Please answer the questions below on regards of
Inadequate Pain Management in Postoperative Patients
Submission Instructions:
After studying Module 2: Lecture Materials & Resources, submit the following:
Submission Instructions:
Please see the attachment for instruction
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.).
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
public health issue related to an environmental issue within the U.S. health care delivery system and examine its effect on a specific population.
Delivering Client Centered Care
kaffy
Shared decision-making (SDM) is a vital component of contemporary healthcare, transforming the landscape of patient-centered care across the lifespan. A significant body of evidence, such as the peer-reviewed article titled “Shared decision-making in primary care: A systematic review and meta-analysis of its effects on patient outcomes” by Stacey J. Pereira et al. published in the Annals of Family Medicine in 2021, underscores the merits of SDM in promoting health and delivering client-centered care.
SDM epitomizes a collaborative process where patients and healthcare providers harmoniously engage in making healthcare decisions. This process revolves around the amalgamation of the best available clinical evidence with the unique values and preferences of the patient. The systematic review and meta-analysis examined 57 randomized controlled trials (RCTs), offering compelling insights into the affirmative influence of SDM on various patient outcomes. These encompassed heightened patient satisfaction, an improved quality of life, reduced decisional regret, greater adherence to treatment regimens, and superior clinical outcomes such as enhanced blood pressure control, glucose management, and cholesterol levels.
There are two overarching reasons that substantiate SDM as an essential and exemplary healthcare practice. Firstly, SDM is rooted in the principle of respecting the autonomy and right to self-determination of patients. It elevates the patient to an active, informed decision-maker in their care, ensuring that their voice is both heard and honored in the decision-making process. Secondly, SDM consistently demonstrates its prowess in enhancing patient outcomes. This patient-centered approach fosters an environment where patients feel valued and involved, leading to increased satisfaction, a better quality of life, and a notable reduction in decisional regret. Moreover, it fortifies patient adherence to treatment plans and significantly betters clinical outcomes.
In the realm of healthcare, SDM transcends being a mere process; it becomes a conduit for the realization of optimal care and health promotion. It effectively personalizes care delivery, ensuring that interventions align with each patient's unique needs, values, and preferences. Importantly, SDM nurtures trust and rapport between patients and healthcare providers, serving as the bedrock of effective communication. When patients feel heard and respected, it paves the way for open and honest dialogues, which, in turn, bolster healthcare decisions and ultimately lead to improved health outcomes. Additionally, SDM is instrumental in empowering patients to be active participants in their health journeys. It fosters a sense of ownership and responsibility for their well-being, thus propelling health promotion efforts to new heights.
In conclusion, the evidence gleaned from the systematic review and meta-analysis by Stacey J. Pereira et al. underscores the pivotal role of SDM in modern healthcare. By respecting patient autonomy and consistently yielding positive patient outcomes, SDM epitomizes a best practice that is integral to the delivery of client-centered care and the promotion of health across the life span. Its capacity to personalize care, foster trust, and empower patients underscores its status as a cornerstone of contemporary healthcare delivery.
Okafor Aboh
he/him/his
19 hours ago, at 10:45 PM
Top of Form
In healthcare allowing the patient to have the autonomy over their own healthcare decisions is an important part in delivering client center care and promoting health. It is important that all parties of the healthcare team work together to achieve the desired needs of the patient. An important “best practice technique” to perform to achieve this is to provide patient centered communication. This means that the patients care is centered around the clients values, health concerns, and beliefs. It is also important for the patient to have an effective trustworthy relationship with nurse or provider on their team so they can effectively establish any possible personal or behavioral related barriers that may interfere with the care of the client.
Patient centered care reflects strictly on the specific needs of the individual patient and the best effective ways to provide them. Providing healthcare services that reflect and respect the needs of the patient results in positive outcomes for the clients health outside of the facility. Patient centered care requires the healthcare team to show respect towards the client, their needs, preferences, and values. When all parties are on the same page it makes an easier recovery process for the client and a smoother visit for the healthcare professionals.
