nursing

/in /by

Introduction to Public Health Virtual Simulation

Complete Introduction to Public Health at https://phtc-online.org/learning/?courseId=15

In this interactive online module, students will learn about introductory concepts in public health. Click on Enroll. You will go to a Login Screen ….at bottom click on create an account now. Create an account. Click on Training Module at the top of the page. Select Orientation to Public Health. Click on Enroll. Read the information and click on Begin Orientation to Public Health. Click on Please check your inbox – A.T. to begin. Complete the training, take a screenshot of the certificate, or scan the certificate and upload it to the course drop box. The online module takes about 45-60 minutes to complete. At the end, students will obtain a screenshot of the Summary screen and upload the screenshot to the assignment drop box for grade credit. In addition, students will write a paragraph in APA format and include one evidence-based journal reference (within the last 5-7 years supporting the definition and synthesis of public health nursing practice. You must submit the word document paragraph summary to the respective assignment dropbox.

HEE week 2 peers resp

/in /by

Hum Ecology & Environment

Peers response

Your responses should consist of your informed input. One or two-sentence peer responses will not fetch full points. Do not merely recite the content you read in the unit; don’t simply give your opinion.

Your input should be in your own words (to avoid plagiarism), demonstrating your understanding and comprehension of the topic. Be sure to support all your posts (initial post + responses) with specific references to the assigned readings, lecture material, and other relevant research you find appropriate in APA format.

1st peees response

Octavia Dykes

Food insecurity and food scarcity by definition are different. Food Insecurity is caused by a lack of means to obtain food with the leading cause being income. Food scarcity is the lack of food available this could be caused by location or production. Both situations create hunger.  A person with food insecurity could be near a market with available goods but have limited or no money to buy food.  A person with food scarcity may have the money for goods at the market but the closest market with goods available is an hour's drive away or the market close by has limited goods available for sale. 
 These would be densely populated areas without an adequate grocery source or areas of very low population where there are no grocery stores until the next major city (The Annie E. Casey Foundation, 2021).  “
It is not confined to one single sector, sub-system (e.g. value chain, market) or discipline, and thus broadens the framing and analysis of a particular issue as the result of an intricate web of interlinked activities and feedbacks. It considers all relevant causal variables of a problem and all social, environmental, and economic impacts of the solutions to achieve transformational systemic changes” (Food and Agricultural Organization of the United Nations. (2018). Sustainable food systems.).

As nurses, we can assess our patients for having signs of being malnourished, and be observant of those that tend to hoard every scrap left on their tray for “later”, these are in my experience the patients having food security issues outside of the hospital. We can provide resources before they discharge, such as their closest food banks and food drive locations so that they may receive these resources. The hospital I work for does monthly community service events, it’s usually a food bank so that we can collect and give food out to those in need. As nurses, we can get involved within these communities. I’m not saying use all your free time but a few hours one weekend a month is such a great help with soap kitchens, food drives, food banks, etc.

 

References: 

Food and Agricultural Organization of the United Nations. (2018). 
Sustainable food systems. 

http://www.fao.org/3/ca2079en/CA2079EN.pdf

The Annie E. Casey Foundation. (2021). 
Food Deserts in the United States. 


https://www.aecf.org/blog/exploring-americas-food-deserts

2nd peer response

Zoe Snider

Food insecurity refers to the lack of consistent access to food. Chronic food insecurity can lead to various health problems among vulnerable populations such as children, the elderly, and those with pre-existing health conditions (Nord, Coleman-Jensen, Andrews, & Carlson, 2020, p. 1). Food insecurity can be on the individual level or the community level. Food scarcity on the other hand is more of a systemic issue, affecting the population. Multiple factors can cause food scarcity including adverse weather conditions, population growth, and political climate (Kanter, Redmond, & Wansink, 2013). When looking at what impacts food security the most I quickly thought consumption would play the largest role. Food production cannot keep up with the amount of food that humans are consuming. This could be from overpopulation. The relationship between food and race takes a look at the community's access to healthy, sustainable food. These communities may only have convenience stores and fast food supplying them with their weekly food intake. Not only would they have to travel farther for healthy food, but it also is much more expensive than a fast food dinner. Nurses can detect food insecurities in a multitude of ways. A basic assessment would tell a nurse a lot. Direct questioning can go a long way! This is why rapport with patients is important. 

