5 235 –


5 235 –

 

Case B 14-year-old biracial male living with his grandmother in a high-density public housing complex.

To start, we should always keep in mind how personal their experience with us can be. They can be coming to us with many issues as far as health both physical and mental, socioeconomic issues, potential unsafe living situations, and many other stresses that life can throw at people. These are all important things that should be discussed besides the chief complaint. We must assess home situations, access to care, social situations, etc. It is important to make sure that we are being personable and not just going through the motions.

We should always knock before coming into the room, introduce yourself and get your patient’s name, make sure that the room has good lighting and is a temperature that is comfortable to the patient, discuss what has brought them in, and discuss what their understanding of the problem is (Ball, Dains, Flynn, 2019). This will show the patient that you care and that you seem them as an individual rather than just another patient for the day. This also instills confidence and makes them more likely to open up to you about different issues. It is always important to include the patient in their care rather than just discussing only your thoughts with them while dismissing their thoughts. Including the patient in their care is known as patient-centered care and is an important part of providing safe and high quality care (Santana, Manalili, Jolley, Zelinsky, Quan, Lu, 2018). That is the reasoning behind using the listed techniques.

I think for the risk assessment instrument, I would use IHELLP. It stands for income, housing, education, legal status, literacy, and personal safety. Since my patient is only 14 and living with a grandmother in a public housing complex, I would have concerns about access to care and resources as well as their living situation and education. This would allow me to explore things like employment status, whether or not the patient has any health coverage or is on any kind of assistance, whether or not they are in safe housing, if they have any substance use disorders, proper education, and safe living situations (Berman, Patel, Belamarich, Gross, 2018). I would be interested in the patient’s chief complaint as well, but we must assess home situations also. We must ensure that our patients are in good hands and properly cared for both in and outside of the office or hospital setting.

It is difficult to narrow it down to just five targeted questions, but if I had to ask only five, they would be the following.

  1. Do you feel safe at home?
  2. How do you cope with stress?
  3. How do you feel about your time spent in school?
  4. Do you feel you have good access to care and resources?
  5. How do you view your health and what are your expectations for care?

I would hope that this would give me an idea of what the patient’s life is like as far as education, safety, concerns, resources, how they see themselves, and what their goals are as far as health. There would be much more to discuss. Sometimes patients of this age can have an especially difficult time expressing themselves or feel nervous about discussing certain topics or even seeking help. Great care would be needed as well as a delicate approach and close attention to all verbal and non-verbal cues.

Resources

Ball, J. W., Dains, J. E., & Flynn, J. A. (2019). Seidel’s Guide to Physical Examination (9th Edition). Elsevier Health Sciences (US). https://mbsdirect.vitalsource.com/books/9780323481953

Berman, R. S., Patel, M. R., Belamarich, P. F., & Gross, R. S. (2018). Screening for Poverty and Poverty-Related Social Determinants of Health. Pediatrics in review39(5), 235–246. https://doi.org/10.1542/pir.2017-0123

Santana, M. J., Manalili, K., Jolley, R. J., Zelinsky, S., Quan, H., & Lu, M. (2018). How to practice person-centred care: A conceptual framework. Health expectations : an international journal of public participation in health care and health policy21(2), 429–440. https://doi.org/10.1111/hex.12640

 

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549 – 51 World – hawkessays.com


 

Adolescent Hispanic/Latino boy living in a middle-class suburb

Building a therapeutic relationship requires effective communication, one of the most crucial components. Finding out if the patient speaks and understands English is vital since, in this case, communication hurdles may arise because the patient is Hispanic. It may be possible to enhance patient outcomes by effectively disseminating complex medical information to various patient populations. The patient’s age is a substantial obstacle to effective communication in this situation; thus, they may have low health literacy. The patient must articulate the agreed-upon plan, and the engagement must be easily understood. Teenagers are typically at the age when risky activities are explored.

Additionally, these patients are more reluctant to speak; maintaining confidentiality is crucial. Consequently, it is necessary to clarify the boundaries of secrecy. For the patient to communicate their requirements privately during the interview, the parent or caregiver should be asked to leave the room (Ball et al., 2019).

How would your communication and interview techniques for building a health history differ with each patient?

To build the trust necessary to help patients to disclose sensitive and personal information, breaking social challenges and working with them to find solutions is very important. The healthcare professional needs to accept people from all cultural backgrounds and avoid stereotyping by realizing that individual variation within groups is frequently more pronounced than the variation between groups (Anderman, Pang, & Newton, 2016). Effective communication establishes a successful provider-patient relationship during the initial consultation with the patient. The patient will comprehend that the physician is accessible, adaptable, and eager to assist with queries while clarifying the care provided. That the goal is to learn what matters to this patient in terms of concerns and expectations, and this is accomplished when the physician demonstrates sincere interest, curiosity, and relationship-building (Ball et al., 2019)

How might you target your questions for building a health history based on the patient’s social determinants of health?

