Guidelines: Support your responses with scholarly academic references using APA style format. Assigned course reading and online library resources are preferred. Weekly lecture notes are designed as overviews to the topic for the respective week and should not serve as a citation or reference.
In your discussion question response, provide a substantive response that illustrates a well-reasoned and thoughtful response; is factually correct with relevant scholarly citations, references, and examples; demonstrates a clear connection to the readings
In your participation responses to your peers, comments must demonstrate thorough analysis of postings and extend meaningful discussion by building on previous postings.

Note: Review South University’s Substantive Participation Policy Criteria, Helpful Tips, ad Late Policy available by clicking on the South University Policy and Guidelines navigation tab. The late policy applies to late discussion question responses.

Gami is a 48-year-old who you discover when completing a health history is taking cinnamon to treat Type II Diabetes. She is specifically using cassia Cinnamon. You also discover that she is taking Ginseng to assist with memory. Her prescribed medications are Aricept and Coumadin.

Ms. GM is a 48-year-old who presents to your clinic to establish care. During the health history, you learn that she has a history of Type II Diabetes. When asked about prescription and non-traditional medications, she reports being prescribed Aricept, Coumadin, Cassia cinnamon for Type II Diabetes and Ginseng for memory.

1. Is there any additional subjective or objective information you need for this client? Explain.
2. What would be your position on the Ms. GMs use of alternative supplements for her diabetes and memory? Explain and include contraindications, if any.
3. Are there any additional test/assessments you would complete for this patient given this list of medications? Explain.
4. How might your treatment plan, in terms of medications, differ for this patient? Include the class of the medication, mechanism of action, route, the half-life; how it is metabolized in and eliminated from the body; contraindications and black box warnings.
5. What health maintenance or preventive education is important for this client based on your choice medication/treatment?

Jordan is a 35-year-old woman who presents with intermittent diarrhea with cramping that is relieved by defecation. The diarrhea is not bloody or accompanied by nausea and vomiting. Review of past medical history includes some childhood “stomach issues”, HTN, and a recent cholecystectomy. She works in the environmental department of a large hotel. . She denies alcohol and cigarette.

Diagnosis: Irritable Bowel Syndrome (IBS)

I.      Discuss the epidemiology of IBS?

II.     What is your treatment goals for this patient?

III.    Discuss First line and second line drug therapy for IBS. Please include pharmacotherapeutic information.

 Reply to this student post with less than 20 % similarity APA style 

1- What originates to attention when you consider about culture? For a lot of us, we instantly think of what’s correct in visible of us: distinctive idioms, diverse clothing and different food. But a humanity’s culture also influences an individual’s principles, customs and beliefs. It influences in what way you view confident concepts or behaviors, and in the event of mental health, it can influence whether or not you pursue help, what type of help you pursue and what sustenance you have nearby you. It is significant that we understand the role culture plays in mental health care so we can sustenance our loved ones and inspire treatment once it is required most. (Kapil, Rubina, 2019). There are four ways culture be able to influence mental health:

– Cultural stigma. Each culture has a diverse method of seeing at mental health. For various, there is increasing stigma round mental health, and mental health trials are measured a weakness and something to hide. This should make it firmer for those struggling to conversation flexibly and request for help.

– Understanding symptoms. Culture should impact how individuals designate and impression about their symptoms. It can affect whether somebody selects to identify and dialogue around only physical signs, only emotional signs or both.

– Community Support. Cultural influences can regulate how much sustenance somebody acquires from their family and communal when it comes to mental health. Since of prevailing stigma, sectors are occasionally left to find mental health management and provision alone.

– Resources. When watching for mental health treatment, you want to discourse to a person who appreciates your precise skills and apprehensions. It can occasionally be problematic or time-consuming to discovery possessions and treatment choices that take into explanation specific cultures influences and needs.

