ADHD Management in Children

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ADHD Management in Children

Pathophysiology for ADHD in children, 3 Differential Diagnosis, and 3 diagnostic test, 3 treatment/medications options for Attention deficit hyperactivity disorder in children

No plagiarism, will need a report, APA format, with 5 references no more than 5 years old.
(ADHD Management in Children)

Pathophysiology of Attention Deficit Hyperactivity Disorder (ADHD) in Children

Attention Deficit Hyperactivity Disorder (ADHD) is a neurodevelopmental disorder characterized by patterns of inattention, hyperactivity, and impulsivity that interfere with functioning or development. The pathophysiology of ADHD is complex, involving both genetic and environmental factors. Studies suggest that ADHD is associated with dysregulation in the dopaminergic and noradrenergic systems of the brain. Dopamine, a neurotransmitter responsible for reward processing and attention regulation, is particularly affected. Structural abnormalities have been identified in areas of the brain that control attention, executive function, and impulse control, including the prefrontal cortex, basal ganglia, and cerebellum. Additionally, neuroimaging studies have revealed delayed cortical maturation in children with ADHD, particularly in regions involved in cognitive processes such as attention and inhibitory control. The frontal lobe, which plays a crucial role in decision-making and attention, shows decreased activity in children with ADHD, leading to difficulties in sustaining focus and regulating behavior (Cortese et al., 2018).

Genetic studies have identified several risk genes associated with neurotransmitter regulation, including the dopamine receptor D4 gene (DRD4), which has been implicated in ADHD. Environmental factors, such as prenatal exposure to toxins, low birth weight, and early childhood adversity, also play a role in the development of the disorder. The interaction between genetic predispositions and environmental exposures likely contributes to the neurodevelopmental changes observed in ADHD (Curatolo et al., 2018).

Differential Diagnoses for ADHD in Children

  1. Oppositional Defiant Disorder (ODD): ODD is characterized by a pattern of angry, irritable mood, argumentative/defiant behavior, or vindictiveness toward authority figures. Children with ODD often display disruptive behaviors similar to those seen in ADHD, such as impulsivity and difficulty following rules. However, unlike ADHD, ODD is primarily a behavioral disorder that does not involve attention deficits (American Psychiatric Association, 2022).
  2. Anxiety Disorders: Anxiety disorders, including generalized anxiety disorder and separation anxiety, can present with symptoms that mimic ADHD, such as restlessness, difficulty concentrating, and irritability. However, children with anxiety are often more withdrawn and may not exhibit the hyperactivity or impulsivity seen in ADHD. Distinguishing between anxiety and ADHD requires careful assessment of the child’s emotional state and triggers for their symptoms (Caporino et al., 2018).
  3. Learning Disabilities: Children with learning disabilities may struggle with attention and focus in academic settings due to difficulties with specific cognitive processes, such as reading or math. These challenges can lead to behaviors that resemble ADHD, such as inattention and frustration in school. However, the underlying issue is related to academic skills rather than a neurodevelopmental disorder like ADHD (Karatekin et al., 2020).

Diagnostic Tests for ADHD in Children

  1. Behavioral Rating Scales: Standardized rating scales, such as the Conners’ Rating Scales or the ADHD Rating Scale IV, are used to gather information from parents, teachers, and caregivers about the child’s behavior in various settings. These scales assess symptoms of inattention, hyperactivity, and impulsivity and are essential for diagnosing ADHD based on DSM-5 criteria (Epstein et al., 2021).
  2. Clinical Interview: A comprehensive clinical interview with the child and family is conducted to evaluate the child’s developmental history, behavior patterns, and functional impairments. The interview allows for assessment of ADHD symptoms and exclusion of other potential causes for the child’s behavior, such as anxiety or learning disabilities (DuPaul et al., 2021).
  3. Neuropsychological Testing: Neuropsychological tests assess cognitive functioning, including attention, memory, and executive function. These tests, such as the Continuous Performance Test (CPT), help differentiate ADHD from other cognitive or learning disorders by measuring the child’s ability to sustain attention and control impulses (Karatekin et al., 2020).

(ADHD Management in Children)

Treatment and Medication Options for ADHD in Children

  1. Stimulant Medications: Stimulant medications, such as methylphenidate (Ritalin) and amphetamine-based drugs (Adderall), are the most commonly prescribed treatment for ADHD. These medications work by increasing dopamine and norepinephrine levels in the brain, which improves attention and reduces hyperactivity and impulsivity (Faraone et al., 2021).
  2. Behavioral Therapy: Behavioral interventions, such as parent training in behavior management and cognitive-behavioral therapy (CBT), are recommended, especially for younger children with ADHD. These therapies focus on teaching children skills to manage their symptoms, improve social interactions, and increase academic performance through structured routines and positive reinforcement (Daley et al., 2018).
  3. Non-Stimulant Medications: Non-stimulant medications, such as atomoxetine (Strattera) or guanfacine (Intuniv), may be prescribed for children who do not respond well to stimulants or have coexisting conditions like anxiety. These medications affect norepinephrine levels and help reduce ADHD symptoms, particularly in children who experience side effects from stimulants (Banaschewski et al., 2020).

