Need help to reply three post.

DO NOT JUST REPEAT SAME INFORMATION, DO NOT JUST SAY I AGREE OR THINGS LIKE THAT. YOU NEED TO ADD NEW INFORMATION TO DISCUSSION.

1- Each reply should be at least 200 words.

2- Minimum One scholarly reference ( NO MAYO CLINIC/ AHA)

3- APA 6th edition style needs to be followed.

4- Each response should have reference at the end of each reply

5- Reference should be within last 5 years

To prepare:

• Reflect on the client family you selected for the Week 3 Practicum Assignment.

The Assignment

Part 1: Progress Note

Using the client family from your Week 3 Practicum Assignment, address in a progress note (without violating HIPAA regulations) the following:

• Treatment modality used and efficacy of approach
• Progress and/or lack of progress toward the mutually agreed-upon client goals (reference the treatment plan for progress toward goals)
• Modification(s) of the treatment plan that were made based on progress/lack of progress
• Clinical impressions regarding diagnosis and or symptoms
• Relevant psychosocial information or changes from original assessment (e.g., marriage, separation/divorce, new relationships, move to a new house/apartment, change of job)
• Safety issues
• Clinical emergencies/actions taken
• Medications used by the patient, even if the nurse psychotherapist was not the one prescribing them
• Treatment compliance/lack of compliance
• Clinical consultations
• Collaboration with other professionals (e.g., phone consultations with physicians, psychiatrists, marriage/family therapists)
• The therapist’s recommendations, including whether the client agreed to the recommendations
• Referrals made/reasons for making referrals
• Termination/issues that are relevant to the termination process (e.g., client informed of loss of insurance or refusal of insurance company to pay for continued sessions)
• Issues related to consent and/or informed consent for treatment
• Information concerning child abuse and/or elder or dependent adult abuse, including documentation as to where the abuse was reported
• Information reflecting the therapist’s exercise of clinical judgment

Note: Be sure to exclude any information that should not be found in a discoverable progress note.

Part 2: Privileged Note

Based on this week’s readings, prepare a privileged psychotherapy note that you would use to document your impressions of therapeutic progress/therapy sessions for your client family from the Week 3 Practicum Assignment.

In your progress note, address the following:

• Include items that you would not typically include in a note as part of the clinical record.
• Explain why the items you included in the privileged note would not be included in the client family’s progress note.
• Explain whether your preceptor uses privileged notes. If so, describe the type of information he or she might include. If not, explain why.

Respond to this post with a positive response :

Ask a probing question, substantiated with additional background information, evidence or research.

Share an insight from having read your colleagues’ postings, synthesizing the information to provide new perspectives.

Offer and support an alternative perspective using readings from the classroom or from your own research in the Walden Library.

Validate an idea with your own experience and additional research.

Make a suggestion based on additional evidence drawn from readings or after synthesizing multiple postings.

Expand on your colleagues’ postings by providing additional insights or contrasting perspectives based on readings and evidence.

Use  references

                                                    INITIAL POST

                                    Diet and Overweight in Tennessee

A significant behavioral risk factor affecting our nation’s population is unhealthy diet resulting in obesity (Knickman & Kovner, 2015).  Unfortunately, this health issue significantly influenced the great state of Tennessee.  Tennessee is ranked 15th out of all the states for highest obesity rates in adults and ranked 20th for ages 10-17 (The State of Obesity, 2018). Tennessee’s obesity rate has increased dramatically in the past few decades.  In 1990, the obesity rate for the state was 11.1%, rose to 20.9% in 2000, and 32.8% in 2017 (The State of Obesity, 2018).  This obesity has affected a rise in health conditions such as diabetes with a current rate of 13.1%, hypertension with a current rate of 38.7%, and heart disease with a current rate of 38.7% (The State of Obesity, 2018).  If the trend of obesity continues at this rate, disease is going to increase substantially in Tennessee.  To stop the trend of poor diet and obesity in Tennessee, drastic interventions are needed.  

