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1) A few weeks after 9/11, a disaster mental health clinician believes she has a patient who is

experiencing either "Acute Stress Disorder" or "Post-traumatic Stress Disorder". a. What criteria

should the clinician use to determine which disorder the patient has (in other words, what are the

diagnostic markers for each)?

 b. Which disorder do you believe the patient has? Note: You don't

have to be a mental health clinician to answer here–your task here is to apply what you learned

in the course–so no need to state that you aren't qualified to diagnose. You must select ONLY

ONE diagnosis, either ASD or PTSD, to receive points for this question.

2) From what you have now learned about Terror Management Theory (TMT), what do you believe

the officials (at every level) could have done differently to better manage the Katrina disaster had

they understood TMT? Be specific here and cite your sources.

3) Describe the differences in the pharmacological (medication) approach to PTSD treatment and

the cognitive-behavioral approach.

4) You have been tasked with developing a two-day workshop focusing on the psychology of

disaster. The workshop is part of a larger several day conference. Other workshops occurring

during the conference will cover disaster preparedness and planning, so those topics won't be

part of your two days. Identify four CRITICAL topics that you would include during your workshop

sessions. 

Critical means you consider a topic a very high priority, something that is absolutely

essential for attendees to know about. Each session is to be an hour long. Below list the 4 topics

you would include in the workshop and, for each one, explain why you selected it (Note: You

must restrict your answer to only four topics-including more will void your answer)

5) Describe the primary psychological needs of children following a major disaster.

6) Use one of the theories discussed in the course to describe psychological risks faced by service

providers (initial responders, EMTs, rescuers, firefighters, police, on-site mental health clinicians,

etc.) in the event of a major disaster.

7) Which area of the study of the psychology of disaster do you think needs more attention these

days in order to effectively deal with contemporary disasters? Why? NOTE: You must link your

answers to course materials here, rather than just giving a brief statement of opinion

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Create a response to the discussion bellow by Sheimeka in NU623 APA style 

Pulmonary Embolism

Presenting/associated symptoms

The classic presentation of pulmonary embolism (PE) is the sudden onset of shortness of breath, pleuritic chest pain, and hypoxia. Nevertheless, most patients don’t have apparent symptoms initially. Symptoms can fluctuate from sudden hemodynamic collapse to progressive dyspnea (Quellette, 2019).

Signs of pulmonary embolism include the following:

• Tachypnea (respiratory rate >16/min)
• Rales
• Accentuated second heart sound
• Tachycardia (heart rate >100/min)
• Fever (temperature >37.8°C [100.04°F])
• Diaphoresis
• S₃or S₄ gallop (Ouellette, 2019)

 

Specific diagnostic tests used in the workup

Wells clinical prediction rule was created to decrease the use of venography which is an invasive test for DVT. The criteria consist of 8 components with a probability score between 0 and 8. This test is useful in predicting pretest probability based on assessing risk factors and physical findings before any diagnostic testing (Uphold, & Graham, 2013).

Diagnostic testing should be implemented on symptomatic patients with probable pulmonary embolism to confirm the diagnosis. The provider should complete a hypercoagulation workup if no distinct origin for an embolic disease is apparent.

Laboratory tests that should be done include:

• D-dimer testing
• Ischemia-modified albumin level
• White blood cell count
• Arterial blood gases:
• Serum troponin levels
• Brain natriuretic peptide (Ouellette, 2019)

Imaging studies that assist in the diagnosis of pulmonary embolism include:

• Computed tomography angiography (CTA):
• Pulmonary angiography:
• Chest radiography:
• V/Q scanning (Quellette, 2019)

Treatment plan using 1st line therapeutic interventions, patient education and follow up expectations

The majority of patients with acute PE should receive LMWH or fondaparinux instead of IV Unfractionated heparin therapy (UFH).   IV UFH is recommended as the initial type of anticoagulation, if the patient has severe renal failure, or if thrombolytic therapy is a possibility.  LMWH given once-daily is endorsed over twice-daily regimens. Instead of giving warfarin, Apixaban, dabigatran, rivaroxaban, and edoxaban are alternatives for prophylaxis and treatment of PE. 

A vitamin K antagonist should be started on the same day as an anticoagulant. A patient with only one thromboembolic event should receive warfarin therapy for at least 3 months. Other interventions include early ambulation, utilizing graduated compression stockings. Long-term anticoagulation is critical to the prevention of recurrence DVT or pulmonary embolism. The patient should follow up with the vascular specialist.

Support whether or not you would refer the patient to another health care provider for treatment. Include the name of the specialty and your rationale for the referral.

A referral to a specialist in vascular medicine and coagulation disorders is recommended for pulmonary embolism (Uphold, & Graham, 2013). Vascular specialist are trained to manage vascular issues which include stroke, PAD, CAD, AAA, PE, DVD, and several other diseases. A hematologist is trained to diagnose and treat diseases of the blood. A Hematologist would recommend a workup for a procoagulant defect and can suggest a pertinent anticoagulation regimen (Uphold, & Graham, 2013).

Uphold, C. R., & Graham, M. V. (2013). Clinical guidelines in family practice (5th ed.). Gainesville, FL: Barmarrae Books.

 

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Create a response to this post by Ivonne Rosado NU631. Using APA style

The prenatal care of a woman is crucial when it comes to maternal and childcare. The concept of substance abuse can negatively impact the wellbeing of the child. The condition a child exposed to opioid intake includes neonatal abstinence syndrome. This syndrome consists of withdrawal after prenatal exposure to opioids. 

According to Sanlorenzo, Stark, and Patrick, the presentation of neonatal abstinence syndrome includes hyperactivity within the nervous and gastrointestinal systm (2018). This includes tremors, irritation, lack of feeding, slow weight gain, vomiting, diarrhea, or a high pitch cry.

