APA format 1 page long with 3 references 2 from walden university library

due 4/21/28 at 1200 noon EST

 

Cirrhosis of the Liver

Initial Discussion

Week 8

Pathophysiology:

Cirrhosis is a late stage of scarring (fibrosis) of the liver caused by many forms of liver diseases and conditions, such as hepatitis and chronic alcoholism. The liver carries out several necessary functions, including detoxifying harmful substances in your body, cleaning your blood and making vital nutrients. Cirrhosis occurs in response to damage to your liver. Each time your liver is injured, it tries to repair itself. In the process, scar tissue forms. As cirrhosis progresses, more and more scar tissue forms, making it difficult for the liver to function, (Huether, 2012).

Complications:

High blood pressure in the veins that supply the liver. Cirrhosis slows the normal flow of blood through the liver, thus increasing pressure in the vein that brings blood from the intestines and spleen to the liver.  Swelling in the legs and abdomen.  Portal hypertension can cause fluid to accumulate in the legs and in the abdomen. Edema and ascites also may result from the inability of the liver to make enough of certain blood proteins, such as albumin, (Mayo Clinic, 2018). 

Medication therapy:

If the cirrhosis is from drinking the doctor may subscribe medications like naltrexone and acamprosate.  If the cirrhosis is from hepatitis the doctor may prescribe interferon alpha 2b, pegylated interferon, and various Antiviral drugs. These medications are designed to attack the hepatitis virus. The drug the doctor prescribes depends on the type of hepatitis the patient may have. The most common side effects from these medicines are weakness, headache, nausea, and sleep problems, (Huether, 2012).

Patient Education:

 Patients should avoid the consumption of alcohol.  The dietary choices should be plant-based with fruits and vegetables.  Whole grains and lean sources of protein are recommended. Patients should reduce their intake of fatty and fried foods.  Improper dieting can lead to excess body fat and excess body fat can damage the liver.  If the patient is obese, they should work with their doctor to build a weight loss plan.  If the patient has a diagnosis of hepatitis, patients should be educated on protecting others from the virus to prevent spreading it, (Iannelli & Schiavo, 2018).  

References

American Liver Foundation. (2017). Cirrhosis of the Liver – Definition, Symptoms, Causes, and Treatment. Retrieved from https://www.liverfoundation.org/for-patients/about-the-liver/diseases-of-the-liver/cirrhosis/

Huether, S. E. (2012). Understanding pathophysiology. St. Louis: Elsevier.

Iannelli, A., & Schiavo, L. (2018). Very Low-Calorie Diet, the Morbidly Obese With Liver Cirrhosis and Bariatric Surgery. Transplantation, 102(4), e188-e189. doi:10.1097/tp.0000000000002065

Mayo Clinic. (2018, January 10). Cirrhosis – Symptoms and causes. Retrieved from https://www.mayoclinic.org/diseases-conditions/cirrhosis/symptoms-causes/syc-20351487

 

No plagiarism please.

Will need minimum of 150 words for each response, APA Style, double spaced, times new roman, font 12, and and Include: (1 reference for each response within years 2015-2018) with intext citations. 

 

An adolescent’s concerns about privacy can prevent them from seeking primary health care, especially for specific sensitive health care services such as STI screening and family planning issues. Those with privacy concerns are also less likely to talk openly with a health care clinician about important health issues, such as substance use, mental health, and risky sex. Recognizing that confidentiality is critical to high-quality care for adolescent women, professional health care organizations have adopted policy statements and practice guidelines that support the provision of confidential services. 

Discuss these guidelines and the laws in your state that address adolescent confidential health care.

Peer Response 1

 

This is a great discussion topic, because I have often thought about adolescent care and confidentiality, but have never gotten the chance to thoroughly investigate the topic. I have worked with adult populations and therefore it has never been a big issue in my professional career. We all know that adolescent brains are not fully developed and they require teaching, support and valid resources when they encounter problems in their lives. This is why laws were enacted to allow adolescents to see a provider confidentially and seek medical help from a professional without the repercussions from their parents who may disapprove of their actions or situation.

