HEALTH ASSESSMENT

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Module 03 Written Assignment – Health History

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Module 03 Content

1.

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This assignment is due no later than Sunday October 22nd at 11:59pm

Conduct a health history on a family member or friend. 
You can use the form located in your Health Assessment lab manual book or from Week Two classroom assignment. 

You do not need to submit the health history form with your paper.
 Be sure they give you permission. Using the interviewing techniques learned in Module 2, 
gather the following information. Use your textbook as your guide.

· Present Health

· Past Medical Health

· Family History

· Review of Systems

 

While this is only a partial health history, summarize in 3 -5 pages the information you gathered.

Include your answers to the following questions in the summary:

a. Was the person willing to share the information? If they were not, what did you do to encourage them?

b. Was there any part of the interview that was more challenging? If so, what part and how did you deal with it?

c. How comfortable were you taking a health history?

d. What interviewing techniques did you use? Were there any that were difficult and if so, how did you overcome the difficulty?

e. Now that you have taken a health history discuss how this information can assist the nurse in determining the health status of a client.

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Power Point

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Assignment

Create a Power Point

Purpose

This assignment will focus on developing a health policy analysis presentation that includes a problem statement, background, landscape, options, and recommendations from the week’s readings. The health policy analysis presentation is based on an identified healthcare issue in one’s local community. 

As Family Nurse Practitioner:

1. Research healthcare issues that have been identified in your local community. Develop a PowerPoint presentation with speaker notes. You will then use the PowerPoint during your Kaltura recording. Structure a health policy analysis presentation that addresses the following topics particular to your health problem:

· Problem Statement 

· Background 

· Landscape 

· Options 

· Recommendations 

Please provide FootNotes

2. Next, record your Kaltura presentation showing your PowerPoint and yourself speaking. Upload your Kaltura presentation into the week 4 assignment. How to use Kaltura resources are in Home/Resources/Technology Resources.

3. Posting your recording:

· Go to the week four assignment tab and hit Submit Assignment

· Use the Text Entry Tab. You will have the option of selecting the Kaltura icon.

· It will take you to your My Media Gallery and upload it from there.

Week 5_ ANALYSIS OF QUANTITATIVE DATA

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Please review the complete instructions.

Unit 11: Discussion Medications for Pain Management. 800w. 4 references. Due 11-01-23

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Unit 11 Discussion Medications for Pain Management. 800w. 4 references. Due 11-01-23

1. Why are many parties, including the U.S. Government, concerned about the use of opioids for pain management?

2. Provide input on the following article “America’s opioid crisis: the need for an integrated public health approach” https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7286889/

3. Which mental health disorders are commonly associated with patients who also need pain relief? ——–I believe this is depression and anxiety.
https://www.health.harvard.edu/mind-and-mood/pain-anxiety-and-depression. https://www.healthcentral.com/pain-management/chronic-pain-and-mental-health

4. What is an MME and how is it calculated?

Responses need to address all components of the question, demonstrate critical thinking and analysis and include peer-reviewed journal evidence to support the student’s position.

Please be sure to validate your opinions and ideas with in-text citations and corresponding references in APA format.

Please review the rubric to ensure that your response meets the criteria.

