Visit the 3 websites from the following below websites and read the entries from Module 2 (Health Indicators) and Module 3 (Health and Education and Health System). Note three (3) similarities and/or three differences between your websites (https://kadey001.wixsite.com/assignment) and each of the 3 websites that you visit. In addition, include at least two citations to support your responses.  APA format.

https://sla2989.wixsite.com/malawi

https://jbren004.wixsite.com/website-1

https://heymissriss.wixsite.com/singaporewebcountry 

https://tclar021.wixsite.com/italy

https://tdela010.wixsite.com/thailand

https://bgate003.wixsite.com/ethiopiawiki

https://tgray013.wixsite.com/mysite

https://rachelhaga757.wixsite.com/madagascar

https://justmejenny.wixsite.com/syria

https://hking006.wixsite.com/globalhealth-japan    

https://alaus001.wixsite.com/southafrica 

https://vmaso001.wixsite.com/nepalvictoriamason

https://jbmorin.wixsite.com/haiti

https://rmurd003.wixsite.com/france

https://blairnelson00.wixsite.com/italy-2 

https://kpont001.wixsite.com/stkittsnevis

https://sskin0077.wixsite.com/website

https://jsmit147.wixsite.com/website 

https://msolo002.wixsite.com/ethiopia

https://bstor003.wixsite.com/websiteswiterland

https://hbasi001.wixsite.com/philippines

https://alill004.wixsite.com/norway

https://rkim0011.wixsite.com/skoreahealth

https://jjarm003.wixsite.com/germany

https://hmaca001.wixsite.com/marshall-islands 

https://mclar032.wixsite.com/mysite

https://cbook011.wixsite.com/liberia

https://ygarc001.wixsite.com/drwc

https://nhood001.wixsite.com/honduras

https://dmcmi003.wixsite.com/mysite

https://janinebrannis.wixsite.com/canadahealth

https://sboll001.wixsite.com/website

https://ssand020.wixsite.com/sierra-leone

https://alphaconstruction26.wixsite.com/website

https://bls2116.wixsite.com/globalhealthbrazil

Https://rsinc008.wixsite.com/Jamaica

https://gkelf001.wixsite.com/kelfalah

https://mvick008.wixsite.com/mysite

https://jdeib001.wixsite.com/bolivianhealth

http://cmcki001.wixsite.com/mysite

  In a well-developed paragraph (300–350 words) to each peer integrating atleast 2 an evidence-based resource, APA format. Respectfully agree and disagree with the responses and explain your reasoning by including your rationales in your explanation.

Response 1

 The purpose of this post is to discuss diagnosis of RR case study. After reviewing the present complaint and past medical history of RR, this writer suspects that the patient has pneumonia. This writer suspects that either of the following S. pneumoniae, H. influenzae, S. aureus, or gram-negative bacteria was the cause of the infection (Woo, Terri Moser, Robinson & Marylou. 2020). This is because RR has symptoms of fever, chills, green sputum (Woo, Terri Moser, Robinson & Marylou. 2020). Additionally, RR has complaints of pain in the right mid-back with deep breathing and coughing (Woo, Terri Moser, Robinson & Marylou. 2020). Additionally, RR had rales during the auscultation of the lungs in the right lower-posterior lung field (Woo, Terri Moser, Robinson & Marylou. 2020). As a result, ordering a lung ultrasound is beneficial to solidify the diagnosis of pneumonia (Long et al., 2017).

Pneumonia is an infection of one or both lungs (Zambare & Thalkari. 2019). The cause of pneumonia is from either bacteria, viruses, or fungi (Zambare & Thalkari. 2019). As a healthcare provider assessing for the cause of pneumonia in patient RR is crucial because pneumonia can be life-threatening (Zambare & Thalkari. 2019). The goal of treatment is to return to the respiratory status before having pneumonia (Woo, Terri Moser, Robinson & Marylou. 2020). This writer would assess the last use of antibiotics to ensure no antibiotics in the past 3 months, and the patient was previously healthly with no cardiopulmonary disease (Woo, Terri Moser, Robinson & Marylou. 2020).The first choice antibiotic this writer would recommend to treat RR with is an advanced-generation macrolide, such as azithromycin or clarithromycin (Woo, Terri Moser, Robinson & Marylou. 2020). Erythromycin would mostly likely be used to treat RR pneumonia because it is the least expensive of the macrolides (Woo, Terri Moser, Robinson & Marylou. 2020). If RR is allergic to macrolide, then this writer would use doxycycline for treatment (Woo, Terri Moser, Robinson & Marylou. 2020). The patient should respond to treatment within 48 to 72 hours, unless the patient illness is not improving (Woo, Terri Moser, Robinson & Marylou. 2020). Due to RR not having any comorbidities fluoroquinolone ushc as moxifloxacin, gemifloxacin, or levofloxacin is not needed for treating pneumonia (Woo, Terri Moser, Robinson & Marylou. 2020).