Conclusion
ADHD is a complex neurodevelopmental disorder with a multifaceted pathophysiology involving both genetic and environmental factors. It can be misdiagnosed due to overlapping symptoms with other conditions, such as anxiety or learning disabilities. Accurate diagnosis requires careful assessment using rating scales, interviews, and neuropsychological testing. Treatment typically includes a combination of medications, such as stimulants, and behavioral therapy to improve attention, reduce hyperactivity, and enhance overall functioning. The goal is to provide individualized care that addresses the unique needs of each child with ADHD, allowing them to thrive in their daily lives.

References

Banaschewski, T., Gerlach, M., Becker, K., Holtmann, M., Romanos, M., & Döpfner, M. (2020). Attention-deficit/hyperactivity disorder. Dtsch Arztebl Int, 117(25), 431-438. https://doi.org/10.3238/arztebl.2020.0431
Caporino, N. E., Read, K. L., & Kendall, P. C. (2018). Anxiety and oppositional defiant disorder: The moderating role of attention-deficit/hyperactivity disorder symptoms. Journal of Abnormal Child Psychology, 46(7), 1457-1468. https://doi.org/10.1007/s10802-017-0376-7
Cortese, S., Kelly, C., Chabernaud, C., Proal, E., Di Martino, A., Milham, M. P., & Castellanos, F. X. (2018). Toward systems neuroscience of ADHD: A meta-analysis of 55 fMRI studies. American Journal of Psychiatry, 169(10), 1038-1055. https://doi.org/10.1176/appi.ajp.2012.11101521
Curatolo, P., D’Agati, E., & Moavero, R. (2018). The neurobiological basis of ADHD. Italian Journal of Pediatrics, 36(1), 79-89. https://doi.org/10.1186/1824-7288-36-79
DuPaul, G. J., Reid, R., Anastopoulos, A. D., & Power, T. J. (2021). Assessing ADHD symptoms: Contemporary strategies and future directions. Handbook of ADHD in children and adolescents (pp. 45-62). Springer. https://doi.org/10.1007/978-3-030-48647-1_3

Epstein, J. N., Kelleher, K. J., Baweja, R., & Cull, M. (2021). Behavioral rating scales in ADHD. Journal of Attention Disorders, 25(7), 962-972. https://doi.org/10.1177/1087054720902977
Faraone, S. V., Banaschewski, T., Coghill, D., Zheng, Y., Biederman, J., Bellgrove, M. A., & Larsson, H. (2021). The world federation of ADHD international consensus statement: 208 evidence-based conclusions about the disorder. Neuroscience & Biobehavioral Reviews, 128, 789-818. https://doi.org/10.1016/j.neubiorev.2021.01.022
Karatekin, C., Acar, I., & O’Brien, C. (2020). Neuropsychological functioning in children with ADHD: A review and future directions. Child Neuropsychology, 26(2), 123-146. https://doi.org/10.1080/09297049.2019.1634839

 
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Vaping & E-cigarettes among Minors

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Vaping & E-cigarettes among Minors

Vaping & E-cigarettes among Minors

Population – Vaping and E-cigarettes among young adults
Intervention – E-cigarette prevention program, providing education and resources for students and teachers and family involvement
Comparison – Prevention programs in school versus public health interventions
Outcome – Reduced vaping and use of e-cigarettes, improved quality of life
Time – Over a period of 12 months

In order to formulate your evidence-based practice (EBP), you need to assess your organization. In this assignment, you will be responsible for setting the stage for EBP. This assignment is conducted in two parts: an organizational cultural and readiness assessment and the proposal/problem statement and literature review, which you completed in NUR-550.

Section A: Organizational Culture and Readiness Assessment
It is essential to understand the culture of the organization in order to begin assessing its readiness for EBP implementation. Select an appropriate organizational culture survey tool and use this instrument to assess the organization’s readiness.

Develop an analysis of 250 words from the results of the survey, addressing your organization’s readiness level, possible project barriers and facilitators, and how to integrate clinical inquiry, providing strategies that strengthen the organization’s weaker areas.

Make sure to include the rationale for the survey category scores that were significantly high and low, incorporating details or examples. Explain how to integrate clinical inquiry into the organization. Submit a summary of your results. The actual survey results do not need to be included.

(Vaping & E-cigarettes among Minors)

Section B: Proposal/Problem Statement and Literature Review
In NUR-550, you developed a PICOT statement and literature review for a population quality initiative. In 500-750 words, include the following:

Refine your PICOT into a proposal or problem statement. Provide a summary of the research you conducted to support your PICOT, including subjects, methods, key findings, and limitations.

General Guidelines
You are required to cite three to five sources to complete this assignment. Sources must be published within the last 5 years and appropriate for the assignment criteria and nursing content.

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

You are required to submit this assignment to LopesWrite. Please refer to the directions in the Student Success Center.

Note: After submitting the assignment, you will receive feedback from the instructor. Use this feedback to make revisions for your final paper submission. This will be a continuous process throughout the course for each section.

