Assessment Of Project

Assessment Of Project

Assessment Description

Develop a PowerPoint slide presentation that’s approximately 10-12 minutes and covers ALL major areas of your project.

Be sure to address:

– site / organization: St. Francis Medical Center

– needs assessment results (or how you knew of the need for your project): Patient satisfaction surveys and scorecards were unsatisfactory with patient emphasis on poor communication between the wound care nurses and physicians causing errors in wound care orders.

– project topic: Improving the wound care departments nurse, and physician communication by improving their main communication tool (Wound Care Order Sheet)

– project goals: Improving the Wound Care Order Sheet so that there is only 1 version hospital wide, implementing the practice of reading back orders, and successfully implementing an improved tool to increase patient satisfaction and outcomes.

– project outcome (or anticipated outcome if not implemented): The organization is still doing a trial of using the new Wound Care Order Tool, but if implemented the anticipated outcome will be, a lower occurrence of wound care order errors, improved communication between nurses, physicians, and patients, and an increase in satisfactory patient surveys and scorecards.

-How was your project received by stakeholders? Positively received and trial was initiated.

-If you implemented your project, how will it be sustained? If it is not sustainable, how will the one-time implementation make a difference? PLEASE FILL IN

-If you did not implement your project, how did you perform a hand-off for the next steps?

-Ultimately, what did you learn from this project? PLEASE FILL IN

-Include an additional slide for References at the end.

While APA style is not required for the body of this assignment, solid academic writing is expected, and documentation of sources should be presented using APA formatting guidelines, which can be found in the APA Style Guide, located in the Student Success Center.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

RUBRIC

Site/Organization 

3.6 points

Needs Assessment Results 

3.6 points

Project Topic 

4.8 points

Project Goals 

4.8 points

Project Outcome 

4.8 points

Stakeholders

4.8 points

Project Sustainability or Hand-off for Next Steps 

4.8 points

Reflection on Project 

4.8 points

Presentation of Content

6 points

Layout

6 points

Language Use and Audience Awareness 

6 points

Mechanics of Writing

3 points

Documentation of Sources 

3 points

Total60 points

Women Health – Week 6 Discussion 2nd REPLY

please reply to the following discussion with one reference. Participate in the discussion by asking a question, providing a statement of clarification, providing a point of view with a rationale, challenging an aspect of the discussion, or indicating a relationship between two or more lines of reasoning in the discussion. Cite resources in your responses to other classmates.

Discussion:

Discuss the questions that would be important to include when interviewing a patient with this issue

Kayla is a 16-year old female who presents with complaints of pelvic pain and previously diagnosed with pelvic inflammatory disease. When interviewing an adolescent presenting with these symptoms, it is crucial to ask questions related to social history in privacy (Smorgick & As-Sanie, 2018). Such questions should cover the home situation, school and other activities and potentially sensitive domains of substance abuse, sexual activity, depression, eating behaviors, and safety. In particular, it would be important to ask whether she had experienced any sexual assault in school or at home and if any, whether she noticed any bleeding during the assault. Another important question to ask is whether she has noticed any discharge and the color of the discharge. A normal vaginal discharge is clear and usually odorless. However, changes in the color, amount, or smell of the vaginal discharge may indicate a problem. For example, a white discharge that is clumpy and looks similar to cottage cheese may be a sign of yeast infection, which may cause symptoms such as burning on urination or vaginal itching. Similarly, a yellow/green discharge can be a sign of STIs or bacterial infection, and which can cause pain in the pelvic (Stratton, 2019).

Describe the clinical findings that may be present in a patient with this issue

The most common symptom of pelvic inflammatory disease is pain or tenderness in the stomach or lower abdomen. Other symptoms include abnormal vaginal discharge, usually yellow or green with an unusual odor, fever, tiredness, pain and bleeding during sex, burning sensation upon urination, and pain in the upper abdomen. Other clinical findings include tenderness of fallopian tubes and ovaries and tenderness of the cervix.

