Health Promotion And Advanced Pathophysiology

Health Promotion And

Health Promotion And

Parts  2 and 3  have the same questions, however, you must answer with references and different writing always addressing them objectively, that is as if you were different students. Similar responses in wording or references will not be accepted.

APA format

1) Minimum 6 pages  (No word count per page)- Follow the 3 x 3 rule: minimum of three paragraphs per page

You must strictly comply with the number of paragraphs requested per page

.

           Part 1: minimum  2 pages

           Part 2: minimum  2 pages

           Part 3: minimum  2 pages

Submit 1 document per part

2)¨******APA norms

All paragraphs must be narrative and cited in the text- each paragraph

         Bulleted responses are not accepted

         Don’t write in the first person 

Don’t copy and paste the questions.

Answer the question objectively, do not make introductions to your answers, answer it when you start the paragraph

Submit 1 document per part

3)****************************** It will be verified by Turnitin (Identify the percentage of exact match of writing with any other resource on the internet and academic sources, including universities and data banks)

********************************It will be verified by SafeAssign (Identify the percentage of similarity of writing with any other resource on the internet and academic sources, including universities and data banks)

4) Minimum 3 references (APA format) per part not older than 5 years  (Journals, books) (No websites)

All references must be consistent with the topic-purpose-focus of the parts. Different references are not allowed.

5) Identify your answer with the numbers, according to the question. Start your answer on the same line, not the next

Example:

Q 1. Nursing is XXXXX

Q 2. Health is XXXX

6) You must name the files according to the part you are answering: 

Example:

Part 1.doc 

Part 2.doc

__________________________________________________________________________________

Part 1: Health Promotion

Topic: Local programs to satisfy health care needs.

Health problem: Smoking in adolescents (Prevention)

Purpose project:   Adolescents will improve their knowledge about the health and physical development problems due to smoking during adolescence from their participation for three months in an educational focus group

Select one research looking for promotion or primary prevention strategies in Florida about the health problem.

One page

1. Summarize its purpose

2. Describe the condition of interest

3. Describe the community or group of interest

4. Describe and providea concise idea about the strategy

5. Describe its implementation, and the evaluation.

6. Is this source providing doable ideas for your project?

One page

Two paragraphs per page

Prepare an annotated bibliography of two journal articles, regardless of the type of the study (quantitative) about the health problem.

** The studies should have a national or global perspective about a preventable condition

** One of them at least should be from a government agency.

7. Prepare a summary for each article in one paragraph per article.

Part 2: Advanced pathophysiology

1. Which of these three is related to imply airways? Describe the concepts of:

a. Ventilation

b. Diffusion

c. Perfusion.

2. Function of:

a. Cilia

b. Goblet cells in airways.

3. Gas exchange in Lungs: where does it occurs?

a. Which are structures that participate on it?

4. Function of Pneumocystis type II in Alveoli.

5. Functions of the Pulmonary System.

6. Function of Surfactant.

7. What is compliance related to Lungs and chest wall?

a. Mention one disease where compliance is decreased.

8. What are expected changes in Lungs in elderly populations?

9. What is Orthopnea and Paroxysmal Nocturnal Dyspnea?

10. What is Hypoxia and what is Hypoxemia?

11. Pneumothorax

a. Concept

b. Types

c. symptoms

12. Pleural effusion: what is exudative vs transudate? Empyema, Hemothorax, Chylothorax: concepts.

13. Restrictive lung diseases: which are…?

14. What is a Pulmonary Edema?

15. What is Acute Lung Injury (ARDS)?

16. Where is located the damage in ARDS?

17. What is Obstructive Lung Disease?

a. Which are Obstructive Lung diseases?

18. Pathophysiology of

a. COPD

b. Chronic Bronchitis?

19. Events that occur in Asthma Pathophysiology.

20. What is Pneumonia?

a. What is most frequent etiology for Community Acquired Pneumonia?

21. What is Pulmonary embolism?

a. What is Virchow Triad?

22. What is pulmonary hypertension?

a. Causes for it.