Erythromycin is the medication used to treatment RR pneumonia. The mechanism of action for macrolide such as erythromycin is to suppresses protein synthesis at the level of the 50S bacterial ribosome (Vallerand & Sanoski. 2016). The therapeutic effect of erythromycin is bacteriostatic action against susceptible bacteria  (Vallerand & Sanoski. 2016). Educating and counseling the patient about the medication is essential for the patient to understand the treatment, expected adverse effects, drug interactions, and length of treatment (Woo, Terri Moser, Robinson & Marylou. 2020). Some of the adverse effects of erythromycin are nausea, vomiting, abdominal pain, and cramping  (Vallerand & Sanoski. 2016). Moreover, RR should be informed to take the medication as prescribed and until finished even if feeling better  (Vallerand & Sanoski. 2016). Patient will be educated that the response to treatment will assist in determining the pathogen (Woo, Terri Moser, Robinson & Marylou. 2020). This writer will discuss lifestyle modifications such as hydration, smoking cessation and rest (Woo, Terri Moser, Robinson & Marylou. 2020). A discussion of worsening symptoms of pneumonia with RR will occur (Woo, Terri Moser, Robinson & Marylou. 2020). Lastly, this writer will inform RR to contact this writer or seek urgent medical care for worsening symptoms (Woo, Terri Moser, Robinson & Marylou. 2020).

Response 2

 The purpose of this discussion is to assess and treat patient RR from the case study provided. RR could have several causes of these symptoms. The test I would focus on due to her health history and symptoms would be for pneumonia, however I would like to rule out Tuberculosis (TB)as well. Mycobacteria is responsible for TB and is defined as an atypical bacterium and are more difficult to treat than other forms of bacteria (Woo & Robinson, 2020). The most common bacteria that causes bacterial pneumonia in America is called Streptococcus pneumoniae (CDC, 2020). Bacterial pneumonia presents with all the symptoms RR lists: fever, productive green sputum, cough that causes pain, difficulty breathing, and rales. Smoking will exacerbate these symptoms. The rule out on TB would be because of her living conditions, patients who are in homeless shelters are at higher risks for being susceptible to TB (Brown, 2019).
The antibiotic used for bacterial community acquired pneumonia is most commonly a combination of azithromycin and ceftriaxone (Woo & Robinson, 2020). Because this condition has not yet been treated starting with the most generally used antibiotics would be recommended. If these medications do not work and the bacteria appears to be resistant other antibiotics can be initiated.
Azithromycin is known as a bacteriostatic or bactericidal antibiotic when given in higher doses (Woo & Robinson, 2020). This is a broad spectrum antibiotic that gram-negative and gram-negative bacteria are susceptible to. Ceftriaxone is a third generation cephalosporin medication that is recommended for broader indications and is more effective against gram-negative bacteria (Woo & Robinson, 2020).
The mechanism of action for azithromycin is that it binds to 50S ribosomal subunit of the causative bacteria and intercepts the detachment of peptidyl tRNA from the ribosomes. The bacteria are dependent on the RNA for protein synthesis therefore, without it the bacteria cannot synthesize (Medscape, 2020). Ceftriaxone works less successfully against gram-positive microorganisms, however, is a better choice for a cephalosporin for resistant organisms. This antibiotic inhibits the production of peptidoglycan which is the bacteria’s enzyme that builds its cell wall. This creates the bacteria lyse (Medscape, 2020).
Studies have concluded that the use of these two medications in a combination therapy has resulted in quicker recovery, less residual symptoms, and a decrease in sepsis occurrence and should be given to high risk patients (Caballero et al., 2011). Given RR’s health history and current living conditions I would conclude that she falls into the high risk population for pneumonia complications. I would also recommend that RR gets plenty of rest and fluid, educate on the benefits of smoking cessation (and offer a nicotine gum prescription), to take the full course of medication even if symptoms resolve, and to come back if any symptoms persist or worsen.

