Assessing and Diagnosing Patients With Substance-Related and Addictive Disorders

An important consideration when working with patients is their cultural background. Understanding an individual’s culture and personal experiences provides insight into who the person is and where he or she may progress in the future. Culture helps to establish a sense of identity, as well as to set values, behaviors, and purpose for individuals within a society. Culture may also contribute to a divide between specific interpretations of cultural behavior and societal norms. What one culture may deem as appropriate another culture may find inappropriate. As a result, it is important for advanced practice nurses to remain aware of cultural considerations and interpretations of behavior for diagnosis, especially with reference to substance-related disorders. At the same time, PMHNPs must balance their professional and legal responsibilities for assessment and diagnosis with such cultural considerations and interpretations.

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Chapter 4/5 Case Study

Chapter 4/5 Case Study

Attached Files:

File ESS 336 Aerobic Fitness Case Study 2021.docx ESS 336 Aerobic Fitness Case Study 2021.docx – Alternative Formats (21.216 KB)

Read over the case study scenario and answer the questions. Save your document and upload it to blackboard under the “Assignment Files” section.

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Assessing and Diagnosing Patients With Mood Disorders

Complete and submit your Comprehensive Psychiatric Evaluation, including your differential diagnosis and critical-thinking process to formulate a primary diagnosis. Incorporate the following into your responses in the template:

  • Subjective: What details did the patient provide regarding their chief complaint and symptomology to derive your differential diagnosis? What is the duration and severity of their symptoms? How are their symptoms impacting their functioning in life?
  • Objective: What observations did you make during the psychiatric assessment?
  • Assessment: Discuss the patient’s mental status examination results. What were your differential diagnoses? Provide a minimum of three possible diagnoses with supporting evidence, listed in order from highest priority to lowest priority. Compare the DSM-5 diagnostic criteria for each differential diagnosis and explain what DSM-5 criteria rules out the differential diagnosis to find an accurate diagnosis. Explain the critical-thinking process that led you to the primary diagnosis you selected. Include pertinent positives and pertinent negatives for the specific patient case.
  • Reflection notes: What would you do differently with this client if you could conduct the session over? Also include in your reflection a discussion related to legal/ethical considerations (demonstrate critical thinking beyond confidentiality and consent for treatment!), health promotion and disease prevention taking into consideration patient factors (such as age, ethnic group, etc.), PMH, and other risk factors (e.g., socioeconomic, cultural background, etc.).

only Support your approach with evidence-based literature.

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Determining the Credibility of Evidence and Resources

Assessment 2 Instructions: Determining the Credibility of Evidence and Resources

 

·

· Develop a 2-4 page scholarly paper in which you describe a quality or safety issue, or a chosen diagnosis, and then identify and analyze credible evidence that could be used as the basis for applying EBP to the issue.

Introduction

The goal of using evidence-based research findings is to enhance safety and quality of patient care and ensure optimal outcomes are achieved. It is not uncommon to hear a nurse say, “why change it as we’ve always done it this way.” However, this is no longer acceptable in today’s practice environment. The profession of nursing has evolved, and the expectation is that the professional nurse has a scientific foundation to support the care that is provided. As the profession of nursing continues to evolve and engage in health care transformation, baccalaureate-prepared nurses are expanding taking on leadership roles that include incorporating EBPs. To be able to do this, the nurse needs to understand the criteria and makes a resource credible, as this is crucial when deciding if the research is valid and reliable for implementation into health care settings. The nurse will need to incorporate the use of evidence-based practice models. EBP models are designed to assist the nurse in developing a plan to gather evidence to answer a practice problem or question. It is a systematic approach to direct the user to incorporate scholarly findings into current practice. These EBP models lead the nurse through the decision-making process of evaluating the literature to determine the best practice evidence for the practice issue or question.