TRANSLATION MODELS AND FRAMEWORKS
|
Criterion (Questions should be answered specifically for the chosen case study) |
Points |
|---|---|
|
1. What key criteria will the PHN need to consider for a successful first visit with this client? |
2 |
|
2. How will the PHN establish professional boundaries with this client? |
2 |
|
3. How will the PHN communicate confidentiality with the client? |
2 |
|
4. What may some ethical challenges be during this home visit with the client? |
2 |
|
5. How does the ANA Scope and Standards of Public Health (2013) nursing practice guide the responsibilities of the public health nurse in this case study? Cite this resource within your answer. |
2 |
|
6. Identify key communication skills to assure respectful interaction with this client. |
1 |
|
7. Describe the components of the nursing process in the planned home visit with this client. |
1 |
|
8. Identify priority problems for this individual/family. |
1 |
|
9. Identify plan and nursing interventions for this individual/family. Expand on what was written in the case study. |
1 |
|
10. Identify plan to evaluate problem outcome. |
.5 |
|
11. Professionally written using APA formatting and writing mechanics. |
.5 |
|
Total Points |
15 points |
EVIDENCE BASE IN DESIGN
When politics and medical science intersect, there can be much debate. Sometimes anecdotes or hearsay are misused as evidence to support a particular point. Despite these and other challenges, however, evidence-based approaches are increasingly used to inform health policy decision-making regarding causes of disease, intervention strategies, and issues impacting society. One example is the introduction of childhood vaccinations and the use of evidence-based arguments surrounding their safety.
In this Discussion, you will identify a recently proposed health policy and share your analysis of the evidence in support of this policy.
RESOURCES
Be sure to review the Learning Resources before completing this activity.
Click the weekly resources link to access the resources.
· Milstead, J. A., & Short, N. M. (2019). Health policy and politics: A nurse’s guide (6th ed.). Jones & Bartlett Learning.
o Chapter 5, “Public Policy Design” (pp. 87–95 only)
o Chapter 8, “The Impact of EHRs, Big Data, and Evidence-Informed Practice” (pp. 137–146)
o Chapter 9, “Interprofessional Practice” (pp. 152–160 only)
o Chapter 10, “Overview: The Economics and Finance of Health Care” (pp. 183–191 only)
· American Nurses Association (ANA). (n.d.). AdvocacyLinks to an external site.. Retrieved September 20, 2018, from https://www.nursingworld.org/practice-policy/advocacy/
· Centers for Disease Control and Prevention (CDC). (n.d.). Step by step: Evaluating violence and injury prevention policies: Brief 4: Evaluating policy implementationLinks to an external site.. Retrieved from https://www.cdc.gov/injury/pdfs/policy/Brief%204-a.pdf
· Congress.govLinks to an external site.. (n.d.). Retrieved September 20, 2018, from https://www.congress.gov/
· Klein, K. J., & Sorra, J. S. (1996). The challenge of innovation implementationLinks to an external site.. Academy of Management Review, 21(4), 1055–1080.
· Sacristán, J., & Dilla, T. D. (2015). No big data without small data: Learning health care systems begin and end with the individual patientLinks to an external site.. Journal of Evaluation in Clinical Practice, 21(6), 1014–1017.
· Tummers, L., & Bekkers, V. (2014). Policy implementation, street level bureaucracy, and the importance of discretionLinks to an external site.. Public Management Review, 16(4), 527–547.
To Prepare:
· Review the Congress website provided in the Resources and identify one recent (within the past 5 years) proposed health policy.
· Review the health policy you identified and reflect on the background and development of this health policy.
· Post a description of the health policy you selected and a brief background for the problem or issue being addressed. Which social determinant most affects this policy? Explain whether you believe there is an evidence base to support the proposed policy and explain why. Be specific and provide examples.
