social history: works as a bartender and he states he often “hooks up” with some of the patrons, both male and female after work. He does not always use condoms. Physical exam within normal limits except for a lesion on the lateral side of the penis adjacent to the glans. The area is indurated with a small round raised lesion. The APRN orders laboratory tests, but feels the patient has syphilis.  
Question:
Describe the 4 stages of syphilis.
1 points   
QUESTION 5
1. A 19-year-old female presents to the clinic with a chief complaint of “fluid filled bumps” and intense pruritis of her vulva. She states these symptoms have been present for about 10 days, but she thought she had a yeast infection. She self-medicated with over the counter (OTC) metronidazole (Flagyl™) intravaginally but the symptoms got worse. No other complaints except for fatigue out of proportion to her activity level. Past medical history noncontributory. Social history: sexually active with several men and did forget to use a condom during one sexual encounter. Physical exam negative except for pelvic exam which revealed multiple fluid filled (vesicular) lesions on the vulva and introitus. Positive lymph nodes in inguinal areas. The APRN diagnoses the patient with herpes simplex virus-type 2 known as genital herpes. 
Question:
What is the pathophysiology of HSV-2? 
1 points   
QUESTION 6
1. A 27-year-old male presents to the clinic with a chief complaint of a gradual onset of scrotal pain and swelling of the left testicle that started 2 days ago.  The pain has gotten progressively worse over the last 12 hours and he now complains of left flank pain. He complains of dysuria, frequency, and urgency with urination. He states his urine smells funny. He denies nausea, vomiting, but admits to urethral discharge just prior to the start of his severe symptoms. He denies any recent heavy lifting or straining for bowel movements. He says the only thing that makes the pain better is if he sits in his recliner and elevates his scrotum on a small pillow. Past medical history negative. Social history + for sexual activity only with his wife of 3 years. Physical exam reveals red, swollen left testicle that is very tender to touch. There is positive left inguinal adenopathy. Clean catch urinalysis in the clinic + for 3+ bacteria. The APRN diagnoses the patient with epididymitis.  
Question:
Discuss how bacteria in the urine causes epididymitis.  
1 points   
QUESTION 7
1. A 42-year-old male presents to the clinic with a chief complaint of fever, chills, malaise, arthralgias, dysuria, urinary frequency, low back pain, perineal, and suprapubic pain. He says he feels like he can’t fully empty his bladder when he voids. He states these symptoms came on suddenly about 12 hours ago and have gotten worse. He noticed some blood in his urine the last time he voided. He tried to have a bowel movement several hours ago but could not empty his bowel due to pain. Past medical and social history noncontributory. Physical exam reveals an ill appearing male. Temperature 101.8 F, pulse 122, respirations 20, BP 108/68. Exam unremarkable apart from left costovertebral angle (CVA) tenderness. Rectal exam difficult due to enlarged and extremely painful prostate.  Complete blood count revealed an elevated white blood cell count, elevated C-reactive protein and elevated sedimentation rate. Urine dip in the clinic + for 2+ bacteria.  
Question:
Explain the differences between acute bacterial prostatitis and nonbacterial prostatitis. 
Path: p
Words:0
1 points   
QUESTION 8
1. A 32-year-old woman presents to the clinic with a chief complaint of pelvic pain, excessive menstrual bleeding, dyspareunia, and inability to become pregnant after 18 months of unprotected sex with her husband. She states she was told she had endometrioses after a high school physical exam, but no doctor or nurse practitioner ever mentioned it again, so she thought it had gone away. She has no other complaints and says she wants to have a family. Past medical history noncontributory except for possible endometriosis as a teenager. Social history negative for tobacco, drugs or alcohol. The physical exam is negative except for the pelvic exam which demonstrated pain on light and deep palpation of the uterus. The APRN believes that the patient does have endometriosis and orders appropriate laboratory and radiological tests. The diagnostics come back highly suggestive of endometriosis.    
Question:
Explain how endometriosis may affect female fertility.
1 points   
QUESTION 9
