DUE TOMORROW @ 8PM……NO PLAGARISM, FOLLOW ALL INSTRUCTIONS

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 GRADUATE PRIMARY CARE CLASS FOR FAMILY NURSE PRACTITIONER

Goals for this semester – Due

11:59 PM

4 goals – each goal should be:

Specific

 Measurable

Achievable

Relevant

Time-Bound.

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Week 1 Discussion: Social Factors

I live in Lady Lake, FL. According to the U.S. Census Bureau in 2022, the city of Lady Lake’s population was 16,661, the median income was $42,088, and the percentage of people living in poverty was 14.0% (U.S. Census Bureau, 2022). The grocery store that I usually shop at and that is local is called Winn-Dixie. The Winn-Dixie I went to was located in Lady Lake FL. I did my research when I went grocery shopping yesterday and gathered the prices of the following, all were non-organic.

· 1 gallon of milk: $ 4.19 (whole milk)

· 1 loaf of bread: $4.19 (butter bread)

· 1 bag of apples (including price per pound): $5.99 (for a 3lb bag) /$2.39 per pound.

· 1 bag of carrots: $2.39 (baby-cut carrots)

· 1 large container of yogurt: $5.99 (Greek yogurt 32 ounces)

· 1 2-liter of soda: $1.49 (liter of coke)

· 1 bag of chips: $5.99 (bag of Doritos)

· 1 package of cookies: $4.19 (Chips Ahoy)

When it comes to buying groceries there are several social factors that could impact what groceries are purchased. Poverty levels can impact what groceries are purchased due to limited income. Those with limited income and are considered to be “in poverty” will rely more on cheaper and more affordable food options.  According to the US Department of Health and Human Services, “Low-income groups tend to rely on foods that are cheap and convenient to access but are often low in nutrients” (U.S. Department of Health and Human Services, n.d.).Cheaper food options may not be the most nutritious or healthy. Also, those who live in poverty might rely more on food that is processed and packaged, these foods will last longer helping them get the most out of their money.  We can look at what is gathered above, yogurt is $5.99 and will not last as long as cookies which is $4.19.

The second social factor that could impact what groceries are purchased would be availability. When grocery stores have a wide variety of fresh fruits and vegetables it can be easier for people to select those healthier options and incorporate them into their diets. If the grocery stores do not have these items readily available, then customers may be led to frozen processed fruits and vegetables. Availability and assortment are important for those who may not have the money or accessibility to other sources of fresh produce.

A community health nurse could use outreach as an intervention to address areas of food security. According to our book,
Community/Public Health Nursing, the definition of outreach is, “locates populations of interest or populations at risk and provides information about the nature of the concern, what can be done about it, and how services can be obtained” (Nies & McEwen, 2022). The community health nurse should focus on the poverty population recognizing that they are at risk for food security and reach out to them. Once information is gathered the CHN can then do further research on how we can help those in need and provide them the services they may need.

References

Nies, M., & McEwen, M. (2022).
Community/Public Health Nursing. Elsevier Health Sciences.

U.S. Census Bureau. (2022).
U.S. Census Bureau. Retrieved from https://www.census.gov/quickfacts/fact/table/ladylaketownflorida,US/PST045222?

U.S. Department of Health and Human Services. (n.d.).
U.S. Department of Health and Human Services. Retrieved from Access to Foods That Support Healthy Dietary Patterns: https://health.gov/healthypeople/priority-areas/social-determinants-health/literature-summaries/access-foods-support-healthy-dietary-patterns#:~:text=Low%2Dincome%20groups%20tend%20to,are%20often%20low%20in%20nutrients.&text=Fresh%20fruits%20and%20vegetab


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Discussion 3-5550

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Visit http://www.aha.org/advocacy-issues/communicatingpts/pt-care-partnership.shtml and review the American Hospital Association’s Patients’ Bill of Rights. Discuss how health care professionals can ensure that patients’ rights are upheld and protected. Please make sure to provide citations and references (in APA, 7th ed. format) for your work.  Limit is 500 words 

informatics

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As you learned from the chapters and video lectures, there is a disbalance in the supply and demand of health care professionals. Some experts think that this happens in the US since too many medical students go into specialty medicine leaving many spots available in primary care while others believe that the problem is the overreliance of physicians instead of using other health care professionals to address a large majority of health care needs. What do you think are the real drivers of this disbalance? What would you do to improve this situation? 