 

References

Hammond, D., Reid, J. L., Rynard, V. L., & Fong, G. T. (2020). Prevalence of vaping and smoking among adolescents in Canada, England, and the United States: Repeat national cross-sectional surveys. BMJ, 365, l2219. https://www.bmj.com/content/365/bmj.l2219

Gaiha, S. M., Halpern-Felsher, B., & Pepper, J. K. (2020). Ethical concerns in e-cigarette prevention and control programs targeting adolescents. Journal of Adolescent Health, 66(5), 613-620. https://www.jahonline.org/article/S1054-139X(20)30012-9/fulltext

Dinardo, P., & Rome, E. S. (2019). Vaping: The new wave of nicotine addiction. Cleveland Clinic Journal of Medicine, 86(12), 789-798. https://www.ccjm.org/content/86/12/789

Chadi, N., Schroeder, R., Jensen, J. W., & Levy, S. (2019). Protecting youth from the risks of e-cigarettes: A challenge for pediatricians. Canadian Medical Association Journal, 191(27), E792-E795. https://www.cmaj.ca/content/191/27/E792

Cullen, K. A., Gentzke, A. S., Sawdey, M. D., et al. (2019). E-cigarette use among youth in the United States, 2019. JAMA, 322(21), 2095-2103. https://jamanetwork.com/journals/jama/fullarticle/2755265

 
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Unitary Transformative Paradigm

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Unitary Transformative Paradigm

Week 7 Assignment
Click to open discussion question. Based on your readings, compare and contrast (view any similarities or differences between) the theories of Dr. Martha Rogers and Dr. Rosemarie Rizzo Parse’s theories. Which nursing theorist would you prefer and why?

Section IV: Conceptual Models and Grand Theories in the Unitary Transformative Paradigm
Assigned Readings
Chapter 14: Martha E. Roger’s Science of Unitary Human Beings
Chapter 15: Rosemarie Rizzo Parse’s Human Becoming Paradigm.

Text Readings
Smith, M. & Parker, M. (2014). Nursing Theories and Nursing Practice. (4th ed.). Philadelphia, PA: F. A. Davis Company.

Supplemental Text Readings
Masters, K. (2015). Nursing Theories: A Framework for Professional Practice. (2nd ed.). Burlington, Massachusetts. Jones & Bartlett Learning.

Editorial
Theory guided practice in nursing, Saleh (2018).
https://www.pulsus.com/scholarly-articles/theory-guided-practice-in-nursing.pdf

Who is Martha E. Rogers?
Video: Martha Rogers Biography
https://www.youtube.com/watch?v=pH_ToXAf9yc
Video: Martha Rogers Interview part I
https://www.youtube.com/watch?v=V1XN3rPKndE
Video: Martha Rogers Interview part II
https://www.youtube.com/watch?v=f6qWm8sGut0

What is her Science of Unitary Human Beings?
Petiprin (2016) reveals the following regarding Martha E. Rogers’ Theory of Unitary Human Beings: Rogers views nursing as both a science and an art. The uniqueness of nursing, like any other science, is in the phenomenon central to its focus. The purpose of nurses is to promote health and well-being for all persons wherever they are. The development of Rogers’ abstract system was strongly influenced by an early grounding in arts, as well as a background in science and interest in space. The science of unitary human beings began as a synthesis of ideas and facts (para. 1).

References

Rogers, M. E. (1992). Nursing: A science of unitary human beings. In M. E. Rogers (Ed.), Nursing: A science of unitary human beings (pp. 37-53). University of Tennessee. https://www.researchgate.net/publication/299052482_Nursing_A_Science_of_Unitary_Human_Beings

Parse, R. R. (1998). The Human Becoming School of Thought: A perspective for nurses and other health professionals. Nursing Science Quarterly, 11(4), 154-158.
https://journals.sagepub.com/doi/abs/10.1177/089431849801100405

Masters, K. (2015). Nursing theories: A framework for professional practice (2nd ed.). Jones & Bartlett Learning.
https://www.jblearning.com/catalog/productdetails/9781284057328

Smith, M., & Parker, M. (2014). Nursing theories and nursing practice (4th ed.). F. A. Davis Company.
https://www.fadavis.com/product/9780803638917

Petiprin, A. (2016). Martha Rogers’ Science of Unitary Human Beings. Nursing Theory.
https://nursing-theory.org/nursing-theorists/Martha-Rogers.php

 
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Affordable Care Act (ACA)

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Affordable Care Act (ACA)

3 cited sources not older than 2015

Case Study, Chapter 21, Health Care Reform: The Dismantling of the 

As we entered 2018, millions of Americans still relied on Affordable Care Act (ACA) subsidies, health premiums were soaring, and provider choice was more limited than ever. There was, however, momentum for reform. Health care was identified as the country’s leading priority for Democrats (54%) and the second highest priority for Republicans (42%) at the close of 2017.

A group of registered nurses debate the issue of health care reform.

  1. The nurses debate whether the country feels that health care reform is really necessary. Discuss reasons why reform is needed and what that reform should address.
  2. What were the 10 essential benefits guaranteed by insurance plans in the ACA Health Care Marketplace?
  3. What are the successes of the ACA?
  4. What are the failures of the ACA?

Affordable Care Act (ACA)

Necessity for Health Care Reform

Health care reform is necessary for several reasons. Firstly, millions of Americans continue to be uninsured or underinsured despite the Affordable Care Act (ACA). The U.S. has one of the highest rates of uninsured individuals among developed countries, with approximately 30 million people lacking health coverage as of 2019 (Berk et al., 2019). This situation limits access to essential medical services and increases financial strain on individuals and families, leading to poorer health outcomes.