 

Kanter, D. R., Redmond, L., & Wansink, B. (2013). Food scarcity and obesity: A view from behavioral economics. American Journal of Preventive Medicine, 45(5), 651-658.

Nord, M., Coleman-Jensen, A., Andrews, M., & Carlson, S. (2020). Household Food Security in the United States in 2019. U.S. Department of Agriculture, Economic Research Service. 

pn1 m9 diss

/in /by

 

Directions:

You are caring for a patient that has a high pain tolerance due to chronic pain and does not look like they are in pain. What would you do if they asked for more pain medication?

Cultural-Week 3 Neighborhood Evaluation

/in /by

 

Statistical Atlas

Utilize the Statistical Analysis website to locate your neighborhood. Explore the topics, which include demographics, income, and education. Upload your assignment on a word document. No APA format required for this assignment. Provide a breakdown of the population in either your neighborhood or place of work. 

https://statisticalatlas.com/United-States/OverviewLinks to an external site.

Gas Exchange

/in /by

 

Mr. Nguyen is a 58-year-old patient that had septic shock and developed Acute Respiratory Distress Syndrome. He is orally intubated and on a mechanical ventilator. He is paralyzed and sedated.

  • What manifestations might you observe for a patient with ARDS?
  • What complications can Mr. Nguyen develop from being mechanically ventilated?
  • List priority nursing interventions to prevent complications associated with ventilatory support.
  • What interventions can be implemented specifically to prevent the development of Ventilator Acquired Pneumonia (VAP)?
  • You are orienting in the ICU, the nurse you are working with is not implementing the VAP interventions. What would you do?

Discussion Post- Presentation Reflection

/in /by

Please answer the questions below on regards of   

Inadequate Pain Management in Postoperative Patients

  1. Regarding your presentation assignment, what did you learn about the research project?
  2. Would you have approached the assignment differently? Why or why not?

 

Submission Instructions:

  • Post should be at least 500 words, formatted and cited in current APA style with support from at least 2 academic sources. 

Nursing assignment 1-a

/in /by

 

After studying Module 2: Lecture Materials & Resources, submit the following:

  • Starting with the precursor substance tyrosine or tryptophan, draw three diagrams showing how the various enzymes convert this substance to serotonin, dopamine and norepinephrine.

Submission Instructions:

  • Your diagrams must be hand-drawn. Scan your diagrams and submit them as an attachment of an image file or PDF. 
  • Follow APA 7th Edition formatting guidelines for graphs and figuresLinks to an external site.
  • Complete and submit the assignment by 11:59 PM ET on Sunday.
  • Late work policies, expectations regarding proper citations, acceptable means of responding to peer feedback, and other expectations are at the discretion of the instructor.
  • You can expect feedback from the instructor within 48 to 72 hours from the Sunday due date.

Clinical practice questions

/in /by

Please see the attachment for instruction 

Week 6 ion channel —2 Peer Response 600w. due 10-12-23

/in /by

Week 6 ion channel —2 Peer Response 600w. due 10-12-23

Please read and respond to at least two of your peers' initial postings. You may want to consider the following questions in your responses to your peers:

· Compare and contrast your initial posting with those of your peers.  

· How are they similar or how are they different?

· What information can you add that would help support the responses of your peers?

· Ask your peers a question for clarification about their post.

· What most interests you about their responses? 

Please be sure to validate your opinions and ideas with citations and references in APA format.

IA

This is a very interesting case since Sam is only 19 years old and has a history of major depressive disorder (MDD) and also generalized anxiety disorder (GAD). At a glance, I noticed that his behavior has highs and lows since he has gone from being violent by throwing a chair at a store window to having a “resounding moment” where everything makes sense. Among many other clues, this leads me to believe Sam can be newly diagnosed with bipolar disorder with manic episodes.