Are there any diagnostic studies that should be ordered on this patient? Why?

There are several diagnostic studies that should be ordered on this patient. A pelvic exam should be ordered first to examine her reproductive organs and look for signs of infection. Vaginal culture can also be taken to check possible bacteria, while the urine test may help to rule out urinary tract infection, which causes similar pelvic pain. Also, the doctor could order for an ultrasound to get clearer images of the reproductive system or CT scans to help detect abnormal structures or growth. Another diagnostic study to be ordered is laparoscopy to view the pelvic organs and check for abnormal tissues or signs of infection.

List the primary diagnosis and three differential diagnoses for this patient. Explain your reasoning for each

Primary diagnosis – Pelvic inflammatory disease – The patient is sexually active and admits to having multiple sexual partners without using a condom. Besides, she has admitted pain and tenderness in the lower abdomen.

Differential diagnoses

Urinary tract infection – Having multiple sexual partners and sometimes without a condom could have caused urinary tract infection.

Ovarian torsion – The patient has come with symptoms of severe pelvic pain that she rates as 10 out of 10.

Endometriosis – The patient admits abdominal cramping and pain in the lower abdomen and pelvis.

Discuss your management plan for this patient, including pharmacologic therapies, tests, patient education, referrals, and follow-ups.

The main goal in the management plan of this patient is to alleviate symptoms and improve her quality of life. The patient needs some pain relievers such as ibuprofen or acetaminophen to provide partial relief from her pelvic pain. The patient may also need some antibiotics to help in case of any infection. In addition, the patient may be prescribed antidepressants to help improve the pelvic pain. Also, the patient needs to be educated about the benefits of practicing safe sex, particularly using condoms every time she has sex and to limit the number of sexual partners (Sanfilippo et al., 2019). She should also be advised to make an appointment for regular screening of sexually transmitted diseases and request her partners to be also tested. Also, the patient can be referred to physical therapists to help her develop coping strategies for the pain. Such include stretching exercises, massage, and other relaxation techniques.

References

Stratton, P. (2019). Evaluation of acute pelvic pain in non-pregnant adult women. UpToDate. Updated May, 9.

Sanfilippo, J. S., Smith, J. P., & Solnik, M. J. (2019). Chronic pelvic pain and endometriosis. In Sanfilippo’s Textbook of Pediatric and Adolescent GynecologySecond Edition (pp. 214-228). CRC Press.

Smorgick, N., & As-Sanie, S. (2018, March). Pelvic pain in adolescents. In Seminars in reproductive medicine (Vol. 36, No. 02, pp. 116-122). Thieme Medical Publishers.

CP – Week 1 Discussion 1st REPLY

CP – Week 1 Discussion 1st REPLY

Reply to the following discussion by supporting the post.  You will want to focus on their point of view, asking pertinent questions, adding to the responses by including information from other sources. Be objective, clear, and concise. 

It is important to support what you say with relevant citations in the APA format from both the course materials and outside resources. 

LH Discussion:

Pediatric Depression

This is a controversial topic and has piqued the interest to explore it further because of the potential adverse impacts, specifically increased risk for violence/aggression, of SSRI therapy in treating adolescent depression. Depression is an overwhelming phenomenon for which there is a wide array of treatment options. It has been suggested and heavily scrutinized that the use of antidepressant medications in the treatment of depression in adolescents and young adults can increase violent or suicidal behavior (Bielefeldt, Danborg, & Gotzsche, 2016).  Youth violence is a growing and significant public health concern that results in the premature death of thousands of people annually (David-Ferdon et al., 2016).  Due to the seriousness of this often-silenced epidemic, it has long been the CDC’s goal to prevent youth violence from occurring in the first place (“CDC ,” 2021).  To successfully achieve this health promotional goal, providers must strive to better understand and address questionable and contributing risk factors. Youth violence can be prevented (David-Ferdon et al., 2016).