 The mother will continue to use drugs, which will increase the resistance, addiction, and possible start of more drugs. This can lead to poor living conditions and further complications due to a decline in self-care needs. Likewise, the long-term risks for the child consists of developmental delays and behavior concerns. 

According to Maguire et al., the child can experience vision, motor, cognitive, sleeping and ear disturbances due to the exposure (2016). This would require referrals to adequately treat the presentation and potentially early interventions programs that promote developmental growth. Correspondingly, the child may be prone to child abuse or neglect and substance abuse. Therefore, the child requires a thorough assessment and extensive treatment regimens to reduce the exposure and reach an optimal level of function.  

Peri-natal Risks 

• Growth restriction 
• Abrupto placenta 
• Pre-term  
• Death 

Post-natal Risks- infant 

• Low birth weight 
• Premature 
• Small head circumference 
• Maltreatment 
• Vision problems 

Post-natal Risks- mother 

• Addiction 
• Overdosing 
• Polysubstance abuse 
• Poor living conditions 
• Death 

References: 

Maguire, D. J., Taylor, S., Armstrong, K., Shaffer-Hudkins, E., Germain, A. M., Brooks, S. S., … Clark, L. (2016). Long-term outcomes of infants with Neonatal Abstinence Syndrome. Neonatal Network, 35(5), 277–286. doi: 10.1891/0730-0832.35.5.277 

Sanlorenzo, L. A., Stark, A. R., & Patrick, S. W. (2018). Neonatal abstinence syndrome: an update. Current opinion in pediatrics, 30(2), 182–186. doi:10.1097/MOP.0000000000000589 

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The nursing theory is going to be based on  Florence Nightengale plaease

Nursing theories are tested and systematic ways to implement nursing practice. Select a nursing theory and its conceptual model. Prepare a 10-15 slide PowerPoint in which you describe the nursing theory and its conceptual model and demonstrate its application in nursing practice. Include the following:

1. Present an overview of the nursing theory. Provide evidence that demonstrates support for the model’s efficacy in nursing practice. Explain how the theory proves the conceptual model.
2. Explain how the nursing theory incorporates the four metaparadigm concepts.
3. Provide three evidence-based examples that demonstrate how the nursing theory supports nursing practice. Provide support and rationale for each.

Refer to the resource, “Creating Effective PowerPoint Presentations,” located in the Student Success Center, for additional guidance on completing this assignment in the appropriate style.

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, which can be found in the APA Style Guide, located in the Student Success Center.

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. Please refer to the directions in the Student Success Center.

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Directions

Review the following scenarios. After reviewing the scenarios record your critical analysis of one scenario in a total of 4-6 pages double-spaced (excluding title and reference pages) . References must be in APA format (6th ed). Your analysis should include references to current literature on nursing management and leadership. For example, for the situation you select choose an appropriate tool that can assist you in analyzing and solving the problem. You may select a problem-solving tool, a decision-making tool, a conflict resolution tool etc. Your textbook is a good source but you may also search for other related references.

1. Workload Worries

You are a newly hired nursing unit manager whose responsibilities include the day-to-day operation of a thirty-two bed pediatric care unit in a large tertiary care facility. Among other things, you are responsible for staffing, ensuring quality patient care and evaluating staff performance. The staff of the unit includes 15 RNs and 22 LPNS � a mix of full-time, part-time and casual staff. Your first day on the unit you become aware that some staff are unhappy with the workload. 

You overhear Jenny Marlone LPN complaining in the hall to Kelly Morris RN that whenever she is assigned to Team 2 she has to work twice as hard as when she is on Team 1.Further, Kelly remarks, �I am always on Team 2!� It is well known that your predecessor resigned out of frustration because he lost the support of the staff (as indicated by frequent sick calls, tardiness and lack of productivity) primarily due to what they perceived as inadequate pay for the workload.

Discuss the steps that you would take to resolve this issue.

2. Parking Protest

You are the nursing manager of a community health unit in the inner city. At the monthly staff meeting a very vocal RN, claiming to represent all employees, complains about the lack of appropriate parking for staff. Mandy, the spokesperson states, �We need our cars close by so that we can get to our community visits. It is ridiculous to have us park in a lot six blocks away.� Further Mandy threatens, �If this situation isn�t resolved to our satisfaction immediately we are going to get the union to help us.�

Discuss the steps that you would take to resolve this issue.

3. Staffing Setback

You are a manager in a small rural hospital in Northern Alberta. The August long weekend is approaching and Friday morning two RNs scheduled to work evenings over the weekend call in sick. You suspect they will both be off for at least the next three shifts. You contact all the casual staff but no one is available to work. Without replacement you will be down to one RN on evenings. Sitting at your desk you wonder out loud, “Now what am I going to do?”

Discuss the steps that you would take to resolve this issue.

Submit assignment via the Assignment dropbox � Due at the end of Unit 10

Assignment 3 Marking Guide – Scenario Analysis -Filling your Toolbox (20%)

Name �

Score ___/20 = ___%

CONTENT � Total Maximum 15%

• Clear objectives and introduction are provided.
• There is a critical analysis of the scenario.
• An appropriate tool is incorporated (e.g. problem-solving tool, a decision-making tool, a conflict resolution tool etc.).
• References to current literature are used to support analysis.
• Appropriate recommendations to resolve situation are made.
• An effective conclusion is included.

Comments:

PRESENTATION � Total Maximum 5%

• Paper is informative and succinct (within page limit).
• The paper is written in a well-organized way.
• It is written in scholarly format with a title page, sentences, paragraphs, headings etc.
• APA format (6th ed) is used.
• Presentation is free of errors in spelling, punctuation, and grammar.

Comments:

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