Describe incidence, prevalence, morbidity, mortality and hospitalizations of COVID-19, compared to the rate of vaccinations in different counties in Maryland. What is your analysis of vaccination rates in the state?
Please give 3 scientific citation.
Choose a case from the https://journalofethics.ama-assn.org/cases and take a position. For this assignment you will evaluate the ethical arguments for or against the issue. Identify the potential legal arguments (consider current federal guidelines), indicate any potential professional code conflicts you foresee, and support your position with an explanation of your own ethical/moral foundation.
Support your position with at least one scholarly source. Be sure to cite the article you choose, use APA format, and include a title page and reference page.
School board trustees are requesting public comment before they vote on a vaccination policy for all children in a local school district. Should individual rights (e.g., parents’ rights to decide whether to vaccinate their children) be compromised to control the spread of communicable diseases for the good of society?
Submission Instructions:
PLEASE RESPOND TO THE FOLLOWING IN 50 WORDS OR MORE:
Barrier #8 Lack of Opportunities for Advancement
There are multiple barriers in leadership when it comes to nursing. Many of the barriers arise from different situations many nurses find themselves in (Nininger). “For example, fear, negative prior experiences, and family commitments are barriers that depend on the nurse to resolve” (Nininger). These situations vary from region to region and nurse to nurse. One of the barriers that is more common across the board is lack of opportunities. The need for nurses continues to grow each year, more and more new nurses are entering the field on the daily. While nursing as a career continues to grow, the leadership does not. Leadership opportunities are far and few, making them very saturated with well qualified nurses. On top of it being a rare find, most leadership roles are found through networking taking the emphasis away from the bedside skill many new nurses need to perfect first.
References:
Nininger, J. M., Abbott, M. R. B., & Shaw, P. (2019). Eradicating Barriers to Advancement From RN to BSN: An Exploratory Study. The Journal of Continuing Education in Nursing, 50(1), 15+. https://link.gale.com/apps/doc/A676574239/AONE?u=lincclin_fkcc&sid=bookmark-AONE&xid=2db64f08Links to an external site.
1. You are the nurse caring for a patient with a tracheostomy. What communication strategies can you
promote with your patient in order to effectively interact and communicate?
2. You are the nurse caring for a patient with methicillin-resistant staphylococcus aureus (MRSA).
a) What is MRSA?
b) Describe the precautions required when providing care to this patient.
c) List topics to include in the patient and family education.
3. Describe the assessment cues and nursing interventions for infiltration and extravasation of an
intravenous (IV) catheter
First, explain the role of the Psychiatric Mental Health Nurse Practitioner as it relates to the scope of psychotherapy. Second, explain how this week’s discussion aligns with the following APNA standard:
. Two scholarly source references are required unless stated otherwise by your professor. The student provides a substantive response to the discussion question or topic Please review the rubric before posting to ensure a maximum of points. Here are the categories of the new discussion rubric: Initial Post relevance to the topic of discussion, applicability, and insight. (20%)Quality of Written Communication Appropriateness of audience and word choice is specific, purposeful, dynamic, and varied. Grammar, spelling, punctuation. (20%)Inclusion of APNA standards essentials explored in the discussion and the role-specific competencies as applicable. (10%)
Advanced Psychopharmacology and Health Promotion
Unit 7 Discussion Case Study 600W. APA. 4 references due 10-17-23.
Case Study:
· Your patient is a 36-year-old woman with bipolar disorder and anxiety. She has been stable on a combination of fluoxetine and olanzapine for two years. She is morbidly obese at 340 pounds at 5’5” in height, has type II diabetes, hypertension, and hyperlipidemia. She has concerns about her weight and has tried numerous ‘fad diets’ to no avail. She explains she has lost, at most, 15 pounds and has been able to keep it off for three months.
