Week 5: 3-Minute Reflection: (2-3 paragraphs with APA format and 2 or 3 references)

Identify some examples of nursing integrity, now utilize reflective learning, and write a 3-minute reflection on a personal example of integrity in your life (work or personal)?

Also can use this article as reference: 

https://nurse.org/articles/nursing-ranked-most-honest-profession/

Required criteria:
1. Writes about the assigned topic.
2. Demonstrates strong evidence of reasoned reflection.
3. Demonstrated depth of original thought.

Required Criteria:
1) Using the template loaded under each week, answers the weekly reflection questions.
2) Uses two specific examples from the video to support writing.
3) Uses Standard English grammar and sentence structure.
4) Contains no more than 3 spelling or typographical errors.
5) Writing demonstrates original thought without an over-reliance on the works of others.

I NEED A RESPONSE TO THIS ASSIGNMENT

3 REFERENCES

William Thompson is a 38-year-old, African American, Catholic who was recently married to Luli Kim. He was a captain in the military during the Iraq war. William is a lawyer specializing in finance law and in jeopardy because of alcohol and PTSD related concerns. He became homeless when he was unable to pay his mortgage. The patient stated, hitting some hard times and needed to move back in with his brother and his brother’s wife. He also stated, they say I have PTSD but that’s another story. William is a marathon runner, plays soccer, enjoys listening to jazz, and is a novice modern art collector.

DSM-5 Criteria

According to the scenario given, the client William Thompson doesn’t have enough signs and symptoms nor enough information to officially diagnose him with PTSD.  According to the DSM 5 criteria requirement, a person being diagnosed with PTSD must have been exposed to actual or threatened death, serious injury, or sexual violence either directly or by experiencing. The traumatic event also needs to be a recurrent event, involuntary, and intrusive.  (DSM-5, 2020). Unfortunately our patient William Thompson does not meet those criteria-based on the information given and information available on patient clinical records.

Client Does Not Meet Criteria 

 As a future nurse practitioner, I will do the ethically right thing and not give my patient any diagnosis if they do not meet the criteria. I believe that labeling the patient based on family history and not on signs and symptoms is wrong. I will conduct a future mental health assessment of the patient to see what the right diagnoses are for the patient and how I can develop an effective treatment plan (Flanagan et al., 2016).

Goals of Treatment

 According to the Psychiatric Association’s practice guidelines for PTSD goals of treatment should include managing signs and symptoms; preventing Comorbid related symptoms such as depression, insomnia, substance abuse, and pain; improve functioning; improve the sense of trust and safety; protect against relapse; and transfer experience into a constructive plan of safety, prevention, and protection (Szafranski et al., 2017). The most important goal of treatment for the patient will include preventing him from committing suicide or hurting those around. The safe of the client and others should always be a priority (Flanagan et al., 2016).

Care plan Options

            As care providers, I will consider using psychotherapy with the client in conjunction with medication therapy that can manage signs and symptoms of depression, insomnia that might be preventing the client from completing his day today activities. Some medication that I will prescribe will include Zoloft to help with the mood and Ambien to help with insomnia, I will also make sure the client enroll in cognitive behavioral therapy (CBT).

References

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author. Retrieved from https://dsm-psychiatryonline-org.ezp.waldenulibrary.org/doi/full/10.1176/appi.books.9780890425596.dsm07

Flanagan, J. C., Korte, K. J., Killeen, T. K., & Back, S. E. (2016). Concurrent treatment of substance use and PTSD. Current psychiatry reports, 18(8), 70.

Stahl, S. M. (2013). Stahl’s essential psychopharmacology: Neuroscientific basis and practical applications (4th ed.). New York, NY: Cambridge University Press *Preface, pp. ix-x

Szafranski, D. D., Smith, B. N., Gros, D. F., & Resick, P. A. (2017). High rates of PTSD treatment dropout: A possible red herring?. Journal of Anxiety Disorders, 47, 91-98.

I need a response to this assignment 

2 references

Cognitive-Behavioral Therapy. Family Versus Individual Settings

         Cognitive-behavioral therapy (CBT) posits maladaptive behavior and dysfunctional thoughts that relate to self, others, and the

world that are rooted in illogical or irrational assumptions. This individual view of the world, self, and others are central to the

determination of emotions, thoughts, and behaviors and by changing these, behavior can also be changed.  (Wheeler, 2014). 