Population-Based Intervention Model Examples

According to the Population-Based Intervention Model, effective interventions include downstream, midstream, and upstream (Knickman & Kovner, 2015).  Downstream interventions include interventions based on an individual.  Providers in my community should focus on BMI at well-visits with individuals.  As part of the well-visit, the provider needs to provide education on the individual’s BMI.  Specifically, discussion regarding what it means and how to decrease it or prevent it from elevation is imperative.  The provider should review the patient’s regular diet, make suggestions on improvements, and provide resources related to healthy eating.  In small southern Tennessee towns, education on healthy nutrition is lacking.  However, people seem to trust their doctors in the rural community.  Individual focus on diet by the providers would be beneficial. 

Midstream interventions of the Population-Based Intervention Model are interventions focused on communities (Knickman & Kovner, 2015).  When traveling through Tennessee, the importance of southern cooking and fast food is announced all over the interstate billboards.  Manchester, TN is no exception as Interstate 24 runs straight through it creating the nickname, Interstate Town.  Manchester is the main town in Coffee County with even smaller towns surrounding it.  This is the community in which I live, full of fast food and very limited healthy restaurant options.   The United States Department of Agriculture (2017) reported 38 fast food restaurants in 2014, making 0.71 fast food restaurants for every 1,000 people.  Restaurants with healthy options in Manchester, TN are nearly non-existent.  An example of an effective midstream intervention in Manchester would be to bring in healthier restaurants.  This busy, working-class community full of families eats out a lot while focusing on church events, sports, and volunteering.   Having quick, healthy restaurant options would be helpful in improving health and decreasing obesity in this area.

Upstream interventions of the Population-Based Intervention Model are interventions made by policies at the state and national levels (Knickman and Kovner, 2015).  According to The State of Obesity (2018), Tennessee has yet to make any laws concerning the requirement of posting caloric information in restaurants.  Perhaps, if individuals saw this information on their regularly eaten food options, they would get accustomed to choosing the lesser calorie options.  Also, this policy may help to inform community members as to why eating at home or having healthier restaurants would be beneficial to their health.

Summary

Poor diet and obesity are huge concerns in Tennessee as the increasing trends will only worsen disease rates in the future.  Ideas such as one-on-one nutritional attention by providers, healthier restaurant choices, and policies requiring posted nutritional information could increase the health of the Tennessee population.  

References

Knickman, J. R., & Kovner, A. R. (Eds.). (2015). Health care delivery in the united states (11th ed.). New York, NY: Springer Publishing.

The State of Obesity. (2018). The state of obesity in tennessee [data file]. Retrieved from https://stateofobesity.org/states/tn/

United States Department of Agriculture. (2017). Economic research service [data file].  Retrieved from https://www.ers.usda.gov/data-products/food-environment-atlas/go-to-the-atlas/

In the assigned article, you read about ovarian teratomas. This diagnosis, although rare, can cause patients to present with psychiatric symptoms. However, if not discovered, the patient can end up in respiratory arrest and/or cardiac arrest on the psychiatric unit. Think back over your experience to a time when a misdiagnosis may have had serious consequences to a patient. Research the disease and discuss it. What are the clinical manifestations? What are common differential diagnoses? How common is the disease? What are the potential consequences of misdiagnosis? How can misdiagnosis be prevented?

Your initial posting should be 200 to 300 words

Article: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2245881/

InstructionsYou are  currently working at NCLEX Memorial Hospital in the  Infectious Diseases Unit. Over the past few days, you have noticed an  increase in patients admitted with a particular infectious disease. You  believe that the ages of these patients play a critical role in the  method used to treat the patients. You decide to speak to your manager,  and together you work to use statistical analysis to look more closely  at the ages of these patients. You do some research and put together a spreadsheet of the data that contains the following information: Client number Infection disease status Age of the patient You are to put together a PowerPoint presentation that explains the  analysis of your findings which you will submit to your manager. The  presentation should contain all components of your  findings. For  review, the components of the report should include: Brief overview of the scenario and variables in the data set Discussion, calculation, and interpretation of the mean, median, mode, range, standard deviation, and variance Discussion, construction, and interpretation of the 95% confidence interval Explanation of the full hypothesis test Conclusion The  calculations should be performed in your spreadsheet that you  will also submit  to your manager. You can find additional information  on what to add to your PowerPoint  presentation in this Word document. Use the  questions in the worksheet as your guide for the contents of your presentation. For your final deliverable, submit your PowerPoint presentation and  the Excel  workbook showing your work. Do NOT submit your Word document