It was reported two weeks ago that an adolescent boy from Iowa was arrested for brutally stabbing his parents to death with a knife and axe inside their home. When the authorities arrived at the scene of this tragic crime, the 17-year-old teen was sitting outside his house and claimed the reason behind his violent act was that he just wanted to regain control of his life (Casiano, 2021).  Where, as a society focused on the promotion of health and prevention of youth violence, is the gap, that so many mentally unstable young people slip through the cracks without early screening and treatment intervention? What are the safest interventions for treating an underlying pediatric depression or other behavioral disorders? If there is a better and safer form of antidepressant therapy for adolescents and young adults than the typical first line SSRI pharmacotherapy, then more statistically significant research evidence is needed to support this theory (Maroun, Thackeray, & Midgley, 2018).  The only way to determine best practice standards is to challenge the existing ones.

References

Bielefeldt, A., Danborg, P. B., & Gotzsche, P. C. (2016, October 11). Precursors to suicidality and violence on antidepressants: Systematic review of trials in adult health volunteers. JRSM, 109(10), 381-392. http://dx.doi.org/10.1177/0141076816666805

Casiano, L. (2021, October 15). Iowa teen covered in blood admits to killing parents with knife and axe, police say. Fox News . Retrieved from /orders/www.foxnews.com/us/iowa-teen-covered-in-blood-admits-to-killing-parents-with-knife-and-axe-police-say

David-Ferdon, C., Vivolo-Kantor, A. M., Dahlberg, L. L., Marshall, K. J., Rainford, N., & Hall, J. E. (2016). A comprehensive technical package for the prevention of youth violence and assoicated risk behaviors . Retrieved from /orders/www.cdc.gov/violenceprevention/pdf/yv-technicalpackage.pdf

Maroun, R. A., Thackeray, L. A., & Midgley, N. (2018, November 28). Meaning and medication: a thematic analysis of depressed adolescents’ views and experiences of SSRI antidepressants alongside psychological therapies. BMC Psychiatry , 18(374). http://dx.doi.org/10.1186/s12888-018-1961-y

Violence prevention strategies . (2021). Retrieved from /orders/www.cdc.gov/violenceprevention/youthviolence/prevention.html

Women Health – Week 4 Discussion 2nd REPLY

Please reply to the following discussion with one reference. Participate in the discussion by asking a question, providing a statement of clarification, providing a point of view with a rationale, challenging an aspect of the discussion, or indicating a relationship between two or more lines of reasoning in the discussion. Cite resources in your responses to other classmates.

Discussion

Discuss the questions that would be important to include when interviewing a patient with this issue, including any risk factors she may have.

While interviewing the patient presenting with this specific issue, it would be essential to ask her regarding the exact location and position of the masses within the patient’s breast. It would also be imperative to ask the patient about the duration or period regarding the symptoms, the absence, the presence of pain, and the course regarding the symptoms (Sethi, 2016). It would also be essential to determine whether she has ever experienced the same complaint before, the treatment administered given that is the case, and the outcome concerning the remedy. Besides, any other signs or symptoms the patient has experienced and the realization of the masses are equally essential to ascertain, such as nipple discharge, loss of weight, and fatigue.

Describe the clinical findings that may be present in a patient with this issue.

The primary clinical findings that would be present are the two painless lumps located on the right breast and a significant loss in weight (Sethi, 2016). Patients with breast cancer are likely to develop concerns related to dimpling of the breasts and breast swelling. Breast dimpling and breast discharge are also remarkable clinical findings manifested in a person having this issue.

Are there any diagnostic studies that should be ordered on this patient? Why?

To confirm the exact diagnosis, it would be pertinent to order further diagnostic studies for her. The first diagnostic tests that are recommended for CM in this scenario relates to the Magnetic Resonance Imaging (MRI) and a mammogram which would be deployed in providing detailed images about the breast, which in turn would indicate whether or not she has breast cancer (Shoko Vos et al., 2016). In addition, a primary needle biopsy would be used to remove or take some samples regarding the breast tissue. The biopsy will assist in determining if the patient has the issue of breast cancer.

