Category: Nursing

Neurological shadow health assessment Subjective Data

Subjective Data Collection: 20 of 20 (100.0%)

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Example Questions
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Scored Items

Experts selected these topics as essential components of a strong, thorough interview with this patient. Neurological shadow health assessment Subjective Data

Patient Data

Not Scored

A combination of open and closed questions will yield better patient data. The following details are facts of the patient’s case.

Chief Complaint

WE ARE THE SHADOW HEALTH EXPERTS,

CHAT US TO PLACE OUR ORDER AND SCORE 100%

Finding:

Established chief complaint

Finding:

Reports recent “fender bender”

(Found)

Pro Tip: Patients choose to seek treatment for a variety of reasons. Asking why Tina chose to seek treatment today might indicate primary concerns, the severity of her symptoms, or failure to manage symptoms herself. Neurological shadow health assessment Subjective Data

Example Question:

Why are you seeking treatment today?

Finding:

Reports headaches

(Found)

Pro Tip: Symptoms often vary from patient to patient. Asking Tina if she’s had headaches specifies the way her individual symptoms and pain manifest.

Example Question:

Have you had any headaches?

Finding:

Reports neck symptoms

(Found)

Pro Tip: Symptoms often vary from patient to patient. Asking Tina if she’s had neck stiffness specifies the way her individual symptoms and pain manifest. Neurological shadow health assessment Subjective Data

Example Question:

Have you had any neck stiffness?

History of Present Illness

Finding:

Asked about onset of symptoms

Finding:

Reports accident occurred 1 week ago

(Available)

Pro Tip: Soliciting a relevant history of Tina’s car accident will allow you to understand the context in which she was injured and the injuries she sustained.

Example Question:

When did the accident happen?

Finding:

Reports symptoms began 2 days after accident

(Found)

Pro Tip: Symptoms often vary from patient to patient. Asking Tina when the headaches begin specifies the way her individual symptoms and pain manifest. Neurological shadow health assessment Subjective Data

Example Question:

When did the headaches begin?

Finding:

Followed up on details of car accident

Finding:

Denies loss of consciousness

(Found)

Pro Tip: Soliciting a relevant history of Tina’s car accident will allow you to understand the context in which she was injured and the injuries she sustained.

Example Question:

Did you lose consciousness during the car accident?

Finding:

Reports low vehicle speed

(Found)

Pro Tip: Soliciting a relevant history of Tina’s car accident will allow you to understand the context in which she was injured and the injuries she sustained.

Example Question:

How fast was the car going?

Finding:

Reports wearing seatbelt

(Found)

Pro Tip: Soliciting a relevant history of Tina’s car accident will allow you to understand the context in which she was injured and the injuries she sustained.

Example Question:

Were you wearing your seatbelt?

Finding:

Reports sitting in front passenger seat

(Found)

Pro Tip: Soliciting a relevant history of Tina’s car accident will allow you to understand the context in which she was injured and the injuries she sustained.

Example Question:

Where in the car were you sitting?

Finding:

Reports no alcohol or drug use during accident

(Found)

Pro Tip: Soliciting a relevant history of Tina’s car accident will allow you to understand the context in which she was injured and the injuries she sustained.

Example Question:

Was anyone in the car under the influence of alcohol?

Finding:

Asked about frequency and duration of symptoms

Finding:

Reports headaches are daily since they began

(Found)

Pro Tip: Symptoms often vary from patient to patient. Asking Tina how often she gets headaches specifies the way her individual symptoms and pain manifest.

Example Question:

How many days have you had a headache since they started?

Finding:

Reports headaches last 1-2 hours

(Found)

Pro Tip: Symptoms often vary from patient to patient. Asking Tina how long the headaches last specifies the way her individual symptoms and pain manifest. Neurological shadow health assessment Subjective Data

Example Question:

How long do the headaches last?

Finding:

Reports last headache was yesterday afternoon

(Found)

Pro Tip: Symptoms often vary from patient to patient. Asking Tina when she got her last headaches specifies the way her individual symptoms and pain manifest.

Example Question:

When was your last headache?

Finding:

Asked location of pain

Finding:

Reports headache pain in crown and back of head

(Found)

Pro Tip: Because symptoms often vary from patient to patient, asking Tina where her headaches are occurring will allow you to most effectively treat her specific symptoms.

Example Question:

Where are the headaches located?

