MR, a 23-year-old Native American male comes in to see you because he has been having anxiety and wants something to help him. He has been smoking “pot” and says he drinks to help himself too. He tells you he is afraid that he will not get into heaven if he continues in this lifestyle. He is not taking any prescriptions medications and denies 

drug use. He has a positive family history of diabetes, hypertension, and alcoholism. 

It is very important for healthcare providers to understand the culture of their patients in history taking and assessment. In the above scenario of a 23-year-old male, it is very important that the nurse practitioner be able to recognize different culture, values and biases in other to create an effective patient center communication (Ball, Dains, Flynn, Solomon, & Stewart, 2019). In other to provide culturally competent care, it is required that healthcare providers be sensitive to the patient’s heritage, sexual orientation, socioeconomic situation, ethnicity and cultural background (Ball et al., 2019). Healthcare professionals should avoid being stereotype base on patient culture but be able to recognize their limitations in knowledge about a patient culture and maintain an open mind on their cultures.

                                                     Socioeconomic, Spiritual, Lifestyle, and other cultural factors 

According to the scenario presented above, the 23-year-old does not have any socioeconomic factors affecting his health, but he has a spiritual and lifestyle factors that could affect his health. Culture, spirituality, and lifestyle is very important in the treatment of native Americans. The patient factor described above shows that the patient has factors like use of alcohol and drugs that may affect is health. Knowing these factors is very important in understanding the treatment approaches that are necessary to the particular individual (Indigenous Policy Journal, 2015). The patient also explains that he has anxiety about his drug use that could prevent him from reaching “heaven” when he dies In exploring this, the  nurse practitioner should be careful to not offend the patient but create rapport with the patient that can lead to a trustful one in other to implement treatment. Ask the patient to explain more about his specific beliefs and if he has a certain church or religion he follows and his thought about treatment options. I would also want to be careful when discussing his family’s medical history. Diabetes and hypertension are prevalent problems in the native community, partly due to the high rate of poverty and access to healthy foods (Struthers & Lowe, 2003). According Espey et al. (2014), there is increase mortality death rate in the native American population due to high incidence of diabetes, smoking prevalence, problem drinking, and social determinants. In this case a discussing patient perceived risk factors is a sensitive topic since patient already has anxiety because of his drug use. Proper assessment of the patient and good history taking to further find out what the patient could be more at risk for is important to provide better treatment and care. Other cultural factors that may affect the native American is that they mostly live in rural areas and are usually poor too making it difficult for them to get better healthcare. Even though not mention in the scenario above, the social determinant of the native Americans is that they are more likely than white to be poor, unemployed, and possess less education (Espey et al., 2014).

Sensitive Issues

The issues that the healthcare provider needs to be sensitive about when talking to the patient is the patient use of alcohol and recreational drugs.  The nurse practitioner will need to explore more by asking how often the patient drinks alcohol and uses recreational drugs. Patient also reported having anxiety. This could be from alcohol or the use of pot as mentioned. Native Americans are culturally sensitive to seek treatment for mental illness or drug/alcohol because of the stigma label on it. So, the nurse practitioner should be careful in suggesting treatment to patient. Nurse practitioner can start by asking the patient questions to find out patient stand regarding initiation of treatment (Ball et al., 2019).

                                               Targeted Questions

1. Do you smoke cigarettes, or are you around second-hand smoke?
2. What do you do for a living?
3. Within the last month has your anxiety impacted your daily living?
4. Have you tried any natural remedies to treat your anxiety?
5. On average, what is your daily/weekly alcohol intake?
6. Do you have a family or community support system?
7. Do you belong to any religious organization?

                                                                                        References

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.

Espey, D. K., Jim, M. A., Cobb, N., Bartholomew, M., Becker, T., Haverkamp, D., & Plescia, M. (2014). Leading Causes of Death and All-Cause Mortality in American Indians and Alaska Natives. American Journal of Public Health, 104(S3), S303-11. https://doi-org.ezp.waldenulibrary.org/10.2105/AJPH.2013.301798

Indigenous Policy Journal. (2015). Native American Indian Cultural Risk Factors – Contact to Termination. Retrieved from http://www.indigenouspolicy.org/index.php/ipj/article/view/338/325

I need a response from this discussion, 1 page

two references

  

Poster Presentation

Students this project will allow you to formulate and hypothetically develop your own research project. The purpose of this project is for the student to follow all of the different steps in a research project on an already published article and presented as a poster presentation. A poster session or poster presentation is the presentation of research information by an individual or representatives of research teams at a congress or conference with an academic or professional focus. The work is usually peer reviewed. Poster sessions are particularly prominent at scientific conferences such as medical congresses. 

Students will select the same article from week 7 and create a poster presentation that include the below information: I upload a template for the poster

The outline of the poster should include the following tabs (minimum requirements)

Abstract Outline: 

-Title of Project

-Problem Statement: what is the problem that needs fixing?