Medications for Pain Management Pain relievers in the opioid class work by binding to specific cells known as opioid receptors in the brain and nervous system. Opioid drugs dull pain perception and heighten pleasure when they bind to opioid receptors within brain cells, activated when the blood reaches the brain. That which makes opiate painkillers so effective also makes them potentially harmful. Many organizations are concerned about opioids because while at lesser dosages, they may make patients sleepy (Townsend et al., 2021). In more significant quantities, they can cause breathing and heart rate slowdowns, resulting in death. Additionally, the pleasurable effects of opioids might make the patients crave more of them, which can be a dangerous spiral into addiction. By taking medications as prescribed, patients can lessen the likelihood of experiencing adverse effects. Patients should inform their healthcare providers of all their drugs and supplements (Mark & Paris, 2019). Significant evidence also links chronic pain to mental health issues and substance dependence. However, the exact nature of the connection, particularly in terms of causation, is sometimes unclear. According to Slawek et al. (2022), pain can increase mental health difficulties such as anxiety, difficulty sleeping, depression, and panic disorders, while stress and depression can make chronic pain severe. Pain can also make it more difficult to sleep. Opioid overdose most commonly causes respiratory depression, which can cause severe consequences or even death. When a patient is close to a potentially harmful threshold, medical professionals look at their daily morphine equivalent doses (MED),which is the sum of the MMEs of all opioids they are likely to take within 24 hours. The Morphine Milligram equivalent (MME) value is the relative potency of a dose of opioids compared to morphine (Dasgupta, This study source was downloaded by 100000769192234 from CourseHero.com on 10-22-2023 14:20:45 GMT -05:00 https://www.coursehero.com/file/184520553/Unit-11-Discussion-Pain-Managementdocx/ 2 2021). MME aims to aid physicians in making safe and appropriate judgments when considering modifications to existing opiate treatment plans. The MME converts multiple different opiate doses into a uniform number based on the strength of morphine using a universal conversion factor defined by the Centers for Disease Control and Prevention (CDC). Every prescription is given in MME daily according to the CDC conversion factor, dosage, and the number of days' worth of medication. Each opiate dose a patient takes per day is converted to milligrams of morphine using a morphine-based conversion factor, and the daily average rate is then used to determine the MME. This study source was downloaded by 100000769192234 from CourseHero.com on 10-22-2023 14:20:45 GMT -05:00 https://www.coursehero.com/file/184520553/Unit-11-Discussion-Pain-Managementdocx/ 3 References Dasgupta, N. (2021). Verbatim MME calculation methods from studies cited in the CDC pain guideline identified from a previous methods review. FDA U.S. Food and Drug Administration. https://doi.org/10.17615/95wd-3150 Mark, T. L., & Parish, W. (2019). Opioid medication discontinuation and risk of adverse opioidrelated health care events. Journal of Substance Abuse Treatment, 101(1), 58-63. https://doi.org/10.1016/j.jsat.2019.05.001 Slawek, D. E., Syed, M., Cunningham, C. O., Zhang, C., Ross, J., Herman, M., Sohler, N., Minami, H., Levin, F. R., Arnsten, J. H., & Starrels, J. L. (2022). Pain catastrophizing and mental health phenotypes in adults with refractory chronic pain: A latent class analysis. Journal of Psychiatric Research, 145(1), 102-110. https://doi.org/10.1016/j.jpsychires.2021.12.001 Townsend, T., Cerda, M., Bohnert, A., Legisetty, P., & Haffajee, R. L. (2021). CDC guideline for opioid prescribing associated with reduced dispensing to certain patients with chronic pain: Study examines the impact of CDC guidelines for opioid prescribing. Health Affairs, 40(11), 1766-1775. https://doi.org/10.1377/hlthaff.2021.00135

Self Care activity

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Setting boundaries and making self-care a priority is extremely important when practicing as a nurse. Discuss methods of self care that you have found to be effective when dealing with an emotional reaction to a situation.

Once you have selected a topic, post a discussion about why that self-care technique is beneficial, how it helps you, how it can benefit your nursing practice, and why self-care is so important when caring for individuals with mental illness. 

250 words or less simple discussion

Week 2 Reflections NR501NP

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Weekly objective

  1. Explore an area of interest through patterns of knowing (CO 1)
  2. Examine the components of the nursing metaparadigm.
  3. Examine different patterns of knowing in nursing. (CO 2)
  4. Analyze the benefits of reflection for shaping and understanding theory. (CO 2)
  5. Differentiate between the received and perceived schools of scientific thought. (CO 2)

Course Outcomes

  1. Demonstrate logical and creative thinking in the analysis and application of a theory to nursing practice. (PO 2 and 5)
  2. Apply nursing theory as a framework to guide the development of new knowledge and implementation of evidence-based practice in future professional settings. (PO 1 and 4)

The above is just additional information for the question below.