· She has three children, one of which is severely disabled, and a husband who has a terminal diagnosis. She expresses worry that her weight will impact her ability to care for her disabled child when her husband dies. She reports she eats out frequently due to her children’s busy schedules. She is a stay-at-home mother but gets little exercise and performs no regular physical activity.
· She reports feelings of shame that she can no longer orgasm on the rare occasions her husband has the energy and desire to be intimate.
Questions:
· What would be your approach to managing this patient’s weight concern? (Discuss at least two aspects of your approach). Please support your answer with research-based evidence.
· What would be our approach to the sexual side effects she is experiencing?
· If you suggested additional medication, look up your state’s prescribing laws. Are PMHNP’s able to prescribe the medication you recommended?
· Please include the subjective and objective information in this post.
All responses must by supported by correct APA 7th edition formatted citations and references.
1. What would be your approach to managing this patient's weight concern? (Discuss at least two aspects of your approach). Please support your answer with research-based evidence.
1. Non-pharmacological Approach
2. Pharmacological Approach
2. What would be our approach to the sexual side effects she is experiencing?
· Lifestyle changes, avoidance of stress or anxiety, drug therapy, physical activity, and psychological support.
3. If you suggested additional medication, look up your state's prescribing laws. Are PMHNPs able to prescribe the medication you recommended?
· Additional medication is Flibanserin, the PMHNP can prescribe this without the supervision of a psychiatrist since PMHNP is Psychiatric-Mental Health Nurse Practitioner which is Board Certified. And/or hormonal therapy which is usually prescribed by a gynecological physician.
Please see the explanation below.
Step-by-step explanation
Approach to solving the question:
· Identification of clinical problems that a bipolar patient attained, classification of nonpharmacological and pharmacological treatment of a patient, planning for therapies essential in treating the patient, and evaluation of the process for positive outcomes.
1. What would be your approach to managing this patient's weight concern? (Discuss at least two aspects of your approach). Please support your answer with research-based evidence.
1.
Non-pharmacological Approach
·
Detailed explanation: this is an approach that is essential in managing a patient's weight concern without the involvement of drugs to treat the weight problem. This aim is to provide alternative prevention in treating weight gain without any chemical side effects on the body.
(Focus (American Psychiatric Publishing). 2021)
·
Examples: (1) Physical activity such as aerobic exercises, can help the patient maintain her within the normal range which will enhance her conditions of type II diabetes, hypertension, and hyperlipidemia and help in improving her sexual desire, (2) Healthy food intake such as fruits, vegetables, whole grains, nonsalty and fatty foods, can reduce the risk of weight gain, and increase blood pressure and cholesterol which can improve her well being, and (3) Peer support which is very helpful in getting motivation from those people who are experiencing the same situation with the patient which increase the chance of preventing to expose her self to stress and anxiety.
2.
Pharmacological Approach
·
Detailed explanation: this is an approach that is essential in managing a patient's weight concern with the involvement of drugs to treat the weight problem. This aim is to provide drug prevention to avoid the progression of the presenting clinical manifestation and development of complications.
(Focus (American Psychiatric Publishing). 2021)
·
Examples: (1) Phentermine-topiramate which is helpful in cutting the cravings, and lessens the appetite during stress and anxiety. This is helpful to increase the chance of weight gain especially when the patient attempted to expose herself to overeating.
2. What would be our approach to the sexual side effects she is experiencing?
· The approach
to the sexual side effects the patient is experiencing are lifestyle changes, avoidance of stress or anxiety, drug therapy, physical activity, and psychological support. Sexual side effects based on the scenario are linked to the stress, anxiety, and weight gain of the patient. It is important that as a healthcare provider, you must assess the related factors to the presenting problem. For a patient with bipolar disorder, it is important to have a care plan to follow so that the patient will be encouraged to do. Lifestyle changes such as physical activity and eating healthy food are the most important since the patient tends to eat out frequently due to her children's busy schedules, gets little exercise, and performs no regular physical activity. If the patient is healthy, their sexual desire will improve and help her to have orgasms since her hormones are healthy. Avoidance of stress and anxiety is helpful in sexual desire because a patient who is stressed can affect the sympathetic nervous system limiting the blood flow to the genitals to achieve genital arousal. Also, therapies are helpful in correcting abnormal hormones in the body system.