Finding:

Reports pain does not radiate into shoulders, back, or arms

(Found)

Pro Tip: Symptoms often vary from patient to patient. Asking Tina to describe what her injury feels like specifies the way her symptoms and pain manifest.

Example Question:

Does the pain radiate?

Finding:

Reports slight pain in back of neck muscles

(Found)

Pro Tip: Because symptoms often vary from patient to patient, asking Tina how her neck feels will allow you to see the ways in which her individual pain manifests.

Example Question:

How does your neck feel?

Finding:

Denies scalp tenderness or injury

(Found)

Pro Tip: Symptoms often vary from patient to patient. Asking Tina if her scalp is tender specifies the way her individual symptoms and pain manifest. Neurological shadow health assessment Subjective Data

Example Question:

Is your scalp tender?

Finding:

Denies jaw symptoms

(Found)

Pro Tip: Symptoms often vary from patient to patient. Asking Tina if her jaw is tender specifies the way her individual symptoms and pain manifest.

Example Question:

Do you have jaw pain?

Finding:

Denies facial pain

(Found)

Pro Tip: Symptoms often vary from patient to patient. Asking Tina if she is experiencing facial pain specifies the way her individual symptoms and pain manifest.

Example Question:

Do you have any facial pain?

Finding:

Asked about severity of pain

Finding:

Rates current head and neck pain severity at 3 out of 10

(Found)

Pro Tip: Pain severity might change over time for a variety of reasons. Asking Tina to rate the severity of her current pain on a scale of 1-10 will provide a quantified and relative measurement of her condition.

Example Question:

How would you rate your current pain on a scale from 0 to 10?

Finding:

Rates pain severity at its worst is 4 out of 10

(Found)

Pro Tip: Pain severity might change over time for a variety of reasons. Asking Tina to rate the severity of her pain when it started on a scale of 1-10 will provide a quantified and relative measurement of her condition.

Example Question:

How would you rate your pain at its worst on a scale from 0 to 10?

Finding:

Followed up on headache characteristics

Finding:

Reports headache pain as a dull ache

(Found)

Pro Tip: Symptoms often vary from patient to patient. Asking Tina to describe what her headaches feel like specifies the way her individual symptoms and pain manifest.

Example Question:

What do your headaches feel like?

Finding:

Denies sharp pain

(Found)

Pro Tip: Because symptoms often vary from patient to patient, asking Tina whether her headaches feel sharp will allow you to most effectively treat her specific symptoms.

Example Question:

Is the headache pain sharp?

Finding:

Reports headaches not cyclic

(Found)

Pro Tip: By understanding the nature of Tina’s pain, you can most effectively treat her. Asking Tina whether her headaches are cyclic will give you a sense for the extent of her pain. Neurological shadow health assessment Subjective Data

Example Question:

Are your headaches cyclic?

Finding:

Reports headaches do not occur in clusters

(Found)

Pro Tip: By understanding the nature of Tina’s pain, you can most effectively treat her. Asking Tina whether her headaches come in clusters will give you a sense for the extent of her pain.

Example Question:

Do your headaches come in clusters?

Finding:

Reports headaches not rapid in crescendo

(Found)

Pro Tip: By understanding the nature of Tina’s pain, you can most effectively treat her. Asking Tina whether her headaches crescendo will give you a sense for the extent of her pain.

Example Question:

Do your headaches crescendo?

Finding:

Asked about aggravating factors

Finding:

Reports that car accident seems to be primary cause

(Found)

Pro Tip: It’s important to ask the patient if they know the primary cause of an injury.

Example Question:

What caused your pain?

Finding:

Reports pain upon head or neck movement

(Found)

Pro Tip: Symptoms often vary from patient to patient. Asking Tina if it hurts to move her head specifies the way her individual symptoms and pain manifest.

Example Question:

Does it hurt to move your head?

Finding:

Reports headaches don’t have a discernible trigger

(Found)

Pro Tip: Pain severity might change for a variety of reasons. Asking Tina what makes her headaches worse might help you to understand sounds, movements, or times that trigger her pain.

Example Question:

What makes your headaches worse?

Finding:

Asked about relieving factors for neck pain and headaches

Finding:

Denies home remedies such as heat or cold

(Found)

Pro Tip: Finding out the non-medication modalities that a patient is treating her pain with will help you understand the severity of the pain.

Example Question:

Have you tried home remedies?