23. Cancers related to cigarettes smoking.

24. What is Cor Pulmonale?

25. What is Cystic Fibrosis?

a. Features of this disease.

Part 3: Advanced pathophysiology

1. Which of these three is related to imply airways? Describe the concepts of:

a. Ventilation

b. Diffusion

c. Perfusion.

2. Function of:

a. Cilia

b. Goblet cells in airways.

3. Gas exchange in Lungs: where does it occurs?

a. Which are structures that participate on it?

4. Function of Pneumocystis type II in Alveoli.

5. Functions of the Pulmonary System.

6. Function of Surfactant.

7. What is compliance related to Lungs and chest wall?

a. Mention one disease where compliance is decreased.

8. What are expected changes in Lungs in elderly populations?

9. What is Orthopnea and Paroxysmal Nocturnal Dyspnea?

10. What is Hypoxia and what is Hypoxemia?

11. Pneumothorax

a. Concept

b. Types

c. symptoms

12. Pleural effusion: what is exudative vs transudate? Empyema, Hemothorax, Chylothorax: concepts.

13. Restrictive lung diseases: which are…?

14. What is a Pulmonary Edema?

15. What is Acute Lung Injury (ARDS)?

16. Where is located the damage in ARDS?

17. What is Obstructive Lung Disease?

a. Which are Obstructive Lung diseases?

18. Pathophysiology of

a. COPD

b. Chronic Bronchitis?

19. Events that occur in Asthma Pathophysiology.

20. What is Pneumonia?

a. What is most frequent etiology for Community Acquired Pneumonia?

21. What is Pulmonary embolism?

a. What is Virchow Triad?

22. What is pulmonary hypertension?

a. Causes for it.

23. Cancers related to cigarettes smoking.

24. What is Cor Pulmonale?

25. What is Cystic Fibrosis?

a. Features of this disease.

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Pt Care

post with a minimum of 250 words and must contain at least (2) professional references, and cited correctly in the current APA format.

consider your last clinical experience.

1. Identify strategies to increase the section of the circle that represents the amount of influence that scientific research has on the patient care clinical experience that you selected for the critical thinking exercise? Strategy examples might include: find and read nursing research studies, peer-reviewed journal sources, and practice guidelines from specialty nursing/medical organizations, etc.
2. How will that scientific research affect your patient care?
3. How do you plan to share information with classmates and staff nurses?

    

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Nursing Care Plan Congestive Hearth Failure

Hearth Failure

Hearth Failure

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STUDENT NAME: DATE:

Medications administered during client assignment including IVF’s, Rate, and reason for Fluids.

LABORATORY AND DIAGNOSTIC TESTS

Other Pertinent labs

NURSING DIAGNOSIS R/T AND EVIDENCED BY

Subjective Supportive Data

Objective Supportive Data

NURSING DIAGNOSIS R/T AND EVIDENCED BY

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DISCHARGE PLANNING

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Care plan Congestive Heart Failure

Care plan Congestive Heart Failure

Care plan Congestive Heart Failure

I need in my care plan be done with the information below, and I need 10 references no more than 5 years old.The care plan have to be done with APA style.

Mr. Kaplan is a 78-year-old jewish white male, he is a retiree and was admitted to the hospital accompanied by his grandson. He is 100kg at a height of 180cm so his calculated body mass index (BMI) was 30.9 indicating that he was overweight. When admitted, the patient complained of shortness of breath for 4 weeks which was worsening on the day of admission and worsening cough. Besides, he also experienced orthopnea, fatigue, paroxysmal nocturnal dyspnea, and leg swelling up to his thigh. Mr. Perez was admitted to the hospital for the same problem 4 months ago.

Mr. Kaplan was diagnosed with heart failure on his last admission and he had also been diagnosed with hypertension for 20 years. Before being admitted to the hospital, the patient was taking Lasix 40mg, Eliquis 5 mg, metoprolol 50 mg, amlodipine 10mg, and simvastatin 40mg for his hypertension and heart failure. The patient is not allergic to any medication and he does not take any traditional medicines at home. His family history revealed that his father had died of ischemic heart disease 4 years ago while his brother has hypertension. As for his social history, he smoked 2-3 cigarettes a day for 35 years and the calculated smoking pack-years was 5 pack years. Besides, Mr. Kaplan also drinks occasionally.