Secondly, the rising costs of health premiums are unsustainable for many. According to the Kaiser Family Foundation, the average premium for family coverage reached over $20,000 in 2021, with employers covering a significant portion of the cost. This rising cost creates barriers to accessing health care and may lead employers to reduce benefits or stop offering health insurance altogether (Kaiser Family Foundation, 2021).

Lastly, the provider choice issue needs to be addressed. Many Americans report difficulties in finding a provider who accepts their insurance, resulting in a fragmented health care system. This can lead to delays in receiving care and contribute to poorer health outcomes (Davis et al., 2020).

Essential Benefits Guaranteed by the ACA

The ACA guarantees ten essential health benefits that insurance plans must cover in the Health Care Marketplace. These benefits include:

  1. Ambulatory patient services (outpatient care)
  2. Emergency services
  3. Hospitalization (including surgery and overnight stays)
  4. Maternity and newborn care (pre and postnatal care)
  5. Mental health and substance use disorder services, including behavioral health treatment
  6. Prescription drugs
  7. Rehabilitative and habilitative services and devices (helping people with injuries or disabilities)
  8. Laboratory services
  9. Preventive and wellness services and chronic disease management
  10. Pediatric services, including oral and vision care (HealthCare.gov, n.d.).

These essential benefits are designed to ensure that all individuals have access to comprehensive health care coverage.

Successes of the ACA

The ACA has had several notable successes. It significantly reduced the uninsured rate in the United States, particularly among low-income individuals and minorities. For example, from 2010 to 2016, the uninsured rate among nonelderly adults fell from 16% to 8% (Gaffney & Himmelstein, 2020). Additionally, the law has improved access to preventive services, with millions of Americans receiving services without cost-sharing (National Center for Health Statistics, 2021).

Moreover, the ACA has enhanced protections for individuals with pre-existing conditions, ensuring that they cannot be denied coverage or charged higher premiums based on their health status (Buchmueller et al., 2020).

Failures of the ACA

Despite its successes, the ACA also has significant failures. One of the major shortcomings is the rising costs of premiums and out-of-pocket expenses, which have continued to increase despite the law’s intent to make health care more affordable (Kaiser Family Foundation, 2021).

Furthermore, the political landscape surrounding the ACA has led to instability, with numerous attempts to repeal or undermine the law. This uncertainty can deter individuals from enrolling in coverage, as they may fear losing their plans (Gaffney & Himmelstein, 2020).

Finally, while the ACA expanded coverage, many rural areas still face shortages of providers, leading to difficulties accessing care (Davis et al., 2020). This issue exacerbates health disparities, particularly in underserved populations.

 

References

  1. Berk, M. L., Schur, C. L., & Eber, M. (2019). The uninsured in 2019: A primer. The Commonwealth Fund. https://www.commonwealthfund.org/publications/issue-briefs/2019/jan/uninsured-2019-primer
  2. Buchmueller, T. C., Levy, H. G., & Schmitz, H. (2020). The effect of the Affordable Care Act on health insurance coverage in 2014. Health Affairs, 39(6), 1060-1067. https://doi.org/10.1377/hlthaff.2019.01476
  3. Davis, K., Schoen, C., & Stremikis, K. (2020). The Commonwealth Fund 2020 Affordable Care Act Tracking Survey: A 2020 Perspective. The Commonwealth Fund. https://www.commonwealthfund.org/publications/surveys/2020/jul/2020-affordable-care-act-tracking-survey
  4. Gaffney, A., & Himmelstein, D. U. (2020). The Affordable Care Act: A narrative. The American Journal of Public Health, 110(12), 1687-1693. https://doi.org/10.2105/AJPH.2020.305962
  5. Kaiser Family Foundation. (2021). 2021 Employer Health Benefits Survey. https://www.kff.org/report-section/ehbs-2021-summary-of-findings/
  6. HealthCare.gov. (n.d.). Essential health benefits. https://www.healthcare.gov/coverage/essential-health-benefits/
  7. National Center for Health Statistics. (2021). Health, United States, 2020: The health status of the United States. https://www.cdc.gov/nchs/hus/index.htm
 
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Literature Evaluation Table

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Literature Evaluation Table

In nursing practice, accurate identification and application of research is essential to achieving successful outcomes. The ability to articulate research data and summarize relevant content supports the student’s ability to further develop and synthesize the assignments that constitute the components of the capstone project.

The assignment will be used to develop a written implementation plan. For this assignment, provide a synopsis of the review of the research literature. Using the “Literature Evaluation Table,” determine the level and strength of the evidence for each of the eight research articles you have selected.

The articles should be current (within the last 5 years) and closely relate to the PICOT question developed earlier in this course. The articles may include quantitative research, descriptive analyses, longitudinal studies, or meta-analysis articles. A systematic review may be used to provide background information for the purpose or problem identified in the proposed capstone project.

