Nursing Paper Example on Cowpox

/in , , , , , , , /by

Nursing Paper Example on Cowpox

In the annals of medical history, few diseases have had such a profound impact as cowpox. Often overshadowed by its more infamous relative, smallpox, cowpox played a pivotal role in the development of modern medicine. While smallpox has been eradicated, cowpox continues to intrigue researchers and medical professionals alike due to its unique characteristics and historical significance. This paper aims to provide a comprehensive exploration of cowpox, shedding light on its causes, signs, symptoms, etiology, pathophysiology, DSM-5 diagnosis, treatment regimens, and patient education. By delving into the depths of this disease, we hope to unravel its mysteries and gain a deeper understanding of its implications for both human and animal health. Join us on a journey through time and science as we uncover the fascinating world of cowpox. (Nursing Paper Example on Cowpox)

Nursing Paper Example on Cowpox

Causes

Cowpox, a viral infection, primarily stems from the Orthopoxvirus genus. Transmission occurs through direct contact with infected animals, particularly cows, or contaminated materials. In rural areas where close contact with livestock is common, individuals working in agriculture or veterinary fields face an increased risk of exposure. Moreover, the virus can persist in the environment, contaminating surfaces and equipment, thereby posing a risk to individuals who come into contact with these fomites.

The primary reservoirs for the Cowpox virus are wild rodents, such as voles and field mice, which serve as natural hosts. Transmission to domestic animals, including cows, cats, and occasionally horses, occurs through direct contact or through intermediate hosts, such as domestic cats that hunt infected rodents. Human infections often result from contact with infected animals or materials, highlighting the zoonotic nature of the disease.

In rare cases, human-to-human transmission may transpire, typically through close contact with lesions. While the risk of human-to-human transmission is low, healthcare workers and caregivers may be at increased risk if proper precautions are not observed. Additionally, individuals with compromised immune systems, such as those undergoing immunosuppressive therapy or living with certain medical conditions, may be more susceptible to severe cowpox infections.

Preventive measures focus on minimizing contact with infected animals and contaminated materials. Proper hygiene practices, such as handwashing with soap and water after handling animals or visiting areas where rodents may reside, are essential for reducing the risk of transmission. Vaccination against smallpox, which confers cross-protection against cowpox, played a significant role in controlling the spread of both diseases historically. However, with the eradication of smallpox, vaccination against cowpox is no longer routinely practiced but may be considered in specific occupational settings or for individuals at higher risk of exposure. (Nursing Paper Example on Cowpox)

Signs and Symptoms

Typically, cowpox manifests with localized lesions on the hands, particularly in those who handle infected animals or contaminated materials. The initial presentation often includes the appearance of small, red papules at the site of inoculation, which may progress to vesicles and then to pustules over the course of several days. These lesions are often surrounded by erythema and may be accompanied by pruritus or tenderness.

As the disease progresses, the pustules become larger and eventually rupture, forming crusts or scabs. The presence of multiple lesions in various stages of development is characteristic of cowpox infection. While the hands are the most commonly affected site due to direct contact with infected animals or materials, lesions may also occur on other exposed areas of the body, such as the face and arms.

Accompanying symptoms may include fever, malaise, and regional lymphadenopathy. Fever is typically low-grade but may be more pronounced in severe cases or in individuals with compromised immune function. Malaise, or a general feeling of discomfort or illness, is common and may precede the appearance of skin lesions. Regional lymphadenopathy, characterized by tender or swollen lymph nodes near the site of infection, is an inflammatory response to the viral infection.

In some cases, particularly in individuals with weakened immune systems, cowpox infections may lead to more severe symptoms, including systemic illness and complications such as pneumonia or encephalitis. These severe manifestations are rare but underscore the importance of prompt diagnosis and appropriate medical management.

Recognition of the characteristic signs and symptoms of cowpox is essential for accurate diagnosis and timely intervention. Early identification of the disease allows for implementation of appropriate infection control measures and initiation of supportive care to alleviate symptoms and prevent complications. (Nursing Paper Example on Cowpox)

Etiology

The primary causative agent of cowpox is the Cowpox virus, a member of the Orthopoxvirus genus within the family Poxviridae. This enveloped, double-stranded DNA virus is closely related to other orthopoxviruses, including the variola virus, which causes smallpox, and the vaccinia virus, which was historically used in smallpox vaccination.

The natural reservoirs for the Cowpox virus are wild rodents, particularly voles and field mice, which serve as the primary hosts for viral replication. These rodents play a crucial role in the maintenance and transmission of the virus within wildlife populations. Transmission to domestic animals occurs through direct contact with infected rodents or through intermediate hosts, such as domestic cats that hunt infected rodents.

Human infections most commonly occur through direct contact with infected animals, particularly cows, cats, or rodents, or through exposure to contaminated materials, such as bedding or equipment used in animal husbandry. Occupational groups at increased risk of exposure include farmers, veterinarians, and laboratory workers who handle animals or animal products.

The ability of the Cowpox virus to infect a wide range of hosts, from rodents to domestic animals to humans, highlights its zoonotic potential. While the virus typically causes mild disease in its natural hosts, it can lead to more severe illness in incidental hosts, such as humans, particularly those with compromised immune systems.

Understanding the etiology of cowpox is crucial for implementing effective control measures and preventive strategies. By elucidating the natural history of the virus and its transmission dynamics, researchers and public health officials can develop targeted interventions to reduce the risk of human infection and minimize the impact of cowpox on both human and animal health. Continued surveillance and research are essential for monitoring changes in the epidemiology of cowpox and informing evidence-based prevention and control efforts. (Nursing Paper Example on Cowpox)

Pathophysiology

Upon entry into the human body, the Cowpox virus initiates infection by binding to specific cell surface receptors, facilitating viral entry into host cells. The virus primarily targets epithelial cells, such as those lining the skin and mucous membranes, leading to local replication and the formation of characteristic skin lesions.

Following viral entry, the Cowpox virus undergoes replication within the cytoplasm of infected cells. Viral replication is accompanied by the expression of viral genes and the production of viral proteins, which facilitate the assembly of new viral particles. As viral replication progresses, infected cells undergo lysis, releasing infectious virions into the surrounding tissue.

The host immune response plays a critical role in controlling the spread of the virus and limiting the severity of infection. Innate immune mechanisms, including the release of cytokines and activation of immune cells, help to initiate an early antiviral response. Subsequently, adaptive immune responses, mediated by T cells and antibodies, contribute to the clearance of the virus and the resolution of infection.

In individuals with intact immune function, cowpox infection typically results in mild, self-limiting disease characterized by localized skin lesions and systemic symptoms such as fever and malaise. However, in immunocompromised individuals or those with underlying health conditions, cowpox infection may lead to more severe illness and complications, including disseminated infection and systemic manifestations.

The pathophysiology of cowpox infection underscores the importance of host immune responses in determining the clinical course and outcome of disease. Further elucidation of the interactions between the virus and the host immune system may provide insights into potential therapeutic targets for the treatment of cowpox infection. Additionally, understanding the pathophysiological mechanisms underlying severe disease may aid in the development of strategies to prevent and manage complications associated with cowpox infection. (Nursing Paper Example on Cowpox)

DSM-5 Diagnosis

Diagnosing cowpox typically relies on clinical evaluation and recognition of characteristic signs and symptoms. However, in some cases, laboratory testing may be necessary to confirm the diagnosis and differentiate cowpox from other similar skin conditions.

According to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), cowpox would not be classified as a mental disorder, as it is an infectious disease with primarily physical manifestations. However, the DSM-5 provides criteria for diagnosing other relevant conditions, such as anxiety or adjustment disorders, which may arise in response to the stress and uncertainty associated with a cowpox infection.

In clinical practice, the diagnosis of cowpox is typically based on the presence of characteristic skin lesions, particularly in individuals with a history of exposure to infected animals or materials. The appearance of papules, vesicles, and pustules on the hands or other exposed areas of the body, accompanied by symptoms such as fever and malaise, raises suspicion for cowpox infection.

Laboratory confirmation of cowpox infection may be pursued through viral culture, polymerase chain reaction (PCR) assays, or serological testing. Viral culture involves isolating the Cowpox virus from clinical specimens, such as skin swabs or vesicular fluid, and observing viral growth in cell culture. PCR assays detect viral nucleic acid in clinical samples, providing a rapid and sensitive method for diagnosing cowpox infection. Serological testing measures the presence of specific antibodies against the Cowpox virus in the blood, indicating past or current infection.

While laboratory testing can provide definitive confirmation of cowpox infection, it is not always necessary for clinical management. In many cases, the diagnosis can be established based on clinical presentation and history of exposure, allowing for timely initiation of appropriate treatment and infection control measures. (Nursing Paper Example on Cowpox)

Treatment Regimens and Patient Education

Management of cowpox primarily revolves around supportive care and symptomatic relief, as the infection typically resolves on its own without specific antiviral therapy. Patients with cowpox lesions should be advised to keep the affected area clean and dry to prevent secondary bacterial infection. Topical antiseptic ointments may be recommended to promote healing and reduce the risk of bacterial superinfection.

For individuals experiencing discomfort or pain associated with cowpox lesions, over-the-counter pain relievers such as acetaminophen or ibuprofen may be used to alleviate symptoms. Additionally, antihistamines may help to reduce itching and inflammation associated with the skin lesions.

In severe or complicated cases of cowpox infection, particularly in immunocompromised individuals or those with underlying health conditions, antiviral medications such as cidofovir or brincidofovir may be considered. These medications work by inhibiting viral replication and may help to reduce the severity and duration of symptoms. However, the use of antiviral therapy in cowpox infection is not well-established, and treatment decisions should be made on a case-by-case basis in consultation with a healthcare provider.

Patient education is essential in the management of cowpox infection to promote understanding of the disease and prevent transmission to others. Patients should be counseled on the importance of hand hygiene, particularly after handling animals or coming into contact with potentially contaminated materials. Avoiding close contact with infected animals or their lesions is also crucial for preventing transmission of the virus.

Individuals at increased risk of cowpox infection, such as farmers, veterinarians, and laboratory workers, should take precautions to minimize exposure to infected animals and materials. This may include wearing gloves and other protective equipment when handling animals or performing tasks that may involve contact with potentially contaminated surfaces.

Vaccination against smallpox, which confers cross-protection against cowpox, played a significant role in controlling the spread of both diseases historically. While routine smallpox vaccination is no longer practiced due to the global eradication of smallpox, vaccination against cowpox may be considered in specific occupational settings or for individuals at higher risk of exposure.

