A 38-year-old woman presents to the office with complaints of weight

loss, fatigue, and insomnia of 3-month duration. She reports that she has

been feeling gradually more tired and staying up late at night because

she can’t sleep. She does not feel that she is doing as well in her occupation

as a secretary and states that she has trouble remembering things.

She does not go outdoors as much as she used to and cannot recall the

last time she went out with friends or enjoyed a social gathering. She

feels tired most of the week and states she feels that she wants to go to

sleep and frequently does not want to get out of bed. She denies any

recent medication, illicit drug, or alcohol use. She feels intense guilt

regarding past failed relationships because she perceives them as faults.

She states she has never thought of suicide, but has begun to feel increasingly

worthless.

Her vital signs and general physical examination are normal, although

she becomes tearful while talking. Her mental status examination is significant

for depressed mood, psychomotor retardation, and difficulty attending

to questions. Laboratory studies reveal a normal metabolic panel, normal

complete blood count, and normal thyroid functions.

➤ What is the most likely diagnosis?

➤ What is your next step?

➤ What are important considerations and potential complications of

management?

I need a response for this 2 peers

Peer 1 

I stay in Miami Dade County in the State of Florida where medical attention is characterized by harsh and poor conditions. The medical attention is at the worst state of its when compared with the top county in the State of Florida. Ranked forty from the sixty seven counties, Miami Dade provides the most awful medical care access as well as interest that is showcased by the uninsured medical hygiene that has twenty one %, bad diabetes care as well as monitoring of eighty seven %, delays as well as prolonged visits for all the individuals in the clinic wards that has a seventy % as compared to the greatest placed at fifty four %. It’s additionally characterized by minimal entry to x-ray and mammography assessment on the individuals that is at fifty seven % implying the assessment methods aren’t readily available on the individuals (Brown, 2011). Additionally, it lacks sufficient wellness as well as medical care personnel which range from the dentists, primary care doctors as well as mental health providers that ratios are one: 1580, one: 1250, 1:700 for the average total population of the county implying that one healthcare personnel is anticipated to deliver a lot more people. These qualities imply the method is very poor and requires improvements. 

As a nurse practitioner I’d suggest quick treatment from the federal government as well as state authorities to plan in enhancing the medical treatment scenarios of the Miami Dade County to better conditions (Kramer, 2008). This is often carried out by installation of even more x-ray and mammography assessment to decrease the unattended instances, employing much more medical care, mental health as well as dentists to reduce the ratio that every personnel offers several individuals that causes prolonged stays and delayed treatment for all the individuals in the clinic wards. Doing this, the medical care access as well as delivery is going to be effective for the individuals and therefore Miami Dade County is a much better place for everybody. 

Peer 2 

One of the healthcare issues that need improvement in a State like Florida is the issue of Alcohol‐impaired driving deaths. According to the countyhealthrankings.org (2019), the percentage of deaths that are due to alcohol consumption stands at 29% In the US, 25 % in the state of Florida, With a Minimum of 10% and maximum of 70% cases in the state. Statistics by the countyrankings.org as of 2018 (data used from 2012-2016) show that Alachua county had the highest number of deaths and approximately 30% are alcohol-impaired (countyhealthrankings.org, 2019). This is a high number, and it’s, therefore, a disturbing issue that should be looked into. Most of these deaths are preventable, and the percentage of drunk driving can be reduced by coming up with effective policies. 

           The creation of the community health center programs will bring the public and healthcare professionals together in advocating for safety measures. In Florida, impaired driving accounts to a quarter of all motor vehicle deaths. By coming up with effective programs, awareness and education campaigns can be provided to reduce cases that occur due to drunk driving. 

Drunk driving is a serious issue for public health. According to the National Highway Traffic Safety Administration (NHTSA) is estimated that at least 30 people die per day (Ying et al., 2013).This is a horrifying figure, and in dealing with such cases nurses need to act as change agents who will advocate for change in policy and processes for individuals in the community. As a nursing practitioner, it is best to come up with innovative ideas and practices that would create knowledge, develop policies and practices that would put assure public safety and reduced cases of drunk driving. According to the American Academy of Nursing (AAN) (2015), nurses need to engage in successful initiatives that would protect the public against health risks. In most cases, Nursing innovation requires the investment of resources-time, energy, reputation and energy (Mason,Leavitt & Chaffee, 2013). Additionally, nurses can corporate with the government to create effective policy programs (Mason,Leavitt & Chaffee, 2013). 