            In my state of Idaho, mental health services are confidential for adolescents after the age of 14 and cannot be shared with the parents without written consent of the adolescent unless they need to disclose information in order to bill insurance, carry out a treatment plan or prevent harm to the child or others or if they are ordered to by a court of law (Children’s Mental Health Services, 2018). Therefore, the clinician does have quite a bit of wiggle room in the statue because a majority of mental health issues can result in harm to the child or others. Either way, it’s good to understand that the age of 14 is the deciding factor. After 18 though, it is all confidential and no parents have rights to the individual’s medical records.

            

As for medical information. Every state allows adolescents to be seen, screened and treated for sexually transmitted infections and diseases without release of information to the parents. This law was passed as research was conducted that indicated that adolescents were MUCH less likely to seek medical help for STD’s if they knew their parents would find out. Therefore, in an attempt to decrease the prevalence of STD’s, no parental consent or notification is necessary (Bornstein, 2000). Even though confidentiality is attempted in this population with sensitive sexual or reproductive issues, obstacles to patient privacy remain. Overall, from what I can find, the provider in Idaho has the discretion to notify parents of any medical information of an adolescent.

Peer Response 2

 

When it comes to healthcare, Patient’s confidentiality is paramount, a sensitive issue, and is part of the law in many states.  When caring for adolescent patients, care is not any different.  If a minor is seeking care and fears his or her information would be disclosed to their parents, it might prevent them from seeking preventative care such as contraceptives, pregnancy testing, sexually transmitted infection testing, or even psychological help if needed.  Unless, the provider suspects neglect or abuse, confidentially should always be provided to adolescents.  Judgement by the provider regarding the best medical interest and safety of the patient should prevail (AAFP, 2013). 

In the state of Florida, the Florida Legislature (2017) there are some cases a minor could consent for their own care without a parent’s consent.  For example, if the minor is not married and pregnant or a mother, she could consent for herself and for her child; if the minor is seventeen years-old he could consent for blood donation; also, contraceptives and services of a nonsurgical nature; confidential medical services and counselling related to substance abuse and mental health outpatient counselling and treatment to minors, that does not need medications and other somatic treatments or less than two outpatient visits.

Healthcare providers must be familiar with their federal and state laws related to adolescent consent and confidentiality.  Respecting adolescent patient’s rights and privacy is essential, but as a provider encouraging the adolescent seeking care to talk to their parents regarding their health could promote better communication between child and parents.  In some facilities, the provider may make a verbal contract with the parents and teenager regarding confidentiality.  This would assure the patient that any information obtain during the visit will remain in strict confidence unless the provider thinks it could pose a danger to the patient or if the patient themselves want to share the information with their parents. 

Ultimately as a healthcare provider, it is important to protect patient’s privacy and confidentiality but, at the same time, we must be aware that in all states, a person needing emergency medical treatment they may be treated without consent if securing a consent would delay treatment and places the patient’s life or health at risk (Olson and Middleman, 2018).  Patient care should not be delayed under any circumstances that will pose harm to the patient or cause death.   

Instructions

Assessing and Planning Care for an Elderly Person

In order to gain an insight into the world of elder adults, it is important to understand how they view themselves and the values they hold. Additionally it is important to assess and determine his/her needs and establish appropriate interventions for this individual.

By the due date assigned, choose an older adult to interview. This cannot be a patient in your clinical setting. You can use a friend, family member, or co-worker. The older adult should be 65 years or older. Use the format provided to record the responses. A list of questions is available for you to start with. Include 2–3 questions of your own to get a complete picture of the older adult. Summarize your findings and also contrast the responses with findings in your readings and other current literature.

Download a patient questionnaire. This form should be used as an example.

After gaining permission, conduct a physical and mental functional assessment of the older adult you have chosen. Review your readings for the process of functional assessment.

Make use of the tools discussed this week to complete a comprehensive assessment of your patient. Search the Internet for resources on these tools.