On examination, Mr. Kaplan was found to be alert and conscious but he was having pedal edema up to his knee. Besides, the patient was noted with bibasal crepitations with no rhonchi. His body temperature was normal. However, his blood pressure was found to be elevated upon admission with a record of 179/100 mmHg with an irregular pulse rate at 85beats/min. His echocardiogram showed that he had left ventricle hypertrophy while a chest X-ray was conducted and revealed that the patient had cardiomegaly. Lab investigations such as full blood count, liver function test, urea, electrolyte test, and cardiac enzyme were done upon admission. His creatinine concentration was found to be 143µmol/L. Therefore, the calculated creatinine clearance was 68.8ml/min. Besides, there was also blood found in the urine and the echocardiography showed that the patient has sinus tachycardia and EF 45%. In addition, an ECG test was performed on day 1 and the result indicated that there was a T-wave inversion. The patient’s INR was 1.04 which was lower than normal while APTT was found to be slightly higher (59.4 seconds). Mr. Kaplan’s random blood glucose was found to be normal during his hospitalization.

Mr. Kaplan was diagnosed with congestive cardiac failure (CCF) with fluid overload. The patient also suffered from hypertension. The management plan included intravenous furosemide 40mg twice daily, Eliquis 5 mg daily, simvastatin 40 mg once at night and ramipril 2.5mg once a day. Besides, the patient was asked to restrict his fluid intake to 500ml per day and oxygen therapy was given to the patient at high flow at 40L/40% using a face mask when the patient was experiencing shortness of breath.

As for his clinical progression, on day 1, the patient complained of shortness of breath, leg swelling, and orthopnea. An echocardiogram showed that he had cardiomegaly. Treatment of CCF was given. Throughout the stay in the hospital, Mr. Kaplan had responded well to the heart failure therapy as there was no more complaint of chest pain or shortness of breath on day 13 and his pedal edema had gradually improved. However, the patient’s blood pressure from day 1 to 9 was fluctuating between the range of 102/67-179/100 mmHg therefore, hypertension treatment was given and blood pressure from day 10 onwards had been seen to fall within the normal range. Furthermore, Mr. Kaplan’s renal function became progressively worse from 143µmol/L on admission to 175µmol/L on day 11 and the calculated creatinine clearance on day 11 was 56.2ml/min. Discharge medications same as hospital regimen, O2 2L/m nasal cannula as needed for shortness of breath, follow up with cardiology in 3 weeks and nephrology in 2 weeks. Home with home health services.

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Response To Cobos

Response To Cobos

Response To Cobos

Osteoarthritis, Celebrex, and Ibuprofen

Osteoarthritis is a form of arthritis that mainly develops due to wear and tear on the cartilage found in bone joints and results in joint pains, especially for the joints that move the most such as the knees, fingers, and arms. According to Sharma (2021), the main symptoms of Osteoarthritis include pain and stiffness in the specified joint which results in limited movements for the patient due to the pain that they experience. Age progression resulting in wear and tear due to joint use is the main cause of Osteoarthritis and reversal of joint cartilage after wear is impossible which leaves the management of symptoms as the main form of treatment for Osteoarthritis.

First-Line Therapy for Osteoarthritis

The lack of treatment for Osteoarthritis results in symptom management as the main form of treatment from which NSAIDs are the main form of medicine for the patient since pain is the most prevalent and presents symptoms requiring management. Arden et al. (2021) acknowledge that topical and oral NSAIDs are the first line of treatment for the patient with dependence on the degree of pain that they are experiencing with the progression of their Osteoarthritis. Bariguian et al. (2020) identify that diclofenac is the best form of NSAID to be applied as a first-line treatment since it is effective and well-tolerated by many patients. The main mechanism of action for NSAIDs is pain-relieving through the inhibition of the enzyme cyclooxygenase which reduces the detection of the pain stimuli by the pain (Ghlichloo & Gerriets, 2019). Thus, the application of NSAIDs results in the patient having less feeling of their pain symptoms while also having their quality of life slightly elevated.