I need a respond for these 2 classmates. Response posts must be minimum 150 words each. Double space. References must be cited in APA format (6th)

This is the original activity if you needed. I selected the state of geogia for my original discussion) 

Go to the following website by clicking on the provided link, http://www.countyhealthrankings.org/ , and select a county and a state (this may be the county/state in which you reside, attend school, or plan to live and work). After reviewing the website and the health outcomes in the County Health Rankings for the area, answer the following questions in a few short sentences as part of your discussion.
 

1. Select one area in need of improvement and list the general statistics pertaining to the specific problem. 
2. How does the creation of the community health center program help to address this public health problem and what can you as a nurse practitioner and/or nurse leader do to influence policy innovation to resolve the problem? 

4 postsRe: Topic 2 DQ 1

There are many factors that influence the heath of an individual or the population. In a broad term one of this factor is termed Social Determinants of Health (SDOH). SDOH are the complex circumstances where people are born, live, grow, play learn, worship, work and age (heathy people. Gov, 2018a; World Health Organization, n.d.). In order words, these are broad range of personal, social, economic and environmental factors. The determinants are about individual place in society, this includes income level, educational level and type of employment. Over the years group of people have experienced racism, discrimination and historical events such as the black people. These experiences have detrimental effects on the health care needs of these group of people. SDOH is the main factor responsible for today’s major health problems in society including depression, hearth disease, diabetes and obesity (What are the Social Determinants of Health? 2018).

There are complex interactions between the SDOH. For example, low income will have direct impact on the individual or community accessibility to proper health care, lack of good food and thus increasing the burden on the individual or family. This burden is often translated into poor coping mechanism in the form of drug use and sometimes comfort eating of unhealthy food. Poor health can reduce the individual opportunities to have meaningful employment which in turn impact on the individual’s income. These factors interplay with each other and have a positive or negative effect on the overall health of the individual or population.

A communicable disease chain is the process by which pathogen of infectious agent is transmitted to another organism (Green, 2018). This model of communicable disease chain is presented by six links, infectious agent, susceptible host, reservoir, portal of entry, mode of transmission and portal of exist (Break the Chain of Infection, n.d.). All these elements most be presence for the spread of communicable disease in a population. To stop the spread of disease is by breaking the chain at any link.

Nurses are in better position in breaking the chain of infection because they are involved at all levels of prevention (Institute for Work and Health, 2015) The nurse can use preventive measures or health education that are aimed at breaking the chain and reducing the risks of infections in other people. These measures include adhering to proper hygiene measures (WHO, 2018). For example, in the case of contact precautions, nurses should always use the appropriate personal protective equipment disposed of immediately after attending the patient to protect the nurse and other patients from getting infection.

  Discuss a clinical experience in which you had to incorporate one or more learning styles such as visual, kinesthetic, and auditory. Explain the outcomes and how you created an effective learning experience 

Assignment Details

MN551-3: Examine the pathophysiological factors that influence the incidence and manifestations of acute, episodic, and chronic diseases in populations across the lifespan.

Topic: Educational Brochure

Design a trifold educational brochure, that will be used to educate the community, about one of the following topics:

• hypertension
• hypercholesterolemia
• heart failure
• artherosclerosis
• pathophysiological factors that influence the incidence and manifestations of acute, episodic, and chronic diseases in populations across the lifespan

Brochure Contents

1. Two evidenced-based web sites or journal articles as a reference
2. Risk factors
3. Possible consequences
4. Prevention strategies
5. Treatment modalities

Assignment Requirements:

Before finalizing your work, you should:

• be sure to read the Assignment description carefully (as displayed above)
• consult the Grading Rubric (under the Course Resources) to make sure you have included everything necessary
• utilize spelling and grammar check to minimize errors.
• follow the conventions of Standard American English (correct grammar, punctuation, etc.)
• be well ordered, logical, and unified, as well as original and insightful
• display superior content, organization, style, and mechanics
• use APA 6th Edition format.

To see your assignment instructions and grading rubric, go to Course Resources / Grading Rubrics.