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Components of a healthy community

Components of a healthy community are outlined in the textbook as having “low crime rates, good schools, strong family life, robust economy, good jobs, high environmental quality (clean air, water), accessible and quality health services, adequate housing, civic involvement, nice weather, good transportation (roads, public transportation), wide variety of leisure activities, exposure to the arts, [and] reasonable taxes” (Maurer & Smith, 2013). Is the culmination of all these variables what defines a healthy community? I don’t think there is ever a perfect combination of these things in most communities. However, I do think that communities that try to achieve these things can be described as healthy or at least striving for health.  For example, a city (a general area that can define community) may not have the best roads or schools or crime rates, but if community members are working towards improving these things, they could be at least described as working towards the improvement of the health of their community. I suppose “health” in a community, as with an individual, is a spectrum and relative to the context in which it exists. We as healthcare providers aim to reach out to our communities and educated them in order to teach them to create changes in themselves and their surrounding areas. “Health promotion is the process of enabling people to improve their health, and stretches beyond individual behavior to encompass areas such as social and environmental interventions… community outreach is a catalysis that can bring these fields together” (Mucedola, 2015).

Educating our youngest community members about healthful lifestyles and learning healthy habits early on is one of the best forms of prevention of chronic diseases. “School and community based health education continue to be valuable assets to curbing the leading causes of morbidity and mortality in the United States” (Mucedola, 2015). This is why public health education and nursing has such an important place in the healthcare system.

 

Maurer, F. A., & Smith, C. M. (2013). Chapter 15: Community assessment. In Community / public health nursing practice: Health for families and populations (5th ed.). Retrieved October 2, 2017.

Mucedola, M. S. (2015). Connecting Health Education and Health Promotion through Community Outreach to Bridge PreK-12 School Health Programs and Corresponding Communities. Virginia Journal, 36(2), 4-7.

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Competency

Competency

Competency

Scenario

You are a website designer and are currently being considered as the designer for a complete redesign of a medical facility’s website page. They have not updated their website in over 15 years due to the lack of staff. The website needs the redesign to target the specific visual preferences of patients and medical clients. They have several other designers that they are interviewing, and you decide to create a video presentation to impress them to choose you as their website designer.

As you begin your presentation, you decide that your design will include the following visual concepts and elements:

  1. Visual Organization
  2. Visual Simplicity
  3. Visual Interactivity
  4. Charts and Graphs
  5. Images

In designing these visual elements, you keep the target audience of patients and medical clients as the main focus. You carefully consider what these types of people wish to see at a medical facility. You also consider what visual elements will attract the eye, and yet enhance a specific mood and emotional response for viewers.

After creating the website, you record your explanation of your visual design choices in an audio/video screen share.

Your presentation should be a maximum of 5 minutes.

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mental health problems

Essay 500 words

1. Please identify a professional practice issue for which you may pursue as you complete your doctoral studies. Please include how you envision accomplishing this project and how it will change nursing practice. The purpose of this essay is for demonstration of critical thinking related to a practice or patient problem and strategies to resolve or address the problem.

(I would like to focus on our war veterans that suffer from PTSD and other Mental disabilities, my goal with the DNP education is to create a Non-profit organization to help our war veterans suffering mental health problems in our communities. To provide more access and information on mental  health services, to create plans and new interventions for those that do not have access or conditions to afford health care including our homeless war veterans)

1. Identify a professional practice issue and its significance.

2. Identify the project proposal’s, address the following item:

3. Population/Problem:

4. Intervention:

5. Comparison (ie: standard care vs proposed intervention)

6. Expected Outcome:

7. Proposed site(s) to conduct the study:  (South Florida – Miami area)

8. Identify at least one of the AACN DNP Essentials that you may find challenging as you implement your project and how you might overcome that challenge.

