A 65-year-old obese African American male patient presents to his HCP with crampy left lower quadrant pain, constipation, and fevers to 101˚ F. He has had multiple episodes like this one over the past 15 years and they always responded to bowel rest and oral antibiotics. He has refused to have the recommended colonoscopy even with his history of chronic inflammatory bowel disease (diverticulitis), sedentary lifestyle, and diet lacking in fiber. His paternal grandfather died of colon cancer back in the 1950s as well. He finally underwent colonoscopy after his acute diverticulitis resolved. Colonoscopy revealed multiple polyps that were retrieved, and the pathology was positive for adenocarcinoma of the colon. 

Write 2-3 pages

·  Explain why you think the patient presented the symptoms described.

·  Identify the genes that may be associated with the development of the disease.

·  Explain the process of immunosuppression and the effect it has on body systems.

   You should write all questions and your corresponding answer to them in this discussion board. 

SEparate by 5.1 and 5.2 but together

A 33-year-old male swallows 30 antidepressants and tells his wife, “I want to die.” She takes him to the local hospital’s emergency department, where he is treated and released that same evening. In the hospital parking lot, he pushes a security guard and is arrested and taken into custody. In the county jail, a nurse places the man on suicide watch. The following evening, while the man is still in custody, a psychologist speaks to him for five minutes, then releases him from suicide watch. The man is returned to his cell, and two hours later, he hangs himself.

1. Does the emergency department have liability for discharging a suicidal patient without further treatment?
2. Does the psychologist have liability for releasing the patient from suicide watch after a five-minute consultation?
3. The psychologist is an “independent contractor” of the jail. Is the county liable for his actions?

LO 5.2

A woman gave birth in the back seat of a taxicab while en route to the hospital. To what standard of care would each of the following individuals be held?

1. The taxicab driver who comforted the mother
2. A registered nurse, also a passenger in the cab, who assisted the mother
3. A physician in general practice who was a passenger in the cab with the expectant mother and assisted the birth taking place in the cab
4. A police officer who stopped the cab for speeding, observed the situation, and assisted with the birth

A woman trained in cardiopulmonary resuscitation (CPR) worked as the office manager for an insurance business. When her coworker at the next desk had a heart attack and fell to the floor, the office manager began CPR and shouted for others in the room to dial 911. The department supervisor came running and told the office manager to stop CPR. She reluctantly obeyed. Emergency medical technicians arrived, but the heart attack victim died.

1. The victim’s husband sued the supervisor, the office manager, and the employees’ parent organization for failure to render medical assistance. In a finding for the defendants, an appeals court ruled there was “no duty of care” for the employees to render assistance. Despite this court’s ruling, in a similar situation, would you have acted as the CPR-trained office manager did? Explain your answer

 I need a response to this assignment

1 page

zero plagiarism

Influencing Social Change

Advocacy is one of the core aspects of nursing professions and is considered an ethic of nursing practice. Advocacy is an essential practice that is important in influencing social change and promoting better nursing practices. This discussion explores how I can steer positive social changes in my community.

Positively Influencing Social Change

Being a psychiatric mental health nurse practitioner (PMHNP), I must advocate for mental health issues. I endeavor to be actively involved in eliminating the stigma faced by individuals with mental health issues. Many individuals with mental health problems come from communities that discriminate against them and hold prejudices, beliefs, and behaviors that make it harder for those living with mental health issues to receive proper treatment or help (Mannarini & Rossi, 2019). Given this issue, an approach that I can use to positively impact how the community views mental health issues is through community education to create awareness for individuals on the issues affecting people with mental health issues – especially risk factors, diagnosis, and treatment.

According to Ahuja, Dhillon, Juneja, and Sharma (2017), educating the community on what is mental health and how people with mental health issues feel can help to change the perspectives of the community about mental health. Educative strategies targeting the normative behaviors of the community will help the public to better understand how mental health issues develop and why the community needs to support individuals with mental health issues rather than stigmatize them. As a change agent, this will represent the process of speaking up for those who may not be able to speak for themselves through community campaigns for better community health outcomes (Rafferty, 2017).

Another way in which I will become a change agent for mental health is by motivating people to discover the reason why supporting individuals with mental health is needed. According to Cosejo (2018), motivation increases the person’s desire to change, and as a social-change agent, I will assume the role of an instructor, facilitator, and motivator to facilitate the understanding of mental health issues at both the individual and community levels. With the backing of empirical evidence, I can lead change through championing mental health at different levels.

Advocating for the Community

An approach I can use to advocate for change in my community includes providing expertise in public forums to improve the understanding of mental health issues. This involves using my expertise in mental health to persuade not only the community leaders but also those in authority regarding issues about mental health. I can also lobby for mental health issues by sharing the statistics, stories, and other information related to mental health with community leaders and elected leaders. These strategies will enable the development of effective partnerships that can enhance support directed at promoting mental health in my community (Williams, Phillips, & Koyama, 2018).