1. An APRN working in an anticoagulation clinic has been asked by the local college to present a lecture on platelets and their role in blood clotting to the graduate pathophysiology nursing students.  
Question:
What key concepts should the APRN include in the presentation? 
1 points   
QUESTION 10
1. A 36-year-old woman presents to the clinic with complaints of dyspnea on exertion, fatigue, leg cramps on climbing stairs, craving ice to suck or chew and cold intolerance. The symptoms have come on gradually over the past 4 months. The only thing that make the symptoms better is for her to sit or lie down and stop the activity. She denies bruising or bleeding and states this is the first time this has happened. Past medical history noncontributory except for a new diagnosis of benign uterine fibroids 6 months ago after experiencing heavy menstrual bleeding every month. Social history noncontributory and she denies alcohol, tobacco, or drug use. Physical exam: pale, thin, Caucasian female who appears older than stated age. Physical exam remarkable for a soft I/IV systolic murmur, pallor of the mucous membranes, spoon-shaped nails (koilonychia), glossy tongue, with atrophy of the lingual papillae, and fissures at the corners of the mouth. The APRN suspects the patient has iron deficient anemia (IDA) secondary to excessive blood loss from uterine fibroids. The appropriate laboratory tests confirmed the diagnosis.  
Question:
Discuss iron deficiency anemia and how the patient’s menstrual bleeding contributed to the diagnosis. 
1 points   
QUESTION 11
1. A 67-year-old woman presents to the clinic with complaints of weakness, fatigue, paresthesias of the feet and fingers, difficulty walking, loss of appetite, and a sore tongue. These symptoms have been present for several months but the patient thought they were due to her recent retirement and geographic move from the Midwest to New England. The symptoms have gotten worse over the past few weeks and she has noticed that she is much more forgetful. This is of great concern as she worries she might have the beginning stages of Alzheimer’s Disease. Past medical history significant for Hashimoto thyroiditis that she developed in her early 20s. The rest of PMH and social history non- contributory. Physical exam reveals an average sized female whose skin has a sallow appearance. BP 128/74, Pulse 120, respirations 18 and temperature 99.0F orally. Examination of the head and neck reveals a smooth and beefy red tongue. Abdominal exam negative for hepatomegaly or splenomegaly.   
The APRN recognizes these symptoms and physical exam indicate the patient has pernicious anemia. After appropriate laboratory data received, the definitive diagnosis of pernicious anemia was made. 
Question 1 of 2:
How does pernicious anemia develop? 
1 points   
QUESTION 12
1. A 67-year-old woman presents to the clinic with complaints of weakness, fatigue, paresthesias of the feet and fingers, difficulty walking, loss of appetite, and a sore tongue. These symptoms have been present for several months but the patient thought they were due to her recent retirement and geographic move from the Midwest to New England. The symptoms have gotten worse over the past few weeks and she has noticed that she is much more forgetful. This is of great concern as she worries she might have the beginning stages of Alzheimer’s Disease. Past medical history significant for Hashimoto thyroiditis that she developed in her early 20s. The rest of PMH and social history non- contributory. Physical exam reveals an average sized female whose skin has a sallow appearance. BP 128/74, Pulse 120, respirations 18 and temperature 99.0F orally. Examination of the head and neck reveals a smooth and beefy red tongue. Abdominal exam negative for hepatomegaly or splenomegaly.   
The APRN recognizes these symptoms and physical exam indicate the patient has pernicious anemia. After appropriate laboratory data received, the definitive diagnosis of pernicious anemia was made. 
Question 2 of 2:
How does pernicious anemia cause the neurological manifestations that are often seen in patients with PA? 
1 points   
QUESTION 13