Finding:

Symptoms improve with rest

(Found)

Pro Tip: Understanding all of the relieving factors, including how a symptom changes at motion or at rest, can help you understand all of the contributing pain factors.

Example Question:

Does the headache get better with rest?

Medical History

Finding:

Confirmed use of medications

Finding:

Confirms medications (no new medications reported)

(Found)

Pro Tip: Determining what, if any, medications a patient is taking is a crucial element of a thorough health history and will help you avoid unwanted drug interactions.

Example Question:

Are you taking any new medications?

Finding:

Reports increased Tylenol use

(Found)

Pro Tip: The amount of pain medication a patient is taking is an important consideration in understanding their level of pain. For a patient who takes pain medication but still experiences pain, it can indicate higher pain severity than she is reporting.

Example Question:

Have you been taking Tylenol?

Finding:

Followed up on Tylenol use

Finding:

Unsure of dosage

(Found)

Pro Tip: The medication that a patient takes reveals a current treatment plan and healthcare access. Asking Tina how much tylenol she takes will illustrate how effectively OTC medication works for her injury. Neurological shadow health assessment Subjective Data

Example Question:

What dose of tylenol do you take?

Finding:

Takes 2 Tylenol at a time

(Found)

Pro Tip: Asking how many pills a patient takes at once time can help you make sure a patient is not taking an unsafe dose.

Example Question:

How many Tylenol do you take at a time?

Finding:

Takes Tylenol once a day

(Found)

Pro Tip: The medication that a patient takes reveals a current treatment plan and healthcare access. Asking Tina how often she takes tylenol will illustrate how effectively OTC medication works for her injury.

Example Question:

How often do you take tylenol?

Finding:

Reports minor relief from Tylenol

(Found)

Pro Tip: Asking Tina if the Tylenol helps will allow you to assess the severity of her headaches and whether her current treatment plan is effective.

Example Question:

Does the Tylenol help?

Finding:

Confirmed allergies

Finding:

Confirms allergies (no new allergies reported)

(Found)

Pro Tip: Asking Tina if she has any new allergies will allow you to understand how, beyond the chief complaint, Tina’s health has been.

Example Question:

Do you have any new allergies?

Finding:

Asked about relevant neurological history

Finding:

Reports past frequent headaches

(Found)

Pro Tip: Assessing which of Tina’s pain (if any) is “normal” versus caused by the accident will allow you to understand the scope of her injuries.

Example Question:

Do you usually get headaches?

Finding:

Denies history of migraine

(Found)

Pro Tip: Assessing which of Tina’s pain (if any) is “normal” versus caused by the accident will allow you to understand the scope of her injuries.

Example Question:

Do you ever get migraines?

Finding:

Denies head trauma

(Found)

Pro Tip: After Tina’s car accident, it is important to establish whether head trauma she might be experiencing predates the accident or, rather, is a result of the crash.

Example Question:

Have you ever had any head trauma?

Finding:

Denies history of seizures

(Found)

Pro Tip: A car accident can result in a traumatic brain injury (TBI). Asking Tina if she’s had seizures might indicate whether or not she is experiencing symptoms of a traumatic brain injury.

Example Question:

Have you had any seizures?

Social History

Finding:

Asked about sleep

Finding:

Denies changes in sleep

(Found)

Pro Tip: A car accident can result in a traumatic brain injury (TBI). Asking Tina if her sleep habits have changed lately might indicate whether she is experiencing symptoms of a traumatic brain injury.

Example Question:

Have your sleep habits changed?

Finding:

Denies increased sleepiness or yawning

(Found)

Pro Tip: A car accident can result in a traumatic brain injury (TBI). Asking Tina if she’s felt more sleepy lately might indicate whether she is experiencing symptoms of a traumatic brain injury.

Example Question:

Have you felt more sleepy lately?

Review of Systems

Finding:

Asked about general symptoms

Finding:

Denies fever

(Found)

Pro Tip: Following a head injury, asking Tina whether she’s had a fever might indicate if she’s suffered any additional complications to her neck trauma.

Example Question:

Have you had a fever?

Finding:

Denies chills

(Found)

Pro Tip: Chills after a car accident might indicate shock. Asking Tina if she’s had any chills will reveal whether or not she’s had shock following her accident.

Example Question:

Have you had any chills?

