week 5-patho

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Gastrointestinal Function:
R.H. is a 74-year-old black woman, who presents to the family practice clinic for a scheduled appointment. She complains of feeling bloated and constipated for the past month, some-times going an entire week with only one bowel movement. Until this episode, she has been very regular all of her life, having a bowel movement every day or every other day. She reports straining most of the time and it often takes her 10 minutes at a minimum to initiate a bowel movement. Stools have been extremely hard. She denies pain during straining. A recent colonoscopy was negative for tumors or other lesions. She has not yet taken any medications to provide relief for her constipation. Furthermore, she reports frequent heartburn (3–4 times each week), most often occur-ring soon after retiring to bed. She uses three pillows to keep herself in a more upright position during sleep. On a friend’s advice, she purchased a package of over-the-counter aluminum hydroxide tablets to help relieve the heartburn. She has had some improvement since she began taking the medicine. She reports using naproxen as needed for arthritic pain her hands and knees. She states that her hands and knees are extremely stiff when she rises in the morning. Because her arthritis has been getting worse, she has stopped taking her daily walks and now gets very little exercise.

Case Study Questions

  1. In your own words define constipation and name the risk factors that might lead to develop constipation. List recommendations you would give to a patient who is suffering from constipation. You might use a previous experience you might have.
  2. Based on the clinical manifestations on R.H. case study, name and explain signs and symptoms presented that are compatible with the constipation diagnosis. Complement your list with signs and symptoms not present on the case study.
  3. Sometimes as an associate diagnosis and a complication, patients with constipation could have anemia. Would you consider that possibility based on the information provided on the case study?

Endocrine Function:
C.B. is a significantly overweight, 48-year-old woman from the Winnebago Indian tribe who had high blood sugar and cholesterol levels three years ago but did not follow up with a clinical diagnostic work-up. She had participated in the state’s annual health screening program and noticed that her fasting blood sugar was 141 and her cholesterol was 225. However, she felt “perfectly fine at the time” and could not afford any more medications. Except for a number of “female infections,” she has felt fine until recently. Today, she presents to the Indian Hospital general practitioner complaining that her left foot has been weak and numb for nearly three weeks and that the foot is difficult to flex. She denies any other weakness or numbness at this time. However, she reports that she has been very thirsty lately and gets up more often at night to urinate. She has attributed these symptoms to the extremely warm weather and drinking more water to keep hydrated. She has gained a total of 65 pounds since her last pregnancy 14 years ago, 15 pounds in the last 6 months alone.

Case Study Questions

  1. In which race and ethnic groups is DM more prevalent? Based on C.B. clinical manifestations, please compile the signs and symptoms that she is exhibiting that are compatible with the Diabetes Mellitus Type 2 diagnosis.
  2. If C.B. develop a bacterial pneumonia on her right lower lobe, how would you expect her Glycemia values to be? Explain and support your answer.
  3. What would be the best initial therapy non-pharmacologic and pharmacologic to be recommended to C.B?

Submission Instructions:

  • You must complete both case studies.
  • Your initial post should be at least 500 words, formatted and cited in current APA style with support from at least 2 academic sources. Your initial post is worth 8 points.

discussion on disaster preparedness

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Purpose

This assignment is intended to help you learn to formulate strategies using clinical judgment and decision-making skills to lead planning efforts for an emergency situation.

Overview

For this assignment you will explore the skills and knowledge you will need to prepare a community for a disaster. You will produce a summary of a community emergency/disaster plan. In order to prepare to write this plan, take the following steps:

Step 1: Identify the most common natural disaster in your community. You could use this or a similar resource to help you: Common Natural Disasters Across U.SLinks to an external site..

Step 2: Review this scenario:

You are the nurse leader involved in your local Crisis Response Team.  Your community (it may be a township, city, or county) is trying to update their emergency response plan.  For this exercise, using the most common natural disaster for your community, you are going to explore the current resources and plans available for your community, and identify gaps and potential resources to fill those gaps.

