For Essays Guru -unit 3 mn566

Poor Patient Outcome

Relying solely on the classic features of a disease may be misleading. That’s because the clinical presentation of a disease often varies: the symptoms and signs of many conditions are non-specific initially and may require hours, days, or even months to develop.

Generating a differential diagnosis; that is, developing a list of the possible conditions that might produce a patient’s symptoms and signs — is an important part of clinical reasoning. It enables appropriate testing to rule out possibilities and confirm a final diagnosis.

This case portrays a poor patient outcome after a misdiagnosis.

Case scenario

A previously healthy 35-year-old lawyer presents to a primary care office with a chief complaint of chest pain and a non-productive cough. The pain started suddenly 2 hours prior to coming to the office while the patient was sitting at his desk. The patient describes the pain as sharp in nature, constantly present but made worse with inspiration and movement, and with radiation to the base of the neck. His blood pressure in the right arm and other vital signs are normal.

On physical examination the only findings of note are chest wall tenderness and a faint cardiac murmur. The ECG in the office is normal. The patient is observed for an hour in the office and assessed. He is diagnosed with viral pleurisy and sent home on non-steroidal analgesics.

The following day the patient collapses at home and cannot be resuscitated by the paramedic service. An autopsy reveals a Type 1 aortic dissection with pericardial tamponade.

Written Assignment:

Developing a list of possible conditions that might produce a patient’s symptoms and signs is an important part of clinical reasoning.

  1. As an NP in primary care what would you have done differently?
  2. Discuss the importance of creating a list of differentials for this patient. How could it have changed this outcome?

If a serious diagnosis comes to mind based on a patient’s symptoms:

  • Ask yourself; Have you considered the likelihood of it and whether it needs to be ruled out by testing or referral?
  • Because many serious disorders are challenging to diagnose, have you considered ruling out the worst case scenario?
  • Ask yourself: Do you have sufficient understanding of the clinical presentation to offer an opinion on the diagnosis?
  • What other diagnosis could it be? How might the treatment to date have altered the patient outcome?
  • What other diagnostic and laboratory or imaging was needed in order to make a complete differential list?  What support tools would you consider using in helping to create a differential diagnosis list?
  • Are you familiar with the current clinical practice guidelines for the investigation of a suspected condition such as chest pain?
  • 5 pages
  • Posted: 21 hours ago
  • Due: 11/01/2019
  • Budget: $25

1-Please answer based on these answers as they are listed, each one must be answered in APAform and not less than 150 words

1-The literal translation for “Imago dei “or ‘the image of God’ is “the Christian understanding of human beings as created in the image of God bestows dignity and honor on every person, regardless of social, mental or physical status” (Shelly & Miller, 2006).The image of God is a foundational concept for understanding our significance and purpose in life. Understanding how we are made in God’s image helps us understand our inherent dignity as a human being created by our heavenly Father. The literal translation for “Imago dei “or ‘the image of God’ is “the Christian understanding of human beings as created in the image of God bestows dignity and honor on every person, regardless of social, mental or physical status” (Shelly & Miller, 2006).The image of God in us survives our fall into sin. For example, in Genesis 9:6, God reminds Noah that man is made in God’s image “ Whoever sheds the blood of man, by man shall his blood be shed, for God made man in his own image.”

                                                                                   Reference:

Shelly J.A., Miller A.B. (2006). “Called to Care: A Christian Worldview for Nursing”. https://www.tandfonline.com/doi/abs/10.1080/15228961003788426?journalCode=wrdh20

2-Providing care with honor and dignity to each patient should be our daily goal and it is important to always keep this as our top priority.

We must remind ourselves  every day even though this can be difficult at  times with time constraints and patient loads. 

3-great post, I liked that you gave a bible reference of the book of Genesis.  Growing up in a Christian home I was thought about the bible.  Every time I think or hear of the book of Genesis I always remember this verse.  In the beginning God created the heavens and the earth.   The bible tells us that in the beginning God with all his power and creativity created a world that reflects his glory.  With his word he created all the planets, oceans, and living creatures, but with his “hands and his breath” he sculpted man and woman unlike anything else.  The scriptures tell us that humans are Gods masterwork, and he imprinted his signature on the human soul.  Humans are created in the Imago Dei “The Image of God”. 

26 Then God said, “Let us make man in our image, according to our likeness; and let them rule over the fish of the sea and over the birds of the sky and over the cattle and over all the earth, and over every creeping thing that creeps on the earth. 27 God created man in His own image, in the image of God He created him; make and female He created them (Genesis 1:26-27).

Learning about this as a young girl I related “God created man on his own image” as we were created to look like him, that we were created to physically resembled God.  I had the physical concept and I was too young to understand the spiritual and psychological concept of the true meaning. Doing research and reading about this topic for this week’s lecture and DQ, I have understood the true concept of what it really means.  It is important to understand the relationship between God and humans. It is amazing to me to know that God created everything, but we are the only ones he created in his image.  We were created to communicate, to think, create, reason, and relate.  We are capable of love and to understand right from wrong, and we are responsible for our actions.  God is love, and I agree with you Nicole that we need to exercise his love and care because it reflects the attributes of God our creator.  Nicole you explained that nursing starts with a concern for human welfare and healing, and the great responsibility God has given us to care and love others.  Like, you I also believe that Imago Dei means that as a Christian and a nurse I need to exercise the love of God with all my patients.  Care for them with respect, dignity, and loving care. “If God so loved us, we also ought to love one another” (1 John 4:11), God is great at designing and creating things and as “God’s image-bearers (Genesis 1:26), we are designed to love God and others in the same way that God loves God and others” (Bloom, 2016).

