1. In 3 or 4 sentences, explain the appropriate drug therapy for a patient who presents with MDD and a history of alcohol abuse. Which drugs are contraindicated, if any, and why? Be specific. What is the timeframe that the patient should see resolution of symptoms?
2. List 4 predictors of late onset generalized anxiety disorder.
3. List 4 potential neurobiology causes of psychotic major depression.
4. An episode of major depression is defined as a period of time lasting at least 2 weeks. List at least 5 symptoms required for the episode to occur. Be specific.
5. List 3 classes of drugs, with a corresponding example for each class, that precipitate insomnia. Be specific

 

Review your problem or issue and the study materials to formulate a PICOT question for your capstone project change proposal. A PICOT question starts with a designated patient population in a particular clinical area and identifies clinical problems or issues that arise from clinical care. The intervention used to address the problem must be a nursing practice intervention. Include a comparison of the nursing intervention to a patient population not currently receiving the nursing intervention, and specify the timeframe needed to implement the change process.  Formulate a PICOT question using the PICOT format (provided in the assigned readings) that addresses the clinical nursing problem.

The PICOT question will provide a framework for your capstone project change proposal.

In a paper of 500-750 words, clearly identify the clinical problem and how it can result in a positive patient outcome.

Describe the problem in the PICOT question as it relates to the following:

1. Evidence-based solution
2. Nursing intervention
3. Patient care
4. Health care agency
5. Nursing practice

Prepare this assignment according to the guidelines found in the APA Style Guide. 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.

 Learning Objectives for this assignment include:

• Apply the principles of delegation in the healthcare setting.
• Demonstrate the use of clinical reasoning in prioritizing and evaluating the delivery of client care.
• Demonstrate principles of collaborative practice within the nursing and healthcare teams fostering mutual respect and shared decision-making to achieve stated outcomes of care. 

For this discussion, we are going to focus on delegation in the workplace. Read the following scenario, review the 2019 Regulations Governing the Practice of Nursing document from the Virginia Board of Nursing, Part VI (pages 20-23. see attached and then submit your answers the three questions below (Be sure to reference your information source in APA format!) You are working the night shift on a medical unit and have been assigned charge nurse responsibilities. You are working with four RNs, one LPN, and two CNAs (nurse’s aides or care partners).  A patient becomes pulseless and is not breathing, and the nurse assigned to the patient’s care calls a code. The nurse is occupied at this patient’s bedside for 1.5 hours until the patient is stabilized and transferred to the intensive care unit. The nurse also has four other assigned patients. In addition to the nurse assigned to the patient requiring resuscitation, two of the other RNs working on your unit are assisting in the code. 

(1) During the time of the resuscitation efforts, what tasks could be delegated to the UAP (NCP) in order to help with the care of the patients that are assigned to the three RNs that are involved in the resuscitation? 

(2) How will you, as the charge nurse, maintain the safety of the other patients on your unit while the three RNs are occupied with the resuscitation efforts?

(3) How might effective delegation to other team members contribute to care for the patients on the unit? 

Your response should be scholarly, between 150 and 200 words for each question, and include at least one peer-reviewed nursing journal article to support your comments. (Your in-text citations and reference should in in correct APA format.) Be sure to use correct grammar and sentence structure. 

Discussion: Diversity and Health Assessments

May 2012, Alice Randall wrote an article for The New York Times on the cultural factors that encouraged black women to maintain a weight above what is considered healthy. Randall explained—from her observations and her personal experience as a black woman—that many African-American communities and cultures consider women who are overweight to be more beautiful and desirable than women at a healthier weight. As she put it, “Many black women are fat because we want to be” (Randall, 2012).

Photo Credit: Getty Images

Randall’s statements sparked a great deal of controversy and debate; however, they emphasize an underlying reality in the healthcare field: different populations, cultures, and groups have diverse beliefs and practices that impact their health. Nurses and healthcare professionals should be aware of this reality and adapt their health assessment techniques and recommendations to accommodate diversity.

In this Discussion, you will consider different socioeconomic, spiritual, lifestyle, and other cultural factors that should be taken into considerations when building a health history for patients with diverse backgrounds. Your Instructor will assign a case study to you for this Discussion.

To prepare:

• Reflect on your experiences as a nurse and on the information provided in this week’s Learning Resources on diversity issues in health assessments.
• By Day 1 of this week, you will be assigned a case study by your Instructor. Note: Please see the “Course Announcements” section of the classroom for your case study assignment.
• Reflect on the specific socioeconomic, spiritual, lifestyle, and other cultural factors related to the health of the patient assigned to you.
• Consider how you would build a health history for the patient. What questions would you ask, and how would you frame them to be sensitive to the patient’s background, lifestyle, and culture? Develop five targeted questions you would ask the patient to build his or her health history and to assess his or her health risks.
• Think about the challenges associated with communicating with patients from a variety of specific populations. What strategies can you as a nurse employ to be sensitive to different cultural factors while gathering the pertinent information?

