Health Assessment

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 Post an explanation of the specific socioeconomic, spiritual, lifestyle, and other cultural factors associated with the patient you were assigned. Explain the issues you would need to be sensitive to when interacting with the patient, and why. Provide at least five targeted questions you would ask the patient to build his or her health history and assess his or her health risks. 

   CASE STUDY AG is a 54-year-old Caucasian male who was referred to your clinic to establish care after a recent hospitalization after having a seizure related to alcohol withdrawal. He has hypertension and a history of alcohol and cocaine abuse. He is homeless and is currently living at a local homeless shelter. He reports that he is out of his amlodipine 10 mg which he takes for hypertension. He reports he is abstaining from alcohol and cocaine but needs to smoke cigarettes to calm down since he is not drinking anymore. 

Isama

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Nicole Washington 

        Explain the agonist-to-antagonist spectrum of action of  psychopharmacologic agents, including how partial and inverse agonist  functionality may impact the efficacy of psychopharmacologic treatments.

Neurotransmitters and some drugs that stimulate receptors are  called agonists. Agonists stimulate receptors to their fullest signal  transduction. Drugs that act as agonists are useful in patients who lack  or are deficient in agonist neurotransmitters. In situations where the  actions of a full agonist or partial agonists are undesirable, an  antagonist is required to revert the receptor back to the state where no  agonist exists, back to neutral. Partial agonists act as they sound,  and produce a conformational change of a receptor that is halfway  between the changes of a full agonist and the baseline conformation of  that receptor. An antagonist can also reverse the effects of inverse  agonists to the receptors baseline. An inverse agonist acts to change  the conformation of a receptor to completely inactivate it and remove  the baseline constitutive activity. 

Compare and contrast the actions of g coupled proteins and ion gated channels.

Both G protein coupled receptors and Ion gated channels are a  form of signal transduction cascades in the brain. They are both  triggered by neurotransmitters, and many of the psychotropic drugs used  today affect one of these two cascades. They both perform when an  extracellular first messenger passes a message to an intracellular  second messenger. However, G protein’s second messenger is a chemical,  such as adenosine monophosphate, while the ion channel second messenger  can be an ion, such as calcium. There are two classes of ion channels,  Ligand gated and voltage sensitive ion channels. The ligand gated ion  channels act similar to g protein receptors because they use the agonist  spectrum. Voltage sensitive ion channels are opened and closed based on  the voltage charge across the membrane.

Explain how the role of epigenetics may contribute to pharmacologic action.

Epigenetics determines if inherited genes are expressed or not  expressed into proteins that make up the story of any one person. The  mechanism of epigenetics turns genes on or off by modifying chromatin.  These modifications are regulated by neurotransmitters, drugs and the  environment. So drugs introduced to patients can affect a person’s  epigenetics.

Explain how this information may impact the way you prescribe  medications to patients. Include a specific example of a situation or  case with a patient in which the psychiatric mental health nurse  practitioner must be aware of the medication’s action.

Understanding the way medications will affect patients based on  their genetic makeup, their current medications, the condition being  treated, what causes the imbalance, is all important when prescribing  medications. For example imipramine, a tricyclic antidepressant,  inhibits the reuptake of serotonin and norepinephrine, elevating these  neurotransmitters in the brain. It is important to understand if this is  the cause of the patients depression before prescribing this medication  because if incorrectly prescribed it could alter the patients  epigenetic mechanisms in an inverse way (Boks, et al. 2012). 

informatics

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The table below gives some operational statistics for two hospitals located in the same community. Use the table to answer the following questions.

  1. Calculate the following measures for each hospital (wherever appropriate, calculate the measure for each pay type). Discuss the meaning and significance of each measure and point out the differences between the two hospitals.
    1. Hospital capacity
    2. ALOS
    3. Occupancy rate
  2. Operationally, which hospital is performing better? Why?
  3. Do you think the nonprofit hospital is meeting its community benefit obligations in exchange for its tax-exempt status? Explain.
  4. Do you think the hospitals have a problem with excess capacity? If so, what would you recommend? In your answer to this question, please consider how hospital governance may impact the ability of an administrator to make changes.

discussion post 3 psycho

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 Analyze and apply critical thinking skills in the psychopathology of mental health patients and provide treatment and health promotion while applying evidence-based research.Scenario:

J.T.  is a 20 year-old who reports to you that he feels depressed and is experiencing a significant amount of stress about school, noting that he’ll “probably flunk out.” He spends much of his day in his dorm room playing video games and has a hard time identifying what, if anything, is enjoyable in a typical day. He rarely attends class and has avoided reaching out to his professors to try to salvage his grades this semester. J.T. has always been a self-described shy person and has had a very small and cohesive group of friends from elementary through high school. Notably, his level of stress significantly amplified when he began college.