Overall, patient education plays a vital role in preventing cowpox infection and minimizing its impact on both individual and public health. By promoting awareness of the disease and implementing preventive measures, healthcare providers can help to reduce the risk of transmission and ensure timely diagnosis and treatment of cowpox infection. (Nursing Paper Example on Cowpox)

Conclusion

Cowpox remains a fascinating yet often overlooked disease with significant historical and medical relevance. Understanding its causes, signs, symptoms, etiology, pathophysiology, DSM-5 diagnosis, treatment regimens, and patient education is crucial for effective management and control. Through this comprehensive exploration, we have highlighted the viral etiology of cowpox, its characteristic signs and symptoms, and the pathophysiological mechanisms underlying its clinical manifestations. We have also discussed the importance of accurate diagnosis, supportive care, and patient education in the management of cowpox infection. By integrating these insights into clinical practice and public health efforts, we can enhance our ability to prevent, diagnose, and treat cowpox effectively. Continued research and surveillance are essential for monitoring changes in the epidemiology of cowpox and informing evidence-based strategies for disease prevention and control in both human and animal populations. (Nursing Paper Example on Cowpox)

References

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5454414/

 
Do you need a similar assignment done for you from scratch? Order now!
Use Discount Code "Newclient" for a 15% Discount!

Nursing Paper Example on Dengue Fever

/in , , , , , , , /by

Nursing Paper Example on Dengue Fever

Dengue fever, a mosquito-borne viral illness, poses a significant public health threat in tropical and subtropical regions worldwide. Characterized by high fever, severe headache, joint and muscle pain, and rash, Dengue has emerged as a major concern due to its rapid spread and potential for severe complications. Each year, millions of cases are reported globally, with a substantial burden on healthcare systems and economies. Despite efforts to control its transmission, Dengue continues to thrive, fueled by urbanization, climate change, and globalization. Understanding its causes, symptoms, and treatment regimens is crucial in mitigating its impact on affected populations. This paper aims to provide comprehensive and accurate information on Dengue fever, shedding light on its epidemiology, pathophysiology, diagnosis, and management strategies. By enhancing awareness and fostering collaborative efforts, we can strive towards a Dengue-free future. (Nursing Paper Example on Dengue Fever)

Nursing Paper Example on Dengue Fever

Causes

Dengue fever is caused by the dengue virus, which belongs to the Flavivirus genus. This virus is primarily transmitted to humans through the bites of infected Aedes mosquitoes, particularly Aedes aegypti and Aedes albopictus. These mosquitoes thrive in urban environments and breed in stagnant water, making urban areas particularly vulnerable to dengue outbreaks. Travelers to endemic regions are also at risk of acquiring the virus and spreading it to non-endemic areas upon their return.

The transmission cycle begins when a female Aedes mosquito ingests the virus by feeding on the blood of an infected individual during the acute phase of the illness. The virus then replicates within the mosquito’s body, eventually infecting its salivary glands. Subsequent bites by infected mosquitoes can then transmit the virus to susceptible individuals, perpetuating the cycle of transmission.

Various factors contribute to the spread of dengue fever, including population growth, urbanization, and climate change. Increased urbanization creates favorable breeding grounds for Aedes mosquitoes, such as discarded tires, containers, and other water-holding receptacles commonly found in urban environments. Climate change further exacerbates the problem by expanding the geographical range of Aedes mosquitoes and prolonging their breeding season.

Additionally, globalization and increased travel facilitate the spread of dengue fever to non-endemic areas, as infected individuals can unknowingly transport the virus across borders. Lack of effective mosquito control measures, inadequate healthcare infrastructure, and socio-economic disparities also contribute to the persistence of dengue fever in endemic regions. Overall, understanding the multifaceted causes of dengue fever is essential in implementing comprehensive strategies for its prevention and control. (Nursing Paper Example on Dengue Fever)

Signs and Symptoms

The onset of dengue fever is often abrupt, typically occurring 4 to 10 days after being bitten by an infected mosquito. The hallmark symptoms of dengue fever include high fever, severe headache, pain behind the eyes (retro-orbital pain), joint and muscle pain (myalgia and arthralgia), and a characteristic skin rash.

The fever associated with dengue fever can rise rapidly, reaching temperatures as high as 104°F (40°C) or more. This fever may be accompanied by chills and sweating. Severe headache, often described as a throbbing pain, is a common feature of dengue fever and can significantly impair daily activities.

Patients may also experience pain behind the eyes, known as retro-orbital pain, which can worsen with eye movement. Joint and muscle pain, including myalgia and arthralgia, are also prevalent and can be debilitating, affecting mobility and quality of life.

In addition to these primary symptoms, patients may present with other manifestations such as nausea, vomiting, and mild bleeding from the nose or gums. Some individuals may develop a characteristic skin rash, which typically appears 2 to 5 days after the onset of fever and may spread throughout the body.

While most cases of dengue fever are self-limiting and resolve within a week, some individuals may progress to severe dengue, also known as dengue hemorrhagic fever (DHF) or dengue shock syndrome (DSS). These severe forms of the disease are characterized by plasma leakage, severe bleeding, and organ impairment, and require prompt medical attention to prevent complications and reduce mortality. Recognizing the signs and symptoms of dengue fever is crucial in facilitating early diagnosis and appropriate management, thereby minimizing the risk of severe outcomes. (Nursing Paper Example on Dengue Fever)

Etiology

The etiology of dengue fever lies in the transmission and replication of the dengue virus within the human body. Upon entering the bloodstream through the bite of an infected mosquito, the dengue virus targets immune cells, including dendritic cells and macrophages. These cells serve as initial targets for viral replication, allowing the virus to establish infection and evade host immune responses.

The dengue virus belongs to the Flavivirus genus and comprises four distinct serotypes: Dengue virus serotypes 1, 2, 3, and 4. Each serotype shares structural and genetic similarities but elicits specific immune responses. Individuals infected with one serotype develop lifelong immunity to that particular serotype but remain susceptible to infection by the other serotypes.

Following viral entry into the bloodstream, the dengue virus undergoes replication in target cells, leading to viremia and dissemination throughout the body. The replication process is facilitated by viral proteins that interact with host cell receptors, enabling viral entry and hijacking of cellular machinery for replication.

The immune response to dengue virus infection plays a crucial role in the pathogenesis of dengue fever. Upon recognition of viral antigens, the host immune system mounts both innate and adaptive immune responses to control viral spread. However, in some cases, an exaggerated immune response can contribute to disease severity, leading to vascular leakage, thrombocytopenia, and hemorrhagic manifestations.

Factors such as host genetic susceptibility, viral virulence, and immune status influence the clinical outcome of dengue fever. Genetic polymorphisms in host immune genes can modulate individual susceptibility to severe dengue, while pre-existing immunity to one serotype may enhance the severity of subsequent infections with a different serotype, a phenomenon known as antibody-dependent enhancement (ADE).

Overall, the etiology of dengue fever is multifactorial, involving complex interactions between the virus, the host immune system, and various environmental and genetic factors. Understanding these factors is essential for developing effective strategies for dengue prevention and control. (Nursing Paper Example on Dengue Fever)

Pathophysiology

The pathophysiology of dengue fever involves a complex interplay between the dengue virus, the host immune system, and various cellular and molecular pathways. Upon entering the bloodstream through the bite of an infected mosquito, the dengue virus targets immune cells, including dendritic cells, macrophages, and monocytes, which serve as primary sites for viral replication.

Once inside the host cells, the dengue virus undergoes replication, leading to the production of viral proteins and the release of viral particles. This process triggers an immune response characterized by the activation of both innate and adaptive immune mechanisms.

The innate immune response involves the release of pro-inflammatory cytokines and chemokines, such as interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-α), which recruit immune cells to the site of infection and promote inflammation. These cytokines also stimulate the production of interferons, which play a crucial role in limiting viral replication and spread.

The adaptive immune response is mediated by T cells and B cells, which recognize specific viral antigens and mount antigen-specific immune responses. T cells are involved in the clearance of virus-infected cells, while B cells produce antibodies that neutralize the virus and prevent its spread to uninfected cells.

However, in some cases, the immune response to dengue virus infection can become dysregulated, leading to excessive inflammation and tissue damage. This dysregulated immune response is thought to contribute to the pathogenesis of severe dengue, including plasma leakage, thrombocytopenia, and hemorrhagic manifestations.

The mechanisms underlying severe dengue are not fully understood but are believed to involve endothelial dysfunction, coagulopathy, and vascular leakage. Endothelial cells lining blood vessels play a central role in maintaining vascular integrity, and their dysfunction during dengue infection contributes to increased vascular permeability and plasma leakage.

Overall, the pathophysiology of dengue fever is complex and multifaceted, involving intricate interactions between the virus, the host immune system, and various cellular and molecular pathways. Further research is needed to elucidate the underlying mechanisms of severe dengue and identify potential targets for therapeutic intervention. (Nursing Paper Example on Dengue Fever)

DSM-5 Diagnosis

Diagnosing dengue fever involves a combination of clinical assessment, travel history, and laboratory testing. According to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), the criteria for diagnosing dengue fever include the presence of fever, thrombocytopenia, and evidence of plasma leakage, such as hemoconcentration or pleural effusion.

The diagnostic process typically begins with a thorough medical history and physical examination to assess the patient’s symptoms and potential exposure to dengue virus. Travel history to endemic regions and recent mosquito bites are important considerations, as they can help identify the likelihood of dengue infection.

Laboratory testing is essential for confirming the diagnosis of dengue fever and ruling out other potential causes of fever and flu-like symptoms. Common laboratory tests include serological assays, such as enzyme-linked immunosorbent assays (ELISA), and molecular tests, such as reverse transcription-polymerase chain reaction (RT-PCR), to detect viral RNA.

Key laboratory findings suggestive of dengue fever include leukopenia, thrombocytopenia, and elevated liver enzymes. Thrombocytopenia, defined as a platelet count below 100,000 cells/mm3, is a hallmark feature of dengue fever and can help distinguish it from other febrile illnesses.

In addition to laboratory tests, imaging studies such as ultrasound and chest X-ray may be performed to evaluate for evidence of plasma leakage and organ involvement. Ultrasonography can detect pleural effusion, ascites, and other signs of vascular leakage, while chest X-ray may reveal pulmonary infiltrates in severe cases of dengue hemorrhagic fever.

Overall, the diagnosis of dengue fever requires a comprehensive approach that integrates clinical assessment, travel history, and laboratory testing. Early recognition and prompt diagnosis are essential for initiating appropriate management and preventing complications associated with severe dengue. (Nursing Paper Example on Dengue Fever)

Treatment Regimens and Patient Education

The management of dengue fever focuses on supportive care to alleviate symptoms and prevent complications. There is currently no specific antiviral treatment for dengue fever, so treatment primarily involves addressing the patient’s symptoms and providing supportive measures. Patients with mild dengue fever are advised to rest, stay hydrated, and take medications such as acetaminophen (paracetamol) to reduce fever and relieve pain. Non-steroidal anti-inflammatory drugs (NSAIDs) should be avoided due to the risk of exacerbating bleeding complications.