(Lancet Public Health. 2021)
3. If you suggested additional medication, look up your state's prescribing laws. Are PMHNPs able to prescribe the medication you recommended?
· Since the patient is already taking combinations of olanzapine which is useful in treating schizophrenic episodes and fluoxetine which is an antidepressant used in bipolar disorder and linked to weight loss, the additional medication that I may recommend is Flibanserin which is an antidepressant helpful in correcting the imbalance of the neurotransmitters in the brain increasing the chance to sexual desire. The PMHNP can prescribe this medication in all states because Flibanserin should be prescribed by a psychiatrist physician and certified nurse practitioners. Another additional medication that I would like to conclude is hormonal therapy like estrogen therapy because the abnormal level of hormones in the body affects the body in sexual desires and can lead to stress and anxiety.
(Psychiatr Serv. 2018)
REFERENCES:
· Vancampfort D, Firth J, Correll CU, et al.. The impact of pharmacological and non-pharmacological interventions to improve physical health outcomes in people with schizophrenia: a meta-review of meta-analyses of randomized controlled trials.
Focus (American Psychiatric Publishing).2021;19:116-28.
· Mitchell K.R., Lewis R., O'Sullivan L.F., Fortenberry J.D. What Is Sexual Wellbeing and Why Does It Matter for Public Health?
Lancet Public Health. 2021;6:e608-e613. doi: 10.1016/S2468-2667(21)00099-2.
· Blackmore M.A., Carleton K.E., Ricketts S.M. Comparison of collaborative care and colocation treatment for patients with clinically significant depression symptoms in primary care.
Psychiatr Serv. 2018;69(11):1184-1187. doi: 10.1176/appi.ps.201700569.
Consider a topic the topic: obesity , that rises to the presidential level. How did the current and previous presidents handle the problem? What would you do differently? I need 150 words
As an advanced practice nurse assisting physicians in the diagnosis and treatment of disorders, it is important to not only understand the impact of disorders on the body, but also the impact of drug treatments on the body. The relationships between drugs and the body can be described by pharmacokinetics and pharmacodynamics.
Pharmacokinetics describes what the body does to the drug through absorption, distribution, metabolism, and excretion, whereas pharmacodynamics describes what the drug does to the body.
When selecting drugs and determining dosages for patients, it is essential to consider individual patient factors that might impact the patient’s pharmacokinetic and pharmacodynamic processes. These patient factors include genetics, gender, ethnicity, age, behavior (i.e., diet, nutrition, smoking, alcohol, illicit drug abuse), and/or pathophysiological changes due to disease.
For this Discussion, you reflect on a case from your past clinical experiences and consider how a patient’s pharmacokinetic and pharmacodynamic processes may alter his or her response to a drug.
To prepare:
Review the Resources for this module and consider the principles of pharmacokinetics and pharmacodynamics.
Reflect on your experiences, observations, and/or clinical practices from the last 5 years and think about how pharmacokinetic and pharmacodynamic factors altered his or her anticipated response to a drug.
Consider factors that might have influenced the patient’s pharmacokinetic and pharmacodynamic processes, such as genetics (including pharmacogenetics), gender, ethnicity, age, behavior, and/or possible pathophysiological changes due to disease.
Think about a personalized plan of care based on these influencing factors and patient history in your case study.
Post a description of the patient case from your experiences, observations, and/or clinical practice from the last 5 years. Then, describe factors that might have influenced pharmacokinetic and pharmacodynamic processes of the patient you identified. Finally, explain details of the personalized plan of care that you would develop based on influencing factors and patient history in your case. Be specific and provide examples.