These are simply a few conducts culture can influence the observation of and treatment for mental health. Each culture and individual is dissimilar and appearance a single journey to recovery. You can support discourse the mental health of subgroups by considerate the role culture plays in mental health and by suitable skilled to help those round you. Mental Health First Aid gives individuals the expertise to recognize signs of mental health and element use contests and action stages to take to help them get treatment

2- Culture is an attractive piece of our lives, but it can similarly negatively impact our approaches in the direction of mental health. Mental disease is still stigmatized in many values. Persons may be disinclined to even dialog about mental health, let alone seek action. For example, African American community were “not very open to acknowledging psychological problems,” and they remained also averse to seek specialized help. In addition, Asian cultures incline to brand mental illness by respecting silence, reserve and face-saving. Physical symptoms of diverse mental illnesses incline to be clarified as appearances of spiritual or ethical weakness, and some Asian dialects don’t even have a word for “depression,” Han says. “In some cultures, they’ll say, ‘My liver is bad,’ and that is translated into, ‘I’m depressed and sad’,” she says. “The standpoint on mental illness as slightly that can be preserved is a pretty new, Western idea for numerous of our clients, so it develops a family secret and persons do not look for help until it becomes out of control or certainly, really bad.” Hispanics/Latinos apply mental health care at an amount that is about half that of non-Hispanic Whites. Stigma and ethnic and spiritual values play a important role in mental health care use differences. Trust that individuals with mental disorder were unsafe, out of control, and grief from an irrepressible illness that occasioned in refusal and ostracism. Greatest families would repudiate the reality of depression and mental disorder, except symptoms seriously inhibited with daily operative or remained life-threatening. Spiritual managing such as prayer, and faith in God, were whispered to be defensive influences. Causative acknowledgements for depression were both biomedical and spiritual, such as absence of faith, not praying, fears, and bad performances of close relative. (Caplan, Susan, 2019).

3- A number of Latinos interpretation mental illness as a signal of weakness. Others think it is a individual subject to be reserved quiet. Others anxiety existence categorized “loco,”  “crazy.” Latinos have robust family connection. Family sustenance should benefit improve the stigma of a mental disorder and reassure patients to discourse it. Distribution evidence with family supporter’s intensifications their understanding of the disease and benefits them improved sustenance the patient. Also, African Americans have faith in that a mental health disorder is a particular signal of weakness. This stigma can performance as a preventive from persons looking for mental health care when they necessity it.

4-Cultural ability has been planned as a approach to progress admittance to healthcare and the superiority of healthcare. (Pullen, Lara, 2016). There are diverse communication techniques:

– Culturally sensitive communication: Open and truthful communication among staff and the individual who is sick, and those acknowledged as significant to them, comprising careers, is critically significant to good care, comprehensible and basic linguistic necessity be used orally and in all other methods of communication.

-Culturally congruent communication: is an instruction theory respected by instructors all finished the world, is the good and correct form to transmit information to patient and family.

-Non-verbal communication: contains the use of form language and facial expressions.

-Transparent communication: it provides the material that individuals need in directive to understand what is successful on at the time that they need it. It evades surprises. It delivers follow-up for apprehensions that are elevated. It is reliable both in gratified and procedure.

References:

– Kapil, Rubina. (2019). Four Ways Culture Impacts Mental Health. Cultural Diversity, Mental Health First Aid, Minority Health, News. (July 11, 2019).

– Caplan, Susan (2019).Intersection of Cultural and Religious Beliefs about Mental Health: Latinos in the Faith-Based Setting. Hispanic Health Care International. First Published: (February 25, 2019). https://doi.org/10.1177/1540415319828265

– Pullen, Lara. (2016). Communication, Transparency Can Improve Healthcare Value. Published: (July 8, 2016).

 This week’s post will focus on Chapter Three. Please address the areas below in your discussion post this week. Please write at least five concise statement discussing the content in this area. Spelling and grammar will be reviewed and graded. Note: When you write the chapters, adhere to the Proposal Paper requirements.

TOPIC: Impact of Medication Administration Errors on 3-4-Year-old Leukemia Patients 

Population and Sample Selection: This section discusses the setting, total population, project population, and project sample. The discussion of the sample includes the project terminology specific to the type of sampling for the project.

Instrumentation or Sources of Data: This section describes, in detail, all data collection instruments and sources (tests, questionnaires, interviews, databases, media, etc.); the specific instrument or source to collect data for each variable or group (quantitative project).

Validity and Reliability: This section provides specific validity statistics for quantitative instruments, identifying how they were developed, and explains how validity will be addressed during data collection approaches. This section provides specific reliability statistics for quantitative instruments, identifying how the statistics were developed, and explains how reliability will be addressed during data collection approaches.