Celecoxib Benefits and Risks

Celecoxib is also an NSAID class of medication that assists in the management of pain and can be applied to patients with Osteoarthritis for their joint pains in order to relieve their pains and try to enhance Osteoarthritis management. According to Huang et al. (2021), celecoxib was found to be more effective and efficient in the reduction of pain when compared to diclofenac for patients with knee Osteoarthritis. The first benefit that the patient will gain through the use of celecoxib will be the elevation of their pain symptoms more effectively and efficiently as compared to other forms of NSAIDs, especially after the failure of ibuprofen. Pu et al. (2021) acknowledge that better analgesic efficacy and higher patient satisfaction levels are also experienced with the application of Celecoxib for pain management. Solomon et al. (2018) identify that the use of Celecoxib in the right dosage resulted in a lower risk for cardiovascular events, and gastrointestinal and also renal adverse events. Shin (2018) also points out that an increase in cardiovascular risk when using Celecoxib was found to only increase with a rise in patient dosage. Thus, the main information that should be included in a teaching plan to help the patient understand the risks and benefits of Celecoxib is the importance of adhering to the prescribed dosage and how risk increases with an increase in Celecoxib dosage.

Ibuprofen and Celecoxib

Celecoxib and ibuprofen serve NSAIDs that can be applied to the management of pain in patients which makes their pain reduction effect the most common similarity between these two types of medication. According to Aziz et al. (2018), both celecoxib and ibuprofen are NSAIDs applied for the analgesic, anti therapeutic and anti-inflammatory properties that they possess in their mechanisms of action. Aziz et al. (2018) identify that the main difference between ibuprofen and celecoxib is that celecoxib is selective and only targets COX 2 enzymes while ibuprofen is non-selective and targets both COX 1 and COX 2 enzymes. Thus, celecoxib is less likely to result in the development of stomach problems such as ulcers in the patient making it a good alternative to ibuprofen in patients who develop ulcers as well.

References

Aziz, N. D., Ouda, M. H., & Ubaid, M. M. (2018). Comparing the toxic effects of non-steroidal anti-inflammatory drugs (Celecoxib and Ibuprofen) on heart, liver, and kidney in rats. Asian J Pharm Clin Res, 11(6), 482-485. http://dx.doi.org/10.22159/ajpcr.2018.v11i6.25487

Arden, N. K., Perry, T. A., Bannuru, R. R., Bruyère, O., Cooper, C., Haugen, I. K., … & Reginster, J. Y. (2021). Non-surgical management of knee osteoarthritis: comparison of ESCEO and OARSI 2019 guidelines. Nature Reviews Rheumatology, 17(1), 59-66. /orders/doi.org/10.1038/s41584-020-00523-9

Bariguian Revel, F., Fayet, M., & Hagen, M. (2020). Topical diclofenac, an efficacious treatment for osteoarthritis: a narrative review. Rheumatology and Therapy, 7(2), 217-236. /orders/doi.org/10.1007/s40744-020-00196-6

Ghlichloo, I., & Gerriets, V. (2019). Nonsteroidal anti-inflammatory drugs (NSAIDs).  StatPearls Publishing, Treasure Island (FL) /orders/europepmc.org/article/nbk/nbk547742

Huang, H., Luo, M., Liang, H., Pan, J., Yang, W., Zeng, L., … & Liu, J. (2021). Meta-analysis comparing celecoxib with diclofenac sodium in patients with knee osteoarthritis. Pain Medicine, 22(2), 352-362. /orders/doi.org/10.1093/pm/pnaa230

Pu, C., Jiang, X., Sun, Y., Lin, H., & Li, S. (2021). Efficacy and safety between early use and late use of celecoxib in hip osteoarthritis patients who receive total hip arthroplasty: a randomized, controlled study. Inflammopharmacology, 29(6), 1761-1768.  /orders/doi.org/10.1007/s10787-021-00880-1