All applicants should review the following additional guidelines and resources prior to writing the required essays and include them in the essay where appropriate. Your Admissions Advisor will speak to you in greater detail regarding this.

http://www.aacnnursing.org/Education-Resources/AACN-Essentials – AACN Essentials for Doctoral Education. This resource provides a solid foundation of the DNP’s focus and philosophy.

http://www.aacnnursing.org/DNP – The latest white paper on DNP.

http://www.nonpf.org/?page=14 – National Organization of Nurse Practitioner Faculties (NONPF NP) Role Competencies and specialty-specific competencies.

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IOM Future of Nursing

In a reflection of 450-600 words, explain how you see yourself fitting into the following IOM Future of Nursing recommendations:

Recommendation 4: Increase the proportion of nurses with a baccalaureate degree to 80% by 2020.
Recommendation 5: Double the number of nurses with a doctorate by 2020.
Recommendation 6: Ensure that nurses engage in lifelong learning.
Identify your options in the job market based on your educational level.

How will increasing your level of education affect how you compete in the current job market?
How will increasing your level of education affect your role in the future of nursing?
While APA format is not required for the body of this assignment, solid academic writing is expected and in-text citations and references should be presented using APA documentation guidelines

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Care Delivery or Nursing Model Change 

TOPIC: Care Delivery or Nursing Model Change 

There will be times when the doctorally prepared advance practice nurse will need to suggest a nursing model change or a change in care delivery. It will be important for the doctorally prepared advanced practice nurse to have an understanding of how to deliver information and what information should be shared with an audience.

This assignment will give you practice with presentation software along with preparing you to provide specific information for your proposed changes. This is a two-part assignment that will also give you practice in presenting to administrators.

General Requirements:

Use the following information to ensure successful completion of the assignment:

  • Doctoral      learners are required to use APA style for their writing assignments.
  • This      assignment requires that at least three additional scholarly research      sources related to this topic, and at least one in-text citation from each      source be included.

Directions:

Part One:

Create a 12-15 slide presentation (PowerPoint, include slide notes or voice over; Prezi, include voice over) that presents a proposed care delivery or nursing model change for a department that aligns costs, quality, and health that supports the care of patients across the continuum. Include the following:

  1. Background      of issue
  2. The      proposed solution
  3. How      solution meets need of population (stakeholders, cost, and payer to      proposed change)
  4. Proposed      change process to implement delivery model
  5. Expected      outcomes
  6. Implications      that are realistic and aligned with current and future health care      financing

Part Two:

  1. Present      your presentation to at least one administrator.

Write a brief summary, 100-250 words, of the feedback given to you by the administrator(s).

You are required to complete your assignment using real-world application. Real-world application requires the use of evidence-based data, contemporary theories, and concepts presented in the course. The culmination of your assignment must present a viable application in a current practice setting.

Resources

Financial and Business Management for the Doctor of Nursing Practice

Read chapters 2, 4, and 5.

URL: http://gcumedia.com/digital-resources/springer-publishing-company/2012/financial-and-business-management-for-the-doctor-of-nursing-practice_ebook_1e.php

Sage, W. M. (2016). Minding Ps and Qs: The political and policy questions framing health care spending. Journal of Law, Medicine & Ethics44(4), 559-568

URL:https://lopes.idm.oclc.org/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=120397894&site=ehost-live&scope=site

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types of anemia

In clinical settings, advanced practice nurses often encounter patients with blood disorders such as anemia. Consider the case of a 17-year-old girl who is rushed to the emergency room after suddenly fainting. The girl’s mother reports that her daughter has had difficulty concentrating for the past week, frequently becomes dizzy, and has not been eating normally due to digestion problems. The mother also informs the nurse that their family has a history of anemia. With the family history of anemia, it appears that this is the likely diagnosis. However, in order to properly diagnose and treat the patient, not only must her symptoms and family history be considered, but also factors such as gender, ethnicity, age, and behavior. This poses the question: How do patient factors impact the incidence and prevalence of different types of anemia?

