Post a summary of the interview and a description of the communication techniques you would use with your assigned patient.
Explain why you would use these techniques.
Identify the risk assessment instrument you selected and justify why it would be applicable to the selected patient.
Provide at least five targeted questions you would ask the patient.
Case study 50 year old LBTQIA male graduate student working in the college bookstore
Answer the questions in the provided Microsoft PowerPoint document and save your responses. Provide resources in APA format to support your answers.
CO 1: Analyze how golden age microbiologists performed experiments to observe, identify, culture and classify different microorganisms and their macromolecules.
CO 2: Apply the concepts of genetics and genome in the study of microorganisms
Conc of Pathophys of NSg peers response
· respond to peers thoughtfully, add value to the discussion, and apply ideas, insights, or concepts from scholarly sources, such as: journal articles, assigned readings, textbook material, lectures, course materials, or authoritative websites. For specific details and criteria, refer to the discussion rubric in the Menu (⋮) or in the Course Overview Weekly Discussion Guidelines.
1st peer post
Samantha WootenSep 11, 2023 at 9:31 AM
Marshall (2022) reports “In anorexia nervosa’s cycle of self-starvation, the body is denied the essential nutrients it needs to function normally. Thus, the body is forced to slow down all of its processes to conserve energy, resulting in serious medical consequences” (P. 1). Marshall also surmises that lab work up on a patient may look normal, but this does not rule out impending death, death could happen quickly by cardiac arrest caused by electrolyte imbalances (2022. P. 1).
Cultural and environmental implications affect a large amount of people within all ethnicity, gender, and age however women are largely targeted, the University of East Anglia state “his quite obvious connection between eating disorders and cultural expectations surrounding femininity is woefully neglected in much treatment” (P. 1). With the technology boom in recent years this is ever more present for this population, a social media environment instills these behaviors in today's society.
Financial implications that cause anorexia include lack of income and homelessness. Underprivileged populations have no choice but to sacrifice food to prioritize other necessities. Chan (2023) reports 64.7 billion being spent on eating disorders per year, with 23,560 hospitalizations yearly (p. 1).
In the ED with 16-year-old Jonathan Collins coming into the facility for anorexia nursing interventions would include evaluating the patients diet/exercise regimen and educate on proper diet and exercise with adequate fluid intake. Identify coping strategies and emotions related to weight, allowing the patient time to think and express how they're feeling. This will allow underlying causes to surface for treatment. Lastly, addressing body images issues. Targeting these fears will allow the patient to accept a healthy body weight to maintain health and stay out of the hospital (Belleza, August 9, 2023. P. 1).
According to Miller, Grinspoon, and Ciampa (2020) vital signs with anorexia tend to include a slower than normal heart rate, hypotension, and hypothermia. Lab values tend to include anemia and in some cases thrombocytopenia. Sodium levels average around 122, with normal levels being 135-145. Average potassium in patients with anorexia being 1.9 with normal values being 3.4-4.8. All of these values contribute to cardiac arrest via electrolyte imbalance. In some anorexia patients there are dysrhythmias due to electrolyte imbalances and hypovolemia. Also of note with women populations are menstrual dysfunction and osteoporosis (P. 1).
Treatment includes a combination of psychotherapy, family therapy, and medicine according to St. Lukes Hospital (2015), they also state “A combination of treatments can give the person the medical, psychological, and practical support they need. Cognitive behavioral therapy, along with antidepressants, can be an effective treatment for eating disorders. Complementary and alternative (CAM) therapies may help with nutritional deficiencies” (P. 1).
references
Belleza, M. August 9, 2023. Eating disorders: Anorexia & Bulimia Nervosa. Nurse Labs.
Eating Disorders: Anorexia & Bulimia Nervosa – Nurseslabs
Chan, T. H. 2023. Report: Economic Costs of Eating Disorders. Harvard School of Public Health.