1. A 49-year-old man with a 22-year history of severe rheumatoid arthritis (RA) presents to clinic for his preadmission testing (PAT) and medical clearance for a planned right total hip arthroplasty. The patient had been severely limited in ambulation due to the RA. Current medications include prednisone 20 mg po qd and methotrexate 7.5 mg Thursdays, 5mg Fridays, and 7.5 mg Saturdays.  The patient had a complete blood count (CBC) with manual differentiation and red blood cell indices, complete metabolic panel (CMP) and coagulation studies (prothrombin time [PT], international normalized ratio [INR] and activated partial thromboplastin time [aPTT]). All the laboratory studies come back within normal limits except for the red blood cell indices. The hemoglobin and hematocrit were low along with mean corpuscle volume, plasma iron and total iron binding capacity, and transferrin also being low. There was a normal reticulocyte count, normal ferritin, serum B12, folate and bilirubin.  
The APRN in the PAT clinic recognizes that the patient has anemia of chronic disease (ACD).  
Question 1 of 2:
What is ACD and how does it develop? 
1 points   
QUESTION 14
1. A 49-year-old man with a 22-year history of severe rheumatoid arthritis (RA) presents to clinic for his preadmission testing (PAT) and medical clearance for a planned right total hip arthroplasty. The patient had been severely limited in ambulation due to the RA. Current medications include prednisone 20 mg po qd and methotrexate 7.5 mg Thursdays, 5mg Fridays, and 7.5 mg Saturdays.  The patient had a complete blood count (CBC) with manual differentiation and red blood cell indices, complete metabolic panel (CMP) and coagulation studies (prothrombin time [PT], international normalized ratio [INR] and activated partial thromboplastin time [aPTT]). All the laboratory studies come back within normal limits except for the red blood cell indices. The hemoglobin and hematocrit were low along with mean corpuscle volume, plasma iron and total iron binding capacity, and transferrin also being low. There was a normal reticulocyte count, normal ferritin, serum B12, folate and bilirubin.  
The APRN in the PAT clinic recognizes that the patient has anemia of chronic disease (ACD).  
Question 2 of 2:
Why do patients with chronic kidney disease (CKD) develop ACD? 
1 points   
QUESTION 15
1. A 14-year-old female is brought to the Urgent Care by her mother who states that the girl has had an abnormal number of bruises and “funny looking red splotches” on her legs. These bruises were first noticed about 2 weeks ago and are not related to trauma. Past medical history not remarkable and she takes no medications. The mother does state the girl is recovering from a “bad case of mono” and was on bedrest at home for the past 3 weeks. The girl noticed that her gums were slightly bleeding when she brushed her teeth that morning.  
Labs at Urgent Care demonstrated normal hemoglobin and hematocrit with normal white blood cell (WBC) differential. Platelet count of 100,000/mm3 was the only abnormal finding. The staff also noticed that the venipuncture site oozed for a few minutes after pressure was released. The doctor at Urgent Care referred the patient and her mother to the ED for a complete work up of the low platelet count including a peripheral blood smear for suspected immune thrombocytopenia purpura (ITP). 
Question:
What is ITP and why do you think this patient has acute, rather than chronic, ITP? 
1 points   
QUESTION 16
1. A 22-year-old male is in the Surgical Intensive Care Unit (SICU) following a motor vehicle crash (MVC) where he sustained multiple life-threatening injuries including a torn aorta, ruptured spleen, and bilateral femur fractures. He has had difficulty maintaining his mean arterial pressure (MAP) and has required various vasopressors. He has a triple lumen central venous catheter (CVC) for monitoring his central venous pressure, administration of medications and blood products, as well as total parenteral nutrition. Per hospital protocol, he is receiving an unfractionated heparin 1:1000 flush after administration of each of the triple antibiotics that have been ordered to maintain patency of the lumens.  Seven days post injury, the APRN in the SICU is reviewing the patient’s morning labs and notes that his platelet count has dropped precipitously to 50,000 /mm3 from 148,000/mm3 two days ago. The APRN suspects the patient is developing heparin induced thrombocytopenia (HIT).  
Question 1 of 2:
What is underlying pathophysiology of heparin induced thrombocytopenia? 
1 points   
QUESTION 17