Shin, S. (2018). Safety of celecoxib versus traditional nonsteroidal anti-inflammatory drugs in older patients with arthritis. Journal of Pain Research, 11, 3211.  /orders/doi.org/10.2147%2FJPR.S186000

Sharma, L. (2021). Osteoarthritis of the knee. New England Journal of Medicine, 384(1), 51-59. /orders/doi.org/10.1056/NEJMcp1903768

Solomon, D. H., Husni, M. E., Wolski, K. E., Wisniewski, L. M., Borer, J. S., Graham, D. Y., … & PRECISION Trial Investigators. (2018). Differences in the safety of nonsteroidal anti-inflammatory drugs in patients with osteoarthritis and patients with rheumatoid arthritis: a randomized clinical trial. Arthritis & Rheumatology, 70(4), 537-546.  /orders/doi.org/10.1002/art.40400

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Response To Clavijo

Response

Response

Response

Response

What is the first line therapy for osteoarthritis and the mechanism of action?

Osteoarthritis (OA) is one of the most common painful musculoskeletal conditions. Osteoarthritis typically affects the knee and hip joints in older patients. The goal of OA treatment is to relieve pain and improve function without causing harm to the patient (Jarrel & Perriman, 2022). If pharmacological treatment is recommended, topical treatments are generally considered the first-line therapy for hand and knee OA (Arcangelo et al., 2021, p. 649). However, for all forms of OA, oral non-steroidal anti-inflammatory drugs (NSAIDs) are recommended as first-line therapy and are preferred to opioids and acetaminophen due to better-proven efficacy and more favorable side effects profile (Arcangelo et al., 2021, p. 649). However, the selection is challenged by several factors, including the patient’s age, comorbidities, and polypharmacy. NSAIDs are a chemically heterogeneous group of agents that inhibit the production of prostaglandins (PG) and thromboxane A through the blockade of cyclooxygenase (COX) (Magni et al., 2021). A study performed (Magni et al., 2021) concluded that diclofenac at 150 mg/ day is the best NSAID in pain and function amelioration in OA, superior to the maximum doses of frequently used NSAIDS, including ibuprofen, naproxen and celecoxib.

Benefits and risks of celecoxib (Celebrex)

Celecoxib (Celebrex) was the first coxib introduced into clinical practice; it is effective for symptomatic treatment as conventional NSAIDs and some other coxibs and can significantly reduce upper gastrointestinal events (Cheng et al., 2021). However, the subsequent coxib, rofecoxib, increased cardiovascular events. Cardiovascular safety on NSAIDs is highly controversial. One hypothesis is that coxibs impact vasoactive endothelium-derived factors, mainly inhibiting prostaglandin synthesis, which is essential for regulating vascular tone and sodium excretion and may influence blood pressure, but it is not sure yet. Nevertheless, according to Cheng et al. (2021) celecoxib does not significantly increase cardiovascular events compared to placebo and slightly decreases the risk of all-cause mortality and cardiovascular mortality compared with NSAIDs, which may prove it safe when used on rheumatoid arthritis and osteoarthritis patients.

Ibuprofen and celecoxib

In a study performed (Gordo et al., 2017), they found that celecoxib was well tolerated compared to placebo and ibuprofen, and the proportion of patients with an upper gastrointestinal event was higher with ibuprofen than with celecoxib. Celecoxib is an alternative for patients experiencing gastrointestinal (GI) adverse effects; this is also an option for patients with GI comorbidities such as a history of ulcer disease (Arcangelo et al., 2021, p. 650). On the other hand, oral non-selective NSAIDs such as ibuprofen can also be used for patients without risk factors for GI disturbances. Alternatively, the use of a non-selective NSAID along with a proton pump inhibitor may be sufficient to provide analgesia along with gastric protection.

References

Arcangelo, V. P., Peterson, A. M., Wilbur, V. F., & Kang, T. M. (2021). Pharmacotherapeutics for advanced practice (5th ed.). Wolters Kluwer Health.

