****************My project topic is on High Blood Pressure in African Americans, that is my target audience****************************
What are the processes and the criteria you will use to select your target audience? What is your personal and/or professional connection to your target audience?  
Your initial posting should be 400 words in length and utilize at least one scholarly source other than the textbook.
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List 4 PROGRESS NOTES BRIEFLY  of the PSYCHOTHERAPY ACTIVITIES IN SOAP FORMAT (NO MORE THE 300 WORDS) describes the activities you completed during this time period.
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  Introduction and Alignment
Laboratory tests should be ordered or reviewed for every mental health patient.  Many of the patients that come to you will have seen their primary care doctors within the past year.  It is acceptable for you to have the patient sign a release of information (ROI) so that you can request their previous labs for a baseline and to include them on the chart in our office. There may be times that you feel that the labs need to be repeated due to previous abnormal values, amount of time since testing or presenting symptoms.  Labs are commonly ordered and depending on the patient’s insurance carrier can be expensive. If labs are not drawn in your office, they may also be inconvenient for the patient. And often times, patients will complain about the discomfort associated with the initial stick for venous access. It is important for the PMHNP to know the most common labs that are indicated for review and chart inclusion for mental health patients according to diagnosis and medications being prescribed.  All mental health patients should have a CBC, CMP, Lipid panel, TSH, Vitamin D and Vitamin B12 at a minimum.  For certain disorders and medications (anticonvulsants and atypical antipsychotics) you may need to consider additional lab tests.  What additional labs do you need to consider? You should include these additional labs in your PowerPoint™. Depending upon presentation, history and office practice, you may also need to order UDS on each patient initially and at established intervals.  Include specifics that you are looking for with the UDS. How often should labs be ordered?
Genetic testing is now being used to identify what medications may be more acceptable or contraindicated for patients based upon their genetic map.  There are multiple tests and labs that have been developed and marketed to providers to potentially aid in medication management choices.  There are some limitations with the testing. The most important being that they predict metabolism and bioavailability of medications but they do not predict a patient’s clinical response (improvement in mental health) to a particular medication.  Genetic testing is most commonly performed using buccal swabs. The provider will swab the patient’s oral cavity and then send the specimen to the lab for processing via UPS or FedEx.
  Background Information
In this workshop, you will discuss each test listed above and laboratory values that may indicate that the patient is suffering from a metabolic issue versus a mental health issue.  Some metabolic imbalances can mimic or produce mental health symptoms.
In this workshop, you will examine the tests mentioned and their pertinence in mental health care assessment and management.
The best PowerPoint presentations use standardized positions and style. They provide only necessary information and when combined with graphics are entertaining as well as informative.  The PowerPoint will have colors that contrast and complement each other.  Also, do not try to include all of the information on the PowerPoint slide itself.  Information can be entered into the notes section to be used during the presentation.  You want your audience to have fun and be engaged.
Instructions Develop a PowerPoint™ presentation to discuss each of the above highlighted labs and how pertinent findings may impact your mental health diagnosis and treatment plan.  Briefly explain the disorder you are ruling out or in with the testing results and state the rationale for the testing needed in the scenario. Be as specific as possible providing a basic overview of the tests that you are assessing as well as the benefits, risks, and limitations. Use on slide for each bolded test – use the notes section on PPT to relay added information regarding each test. Provide citations for information on each slide. When you have completed your assignment, save a copy for yourself and submit a copy to your instructor using the 3.2 Assignment by day Five of the workshop. Submit a copy in the Laboratory testing discussion thread for your peers to read on day Six.  Review the rubric to make sure you understand the criteria for earning your grade.
NOTE:  This information should be useful to refer back to your clinical settings, so students are recommended to download the PowerPoints or print the handouts of other student’s presentations for future reference.

 
Chief complaint: “I have recurrent H. Pylori infection”.