It would be an excellent choice to complete the Vila Health Determining the Credibility of Evidence activity prior to developing the report. The activity is a media simulation that offers an opportunity to review a scenario and work on determining the credibility of presented evidence. These skills will be necessary to complete Assessment 2 successfully. This media simulation is one potential source of context on which to base your assessment submission. This will take just a few minutes of your time and is not graded.

Professional Context

As a baccalaureate-prepared nurse, you will be responsible for locating and identifying credible and scholarly resources to incorporate the best available evidence for the purposes of enhancing clinical reasoning and judgement skills. When reliable and relevant evidence-based findings are utilized, patients, health care systems, and nursing practice outcomes are positively impacted.

Scenario

For this assessment, you may choose from the following options as the context for the quality or safety issue or chosen diagnosis/health issue for researching and completing this assessment:

· The specific diagnosis/health issue you identified in your previous assessment.

· The simulation Vila Health: Determining the Credibility of Evidence.

· A personal practice experience in which a sentinel event occurred.

Instructions

The purpose of this analysis is to better understand what constitutes credibility of journal articles as well as websites. The role of the baccalaureate-prepared nurse in incorporating evidence-based research continues to growth in clinical practice. As quality improvement (QI) measures to reduce safety risks continue to be emphasized, the need for evidence-based models and evidence-based templates is growing. This type of systematic approach to incorporating evidence-based findings allows nurses to make clinical and operational decisions based upon the best available evidence. When the most up-to-date evidence-based findings are utilized, patient-centered care improves outcomes and enhances the patient experience.

Below is a quick review table of several well-known Evidence-Based Practice Models used to guide exploration:

Evidence-Based Practice Models
Iowa Model of Evidence-Based Practice
Stetler Model
Ottawa Model
PARiHS (Promoting Action on Research Implementation in Health Services) Model
ACE (Academic Center for Evidence-Based Practice) Star Model
ARCC (Advancing Research and Clinical Practice Through Close Collaboration) Mode
John Hopkins Model
KTA (Knowledge-to-Action) Model

For this assessment:

· Explain the criteria that should be used when determining the credibility of journal articles as well as websites.

· Support your explanations with references to the literature or research articles that describe criteria that should be used to determine credibility.

5. Your identification and determination of credibility should be done within the context of your chosen scenario for this assessment. For example, if you choose to use the provided Vila Health scenario, your initial identification of resources should be of resources that will best help address the presented issue. However, if you are locating resources to help provide evidence-based care for the diagnosis/health care issue you identified in the first assessment, you may want to begin your literature and evidence search from the databases that were identified. Any of the three scenario options are acceptable. So, pick the one that most interests you.

Be sure to address the following in this assessment, which correspond to the grading criteria in the scoring guide. Please study the scoring guide carefully so that you will know what is needed for a distinguished score.

. Describe a quality or safety issue, or a chosen diagnosis, that could benefit from an evidence-based approach.

. Explain criteria that should be considered when determining credibility of resources such as journal articles and websites.

. Analyze the credibility and relevance of evidence and resources within the context of a quality or safety issue, or a chosen diagnosis.

8. This is where you are selecting the specific resources to help address the issue in your chosen scenario.

. Identify the Evidence-Based Practice model and explain the importance of incorporating credible evidence into the EBP model used to address a quality or safety issue, or a chosen diagnosis/health care issue. Review the literature below and choose the appropriate model for your diagnosis/health care issue.

9. Selecting a model for evidence-based practice changes. [PDF] and Evidence-Based Practice Models help explain the various evidence-based nursing models.

. Communicate using writing that is clear, logical, and professional with correct grammar and spelling using current APA style.

Additional Requirements

Your assessment should meet the following requirements:

. Length of submission: 2-4-page scholarly paper, this does not include the APA-formatted title page and reference list.

. Number of references: Cite 3-5 sources of scholarly or professional evidence that support your findings and considerations. Resources should be no more than five years old.

. APA formatting: References and citations are formatted according to current APA style.