In severe cases of dengue fever, hospitalization may be necessary for close monitoring and intravenous fluid therapy to prevent or manage dehydration. Patients with evidence of plasma leakage or severe bleeding may require transfusion of blood products, such as packed red blood cells or platelets, to maintain adequate circulation and prevent shock.

In addition to supportive care, patient education plays a crucial role in dengue prevention and management. Patients should be counseled on measures to reduce mosquito exposure, including using insect repellents, wearing protective clothing, and sleeping under mosquito nets, especially during peak biting times (dawn and dusk). Eliminating mosquito breeding sites around the home, such as stagnant water containers, gutters, and flower pots, is also essential in preventing mosquito breeding and reducing the risk of dengue transmission.

Furthermore, patients should be educated on the signs and symptoms of dengue fever and instructed to seek medical attention promptly if they experience fever, severe headache, pain behind the eyes, or unexplained bleeding. Early diagnosis and treatment can help prevent complications associated with severe dengue and improve patient outcomes.

Healthcare providers play a vital role in patient education, providing accurate information about dengue fever, its transmission, and prevention strategies. This includes addressing misconceptions and myths about dengue, such as the use of herbal remedies or traditional medicines, which may not be effective and can delay appropriate medical care.

Community-based education and outreach programs are also important in raising awareness about dengue fever and promoting preventive measures at the population level. By empowering individuals and communities with knowledge and resources, we can work together to reduce the burden of dengue fever and create healthier and safer environments for all. (Nursing Paper Example on Dengue Fever)

Conclusion

Dengue fever remains a pressing global health concern, necessitating a comprehensive approach to its understanding, prevention, and management. This paper has provided an in-depth exploration of Dengue fever, covering its causes, signs and symptoms, etiology, pathophysiology, DSM-5 diagnosis, treatment regimens, and patient education. By elucidating the multifaceted nature of Dengue fever, including its complex pathophysiology and diagnostic criteria, this paper aims to enhance awareness and facilitate early detection and intervention. The revised treatment regimens and emphasis on patient education underscore the importance of supportive care and preventive measures in mitigating the impact of Dengue fever. Moving forward, collaborative efforts between healthcare providers, policymakers, and communities are essential in implementing effective strategies for Dengue prevention and control. By prioritizing education, research, and public health interventions, we can work towards reducing the global burden of Dengue fever and improving the health and well-being of populations worldwide. (Nursing Paper Example on Dengue Fever)

References

https://www.ncbi.nlm.nih.gov/books/NBK430732/

 
Do you need a similar assignment done for you from scratch? Order now!
Use Discount Code "Newclient" for a 15% Discount!

Nursing Paper Example on Diphtheria

/in , , , , , , , /by

Nursing Paper Example on Diphtheria

Diphtheria, a highly contagious bacterial infection, has long posed a significant threat to public health worldwide. Despite advancements in vaccination programs, this potentially fatal disease continues to present challenges in various regions. In this paper, we delve into the intricacies of diphtheria, exploring its causes, signs and symptoms, etiology, pathophysiology, DSM-5 diagnosis, treatment regimens, and patient education strategies. With its ability to cause severe respiratory distress and systemic complications, diphtheria demands a comprehensive understanding of its clinical presentation, transmission dynamics, and management strategies. By elucidating the nuances of this disease, we aim to equip healthcare professionals, policymakers, and the general public with the knowledge necessary to combat its spread effectively. Through collective efforts to enhance vaccination coverage and implement stringent infection control measures, we can work towards eliminating the threat of diphtheria and safeguarding global health. (Nursing Paper Example on Diphtheria)

Nursing Paper Example on DiphtheriaCauses

Diphtheria is primarily caused by Corynebacterium diphtheriae, a bacterium that thrives in environments with poor hygiene and overcrowded conditions. Transmission commonly occurs through respiratory droplets expelled during coughing or sneezing by infected individuals. Additionally, indirect contact with contaminated objects, such as toys or utensils, can facilitate the spread of the disease.

Unvaccinated or under-vaccinated populations are particularly susceptible to diphtheria outbreaks, as immunization against the bacterium is a cornerstone of disease prevention. Inadequate vaccination coverage leaves individuals vulnerable to infection and contributes to the persistence of diphtheria in certain regions.

Furthermore, socioeconomic factors play a significant role in diphtheria transmission, with marginalized communities facing higher rates of infection due to limited access to healthcare services and overcrowded living conditions. In such environments, the bacterium can easily spread among close contacts, leading to clusters of cases and outbreaks.

The resurgence of diphtheria in recent years highlights the importance of vaccination efforts and public health interventions aimed at controlling its spread. By addressing the underlying factors driving transmission, such as poverty, inadequate sanitation, and vaccine hesitancy, we can mitigate the impact of diphtheria on vulnerable populations and prevent future outbreaks.

Education campaigns emphasizing the importance of vaccination, proper hygiene practices, and early recognition of symptoms are essential for raising awareness about diphtheria and promoting preventive measures. Additionally, strengthening healthcare infrastructure and ensuring access to affordable vaccines are crucial steps in achieving sustainable control of the disease.

In summary, diphtheria is caused by the bacterium Corynebacterium diphtheriae and is transmitted through respiratory droplets and contact with contaminated objects. Factors such as inadequate vaccination coverage, socioeconomic disparities, and overcrowded living conditions contribute to its spread. Addressing these underlying causes through vaccination campaigns, public health interventions, and community engagement is essential for controlling diphtheria transmission and preventing outbreaks. (Nursing Paper Example on Diphtheria)

Signs and Symptoms

The onset of diphtheria is insidious, with initial symptoms often resembling those of a common cold, including low-grade fever, sore throat, and mild cough. However, what distinguishes diphtheria from other respiratory infections is the hallmark feature of a thick grayish coating that forms in the throat and tonsils, known as a pseudomembrane. This membrane can rapidly spread and adhere to the respiratory mucosa, leading to airway obstruction and respiratory distress.

As the disease progresses, patients may experience difficulty breathing, stridor (a high-pitched sound during inhalation), and cyanosis (bluish discoloration of the skin) due to impaired oxygenation. In severe cases, diphtheria toxin can spread systemically, causing damage to vital organs such as the heart and nervous system.

Other symptoms of diphtheria may include malaise, fatigue, and swollen lymph nodes in the neck (cervical lymphadenopathy). Complications of diphtheria can be life-threatening and may include myocarditis (inflammation of the heart muscle), neuritis (nerve inflammation), and paralysis.

It is important to note that not all individuals infected with Corynebacterium diphtheriae will develop the characteristic pseudomembrane. Some cases, known as “nondiphtheritic” or “corynebacterium carriage,” may present with milder symptoms or be asymptomatic carriers of the bacterium. However, these individuals can still transmit the bacteria to others, highlighting the importance of early diagnosis and treatment.

Prompt recognition of the signs and symptoms of diphtheria is essential for initiating appropriate medical management and preventing complications. Healthcare providers should maintain a high index of suspicion, particularly in regions where diphtheria is endemic or during outbreaks, and promptly isolate suspected cases to prevent further transmission. Early intervention with antitoxin and antibiotics can significantly improve patient outcomes and reduce the risk of severe complications associated with diphtheria infection. (Nursing Paper Example on Diphtheria)

Etiology

The etiology of diphtheria encompasses various factors contributing to the transmission and pathogenesis of the disease. Central to its etiology is the bacterium Corynebacterium diphtheriae, a gram-positive, aerobic bacterium capable of producing a potent exotoxin. This toxin, known as diphtheria toxin, plays a critical role in the development of clinical manifestations associated with diphtheria.

Transmission of Corynebacterium diphtheriae occurs primarily through respiratory droplets expelled during coughing, sneezing, or talking by infected individuals. Additionally, indirect contact with contaminated objects, such as toys, utensils, or clothing, can facilitate the spread of the bacterium. Factors such as overcrowded living conditions, poor sanitation, and inadequate vaccination coverage contribute to the persistence and transmission of diphtheria, particularly in resource-limited settings.

The bacterium colonizes the mucous membranes of the upper respiratory tract, where it adheres to epithelial cells and proliferates. Under favorable conditions, Corynebacterium diphtheriae releases diphtheria toxin, a key virulence factor that inhibits protein synthesis in host cells. The toxin is encoded by a bacteriophage integrated into the bacterial genome, highlighting the complex interplay between bacterial and viral components in the pathogenesis of diphtheria.

Host factors also play a role in susceptibility to diphtheria, with individuals who are unvaccinated, under-vaccinated, or immunocompromised being at increased risk of infection and severe disease. Moreover, socioeconomic disparities, including poverty, limited access to healthcare, and overcrowded living conditions, further exacerbate the burden of diphtheria in vulnerable populations.

Understanding the multifactorial etiology of diphtheria is essential for implementing effective prevention and control measures. Strategies aimed at promoting vaccination, improving hygiene practices, and enhancing healthcare infrastructure are critical for reducing the incidence of diphtheria and mitigating its impact on public health. By addressing the underlying factors driving transmission, we can work towards eliminating diphtheria as a global health threat. (Nursing Paper Example on Diphtheria)

Pathophysiology

The pathophysiology of diphtheria revolves around the intricate interplay between Corynebacterium diphtheriae and its potent exotoxin, diphtheria toxin, within the host’s body. Following transmission and colonization of the upper respiratory tract, the bacterium produces and releases diphtheria toxin, a key virulence factor responsible for the clinical manifestations of the disease.

Diphtheria toxin is encoded by a bacteriophage integrated into the bacterial genome and is released as a single polypeptide chain. Upon entry into host cells, the toxin undergoes proteolytic cleavage to yield an active fragment capable of inhibiting protein synthesis by targeting elongation factor 2 (EF-2). This disruption of protein synthesis leads to cell death and tissue damage, particularly in the respiratory mucosa.

The effects of diphtheria toxin extend beyond the local site of infection, as it can also disseminate systemically and affect various organs, including the heart and nervous system. In cardiac tissue, diphtheria toxin can cause myocarditis, leading to impaired cardiac function and potentially fatal arrhythmias. Neurological complications may include neuritis, paralysis, and cranial nerve involvement, resulting in symptoms such as difficulty swallowing, double vision, and respiratory failure.

The severity of diphtheria is influenced by various factors, including the dose and duration of toxin exposure, the host’s immune response, and the presence of underlying comorbidities. Severe cases may progress rapidly, with the formation of a thick grayish pseudomembrane in the throat and tonsils, leading to airway obstruction and respiratory distress.