The exercise will help you understand the need for community resources to protect a community during and after an emergency situation. To successfully complete this assignment, you will address each of the following:

  • Explore your community disaster/emergency response plans (look at city, county, etc., using search terms such as “disaster preparedness,” “crisis management,” and/or “emergency management.”)
  • Are there emergency/disaster strategic plans in place? What elements do they contain?
  • Identify current resources, and gaps where additional resources may be needed.  Consider needs for safe water, housing, transportation, and food and medical supplies.
  • What plans are in place to ensure health of the community, including care of the injured, management of the deceased, and physical and mental health. 
  • Identify the partner agencies (such as Red Cross, United Way, etc.) and governmental agencies (FEMA, Homeland Security, etc.) that may be needed to support a crisis response.
  • Discuss the current communication plans and alert systems and recommend additional communication strategies.

Action Items

  1. Complete the required readings for this module.
  2. Write a 2- to 3-page summary of your community emergency/disaster plans, addressing each of the bulleted items listed in the Overview for this assignment.
  3. Use APA format and be sure to cite the web resources that you searched for your community.
  4. Submit the completed first draft of your assignment. Your work will automatically be checked by Turnitin. 
  5. Access your Turnitin report by reviewing your Submission Details for this assignment. Revise your work as needed based on the feedback. 
  6. By the due date indicated, re-submit the final version of your work. 

Rubric

Disaster PreparednessDisaster PreparednessCriteriaRatingsPtsThis criterion is linked to a Learning OutcomeEmergency Preparedness Plan90 to >83.0 ptsAll elements of the plan were included as stated in the assignment. The plan design reflects community protection and strategies to improve collaboration and communication. Strategies apply enhanced clinical judgement and decision-making skills.83 to >76.0 ptsMost elements of the plan were included as stated in the assignment. The plan design reflects community protection and strategies to improve collaboration and communication. Strategies apply clinical judgement and decision-making skills.76 to >0 ptsThe plan was not created and/or did not include strategies that applied clinical judgment and decision-making skills.90 pts
This criterion is linked to a Learning OutcomeAPA, Grammar, and Mechanics10 to >9.0 ptsFollows all APA guidelines for writing skills, formatting, citing, and referencing sources. Contains no notable spelling, grammatical, or mechanical errors.9 to >8.0 ptsFollows most APA guidelines for writing skills, formatting, citing, and referencing sources. Few spelling, grammatical, and/or mechanical errors.8 to >0 ptsDoes not consistently follow APA guidelines for writing skills, formatting, citing, and referencing sources. Has many spelling, grammatical, and/or mechanical errors.10 pts
Total Points: 100PreviousNext
 

Overview

During this module we will look at the role of the professional nurse in working with aggregates in the community.  We will emphasize the components of health promotion and disease prevention at the individual and population level in order to improve the health of individuals, families, groups, communities, and populations. In addition, we will explore the health attitudes, beliefs, and practices of culturally diverse populations.

Learning Outcomes

After successfully completing this module, you should be able to:

  • Describe the practice of community focused and community based nursing.
  • Formulate strategies using clinical judgment and decision-making skills to lead planning efforts for an emergency situation.
  • Develop clinical prevention and population-focused interventions for culturally diverse populations.

Reading & Preparation

Here are the resources you need to prepare for this module:

Cultural Analysis

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 focus should be on Family Nurse Practitioners. Please let me know what the topic will be 

Discussion: Public and Community Health

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 Discussion: Public and Community Health

Purpose

This assignment is intended to help you learn to do the following:

  • Describe the practice of community focused and community based nursing.
  • Develop clinical prevention and population-focused interventions for culturally diverse populations.

Overview

This discussion addresses common health promotion issues from the perspective of populations and the community. We will look closely at the ways that we can improve the health of populations by exploring leading health indicators and sharing findings.

Action Items

  1. Review the 2030 Leading Health IndicatorsLinks to an external site. from this module’s readings.
  2. Select a Leading Health Indicator topic and focus. For example, you may have selected the topic of “Access to Health Services” with a focus on “persons with medical insurance.” (Hint: use the Healthy People 2030 Leading Health Indicators Custom ListLinks to an external site. link on the webpage.)
  3. Respond to these prompts:
    1. Which Leading Health Indicator topic and focus did you select?
    2. Provide a brief overview of the focus area (1-2 sentences).
    3. Identify the interventions and resources available.
    4. Briefly summarize the national data that was provided about your focus area.
    5. Include a reference list. All citations and your reference list must adhere to APA GuidelinesLinks to an external site..

