Hernandez Family Assessment

/in /by

Assignment 1: Hernandez Family Assessment

Assessment is as essential to family therapy as it is to individual therapy. Although families often present with one person identified as the “problem,” the assessment process will help you better understand family roles and determine whether the identified problem client is in fact the root of the family’s issues. As you examine the Hernandez Family: Sessions 1-6 videos in this week’s Learning Resources, consider how you might assess and treat the client family.

Learning Objectives

Students will:

Assess client families presenting for psychotherapy

To prepare:

Review this week’s Learning Resources and reflect on the insights they provide on family assessment.

View the Hernandez Family: Sessions 1-6 videos, and consider how you might assess the family in the case study.

Note: For guidance on writing a comprehensive client assessment, refer to pages 137–142 of Wheeler (2014) in this week’s Learning Resources.

The Assignment

Address in a comprehensive client assessment of the Hernandez family the following:

Demographic information

Presenting problem

History or present illness

Past psychiatric history

Medical history

Substance use history

Developmental history

Family psychiatric history

Psychosocial history

History of abuse and/or trauma

Review of systems

Physical assessment

Mental status exam

Differential diagnosis

Case formulation

Treatment plan

Note: Any item you are unable to address from the video should be marked “needs to be added to” as you would in an actual comprehensive client assessment

Needs help with similar assignment?

We are available 24x7 to deliver the best services and assignment ready within 3-4 hours? Order a custom-written, plagiarism-free paper

Get Answer Over WhatsApp Order Paper Now

Nursing homework help

/in /by

Adverse Reaction to Depakote

As a nurse working in a skilled nursing facility you will frequently see patients with dementia and Alzheimer’s disease with orders for Depakote also known as valproic acid, to manage their behaviors. I had a resident that was taking Depakote for the diagnosis of dementia with behavioral disturbance. She got into an altercation with her roommate and had to be moved which intensified her behaviors and agitation. The doctor increased her Depakote due to the increased behaviors. The resident’s behaviors improved. Later the resident began to have a decline in condition and we all believed that she was having transient ischemic attacks (TIA). The resident had a history of TIAs. We placed the resident on comfort care and discontinued all of her medications. A short time after discontinuing her medication the resident became more alert and was functioning at her prior level. Her physician believed that her decline was from the Depakote because she had no other new medications or medication changes.

Pharmacokinetics & Pharmacodynamics

Depakote is typically used to treat seizure disorders but can be used as a mood stabilizer. Many providers prefer to use Depakote for behaviors with geriatric population than antipsychotics because of their side effects. Depakote is easily absorbed when taken orally. It is rapidly distributed into plasma, extracellular water, and crosses the blood-brain barrier (Deglin, Vallerand, & Sanoski, 2009, p. 1263). Depakote binds easily to protein which results in low clearance of the medication (Ghodke-Puranik, et al., 2013).  Depakote is metabolized in the liver and excreted in the urine. Depakote increases the levels of GABA, an inhibitory neurotransmitter in the CNS which is involved in controlling cortical excitability (Pravat, Krity, & Aroma, 2017).  According to Puerta & Ramirez (2015), “Significant reductions in GABA levels have been described in severe cases of AD, which could be underlying the behavioral and psychological symptoms of AD.

Influencing Factor of Adverse Effect to Depakote

This patient may have been having an adverse reaction to Depakote due to impaired hepatic function. As we age the liver’s ability to metabolize many substances decreases (Siddoqui, 2017). The level of Depakote likely built up in this patient’s bloodstream related to impaired ability to metabolize the medication and the kidneys functions also decline as we age so execration may be impaired. What I have learned from this experience is that geriatric patients should have a hepatic function panel and comprehensive metabolic panel before starting to rule out impairment. A valproic acid level should be drawn during the course of treatment periodically to ensure that the medication is not at a toxic level.

Needs help with similar assignment?

We are available 24x7 to deliver the best services and assignment ready within 3-4 hours? Order a custom-written, plagiarism-free paper

Get Answer Over WhatsApp Order Paper Now

Nursing Assignment

/in /by

Below is my nursing assignment and this is the Professor’s instruction:

· Please write one paragraph for each question.

· Each question should be one paragraph (no less than 3 sentences and no more than 7 sentences), and well detailed.

· Plagiarized content of your assignment will get you a zero or withdrawal from class.

· Copying all or part of your classmate’s answers will earn you a zero.

· Works cited for each question is required.

· Deadline for submission is Wednesday 28th August 2019 by 6:00pm EST.

QUESTIONS:

1. Discuss one male reproductive system disorder and relate how you would plan and intervene

2. Discuss one diagnosis related to transgender care and how you would plan and intervene

3. Discuss one sexually transmitted disease in men or women and related few possible treatments

Needs help with similar assignment?