Portfolio Prompt: Remember to save the final assessment to your ePortfolio so that you may refer to it as you complete the final capstone course.

Competencies Measured

By successfully completing this assessment, you will demonstrate your proficiency in the course competencies through the following assessment scoring guide criteria:

. Competency 2: Analyze the relevance and potential effectiveness of evidence when making a decision.

14. Explain criteria that should be considered when determining credibility of resources such as journal articles and websites.

14. Analyze the credibility and relevance of evidence and resources within the context of a quality or safety issue, or a chosen diagnosis.

. Competency 3: Apply an evidence-based practice model to address a practice issue.

15. Identify an evidence-based practice model (such as Iowa, Stetler, John Hopkins, etc.) and explain the importance of incorporating credible evidence into an EBP model used to address a quality or safety issue, or a chosen diagnosis/health care issue.

. Competency 4: Plan care based on the best available evidence.

16. Describe a quality or safety issue, or a chosen diagnosis, that could benefit from an evidence-based approach.

. Competency 5: Apply professional, scholarly communication strategies to lead practice changes based on evidence.

17. Organize content so ideas flow logically with smooth transitions; contains few errors in grammar/punctuation, word choice, and spelling.

17. Apply APA formatting to in-text citations and references exhibiting nearly flawless adherence to APA format.

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module 5

  1. Course Competency :
    • Design plans for care specific to the older adult.
    • Consider the scenario below, then follow the instructions underneath it to complete the assignment.

      Mrs. Y
      Mrs. Y is an 84-year-old client who was recently discharged from the hospital for an infected diabetic ulcer on her left leg. During her hospitalization, Mrs. Y required intravenous antibiotic therapy through a peripherally inserted central catheter (PICC) line.
      Due to Mrs. Y’s long history of diabetes, her physician ordered that intravenous antibiotic therapy be continued at home. Subsequently, home health services were initiated, a home health nurse was assigned to Mrs. Y’s case, and an initial home visit was scheduled.
      The home health nurse arrives at Mrs. Y’s home and introduces herself to the client and the family. The nurse explains the home nursing services that will be provided, including the PICC line and intravenous antibiotic therapy treatments.
      During the initial home visit, the nurse assessed the physiological, psychological, functional, and safety needs of the client. The nurse’s findings were as follows:

    • Mrs. Y lives alone; however, her daughter checks on her frequently throughout the day.
    • The client is noted to have moderate functional issues and ambulates with a cane.
    • The client has several throw rugs in the main walking quarters and minimal lighting throughout the hallways.
    • Mrs. Y states “I used to get around my house with ease, but now I get a little tired and have to sit down and rest frequently.”
    • Consider Mrs. Y’s current health status and functional decline, then address the following:
    • Download the Concept Map and Plan of Care worksheet below. An example is also provided for your reference.
    • Concept Map and Plan of Care worksheet

      Concept Map and Plan of Care example

    • Identify three (3) priority nursing diagnoses for Mrs. Y. Visit the School of Nursing Guide Nursing Reference eBooks section for resources to assist with nursing diagnoses.
    • Create a visual representation of the three (3) priority nursing diagnoses by incorporating them into the Concept Map (template in the worksheet). Be sure each nursing diagnosis includes the following elements:
    • “related to (r/t)” — description of the client’s problem
    • “as evidenced by” — description of the client’s symptoms
    • Complete the Nursing Plan of Care (table in the worksheet) describing what should be implemented for Mrs. Y.
    • Goals: Establish at least one (1) goal for each of the nursing diagnoses you identified (for a total of 3 goals). Goals should be: patient specific, measurable, actionable, realistic, and time limited.
    • Nursing Interventions: Describe at least three (3) nursing interventions for each of the goals (for a total of 9 nursing interventions). Each intervention should be in alignment with the goal it is supporting.
    • Complete the assignment using proper spelling, grammar, and APA.