RUBRIC

 Peer Response Post. Offers both supportive and alternative viewpoints to the discussion, using two or more scholarly references per peer post. Post provides additional value to the conversation.

All instruction requirements noted.

40 pointsEvidence of further synthesis of course content. Provides clarification and new information or insight related to the content of the peer’s post.

Response is supported by course content and a minimum of one scholarly reference per each peer post.

All instruction requirements noted.

35 pointsLacks clarification or new information. Scholarly reference supports the content in the peer post without adding new information or insight.

Missing reference from one peer post.

Partially followed instructions regarding number of reply posts.

Most instruction requirements are noted.

31 pointsPost is primarily a summation of peer’s post without further synthesis of course content.

Demonstrates incomplete understanding of content and/or inadequate preparation.

Did not follow instructions regarding number of reply posts.

Missing reference from peer posts.

Missing several instruction requirements.

Submits post late.

27 points40Frequency of DistributionInitial post and peer post(s) made on multiple separate days.

All instruction requirements noted.

10 pointsInitial post and peer post(s) made on multiple separate days.

8 pointsMinimum of two post options (initial and/or peer) made on separate days.

7 pointsAll posts made on same day.

Submission demonstrates inadequate preparation.

No post submitted.

6 points10OrganizationWell-organized content with a clear and complex purpose statement and content argument. Writing is concise with a logical flow of ideas.

5 pointsOrganized content with an informative purpose statement, supportive content, and summary statement. Argument content is developed with minimal issues in content flow.

4 pointsPoor organization and flow of ideas distract from content. Narrative is difficult to follow and frequently causes reader to reread work.

Purpose statement is noted.

3 pointsIllogical flow of ideas. Prose rambles. Purpose statement is unclear or missing.

Demonstrates incomplete understanding of content and/or inadequate preparation.

No purpose statement.

Submits assignment late.

2 points5APA, Grammar, and SpellingCorrect APA formatting with no errors.

The writer correctly identifies reading audience, as demonstrated by appropriate language (avoids jargon and simplifies complex concepts appropriately).

Writing is concise, in active voice, and avoids awkward transitions and overuse of conjunctions.

There are no spelling, punctuation, or word-usage errors.

5 pointsCorrect and consistent APA formatting of references and cites all references used. No more than two unique APA errors.

The writer demonstrates correct usage of formal English language in sentence construction. Variation in sentence structure and word usage promotes readability.

There are minimal to no grammar, punctuation, or word-usage errors.

4 pointsThree to four unique APA formatting errors.

The writer occasionally uses awkward sentence construction or overuses/inappropriately uses complex sentence structure. Problems with word usage (evidence of incorrect use of thesaurus) and punctuation persist, often causing some difficulties with grammar. Some words, transitional phrases, and conjunctions are overused.

Multiple grammar, punctuation, or word usage errors.

3 pointsFive or more unique formatting errors or no attempt to format in APA.

The writer demonstrates limited understanding of formal written language use; writing is colloquial (conforms to spoken language).

The writer struggles with limited vocabulary and has difficulty conveying meaning such that only the broadest, most general messages are presented.

Grammar and punctuation are consistently incorrect. Spelling errors are numerous.

1.Read the article, understand it, interpret it, and create a summary in APA style in your own words clearly and succinctly (two pages double spaced)
2.In-text citations used accurately in summary including the last name of the author(s), year, and page numbers if direct quote. No other errors noted.
3.At the end of the summary, type the reference to your article in correct APA style. 

   Hello i need a Briefly, Good and Positive Comment for this Post.Thank you.  I need at least two references. 