In addition to the above strategies, I can advocate for my community by joining or forming civic interest groups. By forming joint partnerships and/or special interests’ groups about mental health, I can facilitate continuing community partnerships that will help manage mental health issues (Carter, et al., 2010). It will also enable me to develop specific mental health initiatives that will continually foster the management of the mental health needs in the community.

References

Ahuja, K. K., Dhillon, M., Juneja, A., & Sharma, B. (2017). Breaking barriers: An education and contact intervention to reduce mental illness stigma among Indian college students. Psychosocial Intervention, 26(2), 103-109. doi:https://doi.org/10.1016/j.psi.2016.11.003

Carter, N., Martin-Misener, R., Kilpatrick, K., Kaasalainen, S., Donald, F., Bryant-Lukosius, D., . . . DiCenso, A. (2010). The role of nursing leadership in integrating clinical nurse specialists and nurse practitioners in healthcare delivery in Canada. Nursing Leadership, 23, 167-185. doi:10.12927/cjnl.2010.22274

Cosejo, D. (2018). Nurse – As the Change Agent. Retrieved from https://www.rnspeak.com/nurse-as-the-change-agent/

Mannarini, S., & Rossi, A. (2019). Assessing mental illness stigma: A complex issue. Frontiers in Psychology, 9, 2722. doi:10.3389/fpsyg.2018.02722

Rafferty, A. M. (2017). Nurses as change agents for a better future in health care: The politics of drift and dilution. Health Economics, Policy, and Law, 13(3-4), 475-491. doi:https://doi.org/10.1017/S1744133117000482

Williams, S., Phillips, J., & Koyama, K. (2018). Nurse advocacy: Adopting a health in all policies approach. OJIN: The Online Journal of Issues in Nursing, 23(3), online. doi:10.3912/OJIN.Vol23No03Man01

NOTE. this paper is link to the community teaching presentation

Note: This is an individual assignment. In 1,500-2,000 words, describe the teaching experience and discuss your observations. The written portion of this assignment should include:

1.Summary of teaching plan

2.Epidemiological rationale for topic

3.Evaluation of teaching experience

4.Community response to teaching

5.Areas of strengths and areas of improvement

Prepare this assignment according to the APA guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

Technology and reimbursement patterns have increased the amount of surgery performed on an ambulatory basis. Hospitals all over the country are experiencing a rise in the number of surgical patients who come into the hospital and go home on the same day; cases that previously required at least an overnight stay in the hospital. The move to outpatient treatment can significantly affect a hospital’s use of beds and its overall organization. However, the move to outpatient care also poses some risks, especially to patients with difficult medical histories. The move from inpatient to outpatient care is driven by cost containment, as well as by new technologies. However, there are risks to care provided in the ambulatory setting. For example, advanced age (especially older than 70 years) is associated with increased hospital stay and perioperative morbidity and mortality. Additionally, the type of surgery is important in the risk assessment.

In the following three case scenarios, determine if the patient has an increased risk for surgical complications based on their current health status and medical history. Write a 1-2 paragraph response for each scenario, and determine the following:

1. Does the patient’s medical history pose a potential risk for complications prior/post surgery? Explain your reasoning.
2. Based on the patient’s current health status and their medical history, should they receive surgery or be evaluated and treated outside of the ambulatory care setting? Explain your reasoning.

Case Scenario 1:

Mr. Rogers is a 51-year old male. During his pre-operative examination, he tells the nurse, “I have an ache in my right foot”. He offers an explanation, suggesting, “I must have stepped on something or twisted my ankle. Maybe I got bitten by a bug when I was outside yesterday”. The nurse notes that the patient’s ankle is reddened, slightly swollen, and warm to the touch. However, his temperature is within normal limits. Mr. Roger’s ankle is x-rayed and there is no fracture noted. He has full range-of-motion of his right ankle. Mr. Rogers has a preexisting medical condition of gout. He is scheduled for outpatient surgery on his thyroid.

Case Scenario 2:

Mr. Sanders is a 61-year old male who presents with nausea and has been vomiting for two days. He is also experiencing mental confusion. His blood glucose is 796 mg/dL. He is a newly diagnosed diabetic and has not been getting medical treatment. Intravenous regular insulin is administered to Mr. Sanders in order to bring his blood glucose level down to a normal level. Further tests show that his Hemoglobin A1C is 10.3%. Mr. Sanders has a preexisting medical condition of coronary heart disease and hypertension. He is scheduled for outpatient surgery on his thyroid.

Case Scenario 3:

Mrs. Miller is an 88-year old woman who presents with nausea, vomiting, and severe abdominal pain. Further tests reveal that her white blood cell count is 13,000/mm3. Her physical examination reveals that her abdomen is distended and very tender to the touch. Her doctor suspects that she has acute pancreatitis. Mrs. Miller has a preexisting medical condition of heart failure and gastroesophageal reflux disease (GERD). She is also scheduled for outpatient surgery on her thyroid.