List the primary diagnosis and three differential diagnoses for this patient. Explain your reasoning for each.

The primary diagnosis for this patient relates to breast cancer, and this is supported by the fact that the patient has two lumps located on the right breast. The presence of family history regarding breast cancer and the fact that the patient previously had atypical lobular hyperplasia also ate risk factors for the patient’s high likelihood of having breast cancer. The other three differential diagnoses which would be considered in this scenario encompass breast cysts, breast lipoma, and fibroadenoma (Shoko Vos et al., 2016).

The presence of lumps typically characterizes breast cysts, and as such, they ought to be incorporated in this patient’s diagnosis. Also, patients presenting with breast fibroadenoma have painless nodes, making this a likely diagnosis for this patient.

Discuss your management plan for this patient, including pharmacologic therapies, tests, patient education, referrals, and follow-ups.

The pharmacological treatment for breast cancer for this patient will encompass the administration of methotrexate, cyclophosphamide, and 5-fluorouracil (5-FU) since these drugs have the potential of inhibiting the progression of breast cancer (Shoko Vos et al., 2016). In regards to patient education, CM will be informed to take a diet rich in vegetables, fruits, fresh foods, and fish since this has the potentiality of reducing the risks associated with the development of breast cancer. The patient will also be informed to engage in regular physical activity and exercises (Shoko Vos et al., 2016). Finally, the patient will be advised to revisit the healthcare facility given that her symptoms worsen.

References

Sethi, S. (2016). MiRNAs and target genes in breast cancer metastasis (3rd ed., p. 78). New York: Springer.

Shoko Vos, S., Farhad Vesuna, F., Raman, V., van Diest, P., & Groep, P. (2016). miRNA expression patterns in normal breast tissue and invasive breast cancers of BRCA1 and BRCA2 germ-line mutation carriers. Oncotarget, 6(31). http://dx.doi.org/10.18632/oncotarget.5617

Assignment: Policy/Regulation Fact Sheet

As a professional nurse, you are expected to apply your expertise to patient care. On occasion, you will also be expected to share that expertise.

With evolving technology and continuous changes to regulations designed to keep up these changes, there is usually a need to share information and expertise to inform colleagues, leadership, patients, and other stakeholders.

In this Assignment, you will study a recent nursing informatics-related healthcare policy, and you will share the relevant details via a fact sheet designed to inform and educate.

To Prepare:

• Review the Resources on healthcare policy and regulatory/legislative topics related to health and nursing informatics.
• Consider the role of the nurse informaticist in relation to a healthcare organization’s compliance with various policies and regulations, such as the Medicare Access and CHIP Reauthorization Act (MACRA).
• Research and select one health or nursing informatics policy (within the past 5 years) or regulation for further study.

The Assignment: (  not including the title and reference page)

Create a  fact sheet that your healthcare organization could hypothetically use to explain the health or nursing informatics policy/regulation you selected. Your fact sheet should address the following:

• Briefly and generally explain the policy or regulation you selected.
• Address the impact of the policy or regulation you selected on system implementation.
• Address the impact of the policy or regulation you selected on clinical care, patient/provider interactions, and workflow.
• Highlight organizational policies and procedures that are/will be in place at your healthcare organization to address the policy or regulation you selected. Be specific.
• Use APA format and include a title page, in-text citations, and reference page.
• Use the Safe Assign Drafts to check your match percentage before submitting your work.
  

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  Who We Are 

  We are a professional custom writing website. If you have searched for a question and bumped into our website just know you are in the right place to get help with your coursework.

  Do you handle any type of coursework?

  Yes. We have posted our previous orders to display our experience. Since we have done this question before, we can also do it for you. To make sure we do it perfectly, please fill out our Order Form. Filling the order form correctly will assist our team in referencing, specifications, and future communication.

  Is it hard to Place an Order?

