DQ 1- 014

Regulatory Environment and Requirements

Select a risk management issue within a specific health care setting or organization. For your initial post to this discussion, construct a plan for regulatory compliance and address principles of high reliability organizations (Youngberg, 2011, p. 346–347). Begin your discussion by defining your selected issue and setting. Then, explain your plan and cite resources and personal experience as appropriate. The issue you select for this discussion will be the focus of the executive summary portion of this unit’s assignment, in which you must create an executive summary that describes your organization’s compliance with the regulatory requirement to promptly identify POAs and proactively assess and manage risk.

Initial posts should be based upon peer-reviewed, evidence-based literature. In your post, include at least one APA-formatted in-text citation and accompanying, congruent APA-formatted reference. Your source can be a course textbook, assigned reading, or other scholarly source.

Reference

Youngberg, B. J. (2011). Principles of risk management and patient safety. Sudbury, MA: Jones and Bartlett.

Response Guidelines

Respond to the posts of other learners according to the Faculty Expectations Response Guidelines. If possible, respond to one learner who has a perspective, background, or goals that are similar to yours, and to one learner whose perspective, background, or goals are different. Peer responses should be substantive and must include one peer-reviewed source that aligns with the discussion thread. You may feel free to add an additional source that is new or provides a completely different perspective. “I agree” and “Thanks for sharing your insights” are examples of responses that do not contribute content for enhanced learning and are not acceptable. The goal is quality, substantive feedback that demonstrates higher order critical thinking and evaluation of peers’ initial posts.

DQ 2, 3 and 4 (24)

  

[u03d1] Unit 3 Discussion 1

Learning   from the Past

Considering your analysis of St.   Anthony Medical Center’s Labor and Delivery service strengths and   opportunities, propose a list of features, advantages, and benefits for the   current service offering. With reference to the previous plan, explain your   reasoning for the new list.

Response   Guidelines

Respond to your fellow learners   according to the Faculty Expectations Response Guidelines. Focus on your   proposal in relation to that of your colleague: Where do your lists align?   Where do they differ? Support your thoughts with your own analysis.

Resources

• Discussion Participation Scoring Guide.

 

[u03d2] Unit 3 Discussion 2

Competitive   Analyses

Review the presentation given by   the marketing director in the media piece, Vila Health: Market Analysis. Then   construct a competitive analysis focused on social media use for St. Anthony   Medical Center’s Labor and Delivery service line versus the two other   competitor organizations. Post your document in the discussion space. This   completes step three of Kotler’s Marketing Plan format, presented in Health   Care Marketing.

Response   Guidelines

Review and respond to your fellow   learners according to the Faculty Expectations Response Guidelines. Focus   your response on a comparison with your own analysis–do you see any emerging   patterns? Support your response with reference to your texts and to the   information gleaned from St. Anthony Medical Center itself.

Resources

• Discussion Participation Scoring Guide.
• Vila Health: Market Analysis | Transcript.

DQ 4

High-Level Marketing Objectives

Revisit the vision, mission, values and strategic plan summary for St. Anthony Medical Center. Given the directional strategy, analyze the current versus desired status of the Labor and Delivery service line. Propose conceptual-level marketing objectives, including performance indicators and proposed measurement units for each indicator. Explain your thinking for each objective.

Response Guidelines

Respond to your fellow learners according to the Faculty Expectations Response Guidelines, focusing on the similarities and differences between your two plans. Where do you see the biggest difference? Explain how you think will affect overall outcomes.

 

BACKGROUND

In psychopharmacology you met Katie, an 8-year-old Caucasian female, who was brought to your office by her mother (age 47) and father (age 49). You worked through the case by recommending possible ADHD medications. As you progress in your PMHNP program, the cases will involve more information for you to sort through.

For this case, you see Katie and her parents again. The parents have reported that the medication given to Katie does not seem to be helping. This has prompted you to reconsider the diagnosis of ADHD. You will consider other differential diagnoses and determine what information you need to accurately assess the DSM-5 criteria to make the diagnosis of ADHD or another disorder with similar diagnostic features.

When parents bring their child to your office, they may have read symptoms on the internet or they may have been told by the school “your child has ADHD”. Your diagnosis will either confirm or refute that diagnosis.

