Health promotion case study

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Read the following case study and answer the reflective questions. Please provide evidence-based rationales for your answers. APA, 7th ed. must be followed.

Citation and references

Nursing Assignment

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Week 3 assignments

30D again

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 30 D again

Reflection Week 1

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 Essential to performing as leaders and advocates of holistic, safe, and quality care  My concept.

 

Reflection: write 1-2 paragraphs reflecting on your learning for the week. Guiding questions are provided or you may write about what you felt was most significant to you for the week.

What were the most important concepts you learned in week 1?

Why were these concepts important?

How will they prepare you for your future role as a master’s prepared nurse?

BMI

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A 68-year-old client lives alone and is independent with all ADLs, has no restrictions for mobility, and is competent, and oriented x4. The client is on a fixed income, but has enough to manage a modest lifestyle. The client has family and social supports but is very independent and is proud of her self-reliance. The client’s height is 5’ 6”, weight is 210 lb. / 95.25 kg.

Please answer the following:

  • What is the client’s BMI?
  • Identify what screening tools you would use to assess nutritional and exercise knowledge, and why?
  • One Outcome/Intervention/Rationale:
    • Identify one outcome/goal that is reasonable, measurable and realistic. Identify 1 nursing intervention for the outcome and give rationale for the intervention.
  • Identify what weakness in the client’s life may be impacting the client’s activity and diet?
  • What referrals would you make and why?

(Use references for your responses, not just opinion.)

PICOT

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Week 2: Problem Identification and Description Using PICOT Format

i. Identify and describe the problem in clear and concise language. To help you

think about what problem you might choose, keep in mind the health or nursing

problems of the patient population(s) you currently serve, those you encountered

in your clinical courses, or those you plan to work with in the future.

•

• Describe the clinical setting.

• Describe the service area for the clinic and population groups who attend the

clinic services.

• What kinds of problems do you see in the clinic?

ii. Give a clear, explicit statement of the problem and target population, as well as

the background of the specific problem relative to the clinical setting.

•

• Is it broad enough that you can analyze it from many theoretical and conceptual

points of view and make suitable plans to address the problem from a number of

perspectives?

• Is it of enough interest to you that you are willing to spend most of the semester

thinking about it, assessing all its dimensions, planning in detail how to address

it, and designing a detailed intervention and evaluation plan?

iii. Describe the significance of the evidence-based project that could be
implemented in the selected setting to the nursing profession. Ask yourself why it
is important to you. Consider your own clinical interest.

•

• Describe clinical observations that point out the knowledge gap, clinical gap, etc.
• Describe the significant research in the area that has been done that delineates

the gap in our knowledge.

Your paper should be 3–4 pages in length, not including the cover or reference pages.
You must reference a minimum of 3 scholarly sources in your paper.

Use the current APA format to style your paper and to cite your sources.

See your Change Project Writing Assignment Resources folder for PICOT resources.

Review the rubric for more information on how the assignment will be graded.

NURS_691A_DE – NURS 691-A Rubric Week 2: Problem Identification and Description
Using PICOT Format

NURS_691A_DE – NURS 691-A Rubric Week 2: Problem Identification and Description Using PICOT

Format

Criteria Ratings Pts

This criterion is linked to a

Learning Outcome Critical

Analysis
33.75 to >27.67 pts

Meets Expectations

Presents a thorough and insightful analysis of the

chosen topic/problem. Describes the problem

thoroughly, including the target population and

history/background information at the assigned

clinic or hospital. The significance and applicability

to nursing is included and well presented.

33.75

pts

This criterion is linked to a

Learning Outcome Content 33.75 to >27.67 pts

Meets Expectations

Includes an appropriate topic identification

related to an advanced practice nursing issue or

practice problem of concern. The population is

fully defined and present in the research

question. Includes specific interventions,

identifies comparisons, and presents appropriate

outcomes in a timely manner for the question.

Overall, it is a well-built question using the PICOT

format.

33.75

pts

This criterion is linked to a

Learning Outcome APA

Format/Mechanics
7.5 to >6.15 pts

Meets Expectations

Follows all the requirements related to format,

length, source citations, and layout. Assignment is

free of spelling and grammatical errors.

7.5 pts

Total Points: 75

You can use the urgent care setting or maybe others. (my idea)

  • Week 2: Problem Identification and Description Using PICOT Format

Nursing Health Promotion Dropbox assignment

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Please read carefully the instructions 

Applying nursing theory as a nurse educator

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how to apply theory to be an efficient nurse educator

Matrix Table (Healthcare) USE TOPIC GIVEN

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 Due 9/24/23    4 pm EST 

  • For this assignment, you must complete a matrix table for three research articles (see template provided below).
  • You will be identifying the following to complete the table:
    • Articles/reference (in APA format)
    • Purpose of the article/Study question
    • Variables (i.e. independent vs dependent)
    • Study design: Quantitative/Qualitative/Mixed
    • Sampling
    • Methods
    • Instruments
    • Findings/Result
  • You will be identifying the concepts being explored in the study: the “what” of the study, the methods or the “how” of the study, participants in the study or the “who,” along with the instruments/tools used in the study to collect data, i.e., surveys, interviews, etc.
  • Lastly, you will state the findings of the study.
  • Remember, the studies should support your ideas and should be less than five (5) years old.
  • They should not be from the Web, but from the library databases. Use the resources found in the library.
  • In addition, you must follow APA 7th edition guidelines when documenting the reference in the first column.
  • Please use, at minimum three scholarly references for this assignment.