  • 1. Click on “Order Now” on the main Menu and a new page will appear with an order form to be filled.
  • 2. Fill in your paper’s requirements in the “PAPER INFORMATION” section and the system will calculate your order price/cost.
  • 3. Fill in your paper’s academic level, deadline, and the required number of pages from the drop-down menus.
  • 4. Click “FINAL STEP” to enter your registration details and get an account with us for record-keeping and then, click on “PROCEED TO CHECKOUT” at the bottom of the page.
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  • Discussion Questions (DQ)

  Initial responses to the DQ should address all components of the questions asked, including a minimum of one scholarly source, and be at least 250 words. Successful responses are substantive (i.e., add something new to the discussion, engage others in the discussion, well-developed idea) and include at least one scholarly source. One or two-sentence responses, simple statements of agreement or “good post,” and responses that are off-topic will not count as substantive. Substantive responses should be at least 150 words. I encourage you to incorporate the readings from the week (as applicable) into your responses.

  • Weekly Participation

  Your initial responses to the mandatory DQ do not count toward participation and are graded separately. In addition to the DQ responses, you must post at least one reply to peers (or me) on three separate days, for a total of three replies. Participation posts do not require a scholarly source/citation (unless you cite someone else’s work). Part of your weekly participation includes viewing the weekly announcement and attesting to watching it in the comments. These announcements are made to ensure you understand everything that is due during the week.

  • APA Format and Writing Quality

  Familiarize yourself with the APA format and practice using it correctly. It is used for most writing assignments for your degree. Visit the Writing Center in the Student Success Center, under the Resources tab in Loud-cloud for APA paper templates, citation examples, tips, etc. Points will be deducted for poor use of APA format or absence of APA format (if required). Cite all sources of information! When in doubt, cite the source. Paraphrasing also requires a citation. I highly recommend using the APA Publication Manual, 6th edition.

  • Use of Direct Quotes

  I discourage over-utilization of direct quotes in DQs and assignments at the Master’s level and deduct points accordingly. As Masters’ level students, it is important that you be able to critically analyze and interpret information from journal articles and other resources. Simply restating someone else’s words does not demonstrate an understanding of the content or critical analysis of the content. It is best to paraphrase content and cite your source.

  • LopesWrite Policy

  For assignments that need to be submitted to Lopes Write, please be sure you have received your report and Similarity Index (SI) percentage BEFORE you do a “final submit” to me. Once you have received your report, please review it. This report will show you grammatical, punctuation, and spelling errors that can easily be fixed. Take the extra few minutes to review instead of getting counted off for these mistakes. Review your similarities. Did you forget to cite something? Did you not paraphrase well enough? Is your paper made up of someone else’s thoughts more than your own? Visit the Writing Center in the Student Success Center, under the Resources tab in Loud-cloud for tips on improving your paper and SI score.

  • Late Policy

  The university’s policy on late assignments is a 10% penalty PER DAY LATE. This also applies to late DQ replies. Please communicate with me if you anticipate having to submit an assignment late. I am happy to be flexible, with advance notice. We may be able to work out an extension based on extenuating circumstances. If you do not communicate with me before submitting an assignment late, the GCU late policy will be in effect. I do not accept assignments that are two or more weeks late unless we have worked out an extension. As per policy, no assignments are accepted after the last day of class. Any assignment submitted after midnight on the last day of class will not be accepted for grading.

  • Communication

  Communication is so very important. There are multiple ways to communicate with me: Questions to Instructor Forum: This is a great place to ask course content or assignment questions. If you have a question, there is a good chance one of your peers does as well. This is a public forum for the class. Individual Forum: This is a private forum to ask me questions or send me messages. This will be checked at least once every 24 hours.

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Advance Pathophysiology Case Study NP Program

42-year-old man presents to ED with 2-day history of dysuria, low back pain, inability to fully empty his bladder, severe perineal pain along with fevers and chills. He says the pain is worse when he stands up and is somewhat relieved when he lies down. Vital signs T 104.0 F, pulse 138, respirations 24. PaO2 96% on room air. Digital rectal exam (DRE) reveals the prostate to be enlarged, extremely tender, swollen, and warm to touch.