Cheng, B., Chen, J., Zhang, X., Gao, Q., Li, W., Yan, L., Zhang, Y., Wu, C., Xing, J., & Liu, J. (2021). Cardiovascular safety of celecoxib in rheumatoid arthritis and osteoarthritis patients: A systematic review and meta-analysis. PLOS ONE, 16(12), e0261239. /orders/doi.org/10.1371/journal.pone.0261239

Gordo, A. C., Walker, C., Armada, B., & Zhou, D. (2017). Efficacy of celecoxib versus ibuprofen for the treatment of patients with osteoarthritis of the knee: A randomized double-blind, non-inferiority trial. Journal of International Medical Research, 45(1), 59–74. /orders/doi.org/10.1177/0300060516673707

Jarrel, L., & Perriman, L. K. (2022). Topical NSAIDs as First-Line Treatment for Mild to Moderate Osteoarthritis. Clinical Advisor, NA. /orders/link.gale.com/apps/doc/A701326019/AONE?u=stu_main&sid=ebsco&xid=ee7e0c3c

Magni, A., Agostoni, P., Bonezzi, C., Massazza, G., Menè, P., Savarino, V., & Fornasari, D. (2021). Management of osteoarthritis: Expert opinion on nsaids. Pain and Therapy, 10(2), 783–808. /orders/doi.org/10.1007/s40122-021-00260-1

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Discussion 6 Respond

Discussion 6 Respond

Discussion 6 Respond

In order to determine how we would measure and monitor quality of care and subsequent outcomes from the APRN, we should first explain what these elements are and how they are used. Quality measures are standards used for evaluating the performance and improvement of population health or of health plans, providers of services, and other clinicians in the delivery of healthcare services. Quality measures are tools that help us assess healthcare processes, outcomes, patient processes, and organizational systems that are associated with the ability to provide high-quality healthcare and/or that relate to one or more quality goals for healthcare (CMS.gov, 2022). Outcomes are put in place by governing bodies as a measurement tool of the healthcare system. These outcomes include, mortality, readmission, patient experience, safety of care, effectiveness and timeliness of care. And these outcomes are a measure of the direct result of an intervention on a patient or group of people that is attributable to an intervention or series of the same ( Tinker, 2018).

The reason that it is important to have these measurements in place is to improve things like patient care experience, general health of a population, reduce healthcare costs and prevent clinician burnout. Because the majority of NP’s work in private practice with about one third in the acute care setting such as hospitals  identifying outcome measures that reflect the specific NP role components—can be adequately used to designate the impact of specialty NP practice (Kleinpell & Kapu, 2017). The outcome of these measures would help to amplify and solidify the role of the NP as a necessary element in todays healthcare. In primary care and community health the NP can be an important tool in monitoring and educating diabetes prevention and care. We would measure the success of the NP intervention by a reduction in Diabetes and related issues such as hypertension, hemoglobin AIC and LDL control.

So what tools do we use to measure the success of the ARNP? There are several ways in which to do this. Patient assessments upon leaving hospital, household interviews and simulated patient groups are used mostly for assessing quality of care from the patient and family’s point of view, while interviewing providers and management or direct assessment are used to assess quality of care from the provider perspective. In the acute care setting, length of stay, time to consultation, cost and patient satisfaction. Finally the ARNP has proven effective in every aspect of healthcare, be it to reduce wait times, increase access to providers or provide affordable healthcare, there does not seem to be a downside to engaging the services of the ARNP, I believe one would fine that as a result of this addition to any staff patient satisfaction scores would increase exponentially.

Reference CMS.gov (2022, May) New to Measures. Retrieved from: /orders/mmshub.cms.gov/about-quality/new-to-measures/what-is-a-measure

Kleinpell, R. Kapu,  April N. (2017, August)  Quality measures for nurse practitioner practice evaluation, Journal of the American Association of Nurse Practitioners, Volume 29 – Issue 8 – p446-451 doi: 10.1002/2327-6924.12474

Discussion 2 ( Christina)

Quality of Care

Quality of care is a term that measures the likelihood of the desired health outcome, however, there are times when it has failed to address the difficulty of the situation. Quality of care reflects on so many aspects of the healthcare system, for example, it reflects the nature and effects it has and how we can make a difference and make improvements. The goal for everyone in the medical field is to improve healthcare quality so that patient care can be prioritized and in essence, made crucially important. Occasionally, quality of care has not been prioritized and is overlooked instead. Therefore, high-quality care is not only essential when providing care but also the perception is given (NCBI, 2017). A great way to put the quality of care in place is by using a checklist that demonstrates and supports the improvement from a standpoint (Oxford Academic, 2019). The list can be used as a reference to follow and guide us with feedback and ways to improve our overall care.