  

RUFINA EWANE 

Initial post

COLLAPSE

Top of Form

Psychiatric emergencies are severe behavioral changes that may result from worsening mental illness. Psychiatric emergency is any disturbance in thoughts, feelings, or actions that require immediate therapeutic intervention (Stahl, S. M., 2014). The providers approach, attitudes and work environment may escalate the situation and interfere with the quality of care. Certain therapeutic measures can reduce the intensity of the situation and provide a more dignified way for patients to recover from the crisis. It is thus important that the PMHNP understand how to assess patient’s emergency status and address their unique needs while maintaining safety.

 Case selected.

Patient is a 25-year-old AA male who presents to the emergency department with psychotic behavior in believing he should kill his mother which led to his attempt to stab his mother. Patient is admitted for inpatient psychiatric stabilization. Patient has a history of schizoaffective disorder and major depression that was managed with use of clozapine 150mg twice a day and Zoloft 100mg daily. Family reported that patient has a history of medication non-compliant and had been on different psychiatric medications in the past but were not working for him. Additional reports by his parents shows that patient had missed several doses of his medication, decompensated and they had notices some changes  recently including increase agitation, delusional believes that he is the savior in the family and God had directed him to cast the demon in his mother. Reports also that he had drawn a picture of himself with knives cutting a woman he portrayed as a demon with blood flowing with a man standing to the side, laughing. Patient currently stated that he participates in a meeting with angels from which he gets directives on how to attack his mother which led to his attempt to stab his mother. Because of this, patient was considered dangerous to his mother per admitting physician. Patients symptoms include psychosis, extreme agitation, paranoia, verbal outburst, combative and very difficult to redirect. Patient has no known drug allergies per parents.  Verbal restraint was used including letting patient know what will happen if he does not comply, respecting his autonomy, empathetic listening, decrease environmental stimulation, reassure patient that they will be safe, and maintain a safe environment. The patient was given emergency medications including haloperidol lactate 5mg, lorazepam 2mg, and diphenhydramine 50mg all IM for severe agitation and danger to others. To prevent re-hospitalization within 12-24 hours of discharge, the physician ordered outpatient therapy and continued use of clozapine and Zoloft along with necessary lab work.

How I would treat the client differently if he or she were a child or adolescent

Children and adolescent are usually brought for treatment when their behavior or thoughts come to the attention of parents, teachers, social workers, or school.  For pediatric patients in a mental health crisis, the typical chaotic nature of the situation may easily further exacerbate an already traumatized state of the patient. Just like in adults, as a PMHNP I would perform an evaluation to determine the type of emergency and contributing factors in child and adolescent emergency by assessing not just the child but also the entire family. Additionally, safety and protection are essential mandate in psychiatric emergency evaluation especially when the patient pose imminent threat to self or others. What I will do different when interviewing children especially younger children is to assess the underlying cause of the violent behavior and delusional symptoms within a developmental context. Specifically, I would clarify that “bizarre thinking ” or accounts of seeing or hearing things that others do not see or hear are different from developmentally appropriate fantasy or difficulty while distinguishing inner voices from distressing hallucinations. On like in adults where they can provide information during the interview, when it comes to younger children, I would need to obtain information from parents or guardian. For adolescents, I would obtain information from the patient first then talk to their parent or guardian if the adolescent is able to tell most of their own story. This may also help to give a sense of autonomy and control to the adolescent which promote cooperation with the interview process.  However, information from family is very crucial particularly for a child who is psychotic, frightened, unable, or unwilling to corporate with the provider to help understand how the situation occurred and the severity of the behavior.

Same interviewing strategies used in adult may be used including speaking in a soft voice respecting patients’ autonomy, assuring safety, validating feelings, offering distractions (like video games) especially with very young children, and clear limit-setting can be helpful. However, children should be evaluated in a carefully planned setting with doors closed for limiting access, and be sure appropriate backup is available (Margret, C. P., & Hilt, R., 2018). 

In violent situations children may require a different approach in deescalating the situation than adults. Safety is the essential mandate in an aggression evaluation, with the interviewer specifically looking for imminent threats, plans, targeted people, and access to means of harm (Margret, C. P., & Hilt, R., 2018). Because adults are much stronger, they may require physical restrain specially to administer medication to calm the patient. Verbal restrain such as providing verbal directions in a nonthreatening manner, setting limits, and assuring the child that treatment may help them calm may be used for children first. However, if the child is dangerously out of control and aggressive, they may need medication to keep them calm and safe.