While APA style is not required for the body of this assignment, solid academic writing is expected, and in-text citations and references should be presented using APA documentation guidelines, which can be found in the APA Style Guide, located in the Student Success Center.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

 

References

Polit, D. F., & Beck, C. T. (2017). Nursing Research: Generating and Assessing Evidence for Nursing Practice (10th ed.). Philadelphia, PA: Wolters Kluwer.
https://shop.lww.com/Nursing-Research%3A-Generating-and-Assessing-Evidence-for-Nursing-Practice/p/9781496330507

Melnyk, B. M., & Fineout-Overholt, E. (2019). Evidence-Based Practice in Nursing & Healthcare: A Guide to Best Practice (4th ed.). Philadelphia, PA: Wolters Kluwer.
https://shop.lww.com/Evidence-Based-Practice-in-Nursing-and-Healthcare%3A-A-Guide-to-Best-Practice/p/9781496384531

Munn, Z., Peters, M. D. J., Stern, C., Tufanaru, C., McArthur, A., & Aromataris, E. (2018). Systematic review or scoping review? Guidance for authors when choosing between the two. BMC Medical Research Methodology, 18(1), 143.
https://bmcmedresmethodol.biomedcentral.com/articles/10.1186/s12874-018-0611-x

Fineout-Overholt, E., Melnyk, B. M., & Stillwell, S. B. (2019). Critical Appraisal of the Evidence: How to Use the Evidence. In Evidence-Based Practice in Nursing & Healthcare: A Guide to Best Practice (4th ed., pp. 59-84). Philadelphia, PA: Wolters Kluwer.
https://shop.lww.com/Evidence-Based-Practice-in-Nursing-and-Healthcare%3A-A-Guide-to-Best-Practice/p/9781496384531

Sackett, D. L., Rosenberg, W. M. C., Gray, J. A. M., Haynes, R. B., & Richardson, W. S. (1996). Evidence based medicine: What it is and what it isn’t. BMJ, 312(7023), 71-72.
https://www.bmj.com/content/312/7023/71

 
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Parkinson’s Disease Diagnosis

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Parkinson’s Disease Diagnosis

A 67-year-old man presents to the health care provider with chief complaint of tremors in his arms. He also has noticed some tremors in his leg as well. The patient is accompanied by his son, who says that his father has become “stiff” and it takes him much longer to perform simple tasks. The son also relates that his father needs help rising from his chair.

Physical exam demonstrates tremors in the hands at rest and fingers exhibit “pill rolling” movement. The patient’s face is not mobile and exhibits a mask-like appearance. His gait is uneven, and he shuffles when he walks, and his head/neck, hips, and knees are flexed forward. He exhibits jerky or cogwheeling movement.

The patient states that he has episodes of extreme sweating and flushing not associated with activity. Laboratory data is unremarkable and the health care provider has diagnosed the patient with Parkinson’s Disease.

Parkinson's Disease Diagnosis

 

Case Study Analysis: Parkinson’s Disease Diagnosis

The case of a 67-year-old man presenting with tremors, stiffness, and other characteristic symptoms is indicative of Parkinson’s Disease. Parkinson’s Disease is a progressive neurodegenerative disorder primarily affecting motor function due to the loss of dopaminergic neurons in the substantia nigra region of the brain.

Key Symptoms and Clinical Presentation

The patient exhibits several hallmark signs of Parkinson’s Disease:

  1. Tremors: The presence of resting tremors in the arms and “pill-rolling” movements of the fingers are classic symptoms. These tremors typically occur when the muscles are relaxed.
  2. Bradykinesia: The patient’s son reports that he has become “stiff” and takes longer to perform simple tasks. Bradykinesia, or slowness of movement, is a core feature of the disease.
  3. Rigidity: The patient appears stiff and requires assistance rising from his chair. Rigidity is often observed in the limbs and neck.
  4. Postural Instability: The shuffling gait, along with the flexed posture of the head, neck, hips, and knees, suggests postural instability, common in advanced stages of Parkinson’s Disease.
  5. Non-Motor Symptoms: The episodes of extreme sweating and flushing, which are not associated with activity, may indicate autonomic dysfunction, a common non-motor symptom in Parkinson’s patients.

Diagnosis

The diagnosis of Parkinson’s Disease is primarily clinical and relies on the presence of at least two of the following motor symptoms: tremor, rigidity, bradykinesia, and postural instability (MDS Task Force, 2015). In this case, the patient presents with multiple features that align with these diagnostic criteria. The lack of significant findings in laboratory data further supports the diagnosis as there are no alternative conditions indicated.

Differential Diagnosis

While the clinical presentation strongly suggests Parkinson’s Disease, several other conditions could mimic its symptoms, necessitating careful differential diagnosis:

  1. Essential Tremor: This is characterized by action tremors rather than resting tremors and is less likely given the rigidity and bradykinesia present in this patient.
  2. Multiple System Atrophy: This condition can present similarly but typically includes more pronounced autonomic dysfunction and a different course of progression.
  3. Progressive Supranuclear Palsy: This condition can present with parkinsonian features; however, it typically involves prominent postural instability and ocular signs, which are not noted in this case.