Both parties can better grasp the challenges and issues that should be prioritized for the patient when the healthcare professional builds a relationship with the patient through development and familiarization with the patient’s health history. According to the World Health Organization (WHO 2020), social determinants of health include “a wider variety of elements and institutions that have an impact on the conditions of daily life, as well as the circumstances under which people are born, grow, work, live, and age.”

What risk assessment instruments would be appropriate to use with each patient, or what questions would you ask each patient to assess his or her health risks?

Van et al., Stated that by the time adolescents reach adulthood, they are “12 times more likely to have attempted suicide, seven times more likely to be exposed to alcohol, and ten times more likely to have injected street drugs” than their peers who have not experience multiple forms of abuse. Such as domestic violence or growing up in a home where family members are mentally ill, substance abusers, or have been imprisoned (2014). The answers to the risk-related questions would rely on several variables, including how peer pressure, a loosening of parental bonds, a lack of school attendance, and low self-esteem (Ball et al., 2019).

Identify any potential health-related risks based upon the patient’s age, gender, ethnicity, or environmental setting that should be taken into consideration.

According to Ball et al. (2019), the main problem, a brief statement explaining why the patient has come in for help, can be addressed after the identifiers are out of the way. The practitioner wants to know more about how this worries the patient so much that they are seeking assistance rather than just putting up with it and going about their everyday lives. Finding out how long this issue has been affecting the patient’s life and collecting direct quotes from them are beneficial. The next step is to gather information on the current topic, any prior medical issues, family history, and personal and social history. Understanding the current issue requires a step-by-step analysis of the facts surrounding the primary cause of this patient’s need for assistance. Any previous medical or surgical procedures are included in the past medical history since they help provide a clearer picture of the patient’s overall health. The patient’s family history may contain hints about potential genetic causes for their issues. Carefully consider the patient’s work patterns, family relationships, and interactions with coworkers while asking about their personal and social experiences. Finally, a system review needs to be finished (Ball et al., 2019).

Select one of the risk assessment instruments presented in Chapter 1 or Chapter 5 of the Seidel’s Guide to Physical Examination text, or another tool with which you are familiar, related to your selected patient.

HEEADSS is a screening assessment instrument that would be effective for adolescents. Using this evaluation tool can help the healthcare professional discover the following:

“What’s going on at home?

“Are you working? “How is school going?”

“Describe your friends to me.”

“What sort of after-school activities do you engage in?”

“What are your strengths?”

To encourage the patient to provide more information later, start by asking them open-ended inquiries. However, several technologies have been created focusing on health promotion and prevention to enhance healthcare interactions with young people. These include the Event History Calendar and the Guidelines for Adolescent Preventive Services (GAPS), the current standard of care (EHC). The GAPS was created to provide a screening tool for routine examination of adolescent psychosocial difficulties, health risk behaviors, and biological problems.

References

Andermann A, Pang T, Newton J. (2016). Evidence for health III: producing evidence for improving health and reducing inequities. Health Res Policy Syst 2016;14:18

Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2019). Seidel’s guide to physical examination: An interprofessional approach (9th ed.). St. Louis, MO: Elsevier Mosby. Low LK. (2003). Guidelines for adolescent preventive services (GAPS) Journal of Midwifery & Women’s Health. 2003;48:231–233.

Van Niel C, Pachter LM, Wade R, Jr. (2014). Adverse events in children: predictors of adult physical and mental conditions. J Dev Behav Pediatr 2014;35:549–51

World Health Organization. (2020). What are the social determinants of health? Geneva: www.who.int/social_determinants/sdh_definition/en/



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Least Two Outside Scholarly – hawkessays.com


Least Two Outside Scholarly

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Select an issue in nurse practitioner (NP) practice that is of interest to you and in which you would like to see a practice change occur. Conduct a review of literature to see what is currently known about the topic. In 1-2 paragraphs, describe the scope and relevance of the issue and your recommended change. Provide reference support from at least two outside scholarly sources to support your ideas. Please pick something you can do as a NP in your practice. Please avoid anything that would require a policy or law change, such as full-practice authority. 

 

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Nursing Profession Also Relies – hawkessays.com


Nursing Profession Also Relies

Part 1;

For this first week in DF1 I ask you to describe where EBP appears in a healthcare organization’s website that you select (You may want to use the one in which you are employed, but it’s not mandatory). Does it look as though the organization is grounded in evidence basis? Explain your view and how your perception is possibly altered after your review with specific examples. Use Jackson health system!!

4 apa sources no older than 5 years. 

Part 2:

In the modern era, there are few professions that do not to some extent rely on data. Stockbrokers rely on market data to advise clients on financial matters. Meteorologists rely on weather data to forecast weather conditions, while realtors rely on data to advise on the purchase and sale of property. In these and other cases, data not only helps solve problems, but adds to the practitioner’s and the discipline’s body of knowledge.

Of course, the nursing profession also relies heavily on data. The field of nursing informatics aims to make sure nurses have access to the appropriate date to solve healthcare problems, make decisions in the interest of patients, and add to knowledge.