According to Patterson (2014), family therapy is usually focused on behavioral outcomes which when it comes to cognitive-

behavioral therapy (CBT), the term behavior tends to be the primary focus. Wheeler (2014) states that CBT can also be further broken

down into primary and secondary thinking which is a structured hierarchy. Cognitive processes are understood as

primary secondary with primary thinking recognizing negative, intermittent, and irrational thinking as an ongoing human action.

Secondary thinking views the cultural and social world in a more positive, rational, and determinant term.  

         Therapeutic alliance has been identified as one of the most important factors in individual therapy of any kind (Nichols and Davis,

2020) It is, however, more difficult to establish a therapeutic alliance in family or group therapy due to a number of different reasons

such as an increased number of participants with individual thoughts and feelings.  Assessment is a pivotal part of CBT and

the advantages of a behavioral emphasis are that it can provide definitive goals, baseline data, and a reliable way to measure

therapeutic success. Certain disadvantages are that by using a structured environment in family therapy, the active family interactions

can not be viewed. All that is seen is individual patient reports (Nichols and Davis, 2020).    

         A study by Thimm and Antonsen (2014) examined the effectiveness of group CBT for depression in a routine outpatient setting,

looking also at predictors of dropout and response. Results suggested a large reduction in anxiety and depression among

participants who received CBT with these observed results maintained at a three-month follow-up. CBT is a very effective therapy with

individual clients but can prove to be challenging in group and family settings.  The video of the Johnson Family Session (2013c) 

is an example of a group of women who had experienced similar trauma but had very different thoughts and feelings about

the experience.  The therapist may find the establishment of a trusting therapeutic alliance somewhat difficult in this situation. 

References

Laureate Education (Producer). (2013c). Johnson family session 3. (Video file). Baltimore, MD: Author

Nichols, M. & Davis, S. d. (2020). The essentials of family therapy. (7th ed.). Boston, MA: Pearson

Patterson, T. (2014). A cognitive-behavioral systems approach to family therapy. Journal of Family Psychotherapy, 25(2)

 132-144. doi.10.1080/08975353.2014.910023

Thimm. J. C. 7 Antonsen, L. (2014). Effectiveness of cognitive-behavioral therapy for depression in routine practice.

  BMC Psychiatry, 14, 292. https?doi.org/10.1188/312888-014-0292-x

Wheeler, K. (Ed.). (2014). Psychotherapy for the advanced practice psychiatric nurse: A how-to guide for evidence-based 

  practice. New York, NY: Springer 

Begin reviewing and replying to peer postings/responses early in the week to enhance peer discussion. See the rubric for participation points. Participate in the discussion by asking a question, providing a statement of clarification, providing viewpoints with a rationale, challenging aspects of the discussion, or indicating relationships between two or more lines of reasoning in the discussion. Always use constructive language, even in criticism, to work toward the goal of positive progress.

TASK

Post your initial response to one of the two topics below.

Epidemiology’s Role in Infectious and Communicable Diseases

Topic 1: Disease Outbreak

Select an infectious disease and research the CDC website for information about the disease including: 

• its natural history,
• presenting symptoms, and
• outbreak characteristics
• Identify an occurrence of the disease by searching the Internet for recent reports of this disease and compare that episode or occurrence with information from the CDC website.
• How closely did that outbreak resemble the case definition?

Topic 2: Epidemiological Applications

• Describe how the concept of multifactorial etiology relates to the natural history of disease and the different levels of prevention.
• How should the nurse incorporate these concepts into health promotion of clients in community settings?
• How should the nurse approach client risk in these health promotion activities?