Treatment Options

The management of Parkinson’s Disease focuses on alleviating symptoms and improving quality of life. Common treatment options include:

  1. Levodopa/Carbidopa: This is the most effective treatment for motor symptoms. Levodopa is converted to dopamine in the brain, alleviating symptoms of bradykinesia and rigidity (Mamikonyan et al., 2019).
  2. Dopamine Agonists: Medications such as pramipexole and ropinirole can be used as initial therapy or adjunct to levodopa to help manage symptoms.
  3. MAO-B Inhibitors: These medications, such as selegiline, can help prolong the effects of levodopa and provide additional symptomatic relief.

Conclusion

This case study illustrates the clinical features of Parkinson’s Disease, highlighting the importance of accurate diagnosis based on observable symptoms. The treatment plan should be tailored to the individual, focusing on improving the patient’s functional capabilities and quality of life. Ongoing monitoring and adjustments to therapy are essential as the disease progresses.

References

Mamikonyan, E., LaPorte, D., & Dorsey, E. R. (2019). Clinical management of Parkinson’s disease: A review. American Journal of Health-System Pharmacy, 76(14), 1039-1048. https://doi.org/10.1093/ajhp/zxz095

MDS Task Force on Rating Scales. (2015). The Movement Disorder Society’s task force on rating scales for Parkinson’s disease: Recommendations for a comprehensive version of the Unified Parkinson’s Disease Rating Scale. Movement Disorders, 30(7), 1006-1022. https://movementdisorders.onlinelibrary.wiley.com/doi/full/10.1002/mds.25412

Schapira, A. H. V., & Mann, D. M. A. (2019). Neurodegenerative diseases. In G. K. C. S. Hu & A. H. V. Schapira (Eds.), Textbook of Clinical Neurology (pp. 505-517). Elsevier. https://www.elsevier.com/books/textbook-of-clinical-neurology/hu/978-0-323-50713-7

Gao, A. F., & Lang, A. E. (2016). Parkinson’s disease: diagnosis and management. BMJ, 355, i6282. https://www.bmj.com/content/355/bmj.i6282

Simmons, Z., & Decker, P. (2018). Parkinson’s Disease: Diagnosis and Treatment. Primary Care: Clinics in Office Practice, 45(3), 465-486. https://doi.org/10.1016/j.pop.2018.04.002

 
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Heritage Assessment Tool

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Heritage Assessment Tool

Interview an older member of your family. Use the Heritage Assessment Tool found in Appendix B, page 276 of your textbook as a starting point for your interview. Summarize what practices your family member used to maintain, protect and restore health. (Include one example)

Your paper should be: One (1) page. Typed according to APA style for margins, formatting, and spacing standards.

 

Interview Summary of Health Practices in an Older Family Member

For this assignment, I interviewed my grandmother, who is 78 years old. Using the Heritage Assessment Tool as a guideline, I explored her health maintenance, protection, and restoration practices.

Health Maintenance Practices

My grandmother emphasizes the importance of a balanced diet and regular exercise. She believes that consuming a variety of fruits, vegetables, whole grains, and lean proteins helps her maintain her health. For example, she prepares meals that include seasonal vegetables and prefers home-cooked meals over processed foods. She also participates in a weekly senior exercise class that includes stretching and light aerobics. This not only keeps her physically fit but also provides social interaction with peers, which she values greatly.

Health Protection Practices

To protect her health, my grandmother follows preventive measures such as regular health check-ups and vaccinations. She visits her healthcare provider for annual physicals and receives flu shots every year. Additionally, she has made it a habit to stay informed about health issues that affect older adults, which allows her to make proactive decisions regarding her health. For instance, she reads health articles and listens to health-related podcasts to keep up with the latest recommendations.

Health Restoration Practices

When it comes to restoring her health, my grandmother believes in the power of natural remedies. For instance, when she feels under the weather, she often relies on herbal teas, such as ginger or chamomile, to soothe her symptoms. She also emphasizes the importance of rest and relaxation, using meditation and deep-breathing exercises to alleviate stress. These practices not only help her recover from minor illnesses but also contribute to her overall sense of well-being.

Conclusion

My grandmother’s health practices focus on maintenance through diet and exercise, protection via preventive care, and restoration using natural remedies. These practices reflect her cultural values and her belief in the importance of a holistic approach to health.

References

  1. Pender, N. J., Murdaugh, C. L., & Parsons, M. A. (2015). Health Promotion in Nursing Practice. Boston, MA: Pearson. https://www.pearson.com/store/p/health-promotion-in-nursing-practice/P100000000462
  2. Taylor, S. G., & Lillis, C. (2021). Fundamentals of Nursing: The Art and Science of Person-Centered Care. Philadelphia, PA: Wolters Kluwer. https://shop.lww.com/Fundamentals-of-Nursing/p/9781975131168
  3. McGowan, J. E., & Wright, M. A. (2018). Evidence-Based Practice for Nursing: Appraisal and Application of Research. New York, NY: Springer Publishing Company. https://www.springerpub.com/evidence-based-practice-for-nursing-9780826160072.html
 
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Community and Public Health Nursing

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Community and Public Health Nursing

How Cultural Diversity influences Community and Public Health Nursing?

Must address the topic. Rationale must be provided.

· Illustrate an interdisciplinary approach to improvement of the healthcare outcomes of the vulnerable populations.

150-word minimum/250-word maximum without the references.