Katie’s parents reported that their PCP felt that she should be evaluated by psychiatry to determine a differential diagnosis and to begin medication, if indicated. The PMHNP makes this diagnostic decision based on interviews and observations of the child, her parents, and the assessment of the parents and teacher.

To start, consider what assessment tools you might need to evaluate Katie.

• Child Behavior Check List
• Conners’ Teacher Rating Scale

The parents give the PMHNP a copy of a form titled “Conner’s Teacher Rating Scale-Revised” (Available at: https://www.ncbi.nlm.nih.gov/projects/gap/cgi-bin/GetPdf.cgi?id=phd000099.1 ). This scale was filled out by Katie’s teacher and sent home to the parents so that they could share it with their provider. According to the scoring provided by her teacher, Katie is inattentive, easily distracted, makes careless mistakes in her schoolwork, forgets things she already learned, is poor in spelling, reading, and arithmetic. Her attention span is short, and she is noted to only pay attention to things she is interested in. She has difficulty interacting with peers in the classroom and likes to play by herself at recess.

When interviewing Katie’s parents, you ask about pre- and post-natal history and you note that Katie is the first born with parents who were close to 40 years old when she was born. She had a low 5 minute Apgar score. The parents say that she met normal developmental milestones and possibly had some difficulty with sleep during the pre-school years. They notice that Katie has difficulty socializing with peers, she is quiet at home and spends a lot of time watching TV.

SUBJECTIVE

You observe Katie in the office and she is not able to sit still during the interview. She is constantly interrupting both you and her parents. Katie reports that school is “OK”- her favorite subjects are “art” and “recess.” She states that she finds some subjects boring or too difficult, and sometimes hard because she feels “lost”. She admits that her mind does wander during class. “Sometimes” Katie reports “I will just be thinking about something else and not looking at the teacher or other students in the class.”

Katie reports that her home life is just fine. She reports that she loves her parents and that they are very good and kind to her. Denies any abuse, denies bullying at school. She offers no other concerns at this time.

Katie’s parents appear somewhat anxious about their daughter’s problems. You notice the mother is fidgeting with her rings and watch while you are talking. The father is tapping his foot. Other than that, they seem attentive and straight forward in the interview process.

MENTAL STATUS EXAM

The client is an 8-year-old Caucasian female who appears appropriately developed for her age. Her speech is clear, coherent, and logical. She is appropriately 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. Self-reported mood is euthymic. Affect is neutral. Katie says that she doesn’t hear any ‘voices’ in her head but does admit to having an imaginary friend, ‘Audrey’. No reports of delusional or paranoid thought processes. Attention and concentration are somewhat limited based on Katie’s short answers to your questions.

Decision Point One

BASED ON THE INFORMATION PROVIDED IN THE SCENARIO ABOVE, WHAT IS YOUR DIAGNOSIS FOR KATIE?

In your write-up of this case, be certain to link specific symptoms presented in the case to DSM–5 criteria to support your diagnosis.

 

The Assignment:

Examine Case 1. You will be asked to make three decisions concerning the diagnosis and treatment for this client. Be sure to consider co-morbid physical as well as mental factors that might impact the client’s diagnosis and treatment.

At each Decision Point, stop to complete the following:

• Decision #1: Differential Diagnosis
  • 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: Treatment Plan for Psychotherapy
  • 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: Treatment Plan for Psychopharmacology
  • 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 and their families.

 Decision Point One
A-i selected Attention Deficit Hyperactivity Disorder, predominantly inattentive presentation

B- Decision Point Two

BASED ON THE ABOVE INFORMATION, SELECT YOUR NEXT ACTION. BE CERTAIN TO DISCUSS THE RATIONALE FOR YOUR DECISION.Explain why i did not select Autism Spectrum Disorder (ASD), mild and co-occurring;  and why i did not select Specific Learning Disorder with Impairment in Reading and 315.1 Impairment in Mathematics

RESULTS OF DECISION POINT ONE

• Client returns to clinic in four weeks
• You selected Attention deficit hyperactivity disorder, predominantly inattentive presentation. Based on this choice, outline the remainder of the diagnostic evaluation that you will conduct on this child and their parents. Be sure to include standardized assessment instruments that you would administer

 Decision Point Two

BASED ON THE ABOVE INFORMATION, SELECT YOUR NEXT ACTION. BE CERTAIN TO DISCUSS THE RATIONALE FOR YOUR DECISION.