1. A 22-year-old male is in the Surgical Intensive Care Unit (SICU) following a motor vehicle crash (MVC) where he sustained multiple life-threatening injuries including a torn aorta, ruptured spleen, and bilateral femur fractures. He has had difficulty maintaining his mean arterial pressure (MAP) and has required various vasopressors. He has a triple lumen central venous catheter (CVC) for monitoring his central venous pressure, administration of medications and blood products, as well as total parenteral nutrition. Per hospital protocol, he is receiving an unfractionated heparin 1:1000 flush after administration of each of the triple antibiotics that have been ordered to maintain patency of the lumens.  Seven days post injury, the APRN in the SICU is reviewing the patient’s morning labs and notes that his platelet count has dropped precipitously to 50,000 /mm3 from 148,000/mm3 two days ago. The APRN suspects the patient is developing heparin induced thrombocytopenia (HIT).  
Question 2 of 2:
The APRN assesses the patient and notes there is a decreased right posterior tibial pulse with cyanosis of the entire foot. The APRN recognizes this probably represents arterial thrombus formation. How does someone who is receiving heparin develop arterial and venous thrombosis? 
1 points   
QUESTION 18
1. A 33-year-old female is brought to Urgent Care by her husband who states his wife has gotten suddenly confused and complains of a severe headache. He also noticed large bruises on her legs which were not there yesterday. Only significant past medical history is that the patient developed herpes zoster 2 weeks ago and was given acyclovir for treatment. Physical exam revealed well developed female who is only oriented to person. Large areas of ecchymosis noted on both arms and legs. Stat CBC revealed a platelet count of 18,000/mm3, hemoglobin of 8 g/dl and hematocrit of 24%. The patient was immediately transported to the Emergency Room by Emergency Medical Services (EMS) where further work up demonstrated idiopathic thrombotic thrombocytopenic purpura (TTP).  
Question:
What is the pathophysiology of TTP? 
1 points   
QUESTION 19
1. A 64-year man is recovering from a transurethral resection of the prostate for treatment of benign prostate hyperplasia. The patient is receiving intravenous antibiotics for the urinary tract infection that was found on the preoperative urine culture and sensitivity (C & S). The post-operative course has been smooth and the APRN is removing the 3-way Foley catheter when there is a sudden release of bright red blood with many blood clots in the Foley bag. The patient becomes hypotensive, tachycardic and the APRN notes new ecchymoses on the patient’s arms and legs. The patient was immediately transferred to the surgical intensive care unit (SICU) and a stat hematology consult was conducted. Stat CBC, d-dimer, peripheral blood smear, partial thromboplastin time, Prothrombin time/international normalization ratio (INR), and fibrinogen labs were drawn. Results were:  
CBC with markedly decreased platelet count, peripheral blood smear showed decreased number of platelets and presence of large platelets and fragmented red cells (schistocytes), prothrombin time prolonged as was the partial thromboplastin time. The d-dimer was markedly elevated, and fibrinogen level was low. The diagnosis of disseminated intravascular coagulation (DIC) was made based on clinical picture and laboratory data.  
Question 1 of 2:
What is DIC and how does it develop? 
1 points   
QUESTION 20
1. A 64-year man is recovering from a transurethral resection of the prostate for treatment of benign prostate hyperplasia. The patient is receiving intravenous antibiotics for the urinary tract infection that was found on the preoperative urine culture and sensitivity (C & S). The post-operative course has been smooth and the APRN is removing the 3-way Foley catheter when there is a sudden release of bright red blood with many blood clots in the Foley bag. The patient becomes hypotensive, tachycardic and the APRN notes new ecchymoses on the patient’s arms and legs. The patient was immediately transferred to the surgical intensive care unit (SICU) and a stat hematology consult was conducted. Stat CBC, d-dimer, peripheral blood smear, partial thromboplastin time, Prothrombin time/international normalization ratio (INR), and fibrinogen labs were drawn. Results were:  
CBC with markedly decreased platelet count, peripheral blood smear showed decreased number of platelets and presence of large platelets and fragmented red cells (schistocytes), prothrombin time prolonged as was the partial thromboplastin time. The d-dimer was markedly elevated, and fibrinogen level was low. The diagnosis of disseminated intravascular coagulation (DIC) was made based on clinical picture and laboratory data.  
Question 2 of 2:
What factors contribute to the development of DIC?  