Finding:

Denies fatigue or changes in energy level

(Found)

Pro Tip: A car accident can result in a traumatic brain injury (TBI). Asking Tina if she’s felt more fatigued lately might indicate whether she is experiencing symptoms of a traumatic brain injury. Neurological shadow health assessment Subjective Data

Example Question:

Have you felt fatigued?

Finding:

Denies nausea or vomiting

(Found)

Pro Tip: One symptom of a concussion is nausea. Asking Tina whether she’s felt nausea might reveal that she sustained a concussion in her car accident.

Example Question:

Have you had nausea?

Finding:

Denies night sweats

(Found)

Pro Tip: One symptom of a concussion is nausea. Asking Tina whether she’s been vomiting might reveal that she sustained a concussion in her car accident.

Example Question:

Have you had night sweats?

Finding:

Asked about review of systems for neurological

Finding:

Denies hemiparesis

(Found)

Pro Tip: A car accident can result in muscle damage and feeling weak on one side of the body. Asking Tina whether she feels weak on one side of her body can indicate whether she is suffering from muscle damage.

Example Question:

Has one side of your body felt weaker than the other?

Finding:

Denies gait disturbance

(Found)

Pro Tip: A car accident can result in muscle damage or nerve damage. Asking Tina whether her gait has changed might indicate a muscle or tissue injury that is impacting the way she walks.

Example Question:

Have you had any changes in your gait?

Finding:

Denies body weakness

(Found)

Pro Tip: A car accident can result in muscle damage and feeling weakness. Asking Tina whether she feels weak can indicate whether or not she is suffering from muscle damage.

Example Question:

Have you felt weak?

Finding:

Denies seeing auras or halos

(Found)

Pro Tip: After Tina’s car accident, it is important to establish whether neurological problems she might be experiencing predate the accident or, rather, are a result of the crash. Asking Tina if she’s been seeing auras will indicate whether she’s experiencing a neurological disturbance.

Example Question:

Have you experienced any auras?

Finding:

Denies dizziness, light-headedness, syncope, or disequilibrium

(Found)

Pro Tip: A car accident can result in a traumatic brain injury (TBI). Asking Tina if she’s felt dizzy might indicate whether she is experiencing symptoms of a traumatic brain injury.

Example Question:

Have you felt dizzy?

Finding:

Denies loss of coordination

(Found)

Pro Tip: People with traumatic brain injuries commonly report loss of coordination. Asking Tina whether she’s lost coordination can indicate that she suffered a traumatic brain injury during her accident.

Example Question:

Have you had any loss of coordination?

Finding:

Denies scotoma

(Found)

Pro Tip: People with traumatic brain injuries commonly report scotoma. Asking Tina whether she’s noticed any scotoma can indicate that she suffered a traumatic brain injury during her accident.

Example Question:

Have you noticed any scotoma?

Finding:

Denies numbness or tingling

(Available)

Pro Tip: Tingling sensations after a car accident can suggest a herniated disc. Asking Tina whether she’s experiencing tingling sensations might indicate additional musculoskeletal damage caused by the accident.

Example Question:

Have you had any tingling sensations?

Finding:

Denies facial flushing

(Found)

Pro Tip: A prolonged flush face can indicate cerebral compression. Asking Tina whether her face has been flushed will indicate if she is suffering from head trauma.

Example Question:

Has your face been flushed?

Finding:

Asked about review of systems for psych and behavioral history

Finding:

Denies depression

(Found)

Pro Tip: After an accident, it is not uncommon to feel anxious or depressed. Asking Tina whether she’s felt depressed can indicate long-term concerns following her accident. Neurological shadow health assessment Subjective Data

Example Question:

Have you felt depressed?

Finding:

Denies increased irritability

(Found)

Pro Tip: One symptom of a concussion is irritability. Asking Tina whether she’s been irritable might reveal that she sustained a concussion in her car accident.

Example Question:

Have you felt more irritable?

Finding:

Denies problems with concentration or memory

(Found)

Pro Tip: One symptom of a concussion is problems concentrating. Asking Tina whether she’s been experiencing problems concentrating might reveal that she sustained a concussion in her car accident. Neurological shadow health assessment Subjective Data

Example Question:

Have you had any problems concentrating?

Finding:

Denies confusion

(Found)

Pro Tip: One symptom of a concussion is confusion. Asking Tina whether she’s felt confusion might reveal that she sustained a concussion in her car accident.

Example Question:

Have you felt confused?