Develop a 1- to 2-page case study analysis, examining the patient symptoms presented in the case study. 

Explain why prostatitis and infection happen. Also explain the causes of systemic reaction.

Laboratory Week 9: Soap Note #1 ADULT : Hypothyroidism

Soap Note 1 “ADULT”  Hypothyroidism Follow the Soap Note:

Use APA format and must include mia minimum of 2 Scholarly Citations.

Must use the sample templates for your soap note. Keep this template for when you start clinicals.

The use of templates is ok with regards to Turn it in, but the Patient History, CC, HPI, Assessment, and Plan should be of your own work and individualized to your made-up patient.

please use the template

Women Health – Week 4 Discussion 1st REPLY

Women Health – Week 4 Discussion 1st REPLY

Women Health – Week 4 Discussion 1st REPLY

question, providing a statement of clarification, providing a point of view with a rationale, challenging an aspect of the discussion, or indicating a relationship between two or more lines of reasoning in the discussion. Cite resources in your responses to other classmates.

2) Also, answer the following question in a separate small paragraph with one reference.

Question: She tells you she uses topical progesterone, does this make a difference?

Discussion

Discuss the questions that would be important to include when interviewing a patient with this issue, including any risk factors she may have.

Some of the questions that the clinician may ask the patient will include the following: At what age did the patient begin menarche? How long has the mass been present? Do you have a history of breast lumps? Did the lump change in size with your menstrual cycle? How long has it been since your last menses? Is there any discharge coming from the nipple? Did you experience recent weight loss? Did you take any hormone replacement therapy (HRT)? Did you have any trauma to the breast? Have you had a mammogram or breast biopsies and when and what were the results?  Do you have a family history of breast cancer?  Do you have any diagnosis of breast cancer (Hawkins, Roberto-Nichols, & Stanley-Haney, 2016)?

 Describe the clinical findings that may be present in a patient with this issue. Are there any diagnostic studies that should be ordered on this patient? Why?

The patient with the diagnosis will breast cancer may not experience any symptoms in the initial stages of the development of the disease. Indicators that dictate the progression of the disease includes the following symptoms that the person experiences such as a change in the size, shape, or skin changes of the breast, color, skin dimpling, nipple inversion, nipple abnormalities, discharge, and axillary lump (Koo, Wagner, Abel, McPhail, & Rubin, 2017). To detect a difference in the breast, tissue the patient must be examined upright with arms raised, hands pressed against hips, and leaning forward. The axillae and the supraclavicular sites should be assessed when examining the breast tissue. The best technique to use detect a mass when palpating the breast is the vertical strip pattern (Bickley, 2017). The diagnosis of breast cancer is determined through diagnostic mammography and breast biopsy. The use of the diagnostic mammogram assists the clinician in determining the presence of a benign or malignant tumor in woman older than 40 years old. A breast tissue biopsy is used to obtain a large tissue sample of a mass to be examined to determine the presence of cancerous cells in the breast tissue (Koo et al., 2017)

 List the primary diagnosis and three differential diagnoses for this patient. Explain your reasoning for each.

The primary diagnosis:

Breast cancer- The diagnostic test revealed that the patient has breast cancer (invasive ductal carcinoma estrogen-receptor positive progesterone-receptor positive) the diagnosis is distinctive due to the risk factor of the patient’s previous history of atypical hyperplasia of the breast. The diagnosis of atypical hyperplasia of the breast is considered a high-risk breast mass that predisposes the patient to breast cancer. Additionally, the patient has a first-degree relation that was diagnosed with breast cancer. The breast biopsy results solidify the diagnosis of breast cancer (Hartmann, Degnim, Santen, Dupont, & Ghosh, 2015).

Differential diagnoses:

Fibrocystic Disease- The diagnosis for fibrocystic breast disease is a possibility for the patient as she presents with the clinical manifestation of possibly asymptomatic singular or multiple palpable smooth breast mass or a mobile round lump. The fibrocystic breast commonly occurs between the age of 30-50 years of age. The breast changes affiliated with fibrocystic disease comprises of atypical ductal and epithelial hyperplasia (Malherbe & Fatima, 2021). However, this is not the diagnosis as the mass does not change with the onset of the patient’s menses.