Data Collection Procedures: Describe the step-by-step procedures used to carry out all the major steps for data collection for the project in a way that would allow another investigator to replicate the project. Can say Step 1, Step 2, Step 3…

Data Analysis Procedures: This section provides a description of how the data will be collected and organized for each variable or group; a description of the type of data to be analyzed, identifying the descriptive, inferential, or nonstatistical analyses; a description of how the raw data will be organized and prepared for analysis; and a step-by-step description of the procedures used to conduct the data analysis.

Ethical Considerations: This section discusses the potential ethical issues surrounding the DPI project, as well as how human subjects and data will be protected. It identifies how any potential ethical issues will be addressed.

Limitations: This section discusses, in detail, the limitations related to the project approach and methodology and the potential impacts on the results.

Post the following statement to this topic’s discussion forum after your references:

“I am attending class, I am engaged in the writing of my DPI Project, and I am communicating regularly with my DPI Project Chairperson/Committee.”

Resources

Read:

Sole, M. L., Talbert, S., Bennett, M., Middleton, A., Deaton, L., & Penoyer, D. (2018). Collecting Nursing Research Data 24 Hours a Day: Challenges, Lessons, and Recommendations. American Journal of Critical Care, 27(4), 305–311.

URL:https://lopes.idm.oclc.org/login?url=https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=130296171&site=ehost-live&scope=site

Read:

Hammer, M. J. (2017). Research Ethics in Big Data. Oncology Nursing Forum, 44(3), 293–295.

URL:https://lopes.idm.oclc.org/login?url=https://search.ebscohost.com/login.aspx?direct=true&db=a9h&AN=122723364&site=ehost-live&scope=site

Read:

Corwin, E., Jones, D., & Dunlop, A. (2019). Symptom science research in the era of big data: Leveraging interdisciplinary resources and partners to make it happen. Journal of Nursing Scholarship, 51(1), 4-8.

URL:https://lopes.idm.oclc.org/login?url=https://search-proquest-com.lopes.idm.oclc.org/docview/2169563196?accountid=7374

Examine Case Study: Pakistani Woman with Delusional Thought Processes.  You will be asked to make three decisions concerning the medication to  prescribe to this client. Be sure to consider factors that might impact  the client’s pharmacokinetic and pharmacodynamic processes.

At each decision point stop to complete the following:

• Decision #1
  • Which decision did you select?
  • Why did you select this decision? Support your response with evidence and references to the Learning Resources.
  • What were you hoping to achieve by making this decision? Support  your response with evidence and references to the Learning Resources.
  • Explain any difference between what you expected to achieve with  Decision #1 and the results of the decision. Why were they different?
• Decision #2
  • Why did you select this decision? Support your response with evidence and references to the Learning Resources.
  • What were you hoping to achieve by making this decision? Support  your response with evidence and references to the Learning Resources.
  • Explain any difference between what you expected to achieve with  Decision #2 and the results of the decision. Why were they different?
• Decision #3
  • Why did you select this decision? Support your response with evidence and references to the Learning Resources.
  • What were you hoping to achieve by making this decision? Support  your response with evidence and references to the Learning Resources.
  • Explain any difference between what you expected to achieve with  Decision #3 and the results of the decision. Why were they different?

Also include how ethical considerations might impact your treatment plan and communication with clients.

BACKGROUND

The client is a 34-year-old Pakistani female who moved to the United  States in her late teens/early 20s. She is currently in an “arranged”  marriage (her husband was selected for her since she was 9 years old).  She presents to your office today following a 21 day hospitalization for  what was diagnosed as “brief psychotic disorder.” She was given this  diagnosis as her symptoms have persisted for less than 1 month. 

Prior to admission, she was reporting visions of Allah, and over the  course of a week, she believed that she was the prophet Mohammad. She  believed that she would deliver the world from sin. Her husband became  concerned about her behavior to the point that he was afraid of leaving  their 4 children with her. One evening, she was “out of control” which  resulted in his calling the police and her subsequent admission to an  inpatient psych unit.

During today’s assessment, she appears quite calm, and insists that  the entire incident was “blown out of proportion.” She denies that she  believed herself to be the prophet Mohammad and states that her husband  was just out to get her because he never loved her and wanted an  “American wife” instead of her. She tells you that she knows this  because the television is telling her so.  

She currently weighs 140 lbs, and is 5’ 5”

SUBJECTIVE

Client reports that her mood is “good.” She denies auditory/visual  hallucinations, but believes that the television does talk to her. She  believes that Allah sends her messages through the TV.  At times  throughout the clinical interview, she becomes hostile towards the  PMHNP, but then calms down.