HPI: M.C. a 46-year-old Hispanic female presents to the GI clinic for complaint of recurrent H. Pylori infection. She was treated about 2 ½ months ago with H. Pylori triple therapy and failed treatment. She has PMH of dyspepsia, and GERD. She also indicates that she has noticed that her symptoms of dyspepsia are worsening for past 2 months. She has associated her symptoms with nausea, upset stomach with all foods. Denies associated symptoms of hematochezia, melena, hemoptysis, abdominal pain, fever, chills, pain or any other symptoms.
PMH:
H. Pylori infection gastritis
Diabetes Mellitus, type 2
Surgeries: None
Allergies: NKDA
Vaccination History: Up-to-date
Social history:
High school graduate, married and no children. He frequently eats out in restaurants. He drinks one 4-ounce glass of red wine daily. He is a former smoker that stopped 3 years ago.
Family history:
Both parents are alive. Father has history of DM type 2, Tinea Pedis. Mother alive and has history of atopic dermatitis, tinea corporis and tinea pedis.
ROS:
Constitutional: Negative for fever. Negative for chills.
Respiratory: No Shortness of breath. No Orthopnea.
Cardiovascular: No edema. No palpitations.
Gastrointestinal: No vomiting. +Dyspepsia. + Nausea. No constipation. No melena. No abdominal pain.
Physical examination:
Vital Signs
Height: 5 feet 5 inches Weight: 140 pounds BMI: 31 obesity, BP 110/70 T 98.0 po P 80 R 22, non-labored
ABDOMEN: No abdominal distention. Nontender. Bowel sounds + x 4 quadrants. No organomegaly. Normal contour; No palpable masses.
Labs day of visit:: Hgb 15.2, Hct 40%, K+ 4.0, Na+137, Serum Creatinine normal 1.0, AST/ALT normal. TSH 3.7 normal, glucose 98 normal
Assessment:
Primary Diagnosis: Recurrent H. Pylori infection gastritis
Secondary Diagnoses: Dyspepsia
Differential Diagnosis: Peptic Ulcer Disease
Previous medication plan: two months ago and failed. Clarithromycin      500 mg po BID for 2 weeks Omeprazole      40 mg po BID for 2 weeks and then po daily. Cipro      500 mg po BID for 2 weeks
Plan: Tests
Pt had EGD done 2 weeks ago that showed H. Pylori positive gastritis in biopsy results.
Urea breath test 8 weeks after treatment with H. Pylori medications. Pt needs to stop PPI’s 2 weeks prior to Urea Breath test.
Labs: No new labs are needed.  
Referrals: may refer based on effect of medication therapy given for 2 weeks.
Follow up: return to office in 8 weeks to reevaluate symptoms.
As a future nurse practitioner, it is important that you determine the medications used for recurrent H. Pylori infection.
Please discuss new therapy guidelines for H. Pylori treatment, and provide patient education.
Below is the website for the American Academy of Gastroenterology Clinical Guidelines (ACG) for the updated H. Pylori therapy. Feel free to consult other peer-reviewed articles within 5 years of publication. 
APA guidelines
 http://gi.org/wp-content/uploads/2017/02/ACGManagementofHpyloriGuideline2017.pdf 
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The purpose of this assignment is to create an operational budget presentation identifying key components of budgeting and possible capital purchases that may be required.Scenario: You have been asked to create an operational budget for a 20-bed nursing unit and present it to the senior leaders of your organization.Create a presentation of 10-12 slides, including comprehensive speaker notes that detail the budget.   
1)Provide the key components of budgeting, including the cost of staff, activities, services, and supplies.
2)Identify and describe a relevant capital purchase this unit may require, including the need, the return on investment, benefits, etc.Use at least three references, including your textbook.While APA style is not required for the body of this assignment, solid academic writing is expected, and documentation of sources should be presented using APA formatting guidelines, which can be found in the APA Style Guide, located in the Student Success Center.This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.