APA format 2pages with 3 peer review references Due Friday 8/31/2018 at 7pm EST  Will pay 15 dollars

 

Collecting Comprehensive Health Assessment

            The United states census Bureau’s 2009 data revealed that 37% of individuals age 65 and older have disabilities. This includes adults with disabilities who developed in old age and those who lived with disability from birth or have acquired disability in younger or middle years (Hahn, Aronow, Rosario, & Guenther, 2013). According to Ball, Dains, Flynn, Solomon & Stewart, 2014 the primary objective of the clinician when conducting an interview and physical assessment on a patient, is to discover the details about a patient’s concern, explore expectations, identify underlying worries, and believing them which optimizes your ability to help them. It is important to adapt to the needs of all patients of any age with disabling physical or emotional states (Ball et al., 2015).

Selected Patient for Face-to-Face Interview and Assessment

As a clinician building a health history on a 76-year-old Black/African American male with disabilities living in an urban setting. It is important to be sensitive to cultural differences that may exist between you and the patient that can help avoid miscommunication. To build health history based on ethnicity and to avoid stereotype, when necessary clinicians should modify their habits to foster effective communication, because your first meeting with the patient set the tone for success. Also, the clinician should be honest, flexible and have a desire to help (Ball et al, 2015).  When you first enter the patient’s, space be respectful by greeting the patient, introduce yourself and state the reason for your visit. Acquire written or verbal consent from the patient to collect health history and to conduct an interview. If possible conduct the interview in an uncluttered quiet area. Have the patients’ health record available and utilize all healthcare professionals involved in this patient’s care. Because the patient may lack the ability to give accurate history, having a family member present with the patient’s permission during the interview helps the patient to be more comfortable to provide needed information (Ball et al., 2015). It is important to sit in front of the patient at eye level, speak slowly, clearly and enunciate each word in the patients view for patients with hearing and visual disability (Ball et al., 2015). To conduct the interview, it is important to have written open-ended questions that are short, uncomplicated and pertinent to the patient to avoid overwhelming and confusion. History on the elderly can be more complex so guiding techniques can be used to obtain important information (Kahn et al., 2013).

Health Related Risk

Frailty is increasingly common among our aging population. Assessing level of frailty is very important, because it has a significant impact on individuals and society with increased risk of dependency, disability, hospitalization, institutional placement, and mortality (Harttgen, Kowal, Strulik, Chatterji, & Vollmer 2013). Frailty is characterized by weakness weight loss and low activity. It is considered an at-risk state caused by age –associated accumulation of deficits (Ball et al., 2015). Functional impairment must be assessed.

Functional Mobility Assessment Screening Tool

Functional assessment must be address for the disabled patient by assessing their health risk. Assessing the patient’s ability to perform activities of daily living (ADL), and cognitive, psychological social and sexual limitation should be completed on all older adults or a disabled patient (Ball et al., 2015). Does the patient has difficulty walking standard distance (0 feet or 2 to 3 blocks), difficulty climbing stairs (up and down), difficulty holding and opening small objects, needs assistance with house-keeping, shopping, money management, meal preparation and assistant eating. Interviewer must keep in mind that the patients will hide or overstate their abilities (Ball et al., 2015).

Conclusion

            To build a health history as it relates to ethnicity, information about personal and social history is important to address cultural background, practices, home environment as a youth, education, occupation, current health habits, health coverage and concern about healthcare cost should be collected to avoid the stereotype as they influence the health problem on the patient’s life (Ball et al., 2015). Understanding a person’s life and daily routine can help you to understand how your patient’s lifestyle might affects his healthcare. Also understanding an older patient usual level of functioning and knowing about any recent significant changes are important to providing appropriate healthcare (Paula, Krzysztof, & Ewa, 2018).

References

Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2015). Seidel’s guide to

physical examination (8th ed.). St. Louis, MO: Elsevier Mosby.

If you have an opportunity, please watch the documentary through HBO at this link: http://www.hbo.com/documentaries/risky-drinking (Links to an external site.)Links to an external site.

you can participate in the discussion as every one should read the following links:

https://www.rethinkingdrinking.niaaa.nih.gov/How-much-is-too-much/Whats-the-harm/What-Are-The-Risks.aspx (Links to an external site.)Links to an external site. (Links to an external site.)Links to an external site.

https://pubs.niaaa.nih.gov/publications/Hangovers/beyondHangovers.htm (Links to an external site.)Links to an external site.

 Please discuss some of the main themes of the documentary (if you watched it) and reasons why you think some college students get caught up in heavy alcohol use. discuss and outline at least 5-10 short term risks/consequences of chronic/binge drinking and 5-10 long-term risks/consequences. Please make sure you include physiological diseases/medical conditions and use medical terms like we have learned about from the various systems of the human body.

Chief complaint: “I have recurrent H. Pylori infection”. 

HPI: M.C. a 46-year-old Hispanic female presents to the GI clinic for complaint of recurrent H. Pylori infection. She was treated about 2 ½ months ago with H. Pylori triple therapy and failed treatment. She has PMH of dyspepsia, and GERD. She also indicates that she has noticed that her symptoms of dyspepsia are worsening for past 2 months. She has associated her symptoms with nausea, upset stomach with all foods. Denies associated symptoms of hematochezia, melena, hemoptysis, abdominal pain, fever, chills, pain or any other symptoms. 