A-I SELECTED  

Begin Adderall XR 10 mg orally daily

B- EXPLAIN WHY YOU DID NOT SELECT  Wellbutrin 75 mg orally daily

 AND DID NOT SELECT Strattera 25 mg orally daily

 

RESULTS OF DECISION POINT TWO

• Client returns to clinic in four weeks
• Katie’s parents seem absolutely delighted upon their return stating that Katie is paying more attention in school, but note that there is still room for improvement, particularly in the afternoon
• They report that Katie’s teacher has reported that Katie is able to maintain her attention throughout the morning classes but come afternoon, she “daydreams.”
• Katie’s parents are also concerned about her decrease in appetite since starting the medication

Decision Point Three

BASED ON THE ABOVE INFORMATION, SELECT YOUR NEXT ACTION. BE CERTAIN TO DISCUSS THE RATIONALE FOR YOUR DECISION.

A- I SELECTED  to Add a small dose of immediate release Adderall in the early afternoon

B- EXPLAIN WHY I DID NOT SELECT Assure Katie’s parents that weight loss is common with stimulant medications used to treat ADHD Augment medication with family therapy

 Guidance to Student

Whereas weight loss is common with stimulant medication, this option does not address Katie’s parents’ concerns about the return of symptoms in the afternoon.

Augmentation with family therapy is also a good idea as it can help Katie with her symptoms and further help her parents to understand the unique challenges that Katie experiences, as well as ways that they can help her with symptoms, however, this option does not address the return of inattentive symptoms in the afternoon.

Adding a small dose of immediate relate Adderall in the afternoon can help Katie to maintain attention throughout the afternoon and into the early evening when she must do homework. This would be the best option.

Overview of the Mechanisms of Kidney Function

Ms. Cornwall is admitted with pyelonephritis. She has chills, and her temperature is 101°F. She is complaining of flank pain, frequency, and dysuria. Her urine has white blood cell casts and shows growth of Escherichia coli (E. coli).

Based on the above scenario, answer the following questions:

1. Why does she have bacteria and white blood cell casts in her urine? Include the pathophysiological response of body for your analysis.
2. What are the differences when comparing prerenal acute renal injury, intrarenal acute renal injury, and postrenal acute renal injury? Give examples of each and pathological processes related to each disease process.

Do one page

Provide References

   

Analyze the key benefits and/or consequences of practicing in a multicultural city such as Miami, FL. Select one (1) scholarly practice-based article that addresses application of theTheory of Culture Care Diversity and Universality in advanced nursing clinical practice, and after reading the article, create a diagram to document the ways in which the article identifies all components of the theory and its application to clinical and/or advanced nursing practice.

Following is the reference for the scholarly practice-based article that addresses application of the Theory of Culture Care Diversity and Universality that I would like to use for my homework:

Hicks, D. (2012, September-October). Cultural competence and the Hispanic population. MedSurg Nursing, 21(5), 314+. Retrieved from https://link.galegroup.com/apps/doc/A305192239/GPS?u=fl_program&sid=GPS&xid=5896481e

Also is needed to use the text book / Chapter 17

Smith, M., & Parker, M.(2015). Nursing Theories & Nursing Practice. (4th Ed) Philadelphia: F.A. Davis Company

 Details:

The practice of health care providers at all levels brings you into contact with people from a variety of faiths. This calls for knowledge and understanding of a diversity of faith expressions; for the purpose of this course, the focus will be on the Christian worldview.

Based on “Case Study: End of Life Decisions,” the Christian worldview, and the worldview questions presented in the required topic study materials you will complete an ethical analysis of George’s situation and his decision from the perspective of the Christian worldview.

Provide a 1,500-2,000-word ethical analysis while answering the following questions:

1. How would George interpret his suffering in light of the Christian narrative, with an emphasis on the fallenness of the world?
2. How would George interpret his suffering in light of the Christian narrative, with an emphasis on the hope of resurrection?
3. As George contemplates life with amyotrophic lateral sclerosis (ALS), how would the Christian worldview inform his view about the value of his life as a person?
4. What sorts of values and considerations would the Christian worldview focus on in deliberating about whether or not George should opt for euthanasia?
5. Given the above, what options would be morally justified in the Christian worldview for George and why?
6. Based on your worldview, what decision would you make if you were in George’s situation?

Remember to support your responses with the topic study materials.

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is required.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.