We are available 24x7 to deliver the best services and assignment ready within 3-4 hours? Order a custom-written, plagiarism-free paper

Get Answer Over WhatsApp Order Paper Now

Discussion: Assessing Musculoskeletal Pain

/in /by

Discussion: Assessing Musculoskeletal Pain

The body is constantly sending signals about its health. One of the most easily recognized signals is pain. Musculoskeletal conditions comprise one of the leading causes of severe long-term pain in patients. The musculoskeletal system is an elaborate system of interconnected levers that provides the body with support and mobility. Because of the interconnectedness of the musculoskeletal system, identifying the causes of pain can be challenging. Accurately interpreting the cause of musculoskeletal pain requires an assessment process informed by patient history and physical exams.

In this Discussion, you will consider case studies that describe abnormal findings in patients seen in a clinical setting.

                                           To prepare:

· By Day 1 of this week, you will be assigned to one of the following specific case studies for this Discussion. Please see the “Course Announcements” section of the classroom for your assignment from your Instructor.

· Your Discussion post should be in the Episodic/Focused SOAP Note format rather than the traditional narrative style Discussion posting format. Refer to Chapter 2 of the Sullivan text and the Episodic/Focused SOAP Template in the Week 5 Learning Resources for guidance. Remember that all Episodic/Focused SOAP notes have specific data included in every patient case.

                                      Case : Ankle Pain

A 46-year-old female reports pain in both of her ankles, but she is more concerned about her right ankle. She was playing soccer over the weekend and heard a “pop.” She is able to bear weight, but it is uncomfortable. In determining the cause of the ankle pain, based on your knowledge of anatomy,

· what foot structures are likely involved?

· What other symptoms need to be explored? What are your differential diagnoses for ankle pain?

· What physical examination will you perform? What special maneuvers will you perform? Should you apply the Ottawa ankle rules to determine if you need additional testing?

With regard to the case study you were assigned:

· Review this week’s Learning Resources, and consider the insights they provide about the case study.

· Consider what history would be necessary to collect from the patient in the case study you were assigned.

· Consider what physical exams and diagnostic tests would be appropriate to gather more information about the patient’s condition. How would the results be used to make a diagnosis?

· Identify at least five possible conditions that may be considered in a differential diagnosis for the patient.

Post an episodic/focused note about the patient in the case study to which you were assigned using the episodic/focused note template provided in the Week 5 resources.

Provide evidence from the literature to support diagnostic tests that would be appropriate for each case.

List five different possible conditions for the patient’s differential diagnosis, and justify why you selected each.

Needs help with similar assignment?

We are available 24x7 to deliver the best services and assignment ready within 3-4 hours? Order a custom-written, plagiarism-free paper

Get Answer Over WhatsApp Order Paper Now

NUR550-D6Q2R1

/in /by

Minimum of 250 words with peer review reference

Identify a clinical prevention intervention to promote health and wellness for a population with which you are familiar. Have these clinical prevention interventions been successful? Why or why not?

Needs help with similar assignment?

We are available 24x7 to deliver the best services and assignment ready within 3-4 hours? Order a custom-written, plagiarism-free paper

Get Answer Over WhatsApp Order Paper Now

Hypothesis testing in Research

/in /by

Provide two different examples of how research uses hypothesis testing, and describe the criteria for rejecting the null hypothesis. Discuss why this is important in your practice and with patient interactions.

Needs help with similar assignment?

We are available 24x7 to deliver the best services and assignment ready within 3-4 hours? Order a custom-written, plagiarism-free paper

Get Answer Over WhatsApp Order Paper Now

NUR630-D4Q1R2

/in /by

Minimum of 250 words with peer review reference

You are the nurse leader on an obstetrics unit. You have been tasked to utilize a Six Sigma approach for standardizing the discharge process. Where do you start?

Needs help with similar assignment?

We are available 24x7 to deliver the best services and assignment ready within 3-4 hours? Order a custom-written, plagiarism-free paper

Get Answer Over WhatsApp Order Paper Now

Power Point about Paperwork reduction act

/in /by

What is paperwork reduction act?

Definition?

Objectives?

Function?

Relation with healthcare policy and delivery system.

Power Point

turinitin report attached

Apa Format

minimum 10 slides

Needs help with similar assignment?

We are available 24x7 to deliver the best services and assignment ready within 3-4 hours? Order a custom-written, plagiarism-free paper

Get Answer Over WhatsApp Order Paper Now

Nursing homework help

/in /by

In quantitative research, we looked at the rate of falls numerically before and after the implementation of a program. In qualitative research, if you were interested in study the impact of falls on the patient’s quality of life, you could obtain this information through personal interviews. The unit of measurement would be the words that the patient uses, and a qualitative method would be used to analyze this data.