To Prepare

· Review Chapter 21 in the Huether and McCance text. Reflect on the pathophysiological mechanisms of iron deficiency anemia.

· Select one of the following types of anemia: pernicious anemia, folate deficiency anemia, sideroblastic anemia, chronic inflammation anemia, or post-hemorrhagic anemia. Identify the pathophysiological mechanisms of the anemia you selected.

· Consider the similarities and differences between iron deficiency anemia and the type of anemia you selected.

· Reflect on how patient factors such as genetics, gender, ethnicity, age, and behavior might impact these anemic disorders.

Write

· An explanation of the pathophysiological mechanisms of iron deficiency anemia and the anemia you selected (pernicious anemia). explanation at the cellular or molecular level (whenever possible).

· Compare these two types of anemia, as well as their potential causes.

· Finally, explain how genetics, gender, ethnicity, age, and behavior might impact the anemic disorders you selected.

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nurse poaching

Before posting to this discussion board, read the following article:Singh, J. A., Mkala, B., Amuah, E., Mehta, N., & Ahmad, A. (2003) The ethics of nurse poaching from the developing world. Nursing Ethics, 10(6), 666-670.This article is available via the Reading tab on the Purdue Northwest Course Library Guide.As you read, think about how this impacts nursing in the United States. Then answer the following:

1-Do you think that nurse poaching from poor nations is ethical? Support your answer….why or why not?

2-What do you think the positions are for: the nurse leaving the country; the home country; and the country that the nurse will be going to? In other words, what are the pros and cons for each of the entities involved?

Your response should be written in your own words, consist of complete sentences, and should be at least two to three complete paragraphs.

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ADHD 

The Assignment

Examine Case Study: A Young Caucasian Girl With ADHD You will be asked to make three decisions concerning the medication to prescribe to this client. Be sure to consider factors that might impact the client’s pharmacokinetic and pharmacodynamic processes.

At each decision point stop to complete the following:

· Decision #1

o Which decision did you select?

o Why did you select this decision? Support your response with evidence and references to the Learning Resources.

o What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.

o Explain any difference between what you expected to achieve with

Decision #1 and the results of the decision. Why were they different?

· Decision #2

o Why did you select this decision? Support your response with evidence and references to the Learning Resources.

o What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.

o Explain any difference between what you expected to achieve with Decision #2 and the results of the decision. Why were they different?

· Decision #3

o Why did you select this decision? Support your response with evidence and references to the Learning Resources.

o What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.

o Explain any difference between what you expected to achieve with

o Decision #3 and the results of the decision. Why were they different?

Also include how ethical considerations might impact your treatment plan and communication with clients.

Note: Support your rationale with a minimum of three academic resources no more than five years old in APA Format

Attention Deficit Hyperactivity Disorder
A Young Girl With ADHD

BACKGROUND

Katie is an 8 year old Caucasian female who is brought to your office today by her mother & father. They report that they were referred to you by their primary care provider after seeking her advice because Katie’s teacher suggested that she may have ADHD. Katie’s parents reported that their PCP felt that she should be evaluated by psychiatry to determine whether or not she has this condition.

The parents give the PMHNP a copy of a form titled “Conner’s Teacher Rating Scale-Revised”. This scale was filled out by Katie’s teacher and sent home to the parents so that they could share it with their family primary care provider. According to the scoring provided by her teacher, Katie is inattentive, easily distracted, forgets things she already learned, is poor in spelling, reading, and arithmetic. Her attention span is short, and she is noted to only pay attention to things she is interested in. The teacher opined that she lacks interest in school work and is easily distracted. Katie is also noted to start things but never finish them, and seldom follows through on instructions and fails to finish her school work.

Katie’s parents actively deny that Katie has ADHD. “She would be running around like a wild person if she had ADHD” reports her mother. “She is never defiant or has temper outburst” adds her father.