-Purpose of the Project

-Research Question(s)

-Hypothesis

-Methodology (Qualitative vs. Quantitative)

-Steps in implementing your project

-Limitations

Results (Pretend results)

-Conclusion

-References

I have attached an example of a poster presentation for guidance. 

  

Criterion

Outstanding 4

Very Good 3

Good 2

Unacceptable 1

Score

 

Completeness

Complete in all respects; reflects all   requirements

Complete in most respects; reflects most   requirements

Incomplete many respects; reflects few   requirements

Incomplete in most respects; does not reflect requirements

 

Understanding

Demonstrates excellent understanding of the   topic(s) and issue(s)

Demonstrates an accomplished understanding of the   topic(s) and issue(s)

Demonstrates an acceptable understanding of the   topic(s) and issue(s)

Demonstrates an inadequate understanding of the   topic(s) and issue(s)

 

Analysis

Presents an insightful and through analysis of the issue (s) identified

Presents a thorough analysis of most of the   issue(s) identified

Presents a superficial analysis of some of the issue(s)   identified

Presents an incomplete analysis of the issue(s)   identified.

 

Evaluation

Makes appropriate and powerful connections between   the issue(s) identified and the concept(s) studied

Makes appropriate connections between the issue(s)   identified and the concept(s) studied

Makes appropriate but somewhat vague connections   between the issue(s) identified and the concept(s) studied

Makes little or no connection between the issue(s)   identified and the concept(s) studied.

 

Opinion

Supports opinion with strong arguments and   evidence; presents a balanced and critical view; interpretation is both   reasonable and objective

Supports opinion with reasons and evidence;   presents a fairly balanced view; interpretation is both reasonable and   objective

Supports opinion with limited reasons and   evidence; presents a somewhat one-sided argument

Supports opinion with few reasons and little   evidence; argument is one-sided and not objective.

 

Recommendations

Presents detailed, realistic, and appropriate   recommendations clearly supported by the information presented and concepts   studied

Presents specific, realistic and appropriate   recommendation supported by the information presented and the concepts   studied

Presents realistic or appropriate recommendation   supported by the information presented and the concepts studied

Presents realistic or appropriate recommendation   with little, if any, support from the information and the concepts studied.

 

Grammar and Spelling

Minimal spelling and grammar errors

Some spelling and grammar errors

Noticeable spelling and grammar errors

Unacceptable number of spelling and grammar errors

 

APA guidelines

Uses APA guidelines accurately and consistently to   cite sources

Uses APA guidelines with minor violations to cite   sources

Reflects incomplete knowledge of APA guidelines

Does not use APA guidelines

 

Total

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.

Evaluate and provide examples of how hypothesis testing and confidence intervals are used together in health care research. Provide a workplace example that illustrates your ideas.

Refining the Theoretical Foundation for Research

Cassandra felt a huge sense of relief as she saw all of the elements of her theoretical foundation come together. She had invested a lot of time and energy into understanding her selected phenomenon and she was confident that she was on her way to developing a strong program of research. She was happy to set aside the work and enjoy some much-needed rest. When she looked at the partial draft of her paper again a few days later, she was surprised to notice a significant inconsistency in how she defined one of the concepts. With fresh eyes, she was able to discover something she had been overlooking for weeks! Now, it seemed like she would need to start at the beginning again to clarify the meaning of this concept.
Since Eduardo first began developing his theoretical foundation for research, a small, quiet voice had been nagging for his attention. He thought that he would understand certain aspects of his phenomenon better by now, and it bothered him that parts of his foundation still did not seem to work together. On the one hand, he reassured himself that his theoretical foundation was probably good enough for now and his confusion was due to his inexperience with the whole research process. On the other hand, he wondered if his doubts could mean that his theoretical foundation was missing something critical. He wasn’t sure what to do.
As Taylor thought more deeply about her theoretical foundation, she wondered if she was using the right symbols to convey the information as she intended. She had already revised her graphic model a number of times, and she still wasn’t sure if it made sense. Finally, she realized that she really needed others’ input, because even if it did seem logical to her, it might not be clear to others who were less familiar with her phenomenon of interest.

What questions or concerns have you encountered while developing your theoretical foundation for research? What kind of feedback would you like to receive from your colleagues as you refine your work?

In this Discussion, you have the opportunity to share your dilemmas and request support to help you hone your theoretical foundation for research. In addition, you can offer ideas and encouragement to your colleagues.

By Day 3

Post questions and/or describe the difficulties you have encountered while developing your theoretical foundation for research. Ask for feedback or support from your colleagues to help you to refine your work.

  

1. Describe the physiologic      events in PVC. How is cardiac output disrupted with the presence of PVCs?

1. Because of Jack’s history,      his PVCs leave him at risk for events such as ventricular tachycardia or      ventricular fibrillation. Compare and contrast these two arrhythmias. Why      are they particularly dangerous?