 Write 1-2 paragraphs reflecting on ways of knowing and the use of metaparadigm in the NP role 

  • Provide one specific example of how you achieved the weekly objectives.
  • What do you value most about your learning this week?
  • What else about the weekly topics do you need to explore to grow further as a future NP?

SEARCHING DATABASES

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To Prepare:

  • Review the Resources below and identify a psychiatric clinical issue of interest that can form the basis of a clinical inquiry.
  • Based on the clinical issue of interest and using keywords related to the clinical issue of interest, search at least two different databases in the Walden university Library to identify at least four relevant peer-reviewed articles related to your clinical issue of interest. You should not be using systematic reviews for this assignment, select original research articles.
  • Review the Resources for guidance and develop a PICO(T) question of interest to you for further study. It is suggested that an Intervention-type PICOT question be developed as these seem to work best for this course. 

the assignment: Post a brief description of your clinical issue of interest. This clinical issue will remain the same for the entire course and will be the basis for the development of your PICOT question. Describe your search results in terms of the number of articles returned on original research and how this changed as you added search terms using your Boolean operators. Finally, explain strategies you might make to increase the rigor and effectiveness of a database search on your PICO(T) question. Be specific and provide examples and at least 3 references.

Resources:

W5 R see attachment

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Make a follow-up of a student's weekly discussion and respond with your opinion regarding to her post

——You don't have to post this in APA format necessarily, it's just giving feedback to the student .



Lili Ketema


Clinical Decision Support Systems

Pros

Cons

Patient Safety. Clinical Decision Support Systems empower Advanced Practice Nurses to make decisions in a timely and informed manner by detecting diseases early and managing them effectively (Ayed Aloufi, 2020). CDSS has reminder systems for medical events different from the ones related to medicine. For example, CDSS for measuring blood glucose in the ICU can decrease the frequency of hypoglycemia events (Sutton et al., 2020). This CDSS automatically prompts nurses to take glucose measurements with respect to the local glucose monitoring protocol that specifies particular patient demographics and previous glucose trends.

Overreliance. CDSS may increase patient safety but increase reliance on the system, resulting in a decrease in critical thinking capabilities since the APN does not feel impelled to utilize their clinical judgment capabilities. This development is undesirable because the APN becomes less equipped for a task that they can execute in the absence of a CDSS. Sutton et al. (2020) compare overreliance on CDSS to using a calculator in math; the authors indicate that the user’s mental math skills decline with extended use. Therefore, APNs may end up less equipped to execute the services they should execute with ease. 

Improved Accuracy and Efficiency. CDSS can process significant quantities of patient data swiftly and precisely, empowering providers of care to effectively diagnose and plan for treatment (Ayed Aloufi, 2020). This decreases the possibility of errors by providing computerized consultation. The Diagnostic Decision Support Service provides data/user selections and then outputs a list of possible diagnoses (Sutton et al., 2020). These developments enhance EHR-integration as well as standardized vocabulary such as Snomed Clinical Terms.      

System and Content Maintenance. Maintenance is an often neglected aspect of the lifecycle of the CDSS. Maintenance encompasses technical and content of the systems that power the CDSS. The applications and knowledge-base of the CDSS should always be apace with the shifting nature of clinical guidelines and medical practice. Failure to stay updated may limit the CDSS’ capacity to maintain the desired levels of accuracy and efficiency. Sutton et al. (2020) assert that even the healthcare institutions that are highly advanced experience challenges keep9ing abreast with keeping their systems updated due to the inevitability of changes in medical knowledge bases. 

Cost Containment. The capacity of CDSS to decrease the length of stay for in-patients, provide clinical interventions, decrease test duplication, and suggest cheaper alternatives of medicine makes the systems more efficient (Sutton et al., 2020). For example, a CPOE-integrated has the capacity to limit the scheduling of blood count to a 24-hr interval when implemented in a paediatric cardiovascular intensive care unit. This laboratory resource utilization cost-reduction has a predictable cost discount of $717,538 every year, minus increasing mortality or length of stay. These advantages reveal the highly capabe nature of the CDSS to contain costs associated with hospital procedures and the overall ROI associated with CDSSs.  