Understanding the pathophysiological mechanisms underlying diphtheria is crucial for guiding therapeutic interventions and preventing complications. Early administration of diphtheria antitoxin can neutralize circulating toxin and mitigate its systemic effects, while antibiotics such as erythromycin target the bacterium itself. Supportive care, including airway management and cardiac monitoring, is essential for managing severe cases and preventing mortality associated with diphtheria infection. (Nursing Paper Example on Diphtheria)

DSM-5 Diagnosis

While diphtheria is primarily diagnosed based on clinical presentation and laboratory confirmation of Corynebacterium diphtheriae infection, its psychiatric diagnosis in the context of the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition) is not applicable. The DSM-5 is a classification system used by mental health professionals to diagnose and classify mental disorders based on specific criteria outlined in the manual. However, diphtheria is not a mental disorder but rather an infectious disease caused by a bacterial pathogen.

Nevertheless, diphtheria can have profound psychological and emotional impacts on affected individuals, particularly those experiencing severe symptoms or complications. The fear and anxiety associated with the disease, coupled with the potential for social stigma and isolation, can contribute to significant distress and impairment in functioning. Additionally, the psychological toll of caring for loved ones with diphtheria or navigating the aftermath of outbreaks can further exacerbate mental health challenges within communities affected by the disease.

While diphtheria does not have a specific DSM-5 diagnosis, mental health support and intervention may be warranted for individuals and communities affected by the disease. Healthcare providers should be attentive to the psychosocial needs of patients with diphtheria and offer appropriate support, resources, and referrals to mental health services as needed. Additionally, public health initiatives aimed at addressing the broader social determinants of health, such as poverty, inequality, and access to healthcare, can contribute to resilience and well-being in populations at risk of diphtheria and other infectious diseases. By adopting a holistic approach that considers both the physical and psychological dimensions of health, we can better support individuals and communities affected by diphtheria and promote overall well-being and resilience in the face of infectious disease threats. (Nursing Paper Example on Diphtheria)

Treatment Regimens and Patient Education

Effective management of diphtheria requires a multi-faceted approach that combines prompt medical intervention with comprehensive patient education to prevent transmission and facilitate recovery. Treatment regimens aim to eradicate the bacterium, neutralize circulating toxin, and alleviate symptoms, while patient education strategies focus on promoting vaccination, hygiene practices, and early recognition of symptoms.

Medical Treatment:

  1. Antitoxin Administration: Prompt administration of diphtheria antitoxin is crucial for neutralizing circulating toxin and preventing further tissue damage. Antitoxin is derived from hyperimmune horse serum and should be administered as soon as diphtheria is suspected, regardless of vaccination status.
  2. Antibiotic Therapy: Antibiotics such as erythromycin or penicillin are used to eradicate Corynebacterium diphtheriae from the respiratory tract and prevent further transmission. Treatment should be initiated promptly upon suspicion of diphtheria and continued for a minimum of 14 days to ensure complete eradication of the bacterium.
  3. Supportive Care: Patients with severe respiratory distress or airway obstruction may require supplemental oxygen therapy, airway management, or mechanical ventilation. Close monitoring of cardiac function is essential, particularly in cases of myocarditis, to detect and manage cardiac complications promptly.

Patient Education:

  1. Vaccination: Educating patients and caregivers about the importance of diphtheria vaccination is essential for preventing future outbreaks. Emphasize the significance of routine immunization, booster doses, and adherence to national vaccination schedules to maintain immunity against diphtheria.
  2. Hygiene Practices: Promote proper hygiene practices, including frequent handwashing with soap and water, covering coughs and sneezes with a tissue or elbow, and avoiding close contact with individuals who are sick. Encourage regular cleaning and disinfection of frequently touched surfaces to reduce the risk of transmission.
  3. Early Recognition of Symptoms: Educate patients and caregivers about the signs and symptoms of diphtheria, including sore throat, fever, difficulty breathing, and the presence of a thick grayish coating in the throat. Encourage prompt medical evaluation and isolation of suspected cases to prevent further spread of the disease.
  4. Community Awareness: Engage community leaders, healthcare providers, and educators in raising awareness about diphtheria and promoting preventive measures. Utilize public health campaigns, social media, and community outreach programs to disseminate accurate information and dispel myths surrounding diphtheria vaccination and treatment.

By combining medical treatment with comprehensive patient education, we can effectively manage diphtheria cases, prevent transmission, and reduce the burden of this potentially fatal disease on public health. Empowering individuals and communities with knowledge and resources is essential for achieving sustainable control of diphtheria and safeguarding the health and well-being of populations worldwide. (Nursing Paper Example on Diphtheria)

Conclusion

Diphtheria remains a formidable public health challenge, demanding a multifaceted approach encompassing both medical intervention and comprehensive patient education. By elucidating the causes, signs and symptoms, etiology, pathophysiology, treatment regimens, and patient education strategies, this paper has provided a thorough understanding of the complexities surrounding diphtheria. The expanded sections on treatment regimens emphasize the importance of prompt administration of diphtheria antitoxin, antibiotic therapy, and supportive care in managing the disease effectively. Furthermore, the enhanced patient education segment underscores the critical role of vaccination promotion, hygiene practices, and early symptom recognition in preventing transmission and facilitating recovery. By implementing these interventions and fostering community engagement, we can work towards eliminating diphtheria as a global health threat and ensuring the health and well-being of individuals worldwide. (Nursing Paper Example on Diphtheria)

References

https://www.ncbi.nlm.nih.gov/books/NBK560911/

 
Do you need a similar assignment done for you from scratch? Order now!
Use Discount Code "Newclient" for a 15% Discount!

Scholarship Application Essay

/in , , , , , , , /by

Scholarship Application Essay

Scholarship Application Essay

I am a student and a mother, and I am still working, and balancing these life aspects has been the most challenging obstacle I have had to overcome. Everyone wants to advance in their careers, and continuing education is the only path to career growth and development. However, it becomes more challenging when one is a mother and have a job to attend to. Work-school-life interference has been immense in the previous few years because you cannot prioritize one over another. I have to be committed to raising my son, who is the greatest gift of my life so far, and at the same time, bear the understanding that I cannot raise my son without working. I have had to give it all at work and in my parental duties to ensure I concur across all fronts and achieve the best results possible. I also understand that to progress career-wise, I need to continue learning and acquiring more skills, knowledge, and competence to enhance my career readiness. We know school requires commitment, perseverance, persistence, and extra effort to achieve the best grades possible. You have to grind through late nights, and any free time is used for schooling because family and work duties take most of the time. Not to forget, I have had to switch schools for different reasons, including work purposes, which is also extremely tiring because of the effort required to start over. It has been challenging, but I have grown to overcome this obstacle. (Scholarship Application Essay)

There are times you come to realize that you do not have much of a choice but need to push through because failure is not an option. I could not imagine failing as a parent, at my workplace, or in school, and this realization is motivation enough to be resilient and ensure you win. Understanding this challenge and adapting to reality was difficult and mentally exhausting. You have minimal time for yourself, and if I am not careful, it would be detrimental to my health and capacity to work and raise my son. I have had to develop coping mechanisms to deal with the stress, anxiety, and physical exhaustion that come with trying to balance family, work, and school. I have received emotional support from my family and friends, which keeps me cruising through the challenges. (Scholarship Application Essay)

I have learned a lot from this experience, including the importance of understanding and accepting the situations you are in and trying your best to make good use of every moment in life and work towards success. I have learned that when you have a family, working and chasing career advancement opportunities, you have to be a winner because the contrary is not an option, and I have the power over these aspects only if I understand their importance in my life and those dear to me. It is also advisable to get help from friends and family because it is unrealistic to remain functional at the top level across all these life aspects from individual effort only. You need a hand from your neighbors, workmates, family, and friends to make the process easier and goals more attainable. Overcoming the work-school-life interference has increased my resilience and belief in myself. I have become stronger mentally, and I have realized I can handle more than I expect or think of myself. I have also improved my self-discipline and persistence because success across these life aspects depends on them. (Scholarship Application Essay)

 
Do you need a similar assignment done for you from scratch? Order now!
Use Discount Code "Newclient" for a 15% Discount!

Critical Appraisal of Early Remdesivir

/in , , , , , , , /by

Critical Appraisal of Early Remdesivir to Prevent Progression to Severe Covid-19 in Outpatients

Critical Appraisal of Early Remdesivir

The article intended to determine the effectiveness of remdesivir use in preventing hospitalization among symptomatic, non-hospitalized patients with Covid-19 who are at an increased risk for disease progression. The authors hypothesized that initiating a short course remdesivir treatment early among outpatients would minimize hospitalization and mortality. Results indicate that the treatment modality helped reduce Covid-related hospitalization or mortality, medically attended visits, and adverse events, confirming the hypothesis.4 Conclusively, the drug can be used to treat Covid-19 outpatients to reduce the risk of hospitalization or death, medically attended visits, and adverse events, offering healthcare providers an additional and effective treatment regimen.  (Critical Appraisal of Early Remdesivir)

Best Available Evidence

Evidence-based practice entails providers using the best available evidence to inform practice and clinical decision-making. Studies are of varying levels of evidence and evidence quality, and providers are expected to select the best available evidence to make the most appropriate decisions.2 This article adopts a randomized, double-blind, placebo-controlled trial, which offers the highest level of evidence available regarding remdesivir effectiveness in treating Covid-19 and preventing hospitalization and mortality among outpatients. Randomized double-blind placebo controls (RDBPC) are perceived gold standard of epidemiological scientific research.6 The design provides the strongest possible evidence showing causation. Therefore, providers can adopt the results of this article to inform practice and make clinical decisions when treating Covid-19 outpatients.    (Critical Appraisal of Early Remdesivir)

Clinical Guidelines

Clinical guidelines include recommendations to help optimize care informed by systematic evidence review and an evaluation of alternative care options’ benefits and harms.1 Remdesivir is an alternative treatment regimen in Covid-19 patients and this article offer recommendation for its use supported by gold-standard research methodology and evidence. This study recommends remdesivir use among outpatients and those with moderate-to-severe Covid-19, offering concrete evidence of its effectiveness in reducing hospitalization, mortality, medically intended visits, adverse events, quick recovery, and reduced risk of disease progression. The study also aligns with other trials, including the SIMPLE trial, which indicated that remdesivir helped achieve better clinical status among individuals with moderate Covid-19 and the ACTT-1, which showed remdesivir effectiveness in accelerating recovery and reducing disease progression. (Critical Appraisal of Early Remdesivir)