Peer 1

In this week lecture we focus on the concept of epidemiology and the role it plays when dealing with communicable and infectious diseases. In addition, we also learned about environmental health in terms of disease prevention as it related to the 3 levels referred to as primary, secondary, tertiary prevention. Hence, disease prevention are important concepts to understand when dealing with infectious diseases (South University Online, 2019). In my discussion, the infectious disease I choose to talk about is Tuberculosis, also known as “TB”. TB is a bacterial disease caused by the bacterium known as Mycobacterium Tuberculosis. TB is known to primary cause damage in the lungs but can also affect other vital organs within the body spreading to the kidneys, brain, bones, and spine. TB is spread from person to person through “airborne Transmission”. Therefore, TB is spread through the air by an infected person when they cough, talks, or sing (Division of Tuberculosis Elimination, 2016). Common presenting symptoms of TB include sneezing, consistent coughing (that last more than 3 weeks) night sweats, fever, chills, and unexplained loss of appetite (National Health Concil , 2020). 

TB is not generally known to cause outbreaks, which can be described as the detection of more than 3 TB cases that has a epidemiology link associated with its transmission. In the years from 2009-2015, there were 21 outbreak cases of TB. Of these 21 cases reported over 80% of the individuals used drugs and illegal substances, which included some who also suffered from mental illness, and or were homeless. Hence, almost all of the TB outbreaks were due to a delayed diagnosis of the disease (Mindra et al., 2017). On the CDC website, there was a reported occurrences of TB outbreaks from 2002-2008.  In there report they found that the majority of outbreaks occurred among drug users and people who drink an excess amount of alcohol. Hence, both studies revealed that the majority of TB outbreaks was among the homeless, and people suffering with mental health conditions (Division of Tuberculosis Elimination, 2019).

References

Division of Tuberculosis Elimination. (2019, September 6). Data & Statistics. Centers for Disease Control and Prevention. https://www.cdc.gov/tb/statistics/default.htm. 

Division of Tuberculosis Elimination. (2016, March 17). Signs & Symptoms. Centers for Disease Control and Prevention. https://www.cdc.gov/tb/topic/basics/signsandsymptoms.htm. 

Mindra, G., Wortham, J. M., Haddad, M. B., & Powell, K. M. (2017, February 1). Tuberculosis Outbreaks in the United States, 2009-2015. Public health reports (Washington, D.C. : 1974). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5349481/. 

National Health Concil . (2020, March 9). Living With Tuberculosis. American Lung Association. https://www.lung.org/lung-health-diseases/lung-disease-lookup/tuberculosis/symptoms-diagnosis. 

Talwar, A., Tsang, C. A., Prince, S. F., Pratt, R. H., Walker, W. L., Schmit, K. M., & Langer, A. J. (2019, March 21). Tuberculosis – United States, 2018. Centers for Disease Control and Prevention. https://www.cdc.gov/mmwr/volumes/68/wr/mm6811a2.htm.

Peer 2 

The infectious disease that I have chosen is Tuberculosis. The bacteria called Mycobacterium tuberculosis is what causes TB. Tuberculosis normally attacks the lungs, but it can also attack other body parts like the brain, kidney, or spine. Tuberculosis is spread through the air from one person to the next. The signs and symptoms that the person presents with usually depends on where in the body that the TB is. The signs and symptoms of pulmonary TB are: pain in the chest, coughing up blood or sputum, a bad cough that lasts 3 weeks or longer, no appetite, weight loss, fever, chills. sweating at night, weakness, fatigue. Other signs and symptoms depend on which body part is affected. There are also people who have TD and don’t get sick or presents with any signs and symptoms that are called Latent TB.

When it comes to outbreaks that pertain to TB, they do not happen often. Usually, the infectious period begins about 3 months before the initiation of any symptoms and usually ends when treatment starts. I did find one.  On an Indian Reservation, there were 5 people who tested positive. When the investigation begins the was doing contact tracing to see 1) who did these people come in contact with and 2) where did this all stem from. They were in contact with a total of 126 people, 121 of them did receive a PPD test. 21 of those had latent TB and 19 were started on treatment. The people were in contact with each other at a party where they were really close to each other. This case does resemble most outbreaks and how they present. The first five had a productive cough and sputum.

References

Basic TB Facts. (2016, March 20). Retrieved September 30, 2020, from https://www.cdc.gov/tb/topic/basics/default.htm

Tuberculosis Outbreak on an American Indian Reservation — Montana, 2000–2001. (2002). Retrieved September 30, 2020, from https://www.cdc.gov/mmwr/preview/mmwrhtml/mm5111a3.htm