Question 1

Routine Health Periodicity for the Gynecologic and Clinical Breast Exam (CBE)

In order to maintain good reproductive and sexual health, females should visit a gynecologist for an exam about once per year, even if a Pap test isn’t performed. A well-woman visit provides an excellent opportunity to counsel patients about maintaining a healthy lifestyle and minimizing health risks (ACOG, 2017).

The periodic well-woman care visit should include screening, evaluation and counseling, and immunizations based on age and risk factors. Sexually active adolescents shouldn’t wait until age 21 to see a gynecologist for the first time. Recent recommendations state that girls should have their first gynecologic visit between the ages of 13 years and 15 years (ACOG, 2017).

According to the U.S. Preventive Services Task Force (2018) the current evidence is insufficient to assess the balance of benefits and harms of performing screening pelvic examinations in asymptomatic women for the early detection and treatment of a range of gynecologic conditions. The interval for specific individual services may differ for individual patients, and the scope of services provided may vary in different ambulatory care settings (USPSTF, 2018).

The Centers for Disease Control and Prevention (2018), states that the best way to find breast cancer is with a mammogram; having a CBE or a BSE has not been found to decrease the risk of dying from breast cancer. Even if the patient chooses to have annual CBEs and to perform regularly BSEs, it is essential to also get mammograms regularly. The USPSTF recommended that women begin mammograms at age 50, not 40, and decrease the frequency thereafter. The USPSTF stated that current evidence is insufficient on the additional benefits versus harms of CBE beyond screening mammogram in women older than 40 years (USPSTF, 2018).

Health Factors Utilized to Determine the Need for a Pap Test

The need for a PAP test depends on factors such as a woman’s age, health history, recent Pap test results, and whether or not she has had HPV. The American Cancer Society (ACS) and the USPSTF both recommend that women get their first Pap test at age 21. Co-testing with Pap and HPV begins at age 30 years. Current interim guidance for stand-alone HPV primary screening begins at age 25 years. Most women between age 21 and age 30 should have a Pap test every three years, assuming their previous Pap test results were normal (Carcio and Secor, 2015).

Women who are Pap/negative and HPV/positive should perform Pap and HPV in 12 months. HIV-infected women should have biannual Pap tests in the first year of diagnosis and then may reduce frequency to annual Pap tests based on the results. A woman who has been vaccinated against HPV should still follow the screening recommendations for her age group (Carcio and Secor, 2015).

When is the Pap test no longer necessary?

The PAP test is no longer necessary in women who have had a total hysterectomy, but if the hysterectomy was done because of cervical cancer or precancerous cell changes, she may still need Pap tests. Also, after age 65, most women may no longer need Pap tests if their last three Pap tests were normal, they are not at high risk for cervical cancer, and they have gone 10 years without an abnormal test (HHS.gov, 2019).

                                                          References

Carcio, H. & Secor, M.C. (2015). Advanced health assessment of women: Clinical skills and procedure. 3rd ed. New York: Springer.

Center for Disease Control and Prevention (2018). What are benefits and riskd of screening. Retrieved from https://www.cdc.gov/cancer/breast/basic_info/benefits-risks.htm

The American College of Obstetricians and Gynecologists (2017). First Gynocologic exam. Retrieved from https://www.acog.org/Patients/FAQs/Your-First-Gynecologic-Visit-Especially-for-Teens

U.S. Preventive Services Task Force (2018). Final recommendation Statement. Ginecological conditions. Retrieved from https://www.uspreventiveservicestaskforce.org/Page/Document/RecommendationStatementFinal/gynecological-conditions-screening-with-the-pelvic-examination

US Department of Health and Human Services (2019). Cervical Cancer Screening (Pap Test). Retrieved from https://www.hhs.gov/opa/reproductive-health/fact-sheets/pap-test/index.html

• CO6 Discuss the principles of data integrity, professional ethics, and legal requirements related to data security, regulatory requirements, confidentiality, and client’s right to privacy. (PO 6)

This week, we will discuss personal communication devices and their use in healthcare. As we focus on this topic, please address the questions below in the discussion.

• How can the use of the nurse’s personal communication device(s) impact patient care positively and/or negatively?
• What are the ethical and legal implications?
• What does the professional literature say about how communication devices can support safe nursing practice?

Module 2 – SLP

BARRIERS TO HEALTHY BEHAVIORS

By now, you have identified and done some literature search on your Module 1 Session Long Project (SLP) topic/health behavior and target population. In short, you have assessed the need for a program or intervention to address the health behavior you previously identified.

For Module 2 SLP, you will again conduct a literature search utilizing peer-reviewed journal articles, books, professional organization articles, etc., to help you identify evidence-based strategies to best address the health behavior in your target population and create a program/intervention plan.

Write a paper (3 pages in length) summarizing your findings on evidence-based strategies and a workplan to address the health behavior. A workplan sample can be found at http://www.cdc.gov/OralHealth/state_programs/pdf/workplans.pdf

The following items will be assessed in particular:

1. Using the same topic you have chosen from Module 1 SLP, develop a program goal and at least two objectives (1 learning objective and 1 behavioral objective) for your target population. Your objectives must be specific, measureable, achievable, realistic, and time-phased (SMART). Make sure that you have read the required readings on SMART objectives before developing your goal and objectives.
2. Based on your literature search, provide a summary of evidence-based strategies that have been shown effective in promoting or reducing the behavior in your target population.
3. Identify two evidence-based strategies that you will use to implement your program or intervention. Provide an explanation why you have chosen these strategies and defend your choices.
4. For now, include a workplan table with your goals, objectives, and activities/strategies. NOTE: Other parts of the workplan such as the data measurement tools, timeframe, responsible person, and measures of success will be completed in the next module SLP.

SLP Assignment Expectations

Assessment and Grading: Your paper will be assessed based on the performance assessment rubric. You can view it under Assessments at the top of the page. Review it before you begin working on the assignment. Your work should also follow these Assignment Expectations.

Describe the importance of revenue cycle management in the acute care environment and the impact it can have on the healthcare organization. In your description be sure to identify the consequences of improper revenue cycle management as it pertains to the healthcare organization as a whole. 

600 words and biblical integration 

Case Study – The Elderly Scenario:

As a community health nurse, you are working in an outpatient clinic in a community that serves mainly elderly clients.This year, you noted that 85 percent of the visits resulting in hospitalization resulted from bronchitis, asthma, pneumonia, and influenza as compared to last year. At that time; the visits were due to colds, sore throats, influenza, bronchitis, and pneumonia, in order of frequency.Maria Perez, a 73-year-old Cuban American woman has been referred for community health nursing services following her discharge from the hospital. She smokes two packs of cigarettes per day. She was recently hospitalized as a result of a severe shortness of breath due to an asthma attack. The primary care provider prescribed respiratory treatments using Albuterol via jet nebulizer every 4-6 hours as needed. Mrs. Perez lives alone and has three cats to take care of.

Instructions:Read the scenario above and answer the following questions:

1)What are the biophysical, psychological, physical environmental, sociocultural, behavioral, and health system factors influencing Mrs. Perez’s health?

2)Describe at least three primary, secondary, and tertiary prevention strategies that would be appropriate in resolving Mrs. Perez’s health problems. 

3)Why would they be appropriate?

4)What activities related to health promotion and disease prevention would you plan for the late fall?

5)How would you evaluate your nursing interventions? 

6)What criteria would you use to evaluate care?

Please read the scenario and answers all questions promptly APA format. please include all references.