Substance use disorders are complicated psychiatric and medical conditions that involve physical addiction as well as psychological or emotional dependence. Substance use disorders are some of the most difficult to treat. It takes a great deal of patience on the part of the provider and the client. It may take several attempts before a client is successfully able to “kick the habit.” Your guidance and patience can help the client to persevere through difficult times during the journey to recovery. 

Clinical Supervision is an essential component of your development as a psychiatric mental health nurse practitioner. It provides an opportunity for professional collaboration as you share experiences with and gain insights from colleagues. For this Clinical Supervision, consider a client with a substance abuse disorder whom you do not think is adequately progressing according to expected clinical outcomes.

Learning Objectives

Students will:

• Analyze clients presenting for treatment of substance-related and addictive disorders 
• Evaluate effectiveness of therapeutic approaches for clients diagnosed with substance-related and addictive disorders 
• Recommend treatment plans
• Describe the client. Note: Do not use the client’s actual name.
• Explain your therapeutic approach with the client, including the perceived effectiveness of your approach.
• Identify any additional information about this client that may potentially impact expected outcomes.
• Provide specific recommendations for the client to help them in determining why they are not progressing and what your suggested treatment plan consists of. It is useful to consult the Prochaska and DiClement model.

Case Study #1

25-year old Caucasian female 5’6” 110 pounds

Allergic to wheat

No medications currently taken

CC:  Glossitis and diarrhea

Patient noticed over the past week her tongue has become sore and inflamed.   She feels the pain is constant, aggravated by eating and alleviated by “not letting anything touch it.”  Patient states tongue feels “tender.”  She has no idea what is causing it.  No other treatments have been attempted.  Severity/significance is a 9 out of 10.  She also states she has had diarrhea “worse than usual for the past 6 months.”  When asked if she has an chronic conditions, she states she has Celiac Disease but has a “tendency not to avoid pastries – her favorite!” Currently, her diarrhea is worse after she eats going up to 6 times per day.  She does notice the frequency increases when she eats any bread product and it is stops when she stops eating bread products.  On occasion, she takes over the counter diarrhea medication.  The severity is 5 out of 10.  Blood work shows red blood cells are larger than normal (macrocytic).

Case Study #2

70-year old Black male 5’10” 200 pounds.

No Known Drug Allergies

Currently taking Lisinopril and Crestor

CC:  Dysphagia

Patient has noticed he has had difficulty swallowing food over the past 8 months.  He has noticed that in the beginning it only occurred with solid food but now it has progressed to include really any type of food.  Nothing appears to alleviate the condition.  He is only reminded of it “when he starts to eat.”  He has tried no other treatments.  Severity is 8 out of 10.  When asked if he has noticed anything else, he mentioned he has lost 10 pounds without trying in the last month and feels he has lost his strength.  Also, he notices when he actually “decides to eat” he does not eat much and feels full quickly.  CT scan shows epigastric mass.

Case Study #3

57-year old female

5’5” 300 pounds

No Known Drug Allergies

Current medications – none

CC:  Sudden one-sided facial paralysis

Patient states that her family noticed during Thanksgiving dinner that one side of her face became “frozen.”  Patient became extremely upset and wanted to be taken to the emergency room.  Family took her to the emergency room and the following exams were done:

CT – negative for infarct but to be sure MRI was done and was also negative for infarct, mass lesion or hemorrhage.  Facial paralysis went away within the hour.  However, patient was kept in the hospital for observation.

please improve this job, correct mistakes and follow this instructions 

 

I have reviewed your Health History submission and would like to go over it with you so you may improve your assignment before the due date. You can edit your assignment and resubmit it before the due date. 
Under obstetrics, you want to ask your patient if they have children, how many, how were they delivered, if they suffered any miscarriages, when was their last menstrual period, are they in menopause, has she gotten a pap smear, what were the results of the pap smear. 
I noticed you were missing your genogram. Do not forget to include that. 
Under the Review of symptoms, you will use the same format as the guide provided but you would not just include “none” or only what she had. It should properly be written as ” Skin: Denies or reports rashes, lumps, sores, itching, dryness, color changes in hair or nails” if your patient suffered from something and not the other you can say ” Skin: reports rashes, lumps, sores, itching, dryness. Denies color changes in hair or nails”
According to APA, the bold titles such as “Review of systems” should be indented left and not in the middle. In your second page you should add a “Health History” (unbolded) in the center of the page and that is your title. 
Under Patterns of healthcare, you want to include if your patient actively participates in preventative care such as annuals or going to the dentist, etc. 
Remember to include identified risk factors and any health promotion activities. Also include what suggestions to made to their diet and what is their evaluation of their own diet (excellent, good, fair, poor). 
If you have any questions, please do not hesitate to contact me. 

Please answer with two paragraphs and two references no more than 5 years. for tomorrow, no plagiarism.

Evidenced-Based Practice is utilized to improve patient safety and outcomes in the workplace. It also has a positive impact to improve employee engagement and job satisfaction. Evidence-Based practice coexists with having policy and procedures in the workplace to help with patient values and clinician’s expertise when making decisions with patient care (Hameed, 2021).

This approached is utilized every day in healthcare. Policies and procedures are implemented everyday especially when an incident occurs. For example, maternal death or fetal demise in the Obstetric unit is a way to implement policies to help improve the workplace. Morbidity and mortality, the goal is to improve the environment which can improve patient outcomes. If there is a policy that is not implemented and can benefit the workplace, the CNO and chairman of the department will assist with making this happen to improve the environment.

I think that Evidence-based practice is not used apart from or in conjunction with the other approaches. However, on the contrary, it coexists with research and QI. All of these are needed to help improve patient outcomes. Patient safety is very important in the healthcare setting as it can impede patient care. Having a policy in place, researching improvement can assist with patient care and making the healthcare organization a better place by decreasing morbidity and mortality. 

1st page- Cover page

2nd page- Abstract (include what is the purpose of this project) 

3rd page- Answering the following questions:

Health information is data related to medical history.Health information records include history, lab results, diagnostic information, and notes. It creates data sets that are used for individuals and populations.

Questions:

1. 1. When thinking about Health Care information and HIT, autonomy is often an ethical issue. What concerns would patients have about their privacy with electronic health records.
2. 2. How is beneficence and non-maleficence violated with ransomware?

4th page- References