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Unit 1 Discussion

Screening Guidelines

Pick one women’s health screening guideline, such as mammogram, Pap smear, bone mineral density scan, or colonoscopy, and outline the current screening recommendations alongside the governing body you selected for age and frequency. Discuss any reasons for potential deviations from routine screening frequency. How do you manage the variety of governing bodies that struggle with a consensus for screening? How do you explain these differences to your patient?

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Strategic Plan Summary

Assess the culture of the organization for potential challenges in incorporating the nursing practice intervention. Use this assessment when creating the strategic plan. Discuss with your preceptor the culture of your organizations and what are the potential problems.

Write a  strategic plan (150-250) defining how the nursing practice intervention will be implemented in the capstone project change proposal.

APA style is not required, but solid academic writing is expected.

You are not required to submit this assignment to LopesWrite.

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homework

 It is estimated that more almost 7% of the U.S. population will experience posttraumatic stress disorder (PTSD) in their lifetime (National Institute of Mental Health, 2017). This debilitating disorder often interferes with an individual’s ability to function in daily life. Common symptoms of anxiousness and depression frequently lead to behavioral issues, adolescent substance abuse issues, and even physical ailments. For this Assignment, you examine a PTSD video case study and consider how you might assess and treat clients presenting with PTSD.

 

  • Review this week’s Learning Resources and reflect on the insights they provide about diagnosing and treating PTSD.
  • View the media Presentation Example: Posttraumatic Stress Disorder (PTSD) and assess the client in the case study.
  • For guidance on assessing the client, refer to Chapter 3 of the Wheeler text.

Note: To complete this Assignment, you must assess the client, but you are not required to submit a formal comprehensive client assessment.

 

 

Succinctly, in 1–2 pages, address the following:

  • Briefly explain the neurobiological basis for PTSD illness.
  • Discuss the DSM-5-TR diagnostic criteria for PTSD and relate these criteria to the symptomology presented in the case study. Does the video case presentation provide sufficient information to derive a PTSD diagnosis? Justify your reasoning. Do you agree with the other diagnoses in the case presentation? Why or why not?
  • Discuss one other psychotherapy treatment option for the client in this case study. Explain whether your treatment option is considered a “gold standard treatment” from a clinical practice guideline perspective, and why using gold standard, evidence-based treatments from clinical practice guidelines is important for psychiatric-mental health nurse practitioners.

Support your Assignment with specific examples from this week’s media and at least three peer-reviewed, evidence-based sources. Explain why each of your supporting sources is considered scholarly. Attach the PDFs of your sources.

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Home Visiting Assignment

For this activity, you will select either an older adult or pregnant/post-partum mom and infant
individual/family to complete your 3 virtual or in-person home visits. To ensure timely completion of
conducting the home visits, it is important to identify an individual and schedule these visits early in the
semester. The three home visits are summarized below:

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Catholicism Written Report

In your readings from the Catechism of the Catholic Church and the Compendium of the Catechism of the Catholic Church, you gleaned a better understanding of what the Catholic Church’s teachings are on specific theological topics.

You will now use the information gleaned in the text to delineate the teachings listed below in a concise manner:

  1. Catholic Understanding of God as Trinity
  2. Salvation is Achieved through the Paschal Mystery of Jesus Christ
  3. Eschatology – Death and the Afterlife
  4. Freedom
  5. Virtues
  6. Sin

Submission Instructions:

When completing this written report, the following guidelines must be followed. Failure to do so will result in points being deducted from your grade: 

  • This report must be typed in a 12 point non-ornamental font.
  • Each section of the report must include a section title on a separate line (ex: Freedom, Virtues, Sin, etc.).
  • Incorporate at least 2 direct quotations with appropriate footnotes.
    • First quotation must come from the specific section of the Catechism of the Catholic Church in the required readings.
    • Second quotation with accompanying footnote must come from the specific section of the Compendium of the Catechism of the Catholic Church in the required readings.

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