USE THIS TOPIC AND ARTICLES

Topic and 3 articles that were used previously TOPIC:  Healthcare Equity among the Elderly in Europe · Article 1: “ Equity in healthcare access and service coverage for older people: a scoping review of the conceptual literature. “The article evaluates the various interventions on health equity, impact on health outcomes, healthcare access, and reductions in health disparities.· Article 2: “Evaluating Policy Reforms for Healthcare Equity Among the Elderly in Europe”It investigates the impact of policy reforms on health disparities and access to healthcare services.· Article 3: “Socioeconomic Factors and Health Outcomes Among European Elderly: A Critical Analysis of Healthcare Equity Policies”It critically examines the role of socioeconomic factors in healthcare equity and disparities. 

Unit 7 Discussion Peer Response. Medications for Psychosis and Schizophrenia Related Disorders 600W. APA. 4 references due 10-20-23.

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Advanced Psychopharmacology and Health Promotion

Unit 7 Discussion
Peer Response. Medications for Psychosis and Schizophrenia Related Disorders 600W. APA. 4 references due 10-20-23.

Instructions:

Please read and respond to at least two of your peers' initial postings. You may want to consider the following questions in your responses to your peers:

· Compare and contrast your initial posting with those of your peers.  

· How are they similar or how are they different?

· What information can you add that would help support the responses of your peers?

· Ask your peers a question for clarification about their post.

· What most interests you about their responses? 

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

JS1

Which antipsychotics are considered first-generation, and why are they used less often than second-generation antipsychotics? Are second-generation antipsychotics more effective?

The first-generation antipsychotic (FGA) medications include chlorpromazine, fluphenazine, droperidol, loxapine, haloperidol, pimozide, perphenazine, thioridazine, prochlorperazine, thiothixene, and trifluoperazine. FGA drugs exert their therapeutic effects by antagonizing dopamine (D2) receptors, specifically addressing the positive symptoms associated with schizophrenia. According to Chokhawala & Stevens, 2023), first-generation antipsychotics are considerably more likely to elicit extrapyramidal movements (i.e., tardive dyskinesia) than second-generation and are thus used less commonly. Second-generation antipsychotic (SGA) medicines have antagonistic effects on the D2 receptor but are often called serotonin-dopamine antagonists. There is also some evidence to suggest that antipsychotics of the second generation provide better symptom management than those of the first generation (Chokhawala & Stevens, 2023). The efficacy of second-generation antipsychotics in addressing the negative symptoms of schizophrenia surpasses that of first-generation antipsychotics, while also demonstrating use in managing the positive symptoms of the disorder.

Compare and contrast the following conditions: Tardive Dyskinesia, Acute Dystonia, Athetosis, and Tics.

Tardive dyskinesia (TD) is a collection of involuntary, repeated movements resulting from disrupting or blocking dopamine receptors. Involuntary motions may range from akathisia and dystonia to buccolingual stereotypy and myoclonus to chorea and tics (Paudel et al., 2023). There is currently no therapy available for TD. However, there are a variety of therapy methods available for reducing symptoms. While other drugs may also contribute to TD, conventional antipsychotics are the most common culprits. Paudel et al. (2023) provide a cautious estimate that around 5% of individuals experience TD annually when on conventional antipsychotics. Statistically speaking, older people have a far greater incidence rate.

Tardive dyskinesia, athetosis, acute dystonia, and tics are all instances of involuntary movements, as stated by Paudel et al. (2023). Repetitive muscular contractions, known as tics, often affect only one part of the body and are sometimes suppressed. Acute dystonia is characterized by sustained, repeated muscular contractions typically triggered by an intentional activity. Slow, writhing motions are characteristic of athetosis, often affecting the arms and hands.

References

Chokhawala, K., & Stevens, L. (2023). Antipsychotic medications. In StatPearls [Internet]. StatPearls Publishing. 
https://www.ncbi.nlm.nih.gov/books/NBK519503
Links to an external site.

Paudel, S., Donovan, A. L., Petriceks, A., Vyas, C. M., Van Alphen, M. U., & Stern, T. A. (2023). Drug-Induced Abnormal Involuntary Movements: Prevalence and Treatment. The Primary Care Companion for CNS Disorders, 25(3), 47041. 
https://www.psychiatrist.com/pcc/effects/drug-induced-abnormal-involuntary-movements-prevalence-and-treatment/
Links to an external site.