Report: Economic Costs of Eating Disorders | STRIPED | Harvard T.H. Chan School of Public Health
Marshall, D. 2022. Anorexia Nervosa. National eating disorders association.
Anorexia Nervosa | National Eating Disorders Association
Miller, K. Grinspoon, S. Ciampa, J. (Marh 14, 2020). Medicla Findings in Outpatients with Anorexia Nervosa. JAMA internal medicine. Doi:10.1001/archinte.165.5.561.
St. Lukes Hospital. April 23, 2015. Complementary and Alternative Medicine of Anorexia Nervosa. A Division of Ebix.
Anorexia nervosa | Complementary and Alternative Medicine | St. Luke's Hospital (stlukes-stl.com)
University of East Anglia. November 13, 2017. Eating disorder treatments need to consider social, cultural implications of the illness. Science Daily.
Eating disorder treatments need to consider social, cultural implications of the illness | ScienceDaily
2nd peer post
Kira DespinsSep 11, 2023 at 3:20 PM
1. Thoroughly explain the pathophysiology of anorexia. Use a scholarly or authoritative source to support your answer.
Anorexia is a medical condition summarized by an inadequate intake of nutrients to regulate an individual’s weight to reduce their BMI and be ‘thin’. It causes physiological imbalances such as amenorrhea and psychological imbalances such as an obsessive-compulsive need to exercise or an all-encompassing fear of gaining weight. This population exhibits body dysmorphia. Once begun, this disease is persistent in select populations (Klein, 2004).
1. Examine each of the following three factors related to this disease process. Support all three with a scholarly source.
Cultural: Western culture perpetuates a standard of beauty based on being thin. This standard is propagated through social media outlets. Klein (2004) summarizes that popular media not only emphasizes the need to be a thing but perpetuates it through advertisements such as marketing diet fads and fitness trends.
Financial: Relating to the treatment of anorexia, a study by Gatt et al. (2014) found significant household financial stress for those seeking treatment for their eating disorder. They compared treatment costs to being the second highest after cardiac artery bypass surgery. As the disease is notoriously difficult to manage by oneself, it would be prudent to establish funding for this patient population so all individuals can access treatment without causing significant burdens on themselves and their families.
Environmental implications: Nature vs. nature has been heavily debated in pursuing the best understanding of anorexia. Klinger (2012) highlights that from an environmental perspective, children who have been neglected and/or abused are more prone to develop anorexia.
1. Identify 3-5 priority nursing interventions for the client in the emergency department.
-Cardiac monitoring due to electrolyte imbalance
-Fall risk prevention related to weakness
-Blood glucose monitoring related to low nutrient intake
1. Describe labs and diagnostic testing you would want to include in client’s plan of care and why. What are critical indicators? Support with a scholarly source.
Metevir, a nutrition counselor, highlights the importance of the following lab and diagnostic tests in anorexic patients (2022):
1. Vital sign monitoring, such as bradycardia, can signify a weak heart-conserving energy.
2. EKG to detect abnormal heart rhythm due to weakened heart muscles.
3. Complete metabolic panel to look for electrolyte imbalances in kidney and liver health. Hypokalemia would be a critical indicator.
4. Blood glucose tests as low food intake results in less glucose, which our brains depend upon
5. Hematology detects if our blood carries enough oxygen to perfuse our organs adequately.
6. Bone density test as low food intact can result in reduced hormone output, leading to weak and brittle bones.
1. What members of the interdisciplinary team need to be included for holistic patient-centered care? Provide a rationale and support with a scholarly source.
I believe that family members and friends are included in any team to support and care for those treated with anorexia. Knowing the care plan, these individuals can best provide care and support to the patient while out of the hospital, setting them up for success. Joy et al. (2003) believe that a physician, mental health professional, and nutritionist are also integral components of the care team as it affect an individual physically and mentally, and each has an overlapping specialty to assist the patient best. In an emergency department setting, involving a social worker or case management is integral to establishing resources for patients seeking help in an outpatient or in-patient setting.