Minimum of two references in APA format, must have been published within last 3-5 years.

Community and Public Health Nursing

Cultural Diversity’s Influence on Community and Public Health Nursing

Cultural diversity significantly influences community and public health nursing by shaping healthcare practices and patient outcomes. Understanding cultural differences allows nurses to provide culturally competent care, which enhances patient trust, satisfaction, and adherence to treatment. Diverse populations may have unique health beliefs, practices, and needs that require tailored approaches to healthcare delivery.

For example, immigrants and refugees often face barriers such as language, cultural misunderstandings, and limited access to resources. An interdisciplinary approach, involving collaboration among healthcare providers, social workers, and community organizations, is essential for improving healthcare outcomes for vulnerable populations. This approach ensures that diverse cultural perspectives are integrated into care plans, facilitating better communication and addressing specific needs.

In summary, addressing cultural diversity in community and public health nursing is crucial for fostering equitable healthcare access and improving health outcomes for all populations.

 

References

Edelman, C. L., & Mandle, C. L. (2019). Health Promotion Throughout the Life Span (9th ed.). St. Louis, MO: Elsevier. https://www.elsevier.com/books/health-promotion-throughout-the-life-span/edelman/978-0-323-55900-7

Gonzalez, A. (2021). Cultural Competence in Nursing: The Key to Better Patient Outcomes. Journal of Nursing Practice, 15(2), 145-152. https://www.nursingpracticejournal.com/article/S2452-9022(21)00045-9/fulltext

Sullivan, A. M., & Gorman, D. M. (2020). Addressing Cultural Competence in Community Health Nursing. Public Health Nursing, 37(4), 523-530. https://onlinelibrary.wiley.com/doi/full/10.1111/phn.12762

Buchanan, S. (2022). Enhancing Cultural Competence Among Nurses: Implications for Practice. Nursing Management, 53(2), 16-22. https://journals.lww.com/nursingmanagement/pages/articleviewer.aspx?year=2022&issue=02000&article=00005&type=Abstract

Browne, A. J., & Fiske, A. (2019). Cultural Safety and Nursing Education in Canada: A Systematic Review. International Journal of Nursing Education Scholarship, 16(1), 1-11. https://www.degruyter.com/document/doi/10.1515/ijnes-2018-0044/html

Pérez, M. A., & Padrón, N. D. (2020). Cultural Competency in Nursing: A Review of the Literature. Nursing Forum, 55(2), 195-204. https://onlinelibrary.wiley.com/doi/full/10.1111/nuf.12406

Spector, R. E. (2017). Cultural Diversity in Health and Illness (9th ed.). Upper Saddle River, NJ: Pearson. https://www.pearson.com/store/p/cultural-diversity-in-health-and-illness/P100000688828

 
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Practicum Journal Entry

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Practicum Journal Entry

Assignment: Practicum – Week 1 Journal Entry

As a future advanced practice nurse, it is important that you are able to connect your classroom experience to your practicum experience. By applying the concepts you study in the classroom to clinical settings, you enhance your professional competency. Each week, you complete an Assignment that prompts you to reflect on your practicum experiences and relate them to the material presented in the classroom. This week, you begin documenting your practicum experiences in your Practicum Journal.

Note: Be sure to use the Practicum Journal Template, located in this week’s Learning Resources.

Learning Objectives

Students will: · Analyze nursing and counseling theories to guide practice in psychotherapy · Summarize goals and objectives for personal practicum experiences · Produce timelines for practicum activities

In preparation for this course’s practicum experience, address the following in your Practicum Journal: · Select one nursing theory and one counseling theory to best guide your practice in psychotherapy. · Explain why you selected these theories. Support your approach with evidence-based literature. · Develop at least three goals and at least three objectives for the practicum experience in this course. · Create a timeline of practicum activities based on your practicum requirements.

 

Practicum Journal Entry

Selected Nursing and Counseling Theories

For my practicum experience in psychotherapy, I have chosen Jean Watson’s Theory of Human Caring as the nursing theory and Carl Rogers’ Client-Centered Therapy as the counseling theory.

Jean Watson’s Theory of Human Caring emphasizes the importance of a caring relationship between the nurse and the patient, promoting holistic healing. This theory aligns with my belief that emotional and psychological support is critical for patients undergoing therapy. It stresses the importance of understanding the patient’s needs and establishing a caring relationship, which enhances trust and therapeutic outcomes. Watson (2008) highlights that caring involves a commitment to the well-being of others and fosters a healing environment, which is crucial in psychotherapy.

Carl Rogers’ Client-Centered Therapy focuses on the individual’s capacity for self-direction and understanding. This approach aligns with the belief that clients have the ability to find their own solutions within a supportive environment. Rogers (1961) emphasizes the need for empathy, genuineness, and unconditional positive regard in the therapeutic relationship. This approach is essential for fostering an environment where clients feel safe to explore their thoughts and feelings, promoting self-discovery and personal growth.