SY-2

Which antipsychotics are considered first-generation and why are they used less often than second-generation antipsychotics? Are second-generation antipsychotics more effective?

Both first-generation antipsychotics and second-generation antipsychotics are used for the treatment of psychiatric disorders such as schizophrenia. First-generation antipsychotics, also known as typical antipsychotics, such as phenothiazines (perphenazine, prochlorperazine), and butyrophenones (haloperidol) are classified by their chemical structure (Chokhawala, 2023). Whereas second-generation antipsychotics also known as atypical antipsychotics such as risperidone, olanzapine, quetiapine, aripiprazole, and clozapine are classified based on pharmacological proprieties (Chokhawala, 2023).

First-generation antipsychotics tend to be used less often than second-generation antipsychotics due to their long list of adverse effects that include extrapyramidal side effects, anticholinergic side effects (dry mouth, urinary retention, constipation), prolonged QT intervals, sedation, as well as the rare but fatal neuroleptic malignancy syndrome (Chokhawala, 2023). In comparison, second-generation antipsychotics have a decreased risk of extrapyramidal side effects but are associated with weight gain and metabolic syndrome, therefore patients should be monitored for diabetes, dyslipidemia, and weight gain (Chokhawala, 2023). Although second-generation antipsychotics tend to be the drug of choice when it comes to treating psychiatric disorders, and this is mainly due to the less severe side effects, this does not necessarily indicate that it is more effective. A study done by Fabrazzo et al. (2022) showed that second-generation antipsychotics showed no clear evidence of their effectiveness on cognitive deficit, however, it did prove to be more effective than first-generation antipsychotics in treating negative symptoms, relapse-free survival, and hospitalization rate.

                                                                                                                                  

Compare and contrast the following conditions: Tardive Dyskinesia, Acute Dystonia, Athetosis, and Tics.

 Tardive Dyskinesia 
(TD) is a disorder characterized by repetitive movement such as facial and tongue movement, tongue protrusion, facial grimacing, chewing, and quick, jerking limb movements. These movements are involuntary and can range in severity (slight tremor to full body movement) thus, making daily function difficult. Its main cause is long-term use of antipsychotics, and this disorder tends to be irreversible (Bergman & Soares-Weiser, 2018).

Acute Dystonia is a neurological symptom characterized by muscle contractions that cause repetitive movements by arms, legs, neck, face, or abnormal posture (Stahl, 2022). The cause of this reaction is due to a dopaminergic-cholinergic imbalance in the basal ganglia (Lewis, 2023). Early intervention can prevent the onset and development of dystonia and neurological damage and treatments include benzodiazepines, baclofen, muscle relaxants, and dopamine depletes (VMAT-2 inhibitors) (Bledsoe et al., 2020).

Akathisia and Tics syndromes are seen in patients treated with D2 blockers and are characterized by inner restlessness and mental unease (Stahl, 2022). Akathisia is a neuropsychiatric syndrome characterized by the inability to remain still and it typically involves the lower extremity (Patel, 2023). Tics on the other hand such as Tourette syndrome are neurodevelopmental disorders characterized by motions, noise, and words and are involuntary (Jones, 2023).

  

References

Bergman, H., & Soares-Weiser, K. (2018). Anticholinergic medication for antipsychotic-induced tardive dyskinesia. 
Cochrane Database of Systematic Reviews, 
2018(1). https://doi.org/10.1002/14651858.cd000204.pub2

Bledsoe, I. O., Viser, A. C., & San Luciano, M. (2020). Treatment of dystonia: Medications, neurotoxins, neuromodulation, and rehabilitation. 
Neurotherapeutics, 
17(4), 1622–1644. https://doi.org/10.1007/s13311-020-00944-0

 Chokhawala, K. (2023, February 26). 
Antipsychotic medications. StatPearls – NCBI Bookshelf. 
https://www.ncbi.nlm.nih.gov/books/NBK519503/Links to an external site.

Fabrazzo, M., Cipolla, S., Camerlengo, A., Perris, F., & Catapano, F. (2022). Second-Generation Antipsychotics’ Effectiveness and Tolerability: A Review of Real-World Studies in Patients with Schizophrenia and Related Disorders. 
Journal of Clinical Medicine, 
11(15), 4530. https://doi.org/10.3390/jcm11154530

Jones, K. S. (2023, May 8). 
Tourette syndrome and other TIC disorders. StatPearls – NCBI Bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK499958/

Lewis, K. (2023, May 1). 
Dystonic reactions. StatPearls – NCBI Bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK531466/#:~:text=An%20acute%20dystonic%20reaction%20is,to%20abnormal%20movements%20or%20postures.

Stahl, S. M. (2021). 
Stahl’s essential psychopharmacology: Neuroscientific basis and practical application (5th ed.).

Patel, J. (2023, July 24). 
Akathisia. StatPearls – NCBI Bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK519543/#:~:text=Akathisia%20is%20defined%20as%20an,usually%20involves%20the%20lower%20extremities.