 

SUBJECTIVE

Katie reports that she doesn’t know what the “big deal” is. She states that school is “OK”- her favorite subjects are “art” and “recess.” She states that she finds her other subjects boring, and sometimes hard because she feels “lost”. She admits that her mind does wander during class to things that she thinks of as more fun. “Sometimes” Katie reports “I will just be thinking about nothing and the teacher will call my name and I don’t know what they were talking about.”

Katie reports that her home life is just fine. She reports that she loves her parents and that they are very good and kind to her. Denies any abuse, denies bullying at school. Offers no other concerns at this time.

 

MENTAL STATUS EXAM

The client is an 8 year old Caucasian female who appears appropriately developed for her age. Her speech is clear, coherent, and logical. She is appropriately oriented to person, place, time, and event. She is dressed appropriately for the weather and time of year. She demonstrates no noteworthy mannerisms, gestures, or tics. Self-reported mood is euthymic. Affect is bright. Katie denies visual or auditory hallucinations, no delusional or paranoid thought processes readily appreciated. Attention and concentration are grossly intact based on Katie’s attending to the clinical interview and her ability to count backwards from 100 by serial 2’s and 5’s. Insight and judgment appear age appropriate. Katie denies any suicidal or homicidal ideation.

Diagnosis: Attention deficit hyperactivity disorder, predominantly inattentive presentation

Decision Point One:

Begin Wellbutrin (bupropion) XL 150 mg orally daily

RESULTS OF DECISION POINT # ONE

Client returns to clinic in four weeks

Katie’s parents inform you that they stopped giving Katie the medication because about 2 weeks into the prescription, Katie told her parents that she was thinking about hurting herself. This scared the parents, but they didn’t want to “bother you” by calling the office, so they felt that it would be best to just stop the medication as they would be seeing you in two weeks

Decision Point #Two:

Select what the PMHNP should do next:

Educate the parents that Bupropion sometimes causes suicidal ideation in children and that this is normal, and restart the drug at the previous dose

RESULTS OF DECISION POINT TWO

Client returns to clinic in four weeks

Katie’s parents again report that after about a week of treatment with the Bupropion, Katie began telling her parents that she wanted to hurt herself and began having dreams about being dead. This scared her parents and they stopped giving her the medication

At this point, they are quite upset with the results of their daughter’s treatment and are convinced that medication is not the answer

Decision Point # Three:

Select what the PMHNP should do next:

Refer the parents to a pediatric psychologist who can use behavioral therapy to treat Katie’s ADHD

Guidance to Student

Bupropion is used off-label for ADHD and is used more commonly in adults. It’s mechanism of action results in increasing the neurotransmitters norepinephrine/noradrenaline and dopamine. Since dopamine is inactivated by norepinephrine reuptake in frontal cortex, (which largely lacks dopamine transporters) bupropion can increase dopamine neurotransmission in this part of the brain, which may explain its effectiveness in ADHD. However, Bupropion as well as other antidepressants have been linked to suicidal ideation in children and adolescents- despite the fact that it was being used initially to treat ADHD, it is still an antidepressant.

At this point, the parents are probably quite frustrated as no parent wants to hear their child talking about hurting themselves or having dreams about being dead. If the parents are adamant about no more medications, referral to a pediatric psychologist or similar therapist skilled in the use of behavioral therapies to treat ADHD in children. However, it should be noted that behavioral therapies work best when combined with medication, however, if the parents are insistent, then behavioral therapy may be the only alternative left in the treatment of Katie.

In terms of the pathophysiology of ADHD, whereas it may be true that increasing age may demonstrate some improvement in symptoms (some people will actually experience complete resolution of symptoms by adulthood), it is not helping Katie in the here and now. Katie still needs help with her symptoms which are causing academic issues.