Legal or ethical issues I would consider when working with a child or adolescent emergency case

The ethical issue I will consider when working with children and adolescent is respect for their autonomy, privacy, and confidentiality. For very young children parents must consent to treatment and the health care provider treating the child should make every reasonable effort to obtain and document informed consent. (American Academy of Pediatrics, 2015). Just like adults, maintaining a patient’s confidentiality is an important ethical consideration when providing care to children and adolescents. However, when a PMHNP is concerned that the patient may be at imminent risk for harm to self or others, confidentiality requirements no longer apply (Chun, T. H., Katz, E. R., & Duffy, S. J., 2013). This means that the PMHNP in this situation may disclose information collected  from patient to caregivers or others as needed and may obtain information from others such as friends, family members, school personnel, employers and other without obtaining consent from the patient or guardians (Chun, T. H., Katz, E. R., & Duffy, S. J., 2013. Patient autonomy is a major principle in making decisions about an individual’s health, and as a PMHNP we are obligated to respect this right and allow patients to practice their autonomy in the course of their treatment (Parsapoor, A., Parsapoor, M. B., Rezaei, N., & Asghari, F., 2014). However, a psychiatric emergency and age may limit a child’s ability to make such decisions. Regardless, it is always important to involve the child in informed decision making even if the consent is signed by the parents or guardian.

References

Chun, T. H., Katz, E. R., & Duffy, S. J. (2013). Pediatric mental health emergencies and special

health care needs. Pediatric clinics of North America, 60(5), 1185–1201. Retrieved from,

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3792398/

Da Silva, A. G., Baldaçara, L., Cavalcante, D. A., Fasanella, N. A., & Palha, A. P. (2020). The

Impact of Mental Illness Stigma on Psychiatric Emergencies. Frontiers in psychiatry, 11,

573. https://doi.org/10.3389/fpsyt.2020.00573

Margret, C. P., & Hilt, R. (2018). Evaluation and Management of Psychiatric Emergencies in

Children. Pediatric Annals, 47(8), e328–e333. https://doi-

org.ezp.waldenulibrary.org/10.3928/19382359-20180709-01

Parsapoor, A., Parsapoor, M. B., Rezaei, N., & Asghari, F. (2014). Autonomy of children and

adolescents in consent to treatment: ethical, jurisprudential and legal considerations.

Iranian journal of pediatrics, 24(3), 241–248. Retrieved from,

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4276576/

Stahl, S. M. (2014). Prescriber’s Guide: Stahl’s Essential Psychopharmacology (5th ed.). New

York, NY: Cambridge University Press.

 

Throughout history, technological advancements have appeared for one purpose before finding applications elsewhere that lead to spikes in its usage and development. The internet, for example, was originally developed to share research before becoming a staple of work and entertainment. But technology—new and repurposed—will undoubtedly continue to be a driver of healthcare information. Informaticists often stay tuned to trends to monitor what the next new technology will be or how the next new idea for applying existing technology can benefit outcomes.

In this Discussion, you will reflect on your healthcare organization’s use of technology and offer a technology trend you observe in your environment.

To Prepare:

• Reflect on the Resources related to digital information tools and technologies.
• Consider your healthcare organization’s use of healthcare technologies to manage and distribute information.
• Reflect on current and potential future trends, such as use of social media and mobile applications/telehealth, Internet of Things (IoT)-enabled asset tracking, or expert systems/artificial intelligence, and how they may impact nursing practice and healthcare delivery.

By Day 3 of Week 6

Post a brief description of general healthcare technology trends, particularly related to data/information you have observed in use in your healthcare organization or nursing practice. Describe any potential challenges or risks that may be inherent in the technologies associated with these trends you described. Then, describe at least one potential benefit and one potential risk associated with data safety, legislation, and patient care for the technologies you described. Next, explain which healthcare technology trends you believe are most promising for impacting healthcare technology in nursing practice and explain why. Describe whether this promise will contribute to improvements in patient care outcomes, efficiencies, or data management. Be specific and provide examples.

By Day 6 of Week 6

Respond to at least two of your colleagues* on two different days, offering additional/alternative ideas regarding opportunities and risks related to the observations shared.