1. Tinetti Balance and Gait Evaluation
2. Katz Index of Activities of Daily Living
3. Assessment of Home Safety
4. The Barthel Index

Make sure the older adult is clearly identified on the tools. Do not include their name, but do include professional or other designation, and age. Your name should also be identified on the tool. (This should be a part of your Appendix.)

Compare and contrast the age-related changes of the older person you interviewed and assessed with those identified in this week’s reading assignment. During this data analysis process provide at least 4–6 preliminary issues that you have identified. Identify three alterations in health that you would propose and describe them. Identify a minimum of three comprehensive interventions for each problem.

Make sure that you integrate personal cultural awareness and cultural competency.

Paper should be 5–6 pages, not including the questionnaire or tools used. These should be attached as an Appendix. Remember to use headings to identify the different sections in your paper.

On a separate references page, cite all sources using APA format.

• Use this APA Citation Helper as a convenient reference for properly citing resources.
• This handout will provide you the details of formatting your essay using APA style.
• You may create your essay in this APA-formatted template.

This week’s topic  is :  The case of  “I can’t catch my breath”

John, a healthy twenty-eight year old electrical engineer, was driving home from work one evening when he experienced sudden stabbing pain in his right pectoral and right lateral axillary regions. He began to feel out of breath and both his respiratory rate and heart rate increased dramatically. As luck would have it, John passed a hospital each day on his way home and was able to get himself to the hospital’s emergency room. The emergency room physician listened to John’s breathing with a stethoscope and requested blood gas analysis and a chest x-ray. John answered a few of the doctor’s questions. The doctor noted that John had no history of respiratory problems but was a heavy smoker.

After viewing the chest radiograph, the doctor informed John that he had experienced a spontaneous pneumothorax, or what is commonly called a collapsed lung. The doctor explained that a hole had opened in John’s right lung and that this hole had allowed air to leak into the cavity surrounding the lung. Then, as a result of the lung’s own elastic nature, the lung had collapsed. The doctor said he could not be certain of the cause of thepneumothorax, but smoking cigarettes had certainly increased the likelihood of it happening. He told John he was fortunate the pneumothorax was small, which meant that relatively little air had escaped from the lung into the surrounding cavity, and it should heal on its own. He instructed John to quit smoking, avoid high altitudes, flying innon pressurized aircraft, and scuba diving. He also had John make an appointment for a re-check and another chest x-ray.

Case Background

Spontaneous pneumothorax occurs when a blister on the surface of the lung opens, allowing air from the lung to move into the pleural cavity. This occurs because alveolar pressure is normally greater than the pressure in the pleural cavity. As air escapes from the lung, the lung tissues will recoil, and the lung will begin to collapse. The lung will continue to collapse until the difference between the alveolar pressure and pleural pressure disappears or until the collapsing of the lung causes the opening to seal.

The pneumothorax decreases the efficiency of the respiratory system, which in turn results in decreased blood oxygen concentration, increased respiratory rate, and increased heart rate. If the pneumothorax is small, the air that escapes into the pleural cavity can be reabsorbed into the lung once the opening has sealed shut. If thepneumothorax is large, a needle or chest tube may have to be inserted into the pleural cavity to draw the air out and allow for the re expansion of the lung.

Utilizing the med terms you learned this week answer the following questions

Why was John instructed to avoid high altitudes and flying in non pressurized aircrafts?

That is, what are the effects of high altitudes and or decreased air pressures on the respiratory system.

Here are the discussion board requirements.

• The initial discussion post must be at least 250 words of content, referencing the reading of the week, and include a scholarly source.
• classmates. 
• Plagiarism of any kind will result in a “0”.

Submit to assignment drop box by 11:59 pm Sunday, 9/9.

In a 2-page paper, identify a specific technological healthcare advancement and discuss the impact it has had on nursing practice and patient quality/safety.

Paper requires a minimum of two references: one from a peer-reviewed NURSING journal (less than 5 years-old) and one from the course textbook. Professional, governmental, or educational organizations (.org, .gov, or .edu) may be used as supplemental references.

APA format required.