In this Discussion, you will consider a scenario that would benefit from access to data and how such access could facilitate both problem-solving and knowledge formation.

To Prepare:

  • Reflect on the concepts of informatics and knowledge work as presented in the Resources.
  • Consider a hypothetical scenario based on your own healthcare practice or organization that would require or benefit from the access/collection and application of data. Your scenario may involve a patient, staff, or management problem or gap.

Post a description of the focus of your scenario. Describe the data that could be used and how the data might be collected and accessed. What knowledge might be derived from that data? How would a nurse leader use clinical reasoning and judgment in the formation of knowledge from this experience?

4 apa sources no older than 5 years!!

 

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Https Ambassadored


  

Weekly assignment: conduct an assessment on the following body systems:

  • Peripheral      vascular, musculoskeletal and neurological

You may conduct the assessment on a fellow student, friend, or family member. Remember to secure their permission.

Collect both subjective and objective data using the process described in the textbook.

Jarvis, C. (2019). Physical Examination and Health Assessment (8th Edition). Elsevier Health Sciences (US). https://ambassadored.vitalsource.com/books/9780323510806

OR ANY OTHER NURSING TEXTBOOK.

Write a summary of the assessment (subjective & objective data in narrative note) and the skills utilized. Answer the following 3 questions in the summary. Do not disclose any patient identifiers.

  1. What      skills (assessment techniques) were utilized during the assessment?
  2. What      subjective data did you collect? (list your findings)
  3. What      objective data did you collect? (list your findings)



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11Th Ed – hawkessays.com


3 references, no plagiarism, original work  

Explain the biological (genetic and neuroscientific); psychological (behavioral and cognitive processes, emotional, developmental); and social, cultural, and interpersonal factors that influence the development of psychopathology. 

 

  • Review this week’s Learning Resources ( Sadock, B. J., Sadock, V. A., & Ruiz, P. (2015). Kaplan & Sadock’s synopsis of psychiatry (11th ed.). Wolters Kluwer. Considering the many interacting factors that contribute to the development of psychopathology.
  • Consider how theoretical perspective on psychopathology impacts the work of the PMHNP.



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National Labor Relations Act – hawkessays.com


National Labor Relations Act

 What is your understanding of the differences between protected and unprotected conduct under the National Labor Relations Act. Choose either the side of the employer or employee, and detail the protection afforded to the side you have chosen. What arguments do you think could be made for the opposite side? 

200 words

 

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Well Accountable Care Organizations – hawkessays.com


Well Accountable Care Organizations

Post, a description of the health process or outcome you selected and explain why. Then, explain variance reduction measures that might be appropriate for improving performance for this health process or outcome. Explain how you would measure the process or outcome to ensure that variance reduction measures worked. Then, explain how well accountable care organizations (ACOs) performed in comparison to non-ACOs as suggested by the McWilliams, Chernew, Landon, & Schwartz (2015) article. Explain whether you believe that ACOs will be effective in controlling cost, quality, and access variation. Then, explain whether you, as a health care administration leader, would encourage a health organization to move toward the ACO model. Why or why not?

https://www.proquest.com/docview/1680992701?account=14872

 

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COMMENT THE DISCUSSION WHICH THEORY SPEAKS TO YOUR ADVANCED NURSING PRACTICE?


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DEVELOP A PERSONAL NURSING PHILOSOPHY.


Please  use the theories Hildegard Peplau

APA format only

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APA cite and reference  format

  
Purpose(s):
1. To develop a Personal Nursing Philosophy
2. Personally define what nursing is, by addressing the elements of a human being, health, environment and professional nursing. 
3. Consider nursing from the prospective of a philosophers’ concern with knowledge and the essential elements of nursing as a scientific discipline also concerned with ethics and aesthetics.
4. To strengthen graduate level writing skills. 
(Graduate level writing displays critical thinking skills. The writer demonstrates the ability to see various sides of an argument: he/she questions assumptions, avoids commonplaces and develops a clear argument from professional experience and/or the available literature on the subject.)
Assignment:
Write a reflective paper on your vision of professional nursing from your present perspective in time. 
You may consider the meta-paradigm concepts of nursing, human being, health, environment and nursing. 
Part I Do not consider a specific nursing theory at this time.
What do see as essential characteristics of your present nursing praxis. You may or may not choose to compare your present view with that of your view as a new graduate. 
Part II Revisit your original philosophy. Review and revise your philosophy if any of your thinking has changed during the semester. If there are revisions make them in your original Philosophy I paper. 
Reflect on the nursing theories you have been exposed to throughout the semester. Identify a current nursing theory that is aligned with your personal philosophy. Discuss the chosen theory as to why or how you see it, or parts of it (a current theory may not be a perfect fit) are aligned with your personal nursing philosophy.
Attach Part I to Part II for hard copy submission in class on the assigned due date for Part II
Requirements:  APA format required. 
 Maximum 5 pages 



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