The PMHNP should attempt to repair the rupture in the therapeutic alliance (the parents now believe that medications are not the answer) by explaining rationale for the use of Bupropion (many people like to start with Bupropion because it has a low-risk for addiction). The family should be encouraged to allow the PMHNP to initiate Adderall as it has a very good track record in terms of its efficacy in treating ADHD.

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Statement and Literature 

Assignment 1 PICOT Statement and Literature

The first step of the EBP process is to develop a question from the nursing practice problem of interest. Select a practice problem of interest to use as the focus of your research. Start with the patient and identify the clinical problems or issues that arise from clinical care. Following the PICOT format, write a PICOT statement in your selected practice problem area of interest, which is applicable to your proposed capstone project. The PICOT statement will provide a framework for your capstone project (the project students must complete during their final course in the RN-BSN program of study). Conduct a literature search to locate research articles focused on your selected practice problem of interest. This literature search should include both quantitative and qualitative peer-reviewed research articles to support your practice problem. Select six peer-reviewed research articles which will be utilized through the next 5 weeks as reference sources. Be sure that some of the articles use qualitative research and that some use quantitative research. Create a reference list in which the six articles are listed. Beneath each reference include the article’s abstract. The completed assignment should have a title page and a reference list with abstracts. Suggestions for locating qualitative and quantitative research articles from credible sources:

1. Use a library database such as CINAHL Complete for your search.

2. Using the advanced search page check the box beside “Research Article” in the “Limit Your Results” section.

3. When setting up the search you can type your topic in the top box, then add quantitative or qualitative as a search term in one of the lower boxes. Research articles often are described as qualitative or quantitative.

To narrow/broaden your search, remove the words qualitative and quantitative and include words that narrow or broaden your main topic. For example: Diabetes and pediatric and dialysis. To determine what research design was used, review the abstract and the methods section of the article. The author will provide a description of data collection using qualitative or quantitative methods. Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required. https://www.guideline.gov/(week 1)

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ethical dilemma

1. Mrs. Elle, 80 years of age, is a female patient who is diagnosed with end-stage cancer of the small intestine. She is currently receiving comfort measures only in hospice. She has gangrene of her right foot and has a history of diabetes controlled with oral agents. She is confused and the physician has determined that she is unable to make her own informed decisions. The hospice nurse, not realizing that the weekly order for CBC and renal profile had been discontinued, obtained the labs and sent them to the nearby laboratory for processing. The abnormal lab results obtained later that day revealed that the patient needed a blood transfusion. The hospice nurse updated the patient’s medical power of attorney who was distressed at the report. The patient’s wishes were to die peacefully and to not have to undergo an amputation of her right foot. But if the patient receives the blood transfusion, she may live long enough to need the amputation. The patient’s physician had previously informed the medical power of attorney that the patient would most likely not be able to survive the amputation. The patient’s medical power of attorney had made the request to cease all labs so that the patient would receive comfort measures until she died. The patient has no complaint of shortness of breath or discomfort.

  1. What ethical dilemma exists?
  2. Who are the stakeholders and what gains or losses do each have?
  3. What strategies should the hospice nurse take to resolve the ethical dilemma?

2. The nurse receives a 12-year-old girl from the operating room after an emergent appendectomy due to ruptured appendix. Upon arrival to the postanesthesia care unit, the patient is drowsy, but arousable to voice; she was extubated in the operating room and is receiving oxygen by facemask at 40%. She has two peripheral IVs in her left arm that are infusing Lactated Ringers solution at 100 mL/hr. A nasogastric tube is attached to low constant suction, and a small amount of aspirate is noted. She has a urinary catheter that is draining clear, yellow urine. Her abdominal dressing is dry and intact. Upon arousal, she complains of abdominal pain.

  1. What NANDA-approved nursing diagnoses may be relevant to this patient?
  2. Once the nursing diagnoses are determined, what steps does the nurse take to complete the Planning Phase of the Nursing Process?
  3. What is the difference between nursing diagnoses and collaborative problems?

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