Finding:

Asked about review of systems for eyes and vision

Finding:

Denies changes in vision since accident

(Found)

Pro Tip: Eye and vision problems are fairly common after a brain injury. Asking Tina whether her vision changed since her accident might indicate that she sustained a head injury.

Example Question:

Has your vision changed since the accident?

Finding:

Reports occasional blurry vision (pre-dating accident)

(Found)

Pro Tip:

Example Question:

Have you ever had blurry vision?

Finding:

Denies unilateral vision disturbance

(Found)

Pro Tip: Eye and vision problems are fairly common after a brain injury. Asking Tina whether she’s had vision problems in just one eye since her accident might indicate that she sustained a head injury.

Example Question:

Have you had any vision problems in just one eye?

Finding:

Denies sensitivity to light

(Found)

Pro Tip: Eye and vision problems are fairly common after a brain injury. Asking Tina whether she is sensitive to light since her accident might indicate that she sustained a head injury.

Example Question:

Are you sensitive to light since the accident?

Finding:

Asked about review of systems for ears, nose, and throat

Finding:

Denies nasal congestion or rhinorrhea

(Found)

Pro Tip: Whiplash from Tina’s car accident might result in congestion and sinus problems. Asking Tina if she’s been congested can indicate that she suffered from whiplash during the accident. Neurological shadow health assessment Subjective Data

Example Question:

Have you had any congestion?

Finding:

Denies tinnitus

(Found)

Pro Tip: Tinnitus, or hearing ringing, can result from the loudness of a car accident. Asking Tina whether she’s hearing ringing can indicate whether she is suffering from Tinnitus.

Example Question:

Have you had ringing in your ears?

Finding:

Denies changes in hearing

(Found)

Pro Tip: Sudden Sensorineural Hearing Losses can be associated with head trauma caused by car accidents. Asking Tina if she’s experiencing hearing loss can indicate possible head trauma.

Example Question:

Have you had any hearing loss?

Finding:

Denies difficulty swallowing

(Found)

Pro Tip: Whiplash from Tina’s car accident might result in damage to the soft tissue of her neck. Asking Tina if she is having trouble swallowing might suggest an injury that she sustained in the crash. Neurological shadow health assessment Subjective Data

Example Question:

Have you had any difficulty swallowing?

Family History

Finding:

Asked about relevant family history

Finding:

Denies family history of migraine

(Found)

Pro Tip: Some causes of migraines can be inherited, and so it’s important to understand your patient’s risk level.

Example Question:

Is there a history of migraines in your family?

Finding:

Denies family history of epilepsy or seizures

(Found)

Pro Tip: Epilepsy or other forms of seizures can be inherited, and so it’s important to understand your patient’s risk level.

Example Question:

Do you have a family history of epilepsy?

Finding:

Denies family history of Alzheimer’s disease

(Found)

Pro Tip: Conditions like Alzheimer’s disease can be inherited, and so it’s important to understand your patient’s risk level.

Example Question:

Do you have a family history of Alzheimer’s disease?

Finding:

Denies family history of Parkinson’s disease Neurological shadow health assessment Subjective Data

Neurological shadow health assessment Transcript

Transcript

All Lines (155)
Interview Questions (94)
Statements (3)
Exam Actions (58)

Hello Tina. Welcome to our clinic. Am Joyce, i will be interviewing you today, and later do a physical examination on you

Greet

03/18/20 10:56 AM PDT

Hey.

What brings you to the clinic today?

Question

03/18/20 10:57 AM PDT

Well, I got into a little fender bender a week ago and I’ve been getting these headaches ever since. And my neck is sore too. Neurological shadow health assessment Transcript

Am sorry to hear that you are having headaches

Empathize

03/18/20 10:59 AM PDT

Thanks for saying that.

WE ARE THE SHADOW HEALTH EXPERTS,

CHAT US TO PLACE OUR ORDER AND SCORE 100%

Have you had any neck stiffness?

Question

03/18/20 11:00 AM PDT

Yeah.

When did the neck stiffness begin?

Question

03/18/20 11:01 AM PDT

My neck started hurting about two days after the accident.

Am sorry that you got an accident (No matching questions found.)

Question

03/18/20 11:02 AM PDT

Am sorry that you got an accident

Neurological shadow health assessment Transcript

Empathize

03/18/20 11:02 AM PDT

Thanks.

And when did the headaches begin? (Clarified to When did the headache begin?.)