Fibroadenomas- The diagnosis of fibroadenomas as they are glandular fibrous tissue that occur during the reproductive year which may be associated with hormone production (Williams, 2018). A risk factor related to fibroadenoma is a familial history of breast disease. The mass is typically a benign painless mobile mass. The diagnosis is of fibroadenoma as the lesion does not fluctuate with the presence of the patient’s menses.

Breast Lipoma- The differential diagnosis of a breast lipoma is possible they can be benign or cancerous as they are the most common soft tissue tumor. A breast lipoma is a unilateral, smooth, soft, painless mass that occur between the ages of 40 to 60 years of age. The diagnosis is not apparent as the pathologic interpretation of the breast biopsy indicates that the patient has breast cancer cancer (Domino, Baldor, Golding, & Stephens, 2017)

Discuss your management plan for this patient, including pharmacologic therapies, tests, patient education, referrals, and follow-ups.

The course of treatment for the patient would involve a consult with the oncologist to direct and guide the course of treatment. The oncologist may prescribe Tamoxifen 20 mg twice a day as the form of cancer that the patient has is hormonal estrogen-receptor positive (Hartman et al., 2015). The patient may also have a lumpectomy of the right breast to remove the disease. A follow-up with radiation therapy to ensure eradication of the disease Hartman et al., 2015).  She will have a mammogram six to twelve month after radiation. A mammogram one year after that.  An annual gynecologic examination. The patient is instructed to not have blood pressure taken on the right arm due to lymphedema. The patient is instructed to observe for new lumps, pain (in bone, chest, stomach), shortness of breath, and headaches.

References

Bickley, L. S. (2017). Bates’ guide to physical examination and history taking (12th ed.). [South University]. Retrieved from /orders/digitalbookshelf.southuniversity.edu/#/books/9781496354709/cfi/372!/4/4@

Domino, F. J., Baldor, R. A., Golding, J., & Stephens, M. B. (2017). The five-minute clinical consult 2018 (26th ed.). Philadelphia, PA: Wolter Kluwer Health/Lippincott Williams & Wilkins

Hartmann, L. C., Degnim, A. C., Santen, R. J., Dupont, W. D., & Ghosh, K. (2015). Atypical hyperplasia of the breast-Risk assessment and management options. New England Journal of Medicine, 372(78).  Retrieved from /orders/www.nejm.org/doi/pdf/10.1056/NEJMsr1407164

Hawkins, J. W., Roberto-Nichols, D. M., & Stanley-Haney, J. L. (2016). Guidelines for nurse practitioners in gynecologic settings (11th ed.). New York, NY: Springer Publishing Company

Malherbe, K. & Fatima, S. (2021).  Fibrocystic breast disease.  StatPearls.  Retrieved from /orders/ncbi.nlm.nih.gov/books/NBK551609/

Williams, J. (2018).  Education case: Fibroadenoma of the breast.  Academic Pathology. /orders/doi.org/10.1177/2374289518790926

Women Health – Week 8 Discussion 2nd REPLY

Please reply to the following discussion with one reference. Participate in the discussion by asking a question, providing a statement of clarification, providing a point of view with a rationale, challenging an aspect of the discussion, or indicating a relationship between two or more lines of reasoning in the discussion. Cite resources in your responses to other classmates.

Discussion:

Discuss any “take-away” thoughts from the articles.