You learn that when meeting new people, he has a hard time concentrating on the interaction because he is busy worrying about what they will think of him – he assumes they will find him “dumb,” “boring,” or a “loser.” When he loses his concentration, he stutters, is at a loss for words, and starts to sweat, which only serves to make him feel more uneasy. After the interaction, he replays the conversation over and over again, focusing on the “stupid” things he said. Similarly, he has a long-standing history of being uncomfortable with authority figures and has had a hard time raising his hand in class and approaching teachers. Since starting college, he has been isolating more, turning down invitations from his roommate to go eat or hang out, ignoring his cell phone when it rings, and habitually skipping class. His concerns about how others view him are what drive him to engage in these avoidance behaviors.

Questions:

Remember to answer these questions from your textbooks and NP guidelines. At all times, explain your answers. 

  1. Generate a primary and differential diagnosis using the DSM-5 criteria.
  2. Develop a biopsychosocial plan of care for this client.
  3. Compare and contrast fear, worry, anxiety, and panic.

Submission Instructions:

  • Your initial post should be at least 500 words, formatted and cited in current APA style with support from at least 2 academic sources.  Your initial post is worth 8 points.
  • You should respond to at least two of your peers by extending, refuting/correcting, or adding additional nuance to their posts. Your reply posts are worth 2 points (1 point per response.) 
  • All replies must be constructive and use literature where possible.
  • Please post your initial response by 11:59 PM ET Thursday, and comment on the posts of two classmates by 11:59 PM ET Sunday.
  • Late work policies, expectations regarding proper citations, acceptable means of responding to peer feedback, and other expectations are at the discretion of the instructor.
  • You can expect feedback from the instructor within 48 to 72 hours from the Sunday due date.

REPLY

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The role of nurses in the COVID-19 vaccination mandate, telemedicine, and prescription drug pricing is pivotal in advocating for and ensuring a more efficient and patient-centered healthcare system. First and foremost, nurses have played an indispensable role in the global fight against the COVID-19 pandemic. Their contribution to the vaccination efforts has been monumental. Nurses have not only administered vaccines but also served as the face of hope and comfort to countless individuals receiving the vaccine. Their compassionate and humanistic approach has helped alleviate vaccine hesitancy and fear, ensuring that a larger segment of the population gets vaccinated. Beyond the actual vaccination process, nurses have been at the forefront of patient education, conducting interviews to gather crucial health information, and explaining the importance of immunization. Their meticulous monitoring of patients for adverse reactions has been essential in maintaining the safety of the vaccination process. In essence, nurses have been the linchpin of prevention during this pandemic, working tirelessly to protect public health (Pérez, 2021).

Telemedicine, another significant development in healthcare, has been further accelerated by the pandemic. Nurses have been instrumental in the adoption and effective implementation of telemedicine services. Through telehealth platforms, nurses have been able to provide care remotely, ensuring that patients continue to receive vital medical attention while minimizing the risk of virus transmission. This has been especially crucial for individuals with chronic conditions who require regular check-ups and monitoring. Nurses have not only conducted virtual consultations but have also played a vital role in educating patients on how to use telemedicine effectively. They have bridged the gap between technology and healthcare, making it more accessible and user-friendly for patients, ultimately saving them time, money, and, most importantly, lives.

On the front of prescription drug pricing, nurses have also been advocates for patients. The pandemic disrupted global supply chains, leading to fluctuations in the prices of essential medications, particularly for individuals with non-communicable diseases (NCDs). Nurses, as patient advocates, have been vocal in highlighting the challenges patients face due to rising drug costs. They have played a crucial role in bringing attention to this issue at both the individual patient level and within healthcare organizations. Nurses have been at the forefront of working with healthcare providers to explore cost-effective alternatives and to ensure that patients continue to have access to the medications they need. Their advocacy extends to policy discussions, pushing for reforms in drug pricing that would prioritize patient affordability and well-being (OPS, 2023).

In conclusion, nurses have demonstrated their indispensable role as advocates in the healthcare system during the COVID-19 pandemic. They have tirelessly worked to administer vaccines, provide compassionate care, and promote prevention. Nurses have embraced telemedicine as a means to deliver care remotely, making it accessible and convenient for patients. Additionally, they have been vocal advocates for patients grappling with rising prescription drug prices, working to ensure that healthcare remains patient-centered. The pandemic has highlighted the resilience, dedication, and advocacy of nurses, reinforcing their crucial position in shaping the future of healthcare.

Discussion post for Presidential Agendas

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Resources to use:

 

 

To Prepare:

  • Review the Resources and reflect on the importance of agenda setting.
  • Consider how federal agendas promote healthcare issues and how these healthcare issues become agenda priorities

 Post your response to the discussion question: Consider a population health topic that rises to the presidential agenda level. Which social determinant most affects this health issue? How did two recent presidents handle the problem? What would you do differently?