Question

03/18/20 11:03 AM PDT

It was a few days after the car accident — I noticed a headache creeping up throughout the day. (Clarified to when the headache began.)

Did you lose consciousnesses after car accident? (Clarified to Did you lose consciousness during the car accident?.)

Question

03/18/20 11:04 AM PDT

No, I don’t think I have ever lost consciousness. (Clarified to if I lost consciousness during the car accident.)

How fast was the car going?

Question

03/18/20 11:06 AM PDT

Oh, it was really slow. We were in a parking lot. Maybe not even fifteen miles an hour.

Were you wearing a seat belt?

Question

03/18/20 11:08 AM PDT

Yes, I always do.

where in the car were you sitting?

Question

03/18/20 11:10 AM PDT

I was in the front passenger seat.

Was the driver under the influence of alcohol? (Clarified to Was anyone under the influence of alcohol when the accident occurred?.)

Question

03/18/20 11:12 AM PDT

No, definitely not. Neither of us had anything to drink. [AUDIO COMING SOON] (Clarified to if anyone was under the influence of alcohol when the accident occurred.)

Great, its not advisable to drink under the influence of alcohol

Educate

03/18/20 11:13 AM PDT

Alright, thanks for letting me know.

How many times have you had the headaches since they started?

Question

03/18/20 11:16 AM PDT

I’ve had a headache just about once a day since a couple days after my accident. Once I feel it coming on, I take something for it and it pretty much goes away for the day.

How long do the headache last?

Question

03/18/20 11:18 AM PDT

About an hour or two.

when was your last headache?

Question

03/18/20 11:19 AM PDT

Yesterday afternoon.

where are the headaches located?

Question

03/18/20 11:22 AM PDT

The headaches are in the crown of my head, and kind of the back of my head.

Does the pain radiate?

Question

03/18/20 11:23 AM PDT

Maybe? The soreness in my neck feels like it goes up into my head. But its just my neck and head that hurt.

how does your neck feel?

Question

03/18/20 11:23 AM PDT

It has been pretty stiff and a little painful since the accident.

Is your scalp tender?

Question

03/18/20 11:24 AM PDT

No.

Do you have jaw pain?

Question

03/18/20 11:24 AM PDT

No, not at all.

Do you have any facial pain?

Question

03/18/20 11:25 AM PDT

No. My face is fine.

How would you rate your pain?

Question

03/18/20 11:25 AM PDT

It’s just my neck that hurts right now. . . I guess I’d say it’s a 3 out of 10.

How would you rate your pain at its worst?

Question

03/18/20 11:26 AM PDT

They probably get up to a 4.

what do your headaches feel like?

Question

03/18/20 11:27 AM PDT

The headaches feel like a dull ache, kind of in the crown of my head, and the back of my head.

is the headache pain sharp?

Question

03/18/20 11:27 AM PDT

No, not really.

are your headaches cyclic?

Question

03/18/20 11:28 AM PDT

No, I don’t think so.

Do your headaches come in clusters?

Question

03/18/20 11:28 AM PDT

No, definitely not.

do your headaches crescendo?

Question

03/18/20 11:29 AM PDT

It’s not, like, a sudden, horrible pain, but they don’t worsen gradually either. They just sort of start, and they never get that bad.

What caused your pain?

Question

03/18/20 11:30 AM PDT

I’m pretty sure it was the car accident. Well, it was really just a fender bender. There was pretty much no damage to the car, and no one got injured, but I guess a sore head and neck can sneak up on you.

Does it hurt to move your head?

Question

03/18/20 11:31 AM PDT

Yeah, my neck hurts when I move it.

what makes your headache worse?

Question

03/18/20 11:31 AM PDT

Nothing really makes them worse. . . they just sort of start, and eventually they go away.

have you tried home remedies?

Question

03/18/20 11:32 AM PDT

I’ve been taking Tylenol. And resting helps, too.

Does your headache get better with rest?

Question

03/18/20 11:33 AM PDT

I don’t think so. They just come on and eventually go away.

Are you taking any new medications?

Question

03/18/20 11:33 AM PDT

I’ve been taking more Tylenol for my headaches, and my neck.

what dose of tylenol do you take?

Question

03/18/20 11:36 AM PDT

I’m not sure the actual dosage, but I generally take 2 regular strength pills.

How often do you take the tylenol?

Question

03/18/20 11:37 AM PDT

I’ve been taking it every day since I started getting these headaches.

How many times a day? (No matching questions found.)