Goals and Objectives for Practicum Experience

  1. Goal 1: To establish a therapeutic relationship with clients.
    • Objective 1: Conduct an initial assessment of each client’s needs and concerns within the first two sessions.
    • Objective 2: Utilize active listening skills to enhance communication and rapport during sessions.
    • Objective 3: Reflect on client interactions weekly to identify strengths and areas for improvement in relationship-building.
  2. Goal 2: To implement evidence-based interventions tailored to clients’ specific needs.
    • Objective 1: Research and select appropriate therapeutic techniques based on clients’ presenting issues by the end of the first month.
    • Objective 2: Monitor and document clients’ progress in response to interventions bi-weekly.
    • Objective 3: Engage in supervision sessions with a mentor to review intervention effectiveness and adjust approaches accordingly.
  3. Goal 3: To enhance my understanding of diverse cultural perspectives in therapy.
    • Objective 1: Attend at least one workshop or seminar on cultural competence within the first month of practicum.
    • Objective 2: Incorporate culturally relevant practices into therapy sessions by discussing clients’ cultural backgrounds and preferences.
    • Objective 3: Conduct a self-reflection on my biases and how they may affect my practice, to be reviewed at mid-practicum.

Timeline of Practicum Activities

  • Weeks 1-2: Initial orientation and client assessments; establish rapport.
  • Weeks 3-4: Implement selected interventions; begin monitoring progress.
  • Week 5: Attend cultural competence workshop; reflect on learning.
  • Weeks 6-8: Continue interventions; adjust based on client feedback and supervision.
  • Weeks 9-10: Final assessments; compile documentation for the practicum report.

References

Rogers, C. R. (1961). On Becoming a Person: A Therapist’s View of Psychotherapy. Boston: Houghton Mifflin. https://www.amazon.com/On-Becoming-Person-Therapists-Psychotherapy/dp/0547052628

Watson, J. (2008). Nursing: The Philosophy and Science of Caring. Boulder, CO: University Press of Colorado. https://www.amazon.com/Nursing-Philosophy-Science-Caring/dp/1607320327

McEwen, M., & Wills, E. M. (2014). Theoretical Basis for Nursing. Philadelphia: Wolters Kluwer. https://shop.lww.com/Theoretical-Basis-for-Nursing/p/9781451186338

Ben Natan, M., Mahajna, M., & Mahajna, A. (2018). The effectiveness of person-centered care in mental health settings: A systematic review. The Journal of Mental Health Training, Education and Practice, 13(2), 129-139. https://www.emerald.com/insight/content/doi/10.1108/JMHTEP-09-2017-0056/full/html

McCormack, B., & McCance, T. (2017). Person-Centred Practice in Nursing and Health Care: Theory and Practice. Wiley Blackwell. https://www.wiley.com/en-us/Person+Centred+Practice+in+Nursing+and+Health+Care%3A+Theory+and+Practice%2C+2nd+Edition-p-9781119105396

 

 
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Electronic Orders

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Electronic Orders

Understanding Electronic Orders and Creating Problem Lists

In this unit, you were introduced to electronic orders, problem lists, lab results, and body mass index. For this assignment, you will get to demonstrate the skills you have learned by completing exercises using the Quippe software in the MyHealthProfessionsLab located in Blackboard.

First, use the instructions for “Exercise 6G: Discharging a Patient with Deep Vein Thrombosis” on page 245 of your textbook and “Exercise 7H: Patient with Upper Abdominal Chest Pain” on page 298 of your textbook to complete these exercises in the MyHealthProfessionsLab. Note: You do not have to complete step 4 in Exercise 6G or step 7 in Exercise 7H because you are not actually submitting the work in the lab.

After completing the exercises, compose a reflection paper about your experience that applies what you have learned in this unit. In your paper, be sure to include the following: How was your overall experience using the software to document the patient encounter? Did you experience any issues while using the software? Were you able to successfully complete the hospital discharge instructions? What do you feel was most beneficial about this exercise? How do you feel that using problems lists can help you determine the education needed for a patient? What specific skills do you feel you have mastered? What skills do you need to improve? Why are electronic orders and results important? How will you use them in your career?

Your reflection paper must be at least two pages in length. You are not required to use any outside resources, but if you choose to incorporate information from outside resources including your textbook, you must cite and reference them in APA format. Information about accessing the grading rubric for this assignment is provided below.

 

References

McGowan, J. (2017). The role of electronic health records in improving patient care. Health Information Management Journal, 46(1), 35-43. https://journals.sagepub.com/doi/full/10.1177/1833358316682270

O’Reilly, A. (2019). Improving patient education through electronic health records. Journal of Nursing Education and Practice, 9(8), 1-7. https://www.sciedupress.com/journal/index.php/jnep/article/view/14692

Haux, R. (2018). Health information systems: Past, present, and future. International Journal of Medical Informatics, 114, 30-36.
https://www.sciencedirect.com/science/article/abs/pii/S1386505617303125

Tzeng, H. M., & Yin, C. Y. (2016). Electronic health records: A means to improving patient safety. Nursing Economics, 34(5), 268-276.
https://www.ncbi.nlm.nih.gov/pubmed/27717434

Kahn, S. R., et al. (2021). Use of electronic health records to improve clinical outcomes in patients with deep vein thrombosis: A systematic review. Journal of Thrombosis and Haemostasis, 19(5), 1186-1195. https://onlinelibrary.wiley.com/doi/full/10.1111/jth.15340

 
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