The system is predicated on computer literacy. Decreased proficiency in technology can be limiting when a person is engaging with CDSS. The high design details associated with CDSS may be exceedingly complicated, decreasing the capacity of some APNs to use them to reach the advantages associated with the implementation of the system within a hospital setting (Sutton et al., 2020). Although some systems stay as close to close functionality as possible, every new system has a learning period, meaning the baseline of the technological competence of users is appropriate. Further training for APNs increase on the costs that the institution was aiming at cutting in the first place.

Future role as an APN and clinical patient and scenario 

A 68 year old man who has a history of diabetes, hypertension, and chronic renal disease shows up at the clinic complaining of fatigue, increased thirst, and frequent urination. Since I feel the patient's symptoms might be brought on by uncontrolled diabetes, I have made the decision as a prospective APN healthcare professional to ask for a blood test to confirm the diagnosis.

Impact of CDSS: Before prescribing any new medications, the system alerts me about the patient's current medications, which include metformin and lisinopril. The CDSS also prompts  to consider the patient's renal status.

After noting the CDSS alert, I decide to review the patient's most recent lab results, particularly the estimated glomerular filtration rate (eGFR). The patient has substantial renal impairment, as seen by their eGFR, which is less than 30 mL/min/1.73m2, as I learned after examining the lab results.

In light of the CDSS alert and the patient's test results, I decide to alter the patient's prescription regimen. As opposed to providing a conventional oral anti-diabetic prescription like sulfonylureas, which may be contraindicated in patients with severe renal impairment, as APN i would consider alternate choices such insulin treatment or a newer family of anti-diabetic pharmaceuticals that are safe for patients with renal impairment.

Based on the patient's renal function and the medications they were taking at the time, the CDSS made recommendations. This let the medical practitioner make a more informed decision and avoid any side effects or drug interactions.

This scenario demonstrates how a CDSS might influence a provider's decision by providing timely reminders and cautions based on the patient's specific clinical data. It guarantees that the healthcare provider considers all relevant information and selects the best course of action for the patient's unique needs.

References

Ayed Aloufi, M. (2020). Effect of clinical decision support systems on quality of care by nurses. 
International Journal for Quality Research, 
14(3), 665–678. https://doi.org/10.24874/ijqr14.03-01

Sutton, R. T., Pincock, D., Baumgart, D. C., Sadowski, D. C., Fedorak, R. N., & Kroeker, K. I. (2020). An overview of clinical decision support systems: Benefits, risks, and strategies for Success. 
Npj Digital Medicine, 
3(1). https://doi.org/10.1038/s41746-020-0221-y

 

Unit 5 Medications for Depression and Anxiety Related Disorders 800W. APA. 4 references due 9-29-23.

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Advanced Psychopharmacology and Health Promotion

Unit 5 Medications for Depression and Anxiety Related Disorders 800W. APA. 4 references due 9-29-23.

Case Study:

A 24-year-old female presents to your office stating that she is troubled by headaches and fatigue. She says that she always feels tired and can’t sleep well, often waking up early if she gets to sleep at all. She describes her headaches as dull, aching, and generalized. These symptoms began about three weeks ago and have been getting worse. She reports a lack of interest in her usual activities, even the ones that she used to enjoy. She also reports that she is missing work due to fatigue and inability to concentrate. Although both her children are in school, she is concerned that she is “losing them”. She is worried that she might have “something bad” because she has difficulty concentrating and is having frequent crying spells. She reports a loss of appetite, with a weight loss of 10 pounds in the last month.

The patient has no significant past medical or psychiatric history and takes no regular medications. However, she takes ibuprofen for headaches. She denies using alcohol or drugs. The patient is married, with two elementary school-age children.

1.