PMH: 

H. Pylori infection gastritis

Diabetes Mellitus, type 2

Surgeries: None

Allergies: NKDA

Vaccination History: Up-to-date

Social history:

High school graduate, married and no children. He frequently eats out in restaurants. He drinks one 4-ounce glass of red wine daily. He is a former smoker that stopped 3 years ago.

Family history:

Both parents are alive. Father has history of DM type 2, Tinea Pedis. Mother alive and has history of atopic dermatitis, tinea corporis and tinea pedis. 

ROS:

Constitutional: Negative for fever. Negative for chills. 

Respiratory: No Shortness of breath. No Orthopnea. 

Cardiovascular: No edema. No palpitations. 

Gastrointestinal: No vomiting. +Dyspepsia. + Nausea. No constipation. No melena. No abdominal pain.

Physical examination:

Vital Signs

Height: 5 feet 5 inches Weight: 140 pounds BMI: 31 obesity, BP 110/70 T 98.0 po P 80 R 22, non-labored

ABDOMEN: No abdominal distention. Nontender. Bowel sounds + x 4 quadrants. No organomegaly. Normal contour; No palpable masses.

Labs day of visit:: Hgb 15.2, Hct 40%, K+ 4.0, Na+137, Serum Creatinine normal 1.0, AST/ALT normal. TSH 3.7 normal, glucose 98 normal

Assessment:

Primary Diagnosis: Recurrent H. Pylori infection gastritis

Secondary Diagnoses: Dyspepsia

Differential Diagnosis: Peptic Ulcer Disease

Previous medication plan: two months ago and failed.

1. Clarithromycin      500 mg po BID for 2 weeks
2. Omeprazole      40 mg po BID for 2 weeks and then po daily.
3. Cipro      500 mg po BID for 2 weeks

Plan: Tests

Pt had EGD done 2 weeks ago that showed H. Pylori positive gastritis in biopsy results. 

Urea breath test 8 weeks after treatment with H. Pylori medications. Pt needs to stop PPI’s 2 weeks prior to Urea Breath test. 

Labs: No new labs are needed.  

Referrals: may refer based on effect of medication therapy given for 2 weeks.

Follow up: return to office in 8 weeks to reevaluate symptoms.

Questions:

As  NP, it is important that you determine the medications used for recurrent H. Pylori infection. 

Please discuss new therapy guidelines for H. Pylori treatment, and provide patient education.

Below is the website for the American Academy of Gastroenterology Clinical Guidelines (ACG) for the updated H. Pylori therapy. 

http://gi.org/wp-content/uploads/2017/02/ACGManagementofHpyloriGuideline2017.pdf

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hi dear,

I just need to response to this assignment,

 responses should be complete paragraph  and should further the conversation using personal experience, information from the textbook or other outside sources, asking questions, and more.  Think about how your classmates answered differently or similarly to you. What did you learn from their post?  What was most surprising or interesting?  What do you agree with or disagree with? Your responses might spark some comments and feedback for one another. 

 

Cocaine 

1. Behavioral effects: The behavioral effects to using cocaine are hyperverbal, energetic, and alertness (National Institute on Drug Abuse, 2017). Sometimes people will even be hypersensitive to sigh, touch, and sound when under the influence of cocaine (NIH, 2017). Just like most drugs, and everyone has a slightly different experience.

2. Physiological effects: The physiological effects of cocaine use are dilated pupils, elevated body temperature, and rapid heart rate (NIH, 2017). Larger amounts of cocaine use can also increase the high. When the high is increased other physical behaviors can happen. Some of these behaviors are restlessness, irritability, anxiety, and paranoia (NIH, 2017).

3. Acute health effects: Acute health effects of cocaine are irregular heart rhythm, stomach pains, and strokes (NIH, 2017).

4. Chronic health effects:Chronic health effects of cocaine are organ damage, or even cause organ failure. Some effects are restricted blood flow in the gastrointestinal tract, ulcers, weight loss, and even malnourishment (NIH, 2017). Cocaine  can even cause cardiac issues such as inflammation of the heart muscle and aortic ruptures (NIH, 2017).

5. Combining with other drugs: Yes when you combine cocaine with other drugs is bad. There are many risk of combining drugs. One example is heroin and cocaine. Cocaine wants to use more oxygen, and the heroin causes the respiratory rate slow down (The dangers of mixing drugs).

6. What surprised me:It really surprises me that drugs are still a massive issue in the world for recreational uses. I find it interesting how some people get very addicted, some people use everyone once in a while, and how some people don’t ever touch them. Working in the medical field really opened my eyes to many different drugs. I understand how different drugs work, and what they do to the body. On a medical standpoint drugs are very interesting and amazing, but when used for personal use they do some horrific things to you.

7llLegalization of all drugs:I think that legalization of all drugs should be done. I think if we legalized all drugs that there would be a better regulations. Legalization might help get a log of the terrible mixed street drugs out, and possibly prevent some people from having massive medical issues. I understand that no matter what, drugs will still be readily available on the streets, but maybe with drugs being regulated people could get help in a better, and control the substance abuse.

8. Decriminalization of all drugs: I think decriminalization of all drugs might be a good idea for possession of small quantities of drugs. I like this idea, because I feel like our prison are very impacted, and that true criminals are not going to prison. Just because these people go to jail for possession of drugs, do not mean they stop them once they our out. I also like the idea that treatment is an options as well.

Thanks,