By Day 3 of Week 2

Post an explanation of the specific socioeconomic, spiritual, lifestyle, and other cultural factors associated with the patient you were assigned. Explain the issues that you would need to be sensitive to when interacting with the patient, and why. Provide at least five targeted questions you would ask the patient to build his or her health history and to assess his or her health risks.

Learning Resources

Required Readings (click to expand/reduce)

Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2019). Seidel’s guide to physical examination: An interprofessional approach (9th ed.). St. Louis, MO: Elsevier Mosby.

Chapter 1, “The History and Interviewing Process”  (Previously read in Week 1)This chapter highlights history and interviewing processes. The authors explore a variety of communication techniques, professionalism, and functional assessment concepts when developing relationships with patients.

Chapter 2, “Cultural Competency”This chapter highlights the importance of cultural awareness when conducting health assessments. The authors explore the impact of culture on health beliefs and practices.

Dains, J. E., Baumann, L. C., & Scheibel, P. (2019). Advanced health assessment and clinical diagnosis in primary care (6th ed.). St. Louis, MO: Elsevier Mosby.
Credit Line: Advanced Health Assessment and Clinical Diagnosis in Primary Care, 6th Edition by Dains, J.E., Baumann, L. C., & Scheibel, P. Copyright 2019 by Mosby. Reprinted by permission of Mosby via the Copyright Clearance Center.

Chapter 2, “Evidenced-Based Clinical Practice Guidelines”

Melton, C., Graff, C., Holmes, G., Brown, L., & Bailey, J. (2014). Health literacy and asthma management among African-American adults: An interpretative phenomenological analysis. Journal of Asthma, 51(7), 703–713. doi:10.3109/02770903.2014.906605
Credit Line: Health literacy and asthma management among African-American adults: An interpretative phenomenological analysis by Melton, C., Graff, C., Holmes, G., Brown, L., & Bailey, J., in Journal of Asthma, Vol. 51/Issue 7. Copyright 2014 by Taylor & Francis, Inc. Reprinted by permission of Taylor & Francis, Inc. via the Copyright Clearance Center.

The authors of this study discuss the relationship between health literacy and health outcomes in African American patients with asthma.

Centers for Disease Control and Prevention. (2015). Cultural competence. Retrieved from https://npin.cdc.gov/pages/cultural-competence

This website discusses cultural competence as defined by the Centers for Disease Control and Prevention (CDC). Understanding the difference between cultural competence, awareness, and sensitivity can be obtained on this website. 

United States Department of Human & Health Services. Office of Minority Health. (n.d.). A physician’s practical guide to culturally competent care. Retrieved June 10, 2019, from https://cccm.thinkculturalhealth.hhs.gov/

From the Office of Minority Health, this website offers CME and CEU credit and equips healthcare professionals with awareness, knowledge, and skills to better treat the increasingly diverse U.S. population they serve.

Espey , D. K., Jim, M. A., Cobb, N., Bartholomew, M., Becker, T., Haverkamp, D., & Plescia, M. (2014). Leading causes of death and all-cause mortality in American Indians and Alaska Natives. American Journal of Public Health, 104(Suppl 3), S303–S311. 

The authors of this article present patterns and trends in all-cause mortality and leading cause of death in American Indians and Alaskan Natives.

Wannasirikul, P., Termsirikulchai, L., Sujirarat, D., Benjakul, S., & Tanasugarn, C. (2016). Health literacy, medication adherence, and blood pressure level among hypertension older adults treated at primary health care centers. Southeast Asian Journal of Tropical Medicine and Public Health, 47(1), 109–120.

The authors of this study explore the causal relationships between health literacy, individual characteristics, literacy, culture and society, cognitive ability, medication adherence, and the blood pressure levels of hypertensive older adults receiving healthcare services at primary healthcare centers.

Required Media (click to expand/reduce)

Module 2 Introduction
Dr. Tara Harris reviews the overall expectations for Module 2. Consider how you will manage your time as you review your media and Learning Resources for your Discussion, Case Study Lab Assignment, and your DCE Assignment (3m).
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Functional Assessments and Cultural and Diversity Awareness in Health Assessment – Week 2 (10m)

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use 3 sources for this discussion

 

Discussion:

Compare and contrast the growth and developmental patterns of two toddlers of different ages using Gordon’s functional health patterns. Describe and apply the components of Gordon’s functional health patterns as it applies to toddlers.   

Instructions: 

Please Word limit 500 words.  Support your answers with the literature and provide citations and references in APA format. 

Please do not forget add references in APA format.