References
Gatt, L., Jan, S., Mondraty, N., Horsfield, S., Hart, S., Russell, J., Laba, T. L., & Essue, B. (2014). The household economic burden of eating disorders and adherence to treatment in Australia. BMC Psychiatry, 14.
https://doi.org/10.1186/s12888-014-0338-0
Joy, E., & Wilson, C., & Varechok, S. (2004). The multidisciplinary team approach to the outpatient treatment of disordered eating. Curr Sports Med Rep, 331(6), 6. https://pubmed.ncbi.nlm.nih.gov/14583163/#:~:text=Team%20members%20include%20a%20physician,of%20individuals%20with%20disordered%20eating.
Klein, D. A., & Walsh, B. T. (2004). Eating disorders: clinical features and pathophysiology. Physiology & Behavior, 81(2), 359–374.
https://doi.org/10.1016/j.physbeh.2004.02.009
Klinger, D. (2012). Genes or environment: What causes eating disorders? GoodTherapy.
https://www.goodtherapy.org/blog/genes-environment-what-causes-eating-disorders
Metevier, J. (2022). The eating disorder medical test and nutrition lab guide. Integrated Care Clinic. https://integratedcareclinic.com/blog/the-eating-disorder-medical-test-and-nutrition-lab-guide/#:~:text=Metabolic%2FElectrolyte%20Labs,your%20sugar%20and%20protein%20levels
Instructions included in the file below its about kids from 3rd-5th grade that’s age 8-11. We did a presentation on basic first aid (stop the bleed).
APA FORMAT
NOTHING LESS THAN 1 1/2 PA G ES.
PLEASE READ THE INSTUCTIONS IN THE FILE.
After you complete this week’s readings, including the Clinical Microsystems Greenbook,
describe one reading that relates most closely to your project topic and how this
microsystem will help you develop your change project.
More than 300 words.
This one will be done after the current one.
Please see the attachment for instructions
The surrogate role is not one that is frequently mentioned in recent nursing practice literature. Is that role as defined by Peplau relevant to nursing practice as currently experienced. If so, in what way. If not, why?
400 word, 1 reference
Using this PICOT model,
In __________(P), how does __________ (I) compared to _________ (C) influence _________ (O) over ________ (T)?
Difference between ovens
Literature Review/Synthesis
Once you have thoroughly learned your studies (this is where the Table of Evidence you did previously will help you!), you need to communicate to your readers the level and quality of literature that was reviewed. The synthesis is a description of the entire body of literature that you have reviewed that supports your EBP project.
Literature Synthesis = (100 points)
Purpose/Objective of this assignment is to:
1. Provide a
synthesis and analysis
of previously selected articles through a systematic review.
2. Evaluate the findings, identifying gaps in knowledge and implications for future research.
Assignment requirements: Students will utilize the articles selected to write a
6 to 7 page
review of the literature on the selected topic. Additional research articles may be included if necessary. (
Note that this is the first section of a two-section paper. (A 4 – 5-page paper discussing the clinical implications of the literature review findings on nursing practice will follow this literature review. See Assignment – Clinical Project: Clinical Implications Paper.) Include a background section.
1. Articles will be reviewed in an integrated manner. Summarize and provide a detailed synthesis of the information from all of your studies as it relates to the topic of interest.
2.
Must provide a synthesis and critical analysis of research designs, methodologies, sampling, independent and dependent variables, research findings, threats to reliability and validity. Discussion to include trends, areas of commonalities and differences in approaches.
3. Discuss outcomes and findings
4. All information must be cited and referenced appropriately.
5. Paper will utilize all appropriate APA 7th Ed guidelines for intro, conclusion, citations, references, document organization, formatting, academic language, and grammar.
First person is not appropriate in this paper.
Topic: In mechanically ventilated patients in the ICU (P), does an oral care protocol using chlorhexidine mouthwash (I) compared to routine oral care (C) reduce the incidence of ventilator-associated pneumonia (O) over six months (T)?