Question

03/18/20 11:38 AM PDT

Does the tylenol help?

Question

03/18/20 11:38 AM PDT

Yeah, it has been helping some.

Do you have any new allergies?

Question

03/18/20 11:39 AM PDT

Well, besides cats, I’m allergic to penicillin.

Do you usually get headaches?

Question

03/18/20 11:40 AM PDT

The only time I got headaches before the accident was when I would read or study for a long time.

Do you ever get migraines?

Question

03/18/20 11:40 AM PDT

No, I’m pretty sure my headaches aren’t migraines.

Have you ever had any head trauma?

Question

03/18/20 11:41 AM PDT

No.

Have you had any seizures?

Question

03/18/20 11:41 AM PDT

No. I’ve seen somebody have one, though. It’s scary.

Have your sleep habits changed?

Question

03/18/20 11:42 AM PDT

No.

Have you felt more sleepy?

Question

03/18/20 11:42 AM PDT

No, I feel about the same as usual.

have you had a fever?

Question

03/18/20 11:43 AM PDT

No, I don’t think so.

have you had any chills?

Question

03/18/20 11:43 AM PDT

No.

have you felt fatigued?

Question

03/18/20 11:43 AM PDT

No, I don’t think so.

have you had nausea?

Question

03/18/20 11:44 AM PDT

No.

any night sweats?

Question

03/18/20 11:44 AM PDT

I don’t get sweaty, but sometimes I wake up hot and have to kick off my sheets.

Has one side of your body felt weaker than the other?

Question

03/18/20 11:45 AM PDT

No, I feel about the same.

Any changes in your gait?

Question

03/18/20 11:45 AM PDT

No.

Have you felt weak?

Question

03/18/20 11:45 AM PDT

No.

Have you experienced any auras?

Question

03/18/20 11:46 AM PDT

No.

have you felt dizzy?

Question

03/18/20 11:47 AM PDT

No, I haven’t been dizzy.

Any loss of coordination?

Question

03/18/20 11:48 AM PDT

Not that I’ve noticed.

have you noticed any scotoma?

Question

03/18/20 11:49 AM PDT

I don’t know what that is, so I guess probably not.

have you felt any tingling?

Question

03/18/20 11:49 AM PDT

No, I haven’t noticed any tingling.

Has your face been flushed?

Question

03/18/20 11:50 AM PDT

Nope.

have you felt depressed?

Question

03/18/20 11:50 AM PDT

No, I’ve been fine.

have you felt more irritable?

Question

03/18/20 11:51 AM PDT

No, not really.

Have you had any problems concentrating?

Question

03/18/20 11:51 AM PDT

No, not really.

Have you felt confused?

Question

03/18/20 11:52 AM PDT

No.

has your vision changed after the accident ? (No matching questions found.)

Question

03/18/20 11:52 AM PDT

has your vision changed since the accident ?

Question

03/18/20 11:53 AM PDT

No, my vision hasn’t changed since the accident.

have you ever had a blurred vision?

Question

03/18/20 11:53 AM PDT

No, my vision hasn’t been blurry since the accident. But, sometimes it gets blurry when I read for too long — that’s been going on for awhile.

any vision problems in just one eye?

Question

03/18/20 11:54 AM PDT

Not that I’ve noticed.

Are you sensitive to light since the accident?

Question

03/18/20 11:55 AM PDT

No, I’m not sensitive to light. [AUDIO COMING SOON]

have you had any congestion ?

Question

03/18/20 11:55 AM PDT

No, I haven’t been congested.

have you had ringing in your ears?

Question

03/18/20 11:56 AM PDT

No.

have you had any hearing loss?

Question

03/18/20 11:56 AM PDT

No.

have you had any difficulty swallowing?

Question

03/18/20 11:57 AM PDT

Nope.

Any history of migraines in your family? Neurological shadow health assessment Transcript

Question

03/18/20 11:57 AM PDT

I don’t think so.

Any family history of epilepsy?

Question

03/18/20 11:58 AM PDT

No.

any history of seizures?

Question

03/18/20 11:58 AM PDT

No. I’ve seen somebody have one, though. It’s scary.

do you have a family history of Alzheimer’s disease?

Question

03/18/20 11:59 AM PDT

No.

do you have a family history of Parkinson disease ?

Question

03/18/20 12:00 PM PDT

No, I don’t think so.

What is your name and date of birth?