Reading the two articles about the care and management of LGBTQ patients was very informative. The LGBTQ community experience particular stressors due to their status as a sexual minority group in the hostile social environment. LGBTQ are faced with various stressors such as discrimination, prejudice, and stigma. This increased stress has significantly contributed to major health issues, especially the major health needs. LGBTQ challenges are not only confined to their social environment but also in the health sector where they also have similar difficulties in seeking treatment. As mentioned in one of the articles, one challenge we have is that a female to male transgender who still carries the female reproductive organs will still need to be screened for cervical cancer. This is a significant problem in healthcare as the system does not allow one to order a PAP smear test on a male patient. Similarly, healthcare professionals have been unable to order PSA screening on a female patient. Also, the article by Paradiso and Lally highlight lack of available published evidence on transgender care, mentioning one of nurse’s disappointment when she could not find a research on caring for transgender patients (Paradiso & Lally, 2018). Reading the articles made me severely saddened by the huge disparity between the numbers of heterosexuals who committed suicide and gay lesbian or bisexual numbers. Due to discrimination in the society, LGBTQ population are likely to have high levels of stressors, substance abuse, and suicidal ideation (Landry, 2017).  In view of this, it is important for healthcare professionals to become sensitive and create comfortably inclusive environment for their patients and work toward understanding their patients so as to provide the best care.

How do you plan to make a positive impact on the care of LGBT patients when you become a NP?

One way I plan to impact the care for LGBT patients is by meeting each patient with compassionate and judgement-free care. I will make this possible by creating a safe and comforting environment for all my patients to promote a healthy patient-provider relationship, which allows for open, honest, and trusting communication. Also, as an NP, I plan to show each and every patient their deserved respect and spend time with them to build a trusting relationship. Research shows that patients who trust their providers are more likely to open up about their feelings and insecurities, thus helping address their mental health concerns that often go undiagnosed and untreated (Greene & Ramos, 2021). Also, I intend to remain open and honest about any questions I may have so as to make the patients help me understand their concerns.

What attitudes/behaviors/communication/understanding is important for the NP to have?

The most important thing for an NP is to remain neutral and avoid judgmental and assumptive interactions. The NPs should consider asking open-ended and generalized questions so as to allow patients to openly share their experiences, preferences, and sexual identity. Nevertheless, the NP should be supportive of every patient’s sexual orientation and gender.

What specific screenings / interventions will you incorporate into practice when providing care to a LGBT patient?

The most important screening intervention for LGBTQ patient is to make sure you ask about their mental health and their moods. In particular, asking them if they feel safe at home or in their relationships will help give a clear picture of their feelings at home. This can help determine any signs of depression or anxiety and thus provide them with resources and support groups. Also, it would be important to screen them for alcohol and other substance abuse. Further, it would be important to assess and screen patients who may still have sex organs from the gender they do not identify with. In particular, a Pap smear test can be done on a trans-male, while a hernia exam can be ordered on a trans-female. It is of great importance to make the patients feel comfortable when performing these exams.

References

Greene, J., & Ramos, C. (2021). A mixed methods examination of health care provider behaviors that build patients’ trust. Patient Education and Counseling, 104(5), 1222-1228.

Landry, J. (2017). Delivering culturally sensitive care to LGBTQI patients. The Journal for Nurse Practitioners, 13(5), 342-347.

Paradiso, C., & Lally, R. M. (2018). Nurse practitioner knowledge, attitudes, and beliefs when caring for transgender people. Transgender health, 3(1), 48-56.

Week 6 SOAP NOTE

Create a SOAP NOTE using the guidelines and template provided below.

CC:  My period is 22 days, I have pelvic pain and also noted some dark vaginal bleeding since yesterday.

Guidelines:

Subjective Information: “CC”, HPI :OPQRST IF f/u: health status since the last visit, response to therapies. PMH, PSH, FH, ROS complete.

Objective Information: Complete physical exam with critical elements related to subjective data.

Assessment: Minimum of 3 differentials supported by S + O data Final diagnosis noted, and optimal and thorough subjective and objective assessment is presented for final diagnosis.

Plan: Diagnostic tests/therapies/follow-up, Patient education, health promotion. Medications listed with dosage/SE/Education/

Analyze quality and relevance of S + O data and the evidence for diagnosis. Use of clinical evidence-based reasoning & literature in designing plan of care, compare to plan of care implemented.

SOAP NOTE