SOAP note rc

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SOAP note renal colic

Reply Microscopy

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I find the use of microscopes fascinating. It still blows my mind that before the microscope was invented looking at cells and all their components was never a thing! The use of the microscope opened so many doors in medicine, it really is incredible. A specific scenario where I would require the use of a microscope would be if I were wanting to identify certain toxins that may be responsible for causing autoimmune diseases such as Lupus. The type of light microscope that is needed in this scenario uses fluorescent-labeled antibodies to detect certain bacteria, viruses, or toxins. It uses specific staining techniques to identify distribution of proteins or other molecules. Fluorescent microscopes were first invented in between 1911 and 1913 by two German physicists Heimstaedt and Lehmann.

The second microscope I would use is a confocal microscope. A confocal microscope offers high-quality images that are relatively easy to obtain from specimens, which makes it one of the more popular microscopes. However, this specific type of microscope can increase cell and tissue death due to the high- intensity laser. This may cause people to opt out of using the Confocal microscope if they are dealing with certain tissues or cells that are more sensitive. 

References:

Caprette, D. (2013). Medical Lab. Up Close: A look at Clinical Microscopy. 

          https://www.medlabmag.com/article/1122#:~:text=The%20light%20microscope%20is%20perhaps,used%20tool%20in%20the%20laboratoryF  e

Fellters, T, Davidson, M. (nd). Evident. Confocal Microscopy. https://www.olympus-lifescience.com/en/microscope-Links to an external site.

    resource/primer/techniques/confocal/confocalintro/

question

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Original work, no plagiarism, Cite, Reference 3-4 paragraphs.

Below is a list of research studies, including the targeted sample population to be included in the study.  Select 
ONE of these studies/populations and discuss how you might apply tools of the principles of human subjects research (autonomy, justice, beneficence). Review the 

slides
 and/or these resources (
University of Virginia
Links to an external site.
 ; 
University of Northern Iowa
Links to an external site.
) to identify specific considerations for your population and study. Consider a specific focus on issues around 1) risk and protections from risk for the specific population, 2) informed consent and how this will be acquired, and 3) additional concerns and protections based on the population or study.  I am not looking for expertise in the research topic but how well you address the human subjects principles for a specific population.

1) Efficacy study of an exercise enrichment program for nursing facilities in reducing fall-related injuries among elderly residents

2) Folic acid supplementation for pregnant women to improve neonatal health outcomes

3) Motivational interviewing and peer counseling to reduce recidivism after incarceration among inmates in federal prison

4) Mixed methods approach to nutritional characterization among parents of young children in low-income households

5) Behavioral interventions to improve asthma-related health outcomes among youth aged 5-12

Research Critique on Impact of Nursing diversity

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write a critique of a research article. (example will be provided) 

research article will be provided in pdf format. 

  research topic is “The Impact of Nursing Diversity in Patient Care on the Medical-Surgical Floor”

Please review previous work done and follow the rubric carefully and write each answer in different paragraphs with titles; 

Rubric;

1.      Is the research study relevant to the study of nursing, (be specific   and include examples from the article)? 

2.  Is the method/design appropriate in terms of the research question/hypothesis? What was the research question/hypothesis? Was it clearly stated? Refer back to Polit & Beck (2021) (The Method Section). Key elements are discussed, and identification of items should be included. Provide a description of each of these key elements.  

3.   What is the theoretical context? See chapter 7 in Polit & Beck. The terms theoretical and conceptual frameworks are used interchangeably. Theories are used to describe, predict, explain, and to control phenomena.   (Theoria is a Greek Word that means beholding or speculation). 

“Theoretical frameworks provide the organization for the study. It guides the researcher in the interpretations of the results. the importance of the theory is dependent on the degree of research based evidence and level of its theory development. There are four levels of theory development 1) factor isolating (describe phenomena) 2) Factor relating (explain phenomena), 3) Situation relating (predict 

the relationships between/among phenomena), 4) Situation producing (control phenomena and relationships

**If your article does not have a theoretical framework what do you suggest based on Polit & Beck Chapter 7?  

4.  Describe the results of the study (identify if they are believable or not)  

5.  Are the results significant? In what way-explain use examples?  

6.   Are the results transferable? How? Transferability refers to the readers of the research to make connections but invites readers of research to make connections between elements of a study and their own experience. Transferability does not involve broad claims. How does this research apply to YOUR specific practice as a Registered Nurse?  

According to Brown (2005), Transferability can be enhanced by providing what is often referred to as thick description (i.e., giving enough detail so the readers can decide for themselves if the results

are transferable to their own contexts).   

7.  Implications for nursing practice, be specific how would this study impact nursing practice (use specific examples from the article)?  

8.  Implications for future research, be specific and use examples from the article.  

9.  The paper shall reflect a scholarly effort; proper grammar, coherence, spelling, and accurately use APA format. Have someone proof read your paper. Read your paper out loud to yourself.  

Also check all the attachments.