Give a different example of qualitative research design. How does qualitative research improve quality of care and health outcomes?

Peer Response 1:

 

Stephanie Knaggs posted

 

There are many ways that qualitative research can improve quality of care and health outcomes. For example, qualitative research studies can “explain the mechanisms by which interventions, evaluated within trials, might achieve their effect” (Booth, 2016, para. 1). Also, they can “investigate differences in effects between different population groups” and “identify which outcomes are most important to patients, carers, health professionals, and other stakeholders” (Booth, 2016, para. 1). Furthermore, qualitative studies can “explore the impact of acceptance, feasibility, meaningfulness, and implementation-related factors within a real world setting” and therefore contribute to enhancements to future interventions (Booth, 2016, para. 1). An example of a qualitative study could be nurse perception of care delivery and patient safety in emergency departments. Nurses could be interviewed and asked questions regarding their ability to provide effective and safe care to their patients. They could also be asked about barriers to implementing safety practices and what tools they needed to provide better outcomes of care delivery. This type of qualitative study could be useful in identifying ways in which policies or procedures need to change, staffing adjustments, equipment or technology maintenance or upgrades, or even scripting conversations with patients to improve their perception of delivery of care. A quantitative study could then be performed to test the relevance and effectiveness of changes implemented as a result of the qualitative study. References

Booth, A. (2016). Searching for qualitative research for inclusion in systematic reviews: a structured methodological review. Systematic Reviews. 5:74. Retrieved October 10, 2019 from: https://systematicreviewsjournal.biomedcentral.com/articles/10.1186/s13643-016-0249-x

Peer 2 Response:

 

Tiffany Spitzner posted

 

Qualitative research is about establishing the answers to the why’s and how’s in a question. Information gathered is subjective as opposed to objective information. (Polit & Tatano Beck, 2018) The sample is selected by convenience rather than a purpose for these studies. Today, healthcare is based on the patient experience and outcomes for the patient. Patient satisfaction surveys, such as Press Ganey, allows for the patient to provide personal feedback on their experience during the time of their stay in the organization. A patient satisfaction survey, or a Press Ganey, is a type of survey that measures the patient’s perception of their experience by using a point system, on the care they received. (Otani, Waterman, Dunagan, & Ehinger, 2012) Based on these results, an organization can apply new strategies in care and experience to improve patient satisfaction and to ensure a quality experience is priority. Such changes, based on survey results, can be improved communication, increased time sensitivity, and cut down on wait times. Also, data collected through these surveys point to better care delivery, improved patient satisfaction, and reimbursement for the organization. References Otani, K., Waterman, B., Dunagan, C., & Ehinger, S. (2012). Patient Satisfaction: How Patient Health Conditions Influence Their Satisfaction. Journal of Healthcare Management; Chicago, 57(4), 276-292. Retrieved from www.proquest.com/snhu.edu Polit, D., & Tatano Beck, C. (2018). Essentials of Nursing Research (9th ed.). http://dx.doi.org/LCCN 2016043994 | ISBN 9781496351296

 

Needs help with similar assignment?

We are available 24x7 to deliver the best services and assignment ready within 3-4 hours? Order a custom-written, plagiarism-free paper

Get Answer Over WhatsApp Order Paper Now

CLC – Evidence-Based Practice Project: Intervention Presentation on Diabetes

/in /by

This is a Collaborative Learning Community (CLC) assignment.

As a group, identify a research or evidence-based article published within the last 5 years that focuses comprehensively on a specific intervention or new treatment tool for the management of diabetes in adults or children. The article must be relevant to nursing practice.

Create a 4 slide PowerPoint presentation on the study’s findings and how they can be used by nurses as an intervention. Include speaker notes for each slide and references.

Article: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5000621/

Include the following:

1. Describe the intervention or treatment tool and the specific patient population used in the study.

You are required to cite to a minimum of two sources to complete this assignment. Sources must be published within the last 5 years and appropriate for the assignment criteria and relevant to nursing practice.

While APA style is not required for the body of this assignment, solid academic writing is expected, and documentation of sources should be presented using APA formatting guidelines.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

You are required to submit this assignment to LopesWrite. Refer to the LopesWrite Technical Support articles for assistance.

Needs help with similar assignment?

We are available 24x7 to deliver the best services and assignment ready within 3-4 hours? Order a custom-written, plagiarism-free paper

Get Answer Over WhatsApp Order Paper Now