After consulting our DSM-5-TR book on page 140, I also realized Sam presents multiple symptoms that represent the diagnosis of bipolar disorder. To start Sam preceded a “psychotic breakdown” along with a history of MDD. He has also presented physiologic changes like diminished sleep, and other signs, and symptoms of a manic episode (Diagnostic and Statistical Manual of Mental Disorders: DSM-5-TR 2022). It also appears he is more talkative than usual by engaging his colleagues for long hours in conversation. Adding on to his symptoms it also appears he has engaged in high-risk behaviors such as drinking and sexual relations which was not his norm before. He has thought of himself as being better than the professors which match the ideas of grandiosity.

At first, I wasn’t sure which medication to prescribe, but it seems he would benefit from lithium since lithium is an antimanic medication primarily used to treat bipolar disorder(Lithium, 2022). Sources such as MedlinePlus indicate lithium is a mood stabilizer and works by releasing dopamine and serotonin in the brain (Lithium: MedlinePlus Drug Information 2023). Just like this case, I have seen many but now I see things differently since I know more in-depth the signs and symptoms as well as researching the proper medication.

References:

Diagnostic and statistical manual of mental disorders: DSM-5-TR (5th ed.). (2022). . American Psychiatric Association Publishing.

Stahl, S. M. (2021). Stahl’s essential psychopharmacology: The Prescriber’s Guide (7th ed.). Cambridge University Press.

Townsend., K. I. M., Mary C. (2020). Essentials of Psychiatric Mental Health Nursing, 8th edition. F.A. Davis.

MAM

Week 6, Medication for Bipolar Disorders

What diagnosis do you believe may apply to this individual?

The patient is a young boy presenting with a 'psychotic break,' characterized by reckless behaviors, sudden and unconventional decision-making (such as changing his major in university), distractibility, reduced need for sleep, a heightened sense of knowledge and grandiosity (believing he can teach courses in the university), and unusual beliefs regarding the nature of reality and his newfound appreciation for life. He is also engaging in high-risk behaviors, including excessive drinking, sexual activity, violence, increased spending, and initiating numerous projects without completing any. These symptoms are indicative of a manic episode (if they present more than a week).

Considering the patient's history of Major Depressive Disorder (MDD) and anxiety disorder, the diagnosis of Bipolar I Disorder (BPD) has been established. It is crucial to first rule out any medical problems, brain trauma, substance abuse, and other mental disorders that may be included in the differential diagnosis of BPD. The primary distinction between bipolar I and II lies in the nature of the manic or hypomanic episodes. In bipolar I disorder, individuals experience full manic episodes that typically last for at least one week. On the other hand, bipolar II disorder is characterized by hypomanic episodes, which are milder in intensity and shorter in duration, lasting no more than four days (Stahl, 2021).

Beyond this key difference, there are also variations in the clinical course and family history associated with these two subtypes. Individuals with bipolar II disorder tend to receive their diagnosis later in life, and their first experience of hypomania occurs at an older age compared to those with bipolar I disorder. These distinctions in age of onset and diagnostic patterns contribute to the differentiation between bipolar I and II disorders (Brancati et al., 2023).

Manic often presents with the feeling of being extremely important and having a very high opinion of oneself, sometimes to the point of having false beliefs about one's capabilities (Howse et al., 2023). In this case, the patient believes he is capable of teaching at the university. An experienced Psychiatric Mental Health Nurse Practitioner (PMHNP) can conduct a thorough history assessment to determine whether the psychosis is linked to brain traumas, substance use, schizoaffective disorders, or BPD.

What classifications of medications can be used to treat this disorder? Which medication do you recommend and why?

When the patient is diagnosed with Bipolar disorder, it indicates the need for mood stabilizers. Various mood stabilizers are available, including Lithium, Lamotrigine, Valproic Acid, and Carbamazepine. According to Stahl (2021), Lithium is considered the foundational and standard treatment for bipolar disorder and acute mania. However, this medication comes with several potential side effects, such as tremors, nephrotoxicity (Diabetes Insipidus), hypothyroidism, dyspepsia, nausea, vomiting, diarrhea, weight gain, hair loss, acne, sedation, decreased cognition, and incoordination. It can also lead to EB Stain anomalies in the fetus if taken during pregnancy.