Hence, for the list to be successful, and biased, it should be conducted as a data point and more as an algorithm (Oxford Academic, 2019). The algorithms are used to make sure it is used correctly as it determines compliance with the facility of altering it depending on the physician’s preference upon patient care (Oxford Academic, 2019). The institution of Medicine based out of the U.S has suggested an alternative way to promote quality care, in that case, they focused on six different goals. The first centering around effectiveness, then efficiency, the quality, patient-centered care timeliness, and lastly safety (NCBI, 2017). By utilizing these six concepts, we can have a better understanding and provide a better quality of care. Researching has become very effective in exposing the change that needs to be made to enhance the quality of care. After all, this study demonstrates the effectiveness of various interactions (NCBI, 2017). It controls how a patient recovers, and it is so important for providers to make it a priority and validate that they have the best outcome possible. The intrapersonal relationship develops throughout the care process, due to the multiple attempts between both patient and provider. This consist of a sense of trust, respect, and understanding.

Quality of care is not only an important part of the basic health process but it’s what determines how well a patient improves overall. As part of the medical team, we should always aim for the best care, and find ways to improve our patient’s health. In all honesty, quality of care is sometimes not fully understood without the basic concepts of installing trust and value. We should all make it a priority to continue finding ways that will benefit our patients and create positive outcomes. Hence, by making positive changes we are also able to decrease medical errors. With the proper resources, there should be enough funds to continue developing and improving the ways we measure the quality.

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 Comprehensive Psychiatric Evaluation Note

(Male,45, Mood Disorder)

A 45-year-old patient with a history of Depression disorder and previous suicidal attempts. Patient last hospitalization was two months ago after a failed suicide attempt by overdose, the patient was in the hospital for eight days; today is his fourth session after discharge. During the nursing assessment, the patient appears awake, alert, and oriented x3, he manifested feeling anxious due to some financial issues, otherwise manifested having no prominent symptoms of depression, anxiety, mania, or psychosis. In the session carried out today, the patient appeared calm, friendly, communicative, and relaxed. His participation today was average. After completing today’s activities, the patient showed improvements in relaxation through psychotherapy. The patient was active and participated fully in discussions today. The patient reports that his mood has improved in the past two weeks, and that he feels hopeful and with plans for the future. During the session, the clinician facilitated a discussion about stress management techniques. Psychoeducation provided regarding clarifying areas of difficulty and identifying coping skills. The clinician provided psychoeducation regarding medication compliance, and the patient was receptive. The patient was encouraged to continue follow-up psychotherapy to monitor his anxiety. Individual psychotherapy schedule in 4 weeks.

Assignment 2: Comprehensive Psychiatric Evaluation Note

Psychiatric notes are a way to reflect on your practicum experiences and connect them to the didactic learning you gain from your NRNP courses. Comprehensive psychiatric evaluation notes, such as the ones required in this practicum course, are often used in clinical settings to document patient care.

For this Assignment, you will document information about a patient that you examined in a group setting during the last 4 weeks (See above), using the Comprehensive Psychiatric Evaluation Note Template provided.

Instructions:

Create a Comprehensive Psychiatric Evaluation Note on this patient using the template provided. There is also a completed template provided as an exemplar and guide.

Include subjective and objective data; assessment from most recent mental status exam; current psychiatric diagnosis including differentials that were ruled out; current psychotherapeutic plan (include one health promotion activity and one patient education strategy you provided); and patient progress toward treatment goals.

· Subjective: What details did the patient provide regarding their chief complaint and symptomology to derive your differential diagnosis? What was the duration and severity of their symptoms? How are their symptoms impacting their functioning in life?

· Objective: What observations did you make during the psychiatric assessment?