Clinical Judgment

Healthcare providers adopt evidence-based insights, their experience, and personally-developed knowledge to make clinical judgements. Clinical judgement includes skills and knowledge accumulated over time from experience and evidence-based research knowledge, which contribute to providers’ ability to analyze and synthesize patient data, objective and subjective and recommend or offer evidence-based nursing interventions to enhance patient outcomes.5 This study provides evidence to guide clinical judgement and decision-making when selecting a treatment regimen to treat moderate Covid-19 or Covid-19 in outpatients. The data offers another treatment option for providers treating Covid-19 with supported insights to inform clinical decisions. (Critical Appraisal of Early Remdesivir)

Patient Preferences

Patient preferences inform clinical decisions, implying the selection of clinical interventions depends on the patient’s deliberations, including anticipations regarding treatment or health outcomes.3 Patients prefer a treatment regimen with promising or proven positive health outcomes. These preferences result from clinician advice and patients’ cognition, experience, and reflection.3 The beneficial clinical benefits of remdesivir indicated in this study are likely to influence patient preferences. The data obtained adds another option for treating vulnerable patient populations to prevent Covid-19 progress.4 Patients have a better option in remdesivir, and they can anticipate improved health outcomes. (Critical Appraisal of Early Remdesivir)

References

  1. Bhaumik S. Use of evidence for clinical practice guideline development. Trop Parasitol. 2017;7(2):65-71. doi:10.4103/tp.TP_6_17
  2. Flecha OD, Douglas de Oliveira DW, Marques LS, Gonçalves PF. A commentary on randomized clinical trials: How to produce them with a good level of evidence. Perspect Clin Res. 2016;7(2):75-80. doi:10.4103/2229-3485.179432
  3. Gärtner FR, Portielje JE, Langendam M, et al. Role of patient preferences in clinical practice guidelines: a multiple methods study using guidelines from oncology as a case. BMJ Open. 2019;9(12):e032483. Published 2019 Dec 5. doi:10.1136/bmjopen-2019-032483
  4. Gottlieb RL, Vaca CE, Paredes R, et al. Early Remdesivir to Prevent Progression to Severe Covid-19 in Outpatients. N Engl J Med. 2022;386(4):305-315. doi:10.1056/NEJMoa2116846
  5. Kinyon K, D’Alton S, Poston K, Navarrete S. Improving Physical Assessment and Clinical Judgment Skills without Increasing Content in a Prelicensure Nursing Health Assessment Course. Nurs Rep. 2021;11(3):600-607. Published 2021 Aug 2. doi:10.3390/nursrep11030057
  6. Misra S. Randomized double blind placebo control studies, the “Gold Standard” in intervention based studies. Indian J Sex Transm Dis AIDS. 2012;33(2):131-134. doi:10.4103/0253-7184.102130 https://pubmed.ncbi.nlm.nih.gov/23188942/
 
Do you need a similar assignment done for you from scratch? Order now!
Use Discount Code "Newclient" for a 15% Discount!

French and Raven’s Five Sources of Power

/in , , , , , , , /by

French and Raven’s Five Sources of Power

French and Raven's Five Sources of Power

French and Raven identified five power dynamics or power bases, including referent, expert, legitimate, reward, and coercive powers. Legitimate power originates from electoral mandates, cultural norms, organizational structure, and social hierarchies (James et al., 2022). This power can be unstable or unpredictable. When people lose their positions, their legitimate power can instantly disappear because individuals are attached to or influenced by the position rather than the position. Most people are promised rewards like salary increases, promotions, benefits, or education and training opportunities if they do well and help the company fulfil its goals and objectives. These situations create reward power held by people with the power to offer or influence these rewards, for instance, managers, supervisors, and CEOs in a company (Kovach, 2020). However, reward power is not as strong as it seems because individuals like managers and supervisors depend on those higher in the hierarchies to offer promotions or salary increases.

Coercive power is problematic because, in most instances, the followers are manipulated or threatened when they do not act or behave as instructed. It often occurs in the workplace when people in leadership positions threaten employees that they will be demoted, transferred, denied privileges, or fired if they fail to follow instructions (Kovach, 2020). An individual’s position can allow them to have this power, although they might like a justification to do so. Experts have in-depth knowledge and skills in particular fields, giving them power over others. People rely on experts to help understand circumstances, suggest solutions and judgments, and guide the implementation of these solutions. Expert power earns people the trust and respect of others (Kovach, 2020). Individuals tend to like and respect celebrities and act, behave, and dress like the celebrities they adore, giving celebrities referent power. Referent power is also present in the workplace, and those holding it make everyone feel good. Individuals with referent power have done nothing unique to earn, which can be overwhelming or a big responsibility (Kovach, 2020). It can also be abused, especially when a likeable individual lacks integrity, morals, and honesty, and be used to manipulate or hurt others for personal benefits. Referent power does not necessarily offer longevity and respect and cannot be relied on.

In the case study, Betty, the software expert, has power because she is more knowledgeable about complicated electronic medical records software. Betty has the knowledge to offer solutions and help other people, especially the new employees, understand the software, which would benefit the company. Betty has more seniority and experience in the company than Joe, but she prefers to do something other than helping people, which denied her the managerial position. Joe also understands that no one in the company has more knowledge and experience regarding the software, and he has minimal influence on what he can do to get Betty to help the new employees. Betty thinks no one can replace her, and her longevity in the company depends on consistent performance at the highest level. As long as she remains excellent, Joe has no power over her and cannot upset her plans.

References

James, S., Mwembezi, G., & Chusi, T. (2022). The effect of five French and raven’s managerial power bases on employee job satisfaction: a review and implications for managers in Tanzania. EPRA International Journal of Research and Development (IJRD), 7(5), 176-183. https://eprajournals.com/IJSR/article/6973/

Kovach, M. (2020, July). Leader Influence: A Resear Leader Influence: A Research Review of Fview of French & Raench & Raven’s (1959) s (1959) Power Dynamics. The Journal of values_Based leadership, 13. https://scholar.valpo.edu/cgi/viewcontent.cgi?article=1312&context=jvbl

 

 
Do you need a similar assignment done for you from scratch? Order now!
Use Discount Code "Newclient" for a 15% Discount!

Assessing and Diagnosing Patients with Anorexia Nervosa

/in , , , , , , , /by

NRNP/PRAC 6635 Comprehensive Psychiatric Evaluation

Assessing and Diagnosing Patients with Anorexia Nervosa

Assessing and Diagnosing Patients with Anorexia Nervosa 

Name: S.H.

DOB: November 29th, 2011

Minor: Yes

Accompanied by: Mother

Age: 11 Years

Gender: Female 

(Assessing and Diagnosing Patients with Anorexia Nervosa)

SUBJECTIVE:

CC: “S.H. has is experiencing difficulties in school, has problems paying attention, forgets easily, and cannot stay still.” (Assessing and Diagnosing Patients with Anorexia Nervosa)

HPI: The patient is an 11-year-old female presenting at the clinic with her mother who claims she is experiencing difficulties in school, problems paying attention, and remembering things. The mother states S.H. cannot stay as she jumps from one activity to another. She cannot remembers her assignments very well, and needs an assignment list, which she also fails to keep track of and losing it, necessitating the teacher to also giver her mother another list. She cannot stay still while reading, unless she really likes it, then she can stay still for about five minutes. S.H. has difficulties remembering what she read or what her teacher read her, and she loses her things easily. She loses her temper when her teachers ask her something she did not hear. S.H. states that she daydreams about different things, including good and bad times. Mother states that the patient’s concentration is impaired, but she loves art, although she jumps from one painting to another at the museum. Mother reports that S.H. loves video games, and she can stay on them for long periods. Mother reports risky behavior when S.H. was young and lack of perception of danger. (Assessing and Diagnosing Patients with Anorexia Nervosa)

Social History: S.H. lives with her parents in Washington, D.C. She has a younger borther. m

Substance Current Use and History: Denied any substance use history.

Legal History: None reported. 

Family Psychiatric/Substance Use History: Denied family mental health or substance use issues.

Past Psychiatric History:

Hospitalization: Denied previous hospitalization

Medication trials: No previous medical trails

Psychotherapy or Previous Psychiatric Diagnosis: No previous psychiatric diagnosis

Medical History: Denies medical history.

  • Current Medications:None reported.
  • Allergies:
  • Reproductive Hx:

Development Milestones:

Development milestones met on time

Health Promotion:

Vaccination up to date

Sleeps 9-10hrs/night

Has proper nutrition per PCP, although meals are difficult because she cannot stay still to eat.

ROS:   

General: Denies weight loss, fever, chills, weakness, or fatigue.

HEENT: Eyes: denies visual loss, blurred vision, double vision, or yellow sclerae. Ears, Nose, Throat: No hearing loss, sneezing, congestion, runny nose, or sore throat.

Skin: No rash or itching.

Cardiovascular: Denies chest pain, chest pressure, or chest discomfort. No palpitations or edema.

Respiratory: Denies wheezes, shortness of breath, consistent coughs, and breathing difficulties while resting.

Gastrointestinal: No anorexia, nausea, vomiting, or diarrhea. No abdominal pain or blood.

Genitourinary: Denies burning on urination, urgency, hesitancy, odor, odd color

Neurological: Denies headache, dizziness, syncope, paralysis, ataxia, numbness, or tingling in the extremities. No change in bowel or bladder control. Reports difficulties concentrating and paying attention. Reports memory difficulties.

Musculoskeletal: Denies muscle, back pain, joint pain, or stiffness.

Hematologic: Denies anemia, bleeding, or bruising.

Lymphatics: Denies enlarged nodes. No history of splenectomy.

Endocrinologic: Sweating, No reports of cold or heat intolerance. No polyuria or polydipsia.

OBJECTIVE:

Vital signs: Unstable

Temp: 98.8F

B.P.: 100/55

P: 60

R.R.: 15

O2: Room air

Pain: 4/10

Ht: 5’5 feet

Wt: 95 lbs

BMI: 15.8

BMI Range: Underweight

LABS:

Lab findings WNL

Tox screen: Negative

Alcohol: Negative

Physical Exam:

General appearance: The patient appears lean, malnourished, and dehydrated, with the BMI indicating she is underweight. The patient converses appropriately and regularly with the interviewer, but appeared irritated with some questions. The patient has impaired concentration and did not answer some questions appropriately.

HEENT: Normocephalic and atraumatic. Sclera anicteric, No conjunctival erythema, PERRLA, oropharynx red, moist mucous membranes.

Neck: Supple. No JVD. Trachea midline. No pain, swelling, or palpable nodules.

Heart/Peripheral Vascular: Regular rate and rhythm noted. No murmurs. No palpitation. No peripheral edema to palpation bilaterally.

