The nurse practitioner must assess and implement an action plan for management. The nurse practitioner will discuss how to initiate a plan of action in resolving the clinical issue and present a PowerPoint presentation.

No more than 10 slides should be used with group participants of 5 to 6 students per group. 

CASE/CONFLIT

The nurse practtioner has been working in a medical surgical unit for years as a unit ADVANCE NURSE PRACTTIONER for 5 years. She is very smart and savvy when it comes to her job. She constantly gets feedback from the patients as being one of the kindest, most thorough  NURSE PRACTIONERs. The physician involved on this case scenario unbelievably thorough and great with patients.

This Nurse Practitioner was approached by a physician wondering why the blood pressure medications of a certain patient were being held over the past few days and he was not notified. This Nurse practitioner, being very diplomatic, offered a response to the physician, “I’m not sure, I didn’t even know that happened, let me look into it for you and get back to you.”

Unrelenting, the physician pressed farther: “There’s no need for you to look into it further, I’ve been sitting her for 20 minutes looking at the blood pressures and medications given–and it makes no sense.” Getting louder with each word.

Knowing she could offer nothing useful in this conversation with it escalating, she simply walked away saying, “I don’t know, I’ve literally taken care of this patient today for the first time.”

What are important interventions and programs for environmental health in Saudi Arabia? How are public health interventions planned and evaluated for environmental health? From Arab News (2014), Riyadh was ranked one of the most polluted cities globally according to the UN. How can air pollution in Riyadh be resolved by public health intervention?

• Requirements:

1. Be sure to support your statements with logic and argument,
2. More citing all sources referenced through the text 
3. APA style
4. 2 pages
5. no plagiarism
6. 3 Minimum references 
7. The references not older than 5 years ago

 ZERO PLAGIARISM

5 REFERENCES

• Develop effective documentation skills for family therapy sessions *
• Develop diagnoses for clients receiving family psychotherapy *
• Evaluate the efficacy of solution-focused therapy and cognitive behavioral therapy for families *
• Analyze legal and ethical implications of counseling clients with psychiatric disorders *

* The Assignment related to this Learning Objective is introduced this week and submitted in Week 7.

Select two clients you observed or counseled this week during a family therapy session. Note: The two clients you select must have attended the same family session. Do not select the same family you selected for Week 2.

Then, address in your Practicum Journal the following:

• Using the Group Therapy Progress Note in this week’s Learning Resources, document the family session.
• Describe each client (without violating HIPAA regulations) and identify any pertinent history or medical information, including prescribed medications.
• Using the DSM-5, explain and justify your diagnosis for each client.
• Explain whether solution-focused or cognitive behavioral therapy would be more effective with this family. Include expected outcomes based on these therapeutic approaches.
• Explain any legal and/or ethical implications related to counseling each client.
• Support your approach with evidence-based literature.

HPI

• Change “strange symptoms” and use the term that the patient used in stating her problem. Note the amount and consistency of the blood and if how many times she changed pantyliners in one day, if its soaked or not. 
• 1/10 is a pain scale, if there is no pain do not use the scale and instead state that she don’t feel any pain
• I got confused if weight loss is related to her symptoms or diet
• HPI means history of present illness, previous illnesses should be on the past health history
• Change the statement for the negative papsmear result to “but the patient claimed that she has positive result.”

OLDCART” which stands for Onset, Location, Duration, Characteristics, Aggravating Factors, Relieving Factors/Radiation and Treatment 

• Character- should describe the blood/spotting
• Aggravating factors- for ex.if the bleeding happens after sexual intercourse, during activity etc
• Relieving factors- does not stop with any remedy

Medications -state how long she is taking the drug and if she’s compliant with her prescriptions

Hospitalizations-rearrange it according to dates, first is when she was 8

Family history-state cause of death of the parents and you stated the age of her siblings twice

Social history 

• occupation is kinda confusing, state the job that she retired on. 
• how many times is a frequent visit? 2-3x a week?once? Pls indicate 

ROS

General- is wt loss sudden?

PhysicalExam

General- Appears alert? 

Skin – pls describe the color of skin not the race, is the skin cold?warm to touch?

HEENT- describe the color of sclera

GI-what do you mean by the abdomen is obese? Pls describe using appropriate medical terms

Breast-I’m sorry i did not understand what you meant by  breast is selling and palpable axillary lymph?

Musculoskeletal- i think you no longer need to state that you observed the rom on waiting area?

Neuro – are you not required to take the reflexes such as tendon reflex, etc? 

PLEASE ANSWER THE QUESTIONS BELOW IN APA FORMAT

EACH ANSWER MUST HAVE A MINIMUM OF 4 SENTENCES

PROVIDE 2 CITATIONS AND 2 REFERENCES (AT LEAST)

1. Try taking a different route to class the next time it meets. Before you do this, think about how many changes, large and small, you will have to make to do this.

a-Will you have to leave earlier to be in class on time? 

b-Will you meet different people on your way to class?

c-See different sights?

d-Would you change your route to class on the day of the final exam? 

e-Why or why not? Summarize the positives and negatives of this small change. Relate your responses to this change to the way staff nurses feel when an administrator makes what he or she thinks is a “minor” change. 

2. Think about a change that has occurred in your life. Some examples may be a change of role, a move, a marriage, a birth, a divorce, or a death. 

a-How did you react to the change? 

b-Would you have reacted differently if you had had more information?

c-Using Lewin’s model, describe the basic elements in the situation and how you eventually achieved a comfortable outcome.