1. What diagnosis do you believe may apply to this individual?

2. What classifications of medications can be used to treat this disorder? Which medication do you recommend and why?

Responses need to address all components of the question, demonstrate critical thinking and analysis and include peer-reviewed journal evidence to support the student’s position.

Please be sure to validate your opinions and ideas with in-text citations and corresponding references in APA format.

Please review the rubric to ensure that your response meets the criteria.

Nursing Assignment

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Bioethical
 Decision
 Making
 Model
 

 

1. Define
 the
 dilemma:
 Use
 your
 own
 words
 to
 describe
 the
 problem.
 State
 it
 in
 a
 way
 
that
 others
 can
 quickly
 understand
 your
 dilemma.
 Review
 
 
 
 

 

2. Identify
 the
 medical
 facts:
 Describe
 the
 facts
 that
 are
 relevant
 to
 the
 dilemma.
 
 

 

3. Remember
 that
 the
 diagnosis
 and
 prognosis
 are
 medical
 facts.
 
 

 

4. Identify
 the
 non-­‐medical
 facts
 (patient
 and
 family,
 external
 influences):
 
 
a. Patient
 and
 family
 facts
 such
 as
 culture,
 religion,
 social,
 economic,
 the
 

existence
 of
 an
 Advance
 Healthcare
 Directive,
 verbal
 preferences
 made
 by
 
the
 patient,
 how
 the
 patient
 lived
 his/her
 life.
 
 

b. Those
 that
 you
 discuss
 should
 be
 relevant
 to
 the
 situation.
 
 

 

5. External
 influences
 include:
 organizational
 policies,
 federal
 and
 state
 laws,
 practice
 
acts,
 code
 of
 ethics.
 These
 should
 be
 relevant
 to
 the
 situation.
 
 
 

 

6. For
 both
 step
 2
 or
 3,
 separate
 the
 facts
 from
 the
 assumptions:
 Sometimes
 all
 
healthcare
 professionals
 allow
 assumptions
 to
 guide
 their
 decision-­‐making.
 These
 
must
 be
 identified
 so
 that
 these
 assumptions
 do
 not
 interfere
 with
 the
 process.
 
 

 

 

7. Identify
 items
 that
 need
 clarification.
 Your
 paper
 should
 identify
 facts
 that
 you
 need
 
to
 clarify.
 When
 initially
 discussing
 an
 ethical
 situation,
 it
 is
 not
 unusual
 to
 not
 have
 
all
 of
 the
 answers.
 
 

 

8. Identify
 the
 decision
 makers:
 Is
 the
 patient
 an
 adult
 competent
 to
 make
 their
 own
 
choices?
 Is
 the
 patient
 a
 child
 who
 is
 old
 enough
 to
 have
 a
 say
 in
 the
 decision.
 If
 the
 
patient
 cannot
 make
 their
 own
 decision,
 who
 is
 the
 decision
 maker?
 How
 was
 this
 
person
 selected?
 
 
 

 

 

9. Review
 the
 underlying
 ethical
 principles:
 Review
 which
 ones
 and
 why
 they
 apply
 t
 
this
 particular
 case:
 beneficence,
 nonmaleficience,
 veracity,
 fidelity,
 autonomy
 and
 
justice.
 

 

10. Define
 alternatives:
 One-­‐Way
 to
 proceed
 may
 be
 apparent
 at
 this
 point.
 However,
 
sometimes
 there
 are
 different
 choices.
 
 They
 should
 be
 addressed
 identifying
 the
 
benefits
 and
 burdens
 for
 doing
 one
 thing
 versus
 the
 other.
 

 
11. Follow-­‐up:
 
 Define
 the
 process
 to
 be
 used
 with
 the
 chosen
 alternative.
 
 

 

 

 
Reference
 Source:
 Levine-­‐Ariff,
 J.
 &
 Groh,
 D.H.
 (1990).
 Creating
 an
 Ethical
 Environment.
 
Nurse
 managers'
 bookshelf
 a
 quarterly
 series:
 2:1.
 Baltimore,
 Maryland:
 Williams
 &
 Wilkins.
 
41-­‐61.