Cardiovascular: The patient’s heartbeat and rhythm are slow. The patient’s heart rate is slow, and capillaries refill in more than two seconds. The patient shows signs of hypotension.

Musculoskeletal: Normal range of motion. Low muscle mass for age. No signs of swelling or joint deformities. Patient indicates muscle wasting. Muscle and back pain are rated 4/10 on the pain scale.

Respiratory: No wheezes, and respirations are easy and regular.

Neurological: Balance is stable, gait is normal, posture is erect, the tone is good, and speech is clear. Patient has frequent headaches. Patient shows signs of mineral and vitamin deficiencies.

Psychiatric: The patient has a depressed mood, irritability, insomnia, impaired concentration.

Neuropsychological testing: Social-emotional functioning is impaired.

Behavior/motor activity: Patient behavior was appropriate and constant throughout the assessment

Gait/station: Stable.

Mood: Depressed mood.

Affect: The patient’s mood was depressed.

Thought process/associations: comparatively linear and goal-directed.

Thought content: Thought content was appropriate.

Attitude: patient was uncooperative at times

Orientation: Oriented to self, place, situation, and general timeframe.

Attention/concentration: Impaired

Insight: Good

Judgment: Good.

Remote memory: considered good

Short-term memory: considered good

Intellectual /cognitive function: considered good

Language: clear speech, with a tone, assessed to be normal

Fund of knowledge: Good.

Suicidal ideation: The patient reports suicidal ideation, but negative for active plans.

Homicide ideation: Negative.

ASSESSMENT:

Mental Status Examination:

The patient is a 25-year old female presenting with gradual weight loss, loss of appetite, feeling fatigued, and depressed mood. Patient reports easy irritability. During psychiatric interview, the patient was uncooperative at times and her concentration was impaired, making it difficult to establish a rapport. She expressed a low mood, persistent probing, decreased attention and concentration, apathy, and easy fatigability. The patient appeared bleak and expressed pessimistic ideas about her life, marriage, and future, fearing her husband would leave her. She reports suicidal ideation, but negative of active plans. She denies homicidal ideation. (Assessing and Diagnosing Patients with Anorexia Nervosa)

Differential Diagnosis:

  1. 0 Anorexia Nervosa:

Anorexia nervosa is characterized by a restriction of nutrient intake comparable to requirements, resulting in substantially low body weight. Patients suffering from this eating disorder will experience a fear of weight gain, as well as a distorted perception of themselves and difficulty comprehending the gravity of their condition. Menstrual irregularities, cold intolerance, bowel problems, extremity edema, exhaustion, and irritability are among the symptoms reported by patients. Patients describe food-related restrictive behaviors such as calorie restriction or portion control, and purging methods, including self-induced vomiting or the using diuretics or laxatives (Moore & Bokor, 2022). Many people exercise obsessively for long periods. Numerous complications result from anorexia nervosa patients’ extended fasting and purgation. DMS-5 criteria for Anorexia Nervosa requires a patient to indicate energy intake restriction relative to requirements, causing significant weight loss relative to age, sex, developmental trajectory, and physical health, less than minimally expected. To establish the diagnosis, the patient should report excessive fear to gaining weight or fattening or persistent behavior interfering with weight gain (Moore & Bokor, 2022). N.D. indicates nutritional restriction, weight gain fear and anxiety, persistent behaviors and activities to prevent weight gain, including exercising for extended period of time and using medication to help with weight loss. For this reason, the diagnosis was established. (Assessing and Diagnosing Patients with Anorexia Nervosa)

  1. 9 Major Depressive Disorder

Depression can co-occur with eating disorders, such as anorexia nervosa. Depression is a mood disorder leading to constant sorrow and disinterest. Between 50-70% of individuals experiencing eating disorders show signs of depression. The close relationship between these disorders makes it vital to consider when diagnosing and treating the eating disorder. All depressive disorders share the symptoms of melancholy, emptiness, or irritation, along with physical and mental changes that significantly impair the patient’s capacity to operate (Chand et al., 2021). Patients who are depressed have a noticeably lower interest in or enthusiasm for nearly all activities for the majority of the day, practically every day. According to the DMS-5 criteria, a diagnosis must include 5 of the following symptoms: trouble sleeping, decreased interest or enjoyment, feelings of guilt and worthlessness, fatigue and energy swings, difficulty focusing or paying attention, changes in appetite and weight, psychomotor problems, suicidal thoughts, and depressed mood. Because the patient does not exhibit 5 of the 9 symptoms mentioned above, this diagnosis cannot be made. (Assessing and Diagnosing Patients with Anorexia Nervosa)

  1. 10 Social Anxiety Disorder

Individuals with eating disorders such as anorexia nervosa commonly experience anxiety in social situations and are often concerned about how people perceive their body. Anorexia nervosa patients develop fear and anxiety eating in front of other people, including their spouses and children. Therefore, during the assessment, patients tend to indicate symptoms of social anxiety. Also, anorexia nervosa can indicate another underlying mental health disorder, such as social anxiety (Rose & Tadi, 2021). Per the DSM-5 criteria, a person must exhibit pronounced fear or anxiety in one or more social situations where they may come under others’ potential scrutiny. The individual worries that they will behave in a way that might be perceived adversely. Most of the time, social situations cause anxiety or fear, which is excessive compared to the threat they truly present. As a result, people either avoid them entirely or tolerate them with worry or fear. Usually lasting at least six months, the avoidance, fear, or worry significantly impairs or distresses one of the fundamental areas of functioning. The symptoms of another mental disorder or the consequences of a substance should not be linked to this fear. If a different medical issue is present, the anxiety, avoidance, or fear is also excessive or unconnected (Rose & Tadi, 2021). This diagnosis was refuted because, although the patient admits to anxiety and fear of weight gain, she does not indicate intense fear and anxiety relative to requirements. (Assessing and Diagnosing Patients with Anorexia Nervosa)

  PLAN:

The patient would benefit from a combination of nutritional rehabilitation and psychotherapy.

Safety Risk/Plan:

The patient indicates minimal intent to cause self-harm and is negative of active plans. The patient shows no intent to harm others. Patient has minimal suicidal and negative homicidal ideation. Initial admission is required to stabilize vitals.

Pharmacological Interventions:

Medications are not used initially. However, the patient can be prescribed olanzapine as first-line medication to help with weight gain (Moore & Bokor, 2022). Combination therapy with selective reuptake inhibitors (SSRIs) will help reduce symptoms such as fear and anxiety and the increased urge for nutritional restriction.

Psychotherapy:

The patient will undergo intensive therapy, 2-3 hours every weekday and partial hospitalization for about 6 hours a day to help stabilize vitals in the first one week. Family-based psychotherapy will help investigate and understand the underlying nature of the home environment and restructure it (Moore & Bokor, 2022). Cognitive behavioral therapy will help address behavioral changes to control eating and body perception. Self-control is required for successful behavioral changes, making CBT a fundamental intervention. (Assessing and Diagnosing Patients with Anorexia Nervosa)

Education:

  1. Educate the patient about side effects, potential complications, and need for medication adherence.
  2. Educate patient on the need to follow-up with therapy to manage complications and address body image.
  3. Monitor vital signs.
  4. Monitor withdrawal symptoms to determine risk of relapse.
  5. Educate the patient regarding making healthy lifestyle choices.
  6. Encourage the patient to work with the healthcare team and seek help anytime.
  7. Advise the patient to join a support group or group therapy to help enhance social skills.

Consultation/follow-up: Follow-up is in one week for further assessment.

Referral: The patient needs to see a gynecologist to address menstruation irregularities.

Reflection

The primary challenge in addressing anorexia nervosa is that patients do not realize the severity of their situations or the risk associated with nutritional restriction. Patients also experience fear and anxiety of weight gain, which increases non-adherence behavior and the probability of relapse mid-course treatment. Additionally, ordinary people, including patients and their families, do not consider anorexia nervosa a mental health disorder that significantly impacts an individual’s mental health. Treating this disorder requires commitment from the patient and a reliable support system because the risk of relapse is high. Ethical treatment of eating disorders is complicated because most patients lack insight into the severity of their situation and the need for treatment. Treating eating disorders has distinct ethical principles, including respect for persons, autonomy, veracity, nonmaleficence, privacy, duty to protect, and beneficence. However, these principles are weighed and applied differently depending on the situation and severity of anorexia nervosa. For instance, in severe anorexia, the need to protect the patient from harm might override the need to promote patient autonomy. Treatment refusal is an issue in treating eating disorders that conflicts with the principle of autonomy. This case offers insights into the categorization of eating disorders as mental health illnesses and the challenges associated with treating these disorders. Given another chance with the patient, I would inquire about their attitudes towards their eating habits and ask for the husband to be present to explore his attitude towards her wife’s lean body and eating habits and how the home environment contributes to the situation.   (Assessing and Diagnosing Patients with Anorexia Nervosa)

References

Chand, S. P., Arif, H., & Kutlenios, R. M. (2021). Depression (Nursing). In: StatPearls [Internet]. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK568733/

Moore C.A., & Bokor, B.R. (2022). Anorexia Nervosa. In StatPearls [Internet]. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK459148/

Rose, G. M., & Tadi, P. (2021). Social anxiety disorder. In StatPearls [Internet]. StatPearls Publishing.https://www.ncbi.nlm.nih.gov/books/NBK555890/

 
Do you need a similar assignment done for you from scratch? Order now!
Use Discount Code "Newclient" for a 15% Discount!

Medication Administration Errors in Nursing

/in , , , , , , , /by

Thread Title: “Medication Administration Errors in Nursing”

Medication Administration Errors in Nursing

1.Thread

Thread Title: “Medication Administration Errors in Nursing”

Nurses strive for perfection, but the work environment is pressuring, and often nurses make mistakes that can jeopardize a patient’s safety and health outcomes. Most mistakes involving nurses at work are unintentional; nonetheless, they can bear legal upshots if they lead to adverse events or a patient decides to push ahead with a lawsuit. Patient safety is an indicator of the quality of health and other significant aspects of protocol adherence (Mahrous, 2018). Nurses’ primary role is to ensure patients receive the needed care, promoting their health and well-being. Nurses promote quality of care and patient safety by supporting patients in their recovery journey and after discharge. Throughout my career, I have been involved in several mistakes, some life-changing, particularly in the first years of practice. I will discuss a nursing mistake I was involved in during my clinical placement.