Healthcare Technology: Local, National, and Global Considerations

Imagine that you are a public health nurse, and you and your colleagues  have determined that the threat of a deadly new strain of influenza  indicates a need for a mass inoculation program in your community. What  public health data would have been used to determine the need for such a  program? Where would you locate public health data? What data will be  collected to determine the success of such a program? How might you  communicate this to other communities or internationally?

strategic planning

  1. How has the role of the strategic planner changed over the past several decades? What new skills will be essential for the strategic planner?
  2. How does the scanning process create a “window” to the external environment? How does the window concept help in understanding organizations and the types of information they produce?

Professional Development: 

  1. Using the questions listed in Exhibit 2-8 (p. 68), as your basis discuss strategic assumptions and how you would respond to them in a strategic planning assessment.

Discussion

 I NEED A RESPONSE FOR THIS ASSIGNMENT

3 REFERENCES

Children and adolescents have the unique advantage and challenge of rapid growth and development within relatively short duration of time.  For this reason, developmental assessments are essential to identify and measuring growth, ensuring milestones are reached at appropriate times (Milbrath, et al., 2020).  Early identification leads to early interventions for children or adolescents who are not appropriately meeting milestones of development.  When performing a general assessment, whether for mental health issues or annual visit, it is important to also rule out any possible developmental symptoms that could be presenting as other acute symptoms.  It is important to ensure that the child or adolescent is developing appropriately or intervene promptly to address potential delays.

One assessment tool that can be used for very young children, even toddlers, is the Cognitive Adaptive Test/Clinical Linguistic and Auditory Milestone Scale (CAT/CLAMS).  The child plays with toys throughout the evaluation while the provider assesses their level of development (Milbrath, et al., 2020).  This is an effective test for determining the child’s language and cognitive development (Milbrath, et al., 2020).  An advantage of this assessment scale is that it can be used for very young children, as there are no specific questions but rather observation.  This tool is used in children since it involves toys and activity that is rated by the evaluator rather than specific questions that are answered by the client.  

Another tool that could be useful for a wider age range of children is the Early Development of Emotional Competence (EDEC), which is a tool that assesses the correlation between the child’s language skills and emotional abilities, particularly expression or behavior (Na, Wilkinson, & Liang, 2018).  This developmental tool may be more helpful in the mental health context, as it assesses the client’s language development as well as emotional response.  Rather than diagnosing, this tool can be useful in assessing the family dynamics, as parents or caregivers are active participants in this evaluation (Na, Wilkinson, & Liang, 2018).  While parents participate, the assessment tool is focused on the emotional regulation of the child or adolescent client.  This tool is used in children as it evaluates language development in relation to emotions, which would not be applicable for adult clients.

As with all populations of clients, evidence based treatments are most effective in treating a variety of symptoms, and can be taught to a large group to implement for practice (Leathers & Strand, 2018).  One method of treatment that would be more appropriate for children or adolescents over adults would be game or activity based treatment modalities.  This allows for the children to interact in a way that does not require verbal articulation.  While activity or other experiential therapies can be utilized for adults, they are more likely to be utilized and effective with a younger population.  Another treatment modality that would be more appropriate for child or adolescent clients is a technology application that can be used on a computer or tablet (Davidson, et al., 2019).  This is another way to engage children to actively participate in an application on a screen, which comes easily to children and adolescents.  While adults would be capable of utilizing an application on a computer, phone, or tablet, it would be more effective for younger clients. 