 

Overview

During this module we will look at the role of the professional nurse in working with aggregates in the community.  We will emphasize the components of health promotion and disease prevention at the individual and population level in order to improve the health of individuals, families, groups, communities, and populations. In addition, we will explore the health attitudes, beliefs, and practices of culturally diverse populations.

Learning Outcomes

After successfully completing this module, you should be able to:

  • Describe the practice of community focused and community based nursing.
  • Formulate strategies using clinical judgment and decision-making skills to lead planning efforts for an emergency situation.
  • Develop clinical prevention and population-focused interventions for culturally diverse populations.

Reading & Preparation

Here are the resources you need to prepare for this module:

humanities

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Pathophysiology Adventure Part 2 response KP

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 Post-Traumatic Stress Disorder (PTSD)

Post Traumatic Stress Disorder (PTSD) is a severe mental health condition that is caused by experiencing a traumatic event. The effect on individuals varies from individual to individual across the lifespan, causing disruption of cognitive, emotional, and physical well-being. The pathophysiology, manifestations, diagnosis, lifespan considerations, and case study analysis of PTSD are covered in this reflective activity. Studying these aspects ultimately helped inform me of how PTSD affects people and the importance of a quick diagnosis and intervention.

Understanding the Pathophysiology of PTSD

PTSD is a neurobiological change that arises in the setting of trauma and results in changes in the hypothalamic-pituitary-adrenal (HPA) axis, autonomic nervous system, and limbic structures such as the amygdala, hippocampus, and prefrontal cortex. The amygdala becomes hyperactive, and fear responses are heightened, while there is hippocampal dysfunction that prevents memory processing (Raise-Abdullahi et al., 2023). Persistent stress response mainly results from excessive cortisol release caused by chronic dysregulation of the HPA axis. Knowing this pathophysiology helps explain the biological underpinnings of PTSD since it suggests the necessity of biological interventions that include targeting both psychological and physiological factors.

Manifestations and Diagnosis of PTSD

Psychological and physiological symptoms associated with PTSD are grouped into four clusters: intrusive thoughts, avoidance, negative alterations of cognition and mood, and hyperarousal. Examples of feelings from which individuals might suffer would include flashbacks, nightmares, emotional detachment, irritability, and heightened startle (jump) responses. Diagnosis is based on the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) criteria adapted by the Clinician-Administered PTSD Scale, Fifth Edition (CAPS-5) and PTSD Checklist (PCL-5) (Wojujutari et al., 2024). Further validations for the biological basis of PTSD are found in its structural and functional abnormalities that are seen in the brains of subjects with PTSD, as seen in neuroimaging studies. Initiating proper treatment and improving patient outcomes requires a proper diagnosis.

Lifespan Considerations in PTSD

PTSD has different expressions depending on the age and the life situation. Symptoms in children may include behavioral regression, nightmares, and inability to speak about the distress. In adolescents, risk-taking, aggression, and the use of substances as coping mechanisms (Du et al., 2022). Those with PTSD and expecting have much higher rates of poor health outcomes for both mother and child, such as preterm birth and postpartum depression. Cognitive decline in older adults may worsen their symptoms and social withdrawal and predispose them to comorbid conditions, most frequently depression. Healthcare providers can tailor interventions depending on developmental and physiological differences with these recognitions.

Case Study Analysis

The case study of Jacob Smith, a 38-year-old combat veteran with PTSD. All of his symptoms are consistent with PTSD diagnostic criteria, including nightmares, hypervigilance, emotional detachment, and avoidance behavior. The presence of comorbid substance abuse is consistent with his history of alcohol use to cope. Diagnostic findings of a high PCL-5 score of 56 with MRI evidence of amygdala hyperactivity meet the criteria of PTSD. Cognitive behavioral therapy (CBT), Eye Movement Desensitization and Reprocessing (EMDR), and selective serotonin reuptake inhibitors (SSRIs) are known to follow as treatment recommendations (Du et al, 2022). The lesson for this case study is that a personalized treatment plan needs to consider the patient’s background and severity of symptoms.