Lithium additionally has a very low therapeutic index, signifying that the lethal dose of this medication is very close to the therapeutic level in the blood. Therefore, monitoring of blood levels of this medication is crucial throughout the treatment process. Regular assessments of kidney function, thyroid hormone levels, and electrolytes are also necessary. Lithium effectively stabilizes mood and reduces the severity of manic episodes (Stahl, 2021). Alongside medication, psychotherapy, such as cognitive-behavioral therapy or family-focused therapy, plays an essential role in treatment. It is equally important to educate the patient's family members about the disease and the treatment process.

References

Brancati, G. E., Nunes, A., Scott, K., O’Donovan, C., Cervantes, P., Grof, P., & Alda, M. (2023). Differential characteristics of bipolar I and II disorders: a retrospective, cross-sectional evaluation of clinical features, illness course, and response to treatment. International Journal of Bipolar Disorders, 11(1), 25. https://doi.org/10.1186/s40345-023-00304-9

Howse, J., Kanter, J., Muhammad, Q. C., & Wojcik, K. D. (2023). Mood disorders with psychotic features: Diagnostic considerations and treatment challenges. Psychiatric Annals, 53(4), 160-165. https://doi.org/10.3928/00485713-20230313-01Links to an external site.

Stahl, S. M. (2021). Stahl’s essential psychopharmacology: Neuroscientific basis and practical application (5th ed.).

AGENDA COMPARISON GRID AND FACT SHEET

/in /by

1

Presidential Agendas

Name

Institution

Course

Instructor

Date

Presidential Agendas

When the presidents come into office several health issues are a priority to them. Likewise, when deciding on the topic of discussion many issues were considered. However, the selected topic is on mental health which has been an issue of concern and has been regarded as a priority health issue among presidents. Mental health is a concern that is attributed to many other factors, which include health factors like the coronavirus pandemic, and economic, social, and contextual factors. There have been significant milestones in mental health treatment among different administrations.

One of the significant progress made in mental health was made during the reign of President Obama. During his reign, Obama expanded mental health care by introducing health coverage under the Affordable Care Act. The ACA was responsible for eliminating the discrimination that existed when offering care to patients with mental health and substance abuse problems. Additionally, the president embarked on building health and behavioral care centers by investing millions of dollars from ACA (National Archives n.d). The services emphasized the importance of promoting mental health access among the police and other personnel involved in the protection of the citizens and their families.

President Trump was not left behind in making positive changes in the provision of mental health care among the citizens. However, Trump's strategy was marred with controversy regarding the eradication of ACA and Medicaid, which reduced the insurance coverage among those who used that program to access mental health services (Courtemanche et al., 2020). This means such strategies hurt low-income earners by denying them to access crucial mental health services. However, the president further implemented an executive order that saw increased access to mental health services among those with the condition, especially during the pandemic. Such services were aimed at prevention of related suicide, reduction of substance use, and improvement of overall mental health. However, the adoption of COVID-19 management measures such as lockdowns, unemployment, and isolation of people from others increased stress and mental health instances among the people.

These two presidents had excellent strategies for addressing the mental health menace that affected the American population. These strategies have been needed for a long time though they have not been put into practice until recently. However, I would focus on improving mental health training among caregivers as a strategy for ensuring everyone has access to mental health services including healthcare providers. It is prudent to ensure even healthcare providers have access to care because they equally share the experiences of dealing with hopeless patients that could potentially affect their emotional and psychological well-being. Availing such services could help caregivers deal with related trauma whenever it occurs.

References

Courtemanche, C., Marton, J., Ukert, B., Yelowitz, A., & Zapata, D. (2020). The impact of the Affordable Care Act on healthcare access and self‐assessed health in the Trump Era (2017‐2018).
Health services research,
55, 841-850.

National Archives.
Addressing Mental Health: Progress in Research, Prevention, Coverage, Recovery and Quality.
https://obamawhitehouse.archives.gov/sites/default/files/docs/mental_health_report_final.pdf