You reviewed her hospital records and find that she has been  medically worked up by a physician who reported her to be in overall  good health. Lab studies were all within normal limits. 

Client admits that she stopped taking her Risperdal about a week  after she got out of the hospital because she thinks her husband is  going to poison her so that he can marry an American woman.  

MENTAL STATUS EXAM

The client is alert, oriented to person, place, time, and event. She  is dressed appropriately for the weather and time of year. She  demonstrates no noteworthy mannerisms, gestures, or tics. Her speech is  slow and at times, interrupted by periods of silence. Self-reported mood  is euthymic. Affect constricted. Although the client denies visual or  auditory hallucinations, she appears to be “listening” to something.  Delusional and paranoid thought processes as described, above. Insight  and judgment are impaired. She is currently denying suicidal or  homicidal ideation.

The PMHNP administers the PANSS which reveals the following scores:

-40 for the positive symptoms scale

-20 for the negative symptom scale

-60 for general psychopathology scale

Diagnosis: Schizophrenia, paranoid type

 Decision Point One

Start Invega Sustenna 234 mg intramuscular X1 followed by 156 mg intramuscular on day 4 and monthly thereafter   

RESULTS OF DECISION POINT ONE

• Client returns to clinic in four weeks
• A decrease in PANSS score of 25% is noted at this visit  
• Client seems to be tolerating medication
• Client’s husband has made sure she makes her appointments for injections (one thus far) 
• Client has noted a 2 pound weight gain but it does not seem to be an important point for her
• Client complains of injection site pain telling the PMHNP that she  has trouble siting for a few hours after the injections and doesn’t like  having to walk around for such a long period of time 

Decision Point Two

 Continue  same decision made but instruct administering nurse to begin injections  into the deltoid at this visit and moving forward     

RESULTS OF DECISION POINT TWO

• Client returns to clinic in four weeks
• Client’s PANNS has reduced by a total of 50% from the initiation of Invega sustenna
• When questioned about injection site pain, client states it is much better in the arm 
• Client’s weight has increased by an  additional 2.5 pounds (total of 4.5 pounds in a 2 month period). She is  somewhat bothered by the weight gain and is afraid that her husband does  not like it. He is not present at this visit as she brought herself 
• Client likes how she feels on the  Invega Sustenna but is wondering if there is another drug like it that  would not cause the weight gain 

Decision Point Three

 Continue  with the Invega Sustenna. Counsel client on the fact that weight gain  from Invega Sustenna is not as much as what other drugs with similar  efficacy can cause. Make appointment with a dietician and an exercise  physiologist. Follow up in one month     

Guidance to Student
 Weight gain can occur with Invega  Sustenna. It is modest in nature and can be controlled with proper  nutrition and exercise. It is always a good idea to try and control a  client’s weight through consultation with a dietician and exercise  physiologist (life coach) before switching to another agent when a  product is showing efficacy for at least 6 months.  
Abilify Maintena is a good option for someone who has good  response to abilify oral. Remember that Abilify does not bind to the D2  receptor for a great period of time (such as Invega) and can be less  affective in certain individuals. Also, remember that akathisia  can be a  possible side effect. Once an IM long acting medication is given, the  effects of the drug (both efficacious and untoward effects) can be  maintained for a long duration (up to a month or longer). Tolerability  and efficacy should be established with oral medication first before  administering the first injection. Also a disadvantage to Abilify  Maintena is a 2-week overlap of oral therapy is required due to  effective blood levels lagging behind the induction dose.  
Qsymia is a weight loss medication that is a combination of  Phenteramine and Topiramate. It is only indicated to treat obesity. This  client’s BMI (28.9 kg/M2) does not fit the definition of obesity (BMI  >30 Kg/M2- Following from CDC website: Class 1: BMI of 30 to < 35,  Class 2: BMI of 35 to < 40, Class 3: BMI of 40 or higher. Class 3  obesity is sometimes categorized as “extreme” or “severe” obesity).   There are two things wrong with this therapy option. First, there are  only a few occasions where add-on therapy to treat a side effect is  acceptable and weight gain is not one of those scenarios. Secondly,  Phenteramine has a lot of cardiovascular toxicities (such as elevated  BP, HR, increased workload on the heart).