Please guide by the questions down below. writing needs to cover all 5 questions. do not skip questions. 

Write a 300 word message in which you:
1.Reflect upon what you have learned about evidence-based practice during the past eight weeks. 

2.Describe how your understanding has changed. 

3.Comment on how the literature search process that you have used in this course differs from the rules for systematic reviews. 

4.Locate one systematic review or clinical guideline using the  AHRQ  website https://www.guideline.gov/

5.Identify the guideline’s purpose.

 

1. Detached Retina

Mr. Gray, a 65-year-old man, was in an automobile accident in which he suffered a concussion. Soon after he was released, he noticed what he described as a “gray spot” in his field of vision. At first he ignored it, thinking it would go away, but the spot seemed to darken and spread over his visual field. He didn’t report any pain with the problem. On calling his physician, he was advised to go to the nearest hospital immediately. A detached retina was diagnosed.

After treatment, he regained most of his normal sight back. Five years later, he began having problems again. The central area of his visual field was becoming blurred, and he was losing his depth perception. An initial eye examination revealed neovascularization in both eyes.

• Question 1:  Relate the patient history and circumstances of the injury and the signs and symptoms related to the pathophysiology of this condition.
• Question 2: Discuss the treatments available for the patient.
• Question 3: Relate the symptoms and signs to those of macular degeneration.
• Question 4: Discuss the treatment available and the prognosis for recovering his normal vision.

Resources to assist you:

https://www.youtube.com/watch?v=3m__6QS8U_8

https://www.youtube.com/watch?v=hZe7VxtuQB0

https://www.youtube.com/watch?v=ozZQIZ_52YY

1. Cardiovascular Accident

Mr. Quinn, age 64 years, developed a severe headache several hours ago that has not responded to acetaminophen. Now his speech is slurred, and his right arm and the right side of his face feel numb. He is very anxious and is transported to the hospital. Mr. Quinn has a history of smoking and arteriosclerosis, and there is family history of CVA and diabetes. Assessment at the hospital indicated weakness on the right side, including facial asymmetry and a blood pressure of 220/110 Hg mm. A CT scan showed damaged tissue on the left side of the brain, and an angiogram indicated narrowing of the carotid arteries and middle cerebral arteries, with occlusion of the left middle cerebral artery.

• Question 1:  Discuss the pathophysiology related to CVA due to thrombus vs. embolus. Describe the stages in the development of an atheroma.
• Question 2: Explain the predisposing factors in this case, and relate Mr. Quinn’s initial signs to the pathological changes.
• Question 3: Discuss the treatments available after first aid for stroke patients and the patient’s prognosis.

Resources to help you:

https://www.youtube.com/watch?v=QIAI6KOwKII&t=16s

https://www.youtube.com/watch?v=U8s427-tv58

https://www.youtube.com/watch?v=qCvV11R2lgg&t=7s

1. Parkinson Disease

Mr. Nimmo, age 66, has noticed excessive fatigue, muscle aches, and weakness in his legs for some time. His hands were shaking slightly, although his wife reported that the shaking appeared to stop when he fell asleep. Some unintentional head movements were also apparent. He remembers that his grandfather died in his mid-60s after suffering for years from a condition with similar symptoms. After several tests and the elimination of some other neuromuscular conditions, a diagnosis of Parkinson’s disease was made for Mr. Nimmo.

• Question 1: Discuss the pathophysiology of Parkinson’s disease and how it differs from other neuromuscular conditions affecting older adults.
• Question 2: Discuss the usual progression of the disease as the pathophysiology develops further. Indicate additional manifestations that will be noticeable.
• Question 3: Describe the complications that frequently develop, including the rationale for each and the early indications of each problem.
• Question 4: Discuss the treatments available to this patient.

 

Respond to your colleagues by providing additional insights or alternative perspectives. 

POSITIVE COMMENT

                                              Main Post

 

How to Become a Social Change Agent for Psychiatric Mental Health

             Mental illness is a significant public health concern. Unfortunately,  society holds a negative attitude about mental illness (Casados, 2016).  The negative attitude impacts individuals on an interpersonal level,  through blaming and name-calling, and on an institutional level, through  employment discrimination (Casado, 2016). Shockingly, one study found  that 68% of Americans do not want mental illness being married into  their family, and 58% of Americans do not want people with mental  illness in the workplace (Dingfelder, 2009). Another study reported that  over 45% of people thought people with depression were unpredictable,  and 20% of people thought people with depression were dangerous  (Dingfelder, 2009).  The stigma associated with mental illness can make  psychological symptoms worse, and hinder treatment and recovery, which  can continue to compromise the individual’s mental health (Casados,  2016).

             The statistics described above are astounding to me. I agree entirely  with one of the statements in the article by Bennett (2015), which  states, “mental health is physical health; the two are inseparable”  (para. 2). I believe a way to bridge that gap is through a new concept  in health care called patient-centered care. Patient-centered care is  providing care that focuses on physical comfort and emotional well-being  (NEJM Catalyst, 2017). It is providing care that is collaborative,  coordinated, and accessible at the right time and in the right place  (NEJM Catalyst, 2017). Patient-centered care allows the patient and  their family to be a part of the care team and play a role in decision  making (NEJM Catalyst, 2017).  If society understood patient-centered  care, then I think mental health would not be stigmatized the way it is.  

             Psychiatric mental health nurse practitioners (PMHNPs) can be a social  change agent by being a voice for our patients and utilizing  patient-centered care. Practicing care coordination and collaborating  with the patient, their family, and other healthcare providers is  essential. Society has a negative attitude about mental illness because  the majority of people do not understand it. Thus, providing education  to the community is also a key to breaking the stigma. 

How I Will Advocate for Change Within My Community

I  will advocate for change in my community by practicing patient-centered  care. I will do this by including the patient and their family when  discussing options and decisions. I will listen to the patient to  understand their preferences, cultural traditions, and socioeconomic  condition (NEJM Catalyst, 2016).  I will provide education within the  community to educate those who are unfamiliar with mental illness. I  will also work in rural areas to help those in underserved areas have  access to mental health care. 

 

        

                                                   References

Bennett, T. (2015). Changing the way society understands mental health. National Alliance on Mental Illness. Retrieved from https://www.nami.org/Blogs/NAMI-Blog/April-2015/Changing-The-Way-Society-Understands-Mental-Health

Casados, A. T. (2016). What makes mental illness stigma so hard to change and to study? Clinical Psychology: Science and Practice. Retrieved from https://www.div12.org/what-makes-mental-illness-stigma-so-hard-to-change-and-also-to-study/

Dingfelder, S. F. (2009). Stigma: Alive and well. American Psychological Association, 40(6), 56. Retrieved from https://www.apa.org/monitor/2009/06/stigma

NEJM Catalyst. (2017). What is patient-centered care? Retrieved from https://catalyst.nejm.org/doi/full/10.1056/CAT.17.0559

 

Using the patient information provided, respond to the following questions: (a) What cultural considerations are important for you to remember while you interview Ms. Li? (b) What is the abuse assessment screen? (c) If abuse is discovered, what should you do?

Patient Information:

Patient: Sue Li

Age: 20

Ethnicity: Asian American

 

Review your problem or issue and the cultural assessment. Consider how the findings connect to your topic and intervention for your capstone change project. Write a list of three to five objectives for your proposed intervention. Below each objective, provide a one or two sentence rationale.

After writing your objectives, provide a rationale for how your proposed project and objectives advocate for autonomy and social justice for individuals and diverse populations.

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