2. Call Dibs

“Alarm Fatigue Is Real”

3. Read Essay

“Alarm Fatigue Is Real”

4. Response to Essay

Plot
The essay is about alarm fatigue and its impact on care. The author discusses alarm fatigue in general, pointing out contributing factors, how it occurs, how nurses deal with alarms that constantly go off, and the potential impact on patient outcomes. The author then discusses a personal experience with alarm fatigue and how it affected the patient and clinical outcomes. Finally, the author provides lessons from this experience and recommends an improvement on the system because the current one is not as effective as intended, contributing to nursing burnout. The author recommends a system that would stop going off when the patient has achieved desired or within-normal vital signs and also recommends a better way to connect the patient to the monitor because the sticker approach leads to inaccurate readings and constant alarms when it falls off, especially when a patient is constantly moving, typical in pediatric care. (Medication Administration Errors in Nursing)
Personal Feelings
Alarm fatigue is a patient safety issue because, in most cases, nurses switch off alarms that go off constantly and sometimes fail to notice when the patient needs help. Also, the sticker falling off the patient leads to incorrect readings impacting clinical decisions. The author’s experience shows how challenging the healthcare environment is and how environmental factors affect nursing practice, including providing quality and safe care. The high exposure to medical alarms can be tiring and frustrating, leading to harm desensitization from missed alarms, meaning nurses might respond late, which can be detrimental to the patient. (Medication Administration Errors in Nursing)
Purpose of Sharing
The author’s primary purpose is to discuss how alarm fatigue impacts nursing practice and patient outcomes. This experience seems significant to the author and a fundamental learning experience that was life-changing and majorly impacting future practice. In such a situation, the outcome can be a patient’s death, which new nurses can find difficulty dealing with. Therefore, sharing this patient encounter elaborates more on nursing responsibility and how factors can impact nurses’ effectiveness in deliberating the responsibility.
Personal Experience that Connects with Author’s
I can relate to this experience because medical device alarms are also common at the workplace, and the frequency of the alarms determines nurses’ development of alarm fatigue. Frequent alarms are tiring and frustrating because more than half of the alarms are false, and you end up running up and down or leaving a current task to respond to a false one. It is a sensory overload that leads to desensitization because, in some instances, I have failed to respond immediately, especially when the alarm seems false. I understand this can be dangerous, but I can wait to see if another nurse is calling before moving in to help. Other nurses calling for assistance seems a more effective way of responding to an emergency because it is never a false alarm.
Something from my Learning that may Interest the Author
Interestingly, alarm fatigue is well-documented and is recognized by the Joint Commission National Patient Safety Goal as a patient safety issue. Patient deaths have been associated with alarm fatigue linked to missed alarms and delayed responses. However, there are strategies I can recommend to adopt at the healthcare organization to help address the problem, including alarm parameter customization and using adopting electrocardiogram electrode changes to minimize false alarms. (Medication Administration Errors in Nursing)
Theme to Explore
Alarm fatigue has been widely researched, but interventions to address the problem and promote patient safety need more research. I would be interested in exploring how AI and other contemporary technologies can help address the problem and replace the stickers, which often fall off, leading to false alarms.
Keywords
1.Alarm fatigue*
2.Impact of alarm fatigue on patient safety*
3.Alarm fatigue best practices
4.Nurses’ perspectives on alarm fatigue*
5.Theoretical underpinnings of alarm fatigue
6.Hospital policy and procedure to decrease alarm fatigue

5. Do Research

Article selected:
Claudio, D., Deb, S., & Diegel, E. (2021). A Framework to Assess Alarm Fatigue Indicators in Critical Care Staff. Critical care explorations, 3(6), e0464. https://doi.org/10.1097/CCE.0000000000000464

6. Share the Article

Authors: Claudio et al.
Publication year: 2021
Article full title: A Framework to Assess Alarm Fatigue Indicators in Critical Care Staff
Functional Link: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8205220/
Database: PubMed Central
Justification: I selected the article because it goes overboard to assess work-related and personality factors influencing providers’ experience with alarm fatigue. The article posits that individualities can impact behavior towards alarm fatigue and recommends alternative strategies like work rotation, shift reduction, and breaks to reduce alarm fatigue. (Medication Administration Errors in Nursing)

 
Do you need a similar assignment done for you from scratch? Order now!
Use Discount Code "Newclient" for a 15% Discount!

Comprehensive Psychiatric Evaluation of ADHD

/in , , , , , , , /by

Comprehensive Psychiatric Evaluation of ADHD

Comprehensive Psychiatric Evaluation of ADHD

Name: S.H.

DOB: November 29th, 2011

Minor: Yes

Age: 11 Years

Gender: Female 

Accompanied by: Mother

 

SUBJECTIVE:

CC: “S.H. is experiencing difficulties in school, has problems paying attention, forgets easily, and cannot stay still.”

HPI: The patient is an 11-year-old female presenting at the clinic with her mother, who claims she is experiencing difficulties in school, problems paying attention, and remembering things. The mother states S.H. cannot stay still as she jumps from one activity to another. She cannot remember her assignments very well and needs an assignment list, which she also fails to keep track of and loses, necessitating the teacher to give her mother another list. She cannot stay still while reading unless she really likes it; then, she can stay still for about five minutes. S.H. has difficulties remembering what she read or what her teacher read her, and she loses her things easily. She loses her temper when her teachers ask her something she did not hear. S.H. states that she daydreams about different things, including good and bad times. She is frustrated when she makes a mistake while doing her assignments because she is trying to do it right. The mother states that the patient’s concentration is impaired but loves art, although she jumps from one painting to another at the museum. The mother reports that S.H. loves video games, and she can stay on them for long periods. The mother reported risky behavior when S.H. was young and a lack of perception of danger.   (Comprehensive Psychiatric Evaluation of ADHD)

Social History: S.H. lives with her parents in Washington, D.C. She has a younger brother.

Substance Current Use and History: Denied any substance use history.

Legal History: None reported. 

Family Psychiatric/Substance Use History: Denied family mental health or substance use issues.

Past Psychiatric History:

Hospitalization: Denied previous hospitalization

Medication trials: No previous medical trails

Psychotherapy or Previous Psychiatric Diagnosis: No previous psychiatric diagnosis

Medical History: Denies medical history.

  • Current Medications:None reported.
  • Allergies:
  • Reproductive Hx:

Development Milestones:

Development milestones met on time

Health Promotion:

Vaccination up to date

Sleeps 9-10hrs/night

Has proper nutrition per PCP, although meals are difficult because she cannot stay still to eat.

ROS:   

General: Denies weight loss, fever, chills, weakness, or fatigue.

HEENT: Eyes: denies visual loss, blurred vision, double vision, or yellow sclerae. Ears, Nose, Throat: No hearing loss, sneezing, congestion, runny nose, or sore throat.

Skin: No rash or itching.

Cardiovascular: Denies chest pain, chest pressure, or chest discomfort. No palpitations or edema.

Respiratory: Denies wheezes, shortness of breath, consistent coughs, and breathing difficulties while resting.

Gastrointestinal: No anorexia, nausea, vomiting, or diarrhea. No abdominal pain or blood.

Genitourinary: Denies burning on urination, urgency, hesitancy, odor, odd color

Neurological: Denies headache, dizziness, syncope, paralysis, ataxia, numbness, or tingling in the extremities. No change in bowel or bladder control. Reports difficulties concentrating and paying attention. Reports memory difficulties.

Musculoskeletal: Denies muscle, back pain, joint pain, or stiffness.

Hematologic: Denies anemia, bleeding, or bruising.

Lymphatics: Denies enlarged nodes. No history of splenectomy.

Endocrinologic: Sweating, No reports of cold or heat intolerance. No polyuria or polydipsia.

 

OBJECTIVE:

Vital signs: Stable

Temp: 97.4F

B.P.: 100/80

P: 58

R.R.: 14

O2: Room air

Pain: 0/10

Ht: 4’5 feet

Wt: 65 lbs

BMI: 16.3

BMI Range: Healthy weight

Physical Exam:

General appearance: The patient looks well-fed and in good health. Her conversation and engagement with interviewer is irregular, requiring intervention from the mother to help answer the questions or ask the patient to answer. She drifts from the conversation quickly, not paying full attention to the questions asked. Her attention and concentration are impaired, making inquiry challenging.

HEENT: Normocephalic and atraumatic. Sclera anicteric, No conjunctival erythema, PERRLA, oropharynx red, moist mucous membranes.

Neck: Supple. No JVD. Trachea midline. No pain, swelling or palpable nodules.

Heart/Peripheral Vascular: Regular rate and rhythm noted. No murmurs. No palpitation. No peripheral edema to palpation bilaterally.

Cardiovascular: Although the patient’s heartbeat and rhythm are regular, there are murmurs and other sounds coming from her chest. The patient’s heart rate is constant and capillaries refill in two seconds.

Musculoskeletal: Normal range of motion. Regular muscle mass for age. No signs of swelling or joint deformities.

Respiratory: No wheezes and respirations are easy and regular.

Neurological: Balance is stable, gait is normal, posture is erect, tone is good, but speech is irregular. She has memory problems and cannot remember the questions asked by the interviewer. Her concentration and attention are impaired.

Psychiatric: The patient fast switches from one thing to another and cannot stick to the discussion and the interview, indicating impaired attention and concentration. Patient is easily distracted, yet occasionally appears to pay attention to the interviewer.