Parents play an important role in assessing child clients, as the parents are able to articulate observable symptoms or concerns that the young client may not be able to identify or label.  Another role that parents play in assessment and treatment is how they may be affected by their children’s diagnoses or symptoms.  It is important to identify parents who require increased support related to treatment, as there are specialized assessment tools to measure this as well (Samadi, Abdollahi-Bograbadi, & McConkey, 2018).  This can be an important part of the assessment and evaluation process for children and parents alike.  Often, the stressors experienced in the home environment affect and exacerbated already existing symptoms among children and parents.

References

Davidson, T.A., Bunnell, B.E., Saunders, B.E., Hanson, R.F., Danielson, C.K., Cook, D., Chu,

B.C., Dorsey, S., Adams, Z.W., Andrews III, A.R., Walker, J.H., Soltis, K.E., Cohen,

J.A., Deblinger, E., & Ruggiero, K.J.  (2019).  Pilot evaluation of a tablet-based

application to improve quality of care in child mental health treatment.  Behavior

Therapy, 50(2), 367-379.  doi:10.1016/j.beth.2018.07.005.

Leathers, S.J., & Strand, T.C.  (2018).  Social work training in the use of evidence-based

treatments for children: What works?  Journal of Social Work Education, 54(S1), S41-

S55.  doi:10.1080/10437797.2018.1434444.

Milbrath, G., Constance, C., Ogendi, A., & Plews-Ogan, J.  (2020).  Comparing two early child

development assessment tools in rural Limpopo, South Africa.  BMC Pediatrics, 20,

197.  doi:10.1186/s12887-020-02101-0.

Na, J.Y., Wilkinson, K., & Liang, J.  (2018).  Early Development of Emotional Competence

(EDEC) assessment tool for children with complex communication needs: Development

and evidence.  American Journal  of Speech-Language Pathology, 27, 24-

36.  doi:10.1044/2017_AJSLP-16-0058.

Samadi, S.A., Abdollahi-Boghrabadi, G., & McConkey, R.  (2018).  Parental satisfaction with

caregiving for children with developmental disabilities: Development of a new

assessment tool.  Children (Basel), 5(12), 166.  doi:10.3390/children5120166.

Assignment 08: Cross-Cultural Conundrum

HA3300D – Healthcare Policy and Ethics

Assignment 08: Cross-Cultural Conundrum 

 Directions

You are the manager of your local regional health clinic. You have a meeting with your Board of Trustees coming up in a few days. Your trustees have asked you to prepare a short presentation in response to an incident that occurred at your clinic just a few weeks ago:

A young Native American woman fell sustaining an injuring to her arm. After a week, her arm is still painful which causes her to visit a physician at your clinic. The physician orders tests, ascertains that there is no fracture, and decides to simply advise over-the-counter medication for inflammation and pain. Two weeks later the patient returns with the same issue at which time the physician believes that physical therapy will help the injured arm. While undergoing physical therapy, the patient also visits with a local healer who prescribes herbal treatments for the injury. The patient returns to see the physician after two weeks with an improvement in her injury. On her last visit she wanted to discuss her desire to use natural treatments in conjunction with physical therapy with the white doctor but did not. In fact, she has discussed very little with her doctor about her injury, how it has affected her ability to care for her children and elderly mother, etc. She does not fully trust the white doctor and has heard him sound skeptical concerning healers from her culture or other types of “non-traditional” treatments. The patient does, however, feel that natural remedies administered by healers help her.

For this assignment, either prepare a speech by typing the transcript in a Word document, OR prepare a brief (7-8 slide) PowerPoint presentation. In your speech/presentation, address the following questions:

.What ethical issues does this incident raise?

.Should you be involved in this issue at all, or is this a job for another part of your organization?

.Propose a solution to the conflict, supporting your plan using ethical concepts.