Implications for Clinical Practice

The knowledge of PTSD helps the clinician in assessing, diagnosing, and strategizing on the treatment of patients. All the talks revolve around recognizing early warning signs so that treatment can be given before long-term complications arrive. However, substantial symptom relief can be obtained through evidence-based treatments, including CBT and pharmacotherapy, requiring an interdisciplinary approach (Han et al., 2021). They also must dispel stigma and dissuade people from not seeking help due to fears of judgment from healthcare providers. Practitioners can provide positive patient outcomes and healthy recovery by integrating research findings.

The Role of Trauma-Informed Care

Trauma-informed care is a crucial aspect of PTSD management, which recognizes the effect of trauma on individuals and how these have psychological implications for the clients. Safety, trust, peer support, collaboration, empowerment, and cultural competence are emphasized in this approach. When trauma-informed principles are integrated into practice, this provides an environment that is healing and further away from traumatization for their clients. An example of this can be to ensure a calm, clinical setting and to offer patient-centered interventions that will significantly increase engagement and treatment adherence.

The Future of PTSD Treatment

The best part about PTSD is that emerging treatments for this illness are evolving. Ketamine-assisted therapy has been found to help reduce symptoms in cases of treatment resistance. Another innovative, virtual reality exposure therapy (VRET) is another intervention that helps patients face and process traumatic memories safely. Also, neurofeedback therapy, which teaches recovering brain patterns, has been thought to reduce PTSD symptoms (Raise-Abdullahi et al., 2023). These advancements demonstrate, not surprisingly, that research and innovations should continue to evolve regarding how patients and patient outcomes are treated.

Personal Insights and Professional Growth

The reflections in this discussion deepened my consciousness regarding PTSD’s far-reaching impact and the requirement for holistic care. Because the disorder is so complicated, pharmacological, psychological, and social support efforts must be made as a totality. Studies of PTSD support the continued need for early intervention, education of the patient, and taking advantage of interdisciplinary collaboration in the field of mental health. This understanding can be incorporated into future practice by healthcare professionals and will contribute to improved patient well-being and resilience.

Conclusion

In conclusion, PTSD is a severe condition with negative effects on both mind and body. Treatment of this condition should be individually comprehensive because its pathophysiology, multiple manifestations, and diagnostic complexities demand this approach. With age-specific considerations and case study analysis, the importance of age-specific interventions is also lived. Knowledge about clinical competence and gaining knowledge about PTSD increases the capacity for patient support and advocacy. In the future, it will be crucial to integrate evidence-based interventions and a supportive healthcare environment in order to effectively address PTSD.

References

Du, J., Diao, H., Zhou, X., Zhang, C., Chen, Y., Gao, Y., & Wang, Y. (2022). Post-traumatic stress disorder: a psychiatric disorder requiring urgent attention. Medical review, 2(3), 219-243. https://doi.org/10.1515/mr-2022-0012Links to an external site. 

Han, H. R., Miller, H. N., Nkimbeng, M., Budhathoki, C., Mikhael, T., Rivers, E., … & Wilson, P. (2021). Trauma informed interventions: A systematic review. PloS one, 16(6), e0252747. https://doi.org/10.1371/journal.pone.0252747Links to an external site. 

Raise-Abdullahi, P., Meamar, M., Vafaei, A. A., Alizadeh, M., Dadkhah, M., Shafia, S., … & Rashidy-Pour, A. (2023). Hypothalamus and post-traumatic stress disorder: a review. Brain sciences, 13(7), 1010. https://doi.org/10.3390/brainsci13071010Links to an external site. 

Wojujutari, A. K., Idemudia, E. S., & Ugwu, L. E. (2024). The assessment of reliability generalisation of clinician-administered PTSD scale for DSM-5 (CAPS-5): a meta-analysis. Frontiers in Psychology, 15, 1354229. https://doi.org/10.3389/fpsyg.2024.1354229Links to an external site. 

PSYCH

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PMHNP- Psyc

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  • Cover letter
  • professional Portfolio/Resume. 
  • The Walden University Career Planning and Development site has information on many topics of relevance

PMHNP.

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  • Choose one of the two following specific populations: either pregnant women or older adults. Then, select a specific disorder from the DSM-5-TR to use.
  • Use the Walden Library to research evidence-based treatments for your selected disorder in your selected population (either older adults or pregnant women). You will need to recommend one FDA-approved drug, one non-FDA-approved “off-label” drug, and one nonpharmacological intervention for treating the disorder in that population.

Search History

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See attachments