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With new information continually emerging, professional nurses must be equipped to critique scholarly literature and discern its value for practice. Select one current, quantitative scholarly nursing article related to your PICOT question and determine its strengths, limitations, and potential application.

Complete the 
Johns Hopkins Nursing Evidence-Based Practice Appendix E Evidence Appraisal ToolLinks to an external site.
 Download Johns Hopkins Nursing Evidence Based Practice Appendix E Evidence Appraisal Tool. Once you’ve completed the tool, use your own words to summarize your appraisal of the article. Include the following:

· Description of the purpose

· Explanation of research design

· Discussion of sample

· Description of data collection methods

· Summary of findings

· Strengths of the study (minimum of 1)

· Limitations of the study (minimum of 1)

· Recommendations regarding potential application for future practice that are insightful and appropriate.

CULTURAL WK 5 DISCUSSION

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 Discussion Post Topic #5: In dealing with cultural differences/potential conflict in nursing/healthcare, what assessments and strategies would you incorporate to gain compliance from your culturally diverse client(s). Provide examples of the culture(s) discussed and your evidenced-based strategies. 

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

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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.).

Response

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  Due today 09/28/23 2000 EST

Respond by making recommendations for how they might strengthen the leadership behaviors profiled in their StrengthsFinder assessment, or by commenting on lessons to be learned from the results that can be applied to personal leadership philosophies and behaviors.

2 scholarly references

The strength finder assessment I took is an eye opener to my strengths and weaknesses. It also showed me where to exert some effort and how to do it. The findings followed this order.

1. Achieving Person: Achiever means someone who is always looking to do better. This theme helps me understand what my drive is. I am always looking to get things done better and more manageable. 

2. Consistency: I care about balance. It is essential to treat everyone the same, no matter their situation, not wanting the scales to tip too far in favor of one person because that sends wrong signals to the team.  

 3. Gathering Information: I think critically and make out opinions of things and people. I might be trying to solve a problem, develop an idea, or understand how someone else feels. 

 4. Harmony/ Teamwork: I want people to have a common ground for achieving goals. There is little to gain from disagreement and chaos. When I know that the people around me have different ideas, finding common ground always breaks the ice and ensures we achieve common goals.

5. Relator/Relationship: The Relator theme makes me want to be with people I already know. Meeting new people might be challenging, but it is worth trying to achieve a common goal.

      The two central values that I would strengthen are optimism and creativity. There are times when I need more confidence concerning some situations. As for creativity, I do have various concepts that I can implement. Nurses are known for their emotional intelligence and critical thinking, which might affect their effectiveness. These attributes may affect clinical decision-making, reasoning, evidence-based practice, and practice-based knowledge in nursing. (Kaya et al. 2018) 

     The two strengths that I would make sturdier is self-confidence because, many times, self-doubt places a trick on me, especially when I am not sure about an issue. I will also work on building relationships because making new associates has advantages. 

       Two qualities must be improved upon: patience with my associates when handling issues. And delegating. Being a perfectionist makes me want to do everything myself to get the desired outcome. I need to harmonize these findings to achieve the best out of my strengths and weaknesses. 

                                                                                     Reference 

Kaya, H., Şenyuva, E., & Bodur, G. (2018). The relationship between critical thinking and emotional intelligence in nursing students: A longitudinal study. Nurse Education Today, 68(68), 26–32. https://doi.org/10.1016/j.nedt.2018.05.024

Rath, T. (2007). Strengthsfinder 2.0. Gallup Press.

Broome, M., & Marshall, E. S. (2021). Transformational leadership in nursing: From expert clinician to influential leader (3rd ed.). New York, NY: Springer. (pp. 182–211)

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Hypertension

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According to the rubric i have attached 

discussion

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 Dear Students, Health information is data related to medical history.

Health information records include history, lab results, diagnostic information, and notes. It creates data sets that are used for individuals and populations.

Questions:

When thinking about Health Care information and HIT, autonomy is often an ethical issue. What concerns would patients have about their privacy with electronic health records.
How is beneficence and non-maleficence violated with ransomware?

Rubrics:

APA style 7th edition format
Submit it as word document attachments.
Presentation and references pages are required. 

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