Reference:

Bloom, J. (2016, June 24). If We Love God Most, We Will Love Others Best. Retrieved January 9, 2019, from https://www.desiringgod.org/articles/if-we-love-god-most-we-will-love-others-best

Imago Dei (Image of God). (n.d.). Retrieved January 9, 2019, from http://www.pbs.org/faithandreason/theogloss/imago-body.html

  • Posted: 21 hours ago
  • Due: 11/01/2019
  • Budget: $8

2 case studies to be done independently

Case Study 1

Instructions

Public health officials and communities are responsible for investigating infectious disease cases, as well as making sure they control the spread of the disease within the community. Their ultimate goal is to reduce and prevent future occurrences.

For the Unit V Case Study, respond to the following.

  • Describe an infectious disease in your community and how it is transmitted.
  • Discuss two public health programs or interventions in your community that were created to reduce the spread of the infectious disease identified.
  • Explain if these programs have been successful in the community. What would you change or add to improve the intervention programs?

Your case study must be a minimum of two pages in length, excluding the title and reference pages. To support your ideas, use a minimum of three outside sources; one may be the textbook. Additionally, use a source that focuses on your community, such as a newspaper or journal article.

Remember that all written assignments must be formatted using APA style, including in-text citations and references. 

Our communities are constantly faced with health crisis due to the increasing burden of chronic disease. Underlying these conditions are substantial health risk factors, such poor nutrition, alcohol abuse, tobaccos exposure and use, and physical inactivity. Engaging the community in healthier behaviors would greatly reduce the risk for chronic disease and death.

case study 2

For the Unit VI Case Study, complete the following.

  • Describe two chronic diseases that have plagued your community.
  • How do public health officials handle the chronic diseases? Provide examples of interventions and programs.
  • What can you, as a public health official, suggest to improve the interventions or programs?

Your case study must be a minimum of two pages in length, excluding the title and reference pages. To support your ideas, use a minimum of three outside sources; one may be the textbook. Additionally, use a source that focuses on your community, such as a newspaper or journal article.

Remember that all written assignments must be formatted using APA style, including in-text citations and references.

  • Posted: 18 hours ago
  • Due: 12/01/2019
  • Budget: $16

Group Processes and Stages of Formation

Group Processes and Stages of Formation

In a 2- to 3-page paper not including cover and reference page, address the following:

Explain the group’s processes and stage of formation.

Explain curative factors that occurred in the group. Include how these factors might impact client progress.

Explain intragroup conflict that occurred and recommend strategies for managing the conflict. Support your recommendations with evidence-based literature.

Required Readings

American Nurses Association. (2014). Psychiatric-mental health nursing: Scope and standards of practice (2nd ed.). Washington, DC: Author.

· Standard 5G “Therapeutic Relationship and Counseling” (page 62)

Yalom, I. D., & Leszcz, M. (2005). The theory and practice of group psychotherapy (5th ed.). New York, NY: Basic Books.

​The Theory and Practice of Group Psychotherapy, 5th Edition by Yalom, Irvin D.; Leszcz, Molyn. Copyright 2005 by Hachette Books Group. Reprinted by permission of Hachette Books Group via the Copyright Clearance Center.

Chapter 5, “The Therapist: Basic Tasks” (pp. 117–140)

Chapter 8, “The Selection of Clients” (pp. 231–258)

Chapter 9, “The Composition of Therapy Groups” (pp. 259–280)

Crane-Okada, R. (2012). The concept of presence in group psychotherapy: An operational definition. Perspectives in Psychiatric Care, 48(3), 156–164. doi:10.1111/j.1744-6163.2011.00320.x

Lerner, M. D., McLeod, B. D., & Mikami, A. Y. (2013). Preliminary evaluation of an observational measure of group cohesion for group psychotherapy. Journal of Clinical Psychology, 69(3), 191–208. doi:10.1002/jclp.21933

Nicholson, R. (2002). The dilemma of psychotherapy notes and HIPAA. Journal of AHIMA, 73(2), 38–39. Retrieved from http://library.ahima.org/doc?oid=58162#.V5J0__krLZ4http://library.ahima.org/doc?oid=58162#.V5J0__krLZ4

U.S. Department of Health & Human Services. (n.d.). HIPAA privacy rule and sharing information related to mental health. Retrieved March 18, 2017, from http://www.hhs.gov/hipaa/for-professionals/special-topics/mental-health/

Psychotherapy.net (Producer). (2011a). Group therapy: A live demonstration. [Video file]. Mill Valley, CA: Author.

American Counseling Association (Producer). (2015). Leading counseling groups with adults: A demonstration of the art of engagement. [Video file]. Alexandria, VA: Author.