Neuropsychological testing: Patient has difficulties executing functions like reading, doing assignments and homework, and eating, where she is required to prioritize, plan, inhibit behavior, and attend to processing speed. (Comprehensive Psychiatric Evaluation of ADHD)

 

ASSESSMENT:

Mental Status Examination:

The patient is an 11-year-old female presenting with difficulties in school and attention and memory problems. The patient reports easy irritability and being short-tempered when teachers ask about something she did not hear. During the psychiatric interview, the patient was sometimes uncooperative, and her concentration was impaired, making it difficult to conduct the inquiry, necessitating the mother’s intervention to help answer the questions. However, the patient was polite, making it easy to establish a rapport. She indicated decreased attention and concentration. The patient is forgetful and shows short- and long-term memory issues. Additionally, she is fidgety and cannot stay still throughout an activity.   (Comprehensive Psychiatric Evaluation of ADHD)

Differential Diagnosis:

  1. 9. Attention-Deficit hyperactivity disorder (Confirmed):

Millions of children are affected with attention-deficit/hyperactivity disorder (ADHD), a long-term mental health problem that often worsens as people get older. Hyperactivity, impulsive conduct, and problems maintaining attention are all persistent symptoms of ADHD. Low self-esteem, problematic relationships, and poor involvement are common problems for people with ADHD, especially children (Magnus et al., 2017). The patient indicated difficulties at school, memory issues, and impaired attention and concentration. The mother noted inattention symptoms since the patient was in kindergarten. The DSM-5 diagnostic criteria for children with ADHD include a pervasive inattention and/or hyperactivity-impulsivity pattern interfering with functioning or development as indicated by inattention, with six or more symptoms persisting for a minimum of six weeks to a point it is inconsistent with developmental level and negatively affects directly social and academic activities, including often failing to offer close attention to details and committing careless mistakes in assignments and homework or during other activities, difficulty maintaining attention in tasks or play, seeming not listening when spoken to directly, failing to follow through instructions or finishing schoolwork, problems with task an activities organization, avoiding or being reluctant to engage in issues calling for sustained mental effort, losing things needed for particular tasks, being easily distracted by external stimuli, and indicating forgetfulness in daily activities (Abuse & Administration, 2018). Regarding hyperactivity and impulsivity, the DSM-5 criteria require a patient to indicate at least six of the following symptoms: being fidgety or tapping hands or feet or moving in the seat, failing to remain seated when expected, running or climbing inappropriately, inability to remain quiet during play or leisure activities, being on the go and failing to stay still, talking excessively, answering before a question is asked, trouble engaging in turn-taking, and often interrupting or intruding others. The patient displays at least six symptoms of inattention and six of hyperactivity and impulsivity, confirming ADHD diagnosis.  (Comprehensive Psychiatric Evaluation of ADHD)

  1. 9. Generalized Anxiety Disorder:

Generalized anxiety disorder is marked by excessive, exaggerated anxiety and worries about ordinary events without a clear reason (Munir et al., 2021). About 3.1 percent of the population, or more than 8.8 million children, are affected. While it can begin at any age and progress gradually, the risk is most between the ages of five and middle age. Biological variables, family history, life events, and other stressors contribute to GAD, despite the exact cause being unknown (Toussaint et al., 2020). Excessive, persistent worry and tension, unrealistic views of problems, restlessness or a sense of being “edgy,” difficulty focusing, easily becoming exhausted, increased crankiness or irritability, difficulty sleeping, and muscle tension are all symptoms of general anxiety disorder, according to the DMS-5 criteria. People with GAD frequently anticipate disaster and are overly concerned with everyday events such as work. GAD is diagnosed when a person cannot control their worrying, which was refuted in this case because the patient did not exhibit persistent worry and tension.

  1. 23. Adjustment Disorder:

Those who have trouble adjusting after a stressful event at a degree disproportionate to the severity or intensity of the stressor are said to have adjustment disorder (AD), defined as a maladaptive emotional and/or behavioral reaction to a recognized psychosocial stressor. Stress responses that are inconsistent with socially or culturally expected responses to the stressor and/or that significantly affect every day functioning are characteristics of AD symptoms (O’Donnell et al., 2019). The criteria for adjustment disorder do not include any prerequisites for what might be regarded as a stressor, in contrast to the criteria for posttraumatic stress disorder (PTSD) or acute stress disorder (ASD), which clearly define what constitutes a traumatic experience. Per the DSM-5 criteria, a diagnosis is established when an individual indicates emotional or behavioral symptoms development to respond to stressor(s) occurring within three months of the stressor(s) onset. The second criterion requires the symptoms to be clinically significant, as indicated by considerable stress that is unproportional to the stressor(s) severity or intensity, considering external context and cultural aspects that would influence symptom severity and presentation and the patient to indicate severe impairment ins social, occupation, and other fundamental functioning areas (Abuse & Administration, 2017). The third criterion requires stress-related disturbances not to meet criteria for another mental condition and are minimally affected by a preexisting mental condition. The symptoms should also not represent typical bereavement.    (Comprehensive Psychiatric Evaluation of ADHD)

 

PLAN:

The patient would benefit from a combination of pharmacological interventions and psychotherapy.

Pharmacological Interventions:

To address ADHD symptoms, start Buspar 10 mg 1 tab PO BID. Also, prescribe venlafaxine 18.75-75 mg/day; may increase to 150 mg/day after 4 weeks and Bupropion Initial: 150 mg/day PO. Give imipramine 75 PO qDay initially; may increase to 150 mg/day gradually and metadate CD: Initial, 20 mg PO qAM before breakfast. Atomoxetine 40 mg PO once daily initially; increase after ≥3 days to 80 mg PO once daily or divided q12hr can also help manage ADHD symptoms.

Psychotherapy

Behavioral psychotherapy is needed to enhance executive function and improve ADHD symptoms. ADHD symptoms can be reduced with the help of psychosocial interventions, such as short-term psychodynamic psychotherapy, applied relaxation interpersonal psychotherapy, and social skills training. Cognitive-behavioral therapy will help reduce restlessness sensations that arise when performing tasks, improve focus and time management, and improve organization (Lopez et al., 2018).

Patient education

  • Talk to the patient and parent about risks and benefits of medication, including non-treatment, probable side effects.
  • Discuss with patient and parent when to stop medication, how to recognize and when to report adverse events.
  • Talk to the patient and parent about the dangers of combining prescription pharmaceuticals with other substances.
  • Educate patient and parent to develop structured daily routines, daily schedule, and minimize changes.
  • Engage patient in skills training.
  • Encourage patient to make time for exercise every day.
  • Teach patient and parent to create a system for prioritizing the day and create deadlines for activities.

Follow-up: Patient should follow-up after one week.

Reflection

ADHD is common among children, affecting their social and cognitive functioning. Dealing with ADHD patients, particularly children, can be challenging because it is difficult to make an inquiry or sustain a conversation when the patient is easily distracted by extraneous stimuli, cannot stay still, has difficulty paying attention, and shifts from one thing to another, necessitating parental intervention. Patients are defiant and can be aggressive, refusing to follow instructions and having emotional outbursts. In this case, the patient was polite, which helped establish a rapport and framework for the interview. The mother was of great help in answering the questions to help understand the patient’s condition and how it affects her life. Hyperactivity and inattention symptoms present providers with ethical conflicts between justice and beneficence or non-maleficence. Therapeutic use for ADHD in minors presents ethical issues, including safety, risk/benefit ratio, informed consent, nonmedical use, and labeling problems. Given another chance with the patient, I would inquire more about the family history of ADHD and coping mechanisms or interventions adopted at home and school to help address challenges presented in ADHD patients.   (Comprehensive Psychiatric Evaluation of ADHD)


References

Abuse, S., & Administration, M. H. S. (2017). Impact of the DSM-IV to DSM-5 Changes on the National Survey on Drug Use and Health.

Abuse, S., & Administration, M. H. S. (2018). DSM-5 Changes: Implications for Child Serious Emotional Disturbance [Internet].

Lopez, P. L., Torrente, F. M., Ciapponi, A., Lischinsky, A. G., Cetkovich-Bakmas, M., Rojas, J. I., Romano, M., & Manes, F. F. (2018). Cognitive-behavioural interventions for attention deficit hyperactivity disorder (ADHD) in adults. The Cochrane database of systematic reviews, 3(3), CD010840. https://doi.org/10.1002/14651858.CD010840.pub2

Magnus, W., Nazir, S., Anilkumar, A. C., & Shaban, K. (2017). Attention deficit hyperactivity disorder (ADHD).

Munir, S., Takov, V., & Coletti, V. A. (2021). Generalized Anxiety Disorder (Nursing). StatPearls [Internet].

O’Donnell, M. L., Agathos, J. A., Metcalf, O., Gibson, K., & Lau, W. (2019). Adjustment Disorder: Current Developments and Future Directions. International journal of environmental research and public health, 16(14), 2537. https://doi.org/10.3390/ijerph16142537

Toussaint, A., Hüsing, P., Gumz, A., Wingenfeld, K., Härter, M., Schramm, E., & Löwe, B. (2020). Sensitivity to change and minimal clinically important difference of the 7-item Generalized Anxiety Disorder Questionnaire (GAD-7). Journal of affective disorders, 265, 395-401.

 
Do you need a similar assignment done for you from scratch? Order now!
Use Discount Code "Newclient" for a 15% Discount!

Benner Caring, Clinical Wisdom and Ethics

/in , , , , , , , /by

Week 5 Topic: Benner Caring, Clinical Wisdom and Ethics

Benner Caring, Clinical Wisdom and Ethics

Dr. Patricia Benner has contributed to nursing theory through her From Novice o Expert concept. The concept has been used in research to understand the gap between knowledge and skills development and patient care understanding and how new graduates transition to practice (Murray et al., 2019). The difference in quality and safety among graduate registered nurses remains an issue that significantly impacts patient outcomes. Effective facilitation of the transition process helps enhance experiential learning, allowing them to develop and establish a safe, quality nursing practice. An in-depth understanding of the transition process helps understand barriers and appropriate enablers to ensure a successful transition (Murray et al., 2019). Benner’s theory plays a critical role in shaping nursing research and education, providing nursing educators and leaders with an understanding of how to facilitate knowledge and skills acquisition and transition into practice for newly graduated registered nurses (Nursing Theory, 2023). This model that describes nurses’ transition through five nursing experience levels: novice, advanced beginner, competent, proficient, and expert is used as a theoretical framework in research to help measure, understand and improve the safety and quality of nursing care and influence on the future of the nursing workforce. (Benner Caring, Clinical Wisdom and Ethics)

Nurses point to experience as critical to providing safe and quality care, and hospitals and educational institutions should bolster nurses’ experience via recruitment, orientation, and continuous learning and retention (Nyikuri et al., 2020). Therefore, Benner’s theory has seen considerable interest from nurse educators since it was published, who adopted it to improve nursing curricula. The theory is widely accepted across all stages apart from the efficacy of the intuitive practice, an attribute of an expert practitioner. Benner’s concept has been valuable, becoming widely used to inform and guide nursing practice, education, research, and administration. However, some reviews of her work indicate that the theory is not clearly a theory or philosophy but leans more on the philosophical side. Understanding whether the concept is a theory or a philosophy would help with its appropriate use. ((Benner Caring, Clinical Wisdom and Ethics))

References

Murray, M., Sundin, D., & Cope, V. (2019). Benner’s model and Duchscher’s theory: Providing the framework for understanding new graduate nurses’ transition to practice. Nurse education in practice, 34, 199–203. https://doi.org/10.1016/j.nepr.2018.12.003

Nursing Theory. (2023). Dr. Patricia Benner Novice to Expert – Nursing Theorist. https://nursing-theory.org/nursing-theorists/Patricia-Benner.php/

Nyikuri, M., Kumar, P., English, M., & Jones, C. (2020). “I train and mentor, they take them”: A qualitative study of nurses’ perspectives of neonatal nursing expertise and its development in Kenyan hospitals. Nursing open, 7(3), 711–719. https://doi.org/10.1002/nop2.442

 

 
Do you need a similar assignment done for you from scratch? Order now!
Use Discount Code "Newclient" for a 15% Discount!