· Assessment: Discuss the patient’s mental status examination results. What were your differential diagnoses? Provide a minimum of three possible diagnoses in order of highest to lowest priority and explain why you chose them. What was your primary diagnosis and why? Describe how your primary diagnosis aligns with DSM-5-TR diagnostic criteria and is supported by the patient’s symptoms.

· Plan: Describe your treatment modality and your plan for psychotherapy. Explain the principles of psychotherapy that underline your chosen treatment plan to support your rationale for the chosen psychotherapy framework. What were your follow-up plan and parameters? What referrals would you make or recommend as a result of this psychotherapy session?

· Reflection notes: What would you do differently in a similar patient evaluation? Reflect on one social determinant of health according to the HealthyPeople 2030 (you will need to research) as applied to this case in the realm of psychiatry and mental health. As a future advanced provider, what are one health promotion activity and one patient education consideration for this patient for improving health disparities and inequities in the realm of psychiatry and mental health? Demonstrate your critical thinking.

**Include at least five scholarly resources to support your assessment and diagnostic reasoning. **

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Comprehensive Psychiatric Evaluation Note And Patient Case Presentation

Evaluation Note And Patient Case Presentation

Evaluation Note And Patient Case Presentation

Psychiatric notes are a way to reflect on your practicum experiences and connect them to the didactic learning you gain from your NRNP courses. Comprehensive psychiatric evaluation notes, such as the ones required in this practicum course, are often used in clinical settings to document patient care.

For this Assignment, you will document information about a patient that you examined in a group setting during the last 4 weeks, using the Comprehensive Psychiatric Evaluation Note Template provided. You will then use this note to develop and record a case presentation for this patient.

Select a group patient for whom you conducted psychotherapy for a mood disorder during the last 4 weeks. Create a Comprehensive Psychiatric Evaluation Note on this patient using the template provided in the Learning Resources. There is also a completed template provided as an exemplar and guide. When you submit your note, you should include the complete comprehensive psychiatric evaluation note as a Word document and pdf/images of each page that is initialed and signed by your Preceptor. You must submit your note using SafeAssign.

Then, based on your evaluation of this patient, develop a video presentation of the case. Plan your presentation using the Assignment rubric and rehearse what you plan to say. Be sure to review the Kaltura Media Uploader resource in the left-hand navigation of the classroom for help creating your self-recorded Kaltura video.

Include at least five scholarly resources to support your assessment and diagnostic reasoning.

The Assignment

Record yourself presenting the complex case for your clinical patient.

Present the full complex case study. Be succinct in your presentation, and do not exceed 8 minutes. Include subjective and objective data; assessment from most recent mental status exam; current psychiatric diagnosis including differentials that were ruled out; current psychotherapeutic plan (include one health promotion activity and one patient education strategy you provided); and patient progress toward treatment goals.

Subjective: What details did the patient provide regarding their chief complaint and symptomology to derive your differential diagnosis? What was the duration and severity of their symptoms? How are their symptoms impacting their functioning in life?

Objective: What observations did you make during the psychiatric assessment?

Assessment: Discuss the patient’s mental status examination results. What were your differential diagnoses? Provide a minimum of three possible diagnoses in order of highest to lowest priority and explain why you chose them. What was your primary diagnosis and why? Describe how your primary diagnosis aligns with DSM-5-TR diagnostic criteria and is supported by the patient’s symptoms.

Plan: Describe your treatment modality and your plan for psychotherapy. Explain the principles of psychotherapy that underline your chosen treatment plan to support your rationale for the chosen psychotherapy framework. What were your follow-up plan and parameters? What referrals would you make or recommend as a result of this psychotherapy session?

Reflection notes: What would you do differently in a similar patient evaluation? Reflect on one social determinant of health according to the HealthyPeople 2030 (you will need to research) as applied to this case in the realm of psychiatry and mental health. As a future advanced provider, what are one health promotion activity and one patient education consideration for this patient for improving health disparities and inequities in the realm of psychiatry and mental health? Demonstrate your critical thinking.

Please provide five scholarly references. I appreciate you

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