Question

03/18/20 1:29 PM PDT

My name is Tina Jones, and I was born on February 17th.

 Evaluated orientation to person

Exam Action

03/18/20 1:29 PM PDT

What building are you in now?

Question

03/18/20 1:30 PM PDT

I’m at the doctor’s office. . . it’s Shadow Health General Clinic.

 Evaluated orientation to place

Exam Action

03/18/20 1:30 PM PDT

What is the date and year?

Question

03/18/20 1:30 PM PDT

Um, today’s date is [Tina says correct date and year]. Neurological shadow health assessment Transcript

 Evaluated orientation to time

Exam Action

03/18/20 1:30 PM PDT

How are oranges and apples alike?

Question

03/18/20 1:32 PM PDT

How are they alike? Um…. they’re both kinds of fruit.

 Evaluated abstract thinking: similarities among fruit

Exam Action

03/18/20 1:32 PM PDT

How are a lake and an ocean alike?

Question

03/18/20 1:32 PM PDT

Uh…. they’re both bodies of water.

 Evaluated abstract thinking: similarities among bodies of water

Exam Action

03/18/20 1:32 PM PDT

How are a trumpet and a flute alike?

Question

03/18/20 1:33 PM PDT

They…… they’re both musical instruments.

 Evaluated abstract thinking: similarities among instruments

Exam Action

03/18/20 1:33 PM PDT

Count backwards by 7s from 100

Question

03/18/20 1:34 PM PDT

Okay. . . 100, 93. . . 86, 79, 72. . . 65. . . 58, 51. . . 44. . . 37, 30, 23, 16. . . 9, and 2.

 Evaluated attention with serial sevens

Exam Action

03/18/20 1:34 PM PDT

 Established one-stage comprehension

Exam Action

03/18/20 1:36 PM PDT

Who was the first president of the united states?

Question

03/18/20 1:37 PM PDT

That’s George Washington.

 Evaluated knowledge of first president

Exam Action

03/18/20 1:37 PM PDT

who are the last four presidents of the united states?

Question

03/18/20 1:37 PM PDT

Well, right now it’s Donald Trump. Before him it was Obama. Before *him* we had Bill Clinton and George W. Bush.

 Evaluated knowledge of last four presidents

Exam Action

03/18/20 1:38 PM PDT

name five large cities in the united states

Question

03/18/20 1:38 PM PDT

Let’s see. . . New York City. . . and Chicago. . . Detroit. . . Los Angeles. . . and Houston. That’s five. Neurological shadow health assessment Transcript

 Evaluated knowledge of five large cities

Exam Action

03/18/20 1:38 PM PDT

What would you do if you found a stamped and addressed envelope on the sidewalk?

Question

03/18/20 1:40 PM PDT

What would I do…. Hmm.. Well, I’d try to figure out who dropped the envelope, but if not… Well, I’d probably just drop it in the first mailbox I saw, if there was one nearby.

 Evaluated judgment

Exam Action

03/18/20 1:40 PM PDT

Repeat and remember burger, tulip, nose and tea

Question

03/18/20 1:41 PM PDT

Burger, tulip, nose, and tea.

 Evaluated immediate memory

Exam Action

03/18/20 1:41 PM PDT

how did you celebrate your last birthday?

Question

03/18/20 1:41 PM PDT

Wow. . . it’s weird, birthdays were huge for us before Dad died because he would always make a really big deal out of them, like he loved planning these huge celebrations. But the past two birthdays, he hasn’t been there, so it’s been kind of sad, thinking about what he’s missing, and we haven’t done huge parties or anything. Last birthday. . . Michael and his fiance came over, and we all had dinner at the house, and I opened presents, and we had a really good cake from this bakery I love. It was nice.

 Evaluated remote memory

Exam Action

03/18/20 1:42 PM PDT

Repeat the four words from before

Question

03/18/20 1:42 PM PDT

Burger. . . tulip. . .nose. . . and tea.

 Evaluated immediate learning

Exam Action

03/18/20 1:42 PM PDT

 Observed patient’s general vocabulary

Exam Action

03/18/20 1:43 PM PDT

what classes are you taking?

Question

03/18/20 1:43 PM PDT

I’m taking two classes right now, one on auditing and one on managerial accounting

 Tested CN I (olfactory nerve) with smell test

Exam Action

03/18/20 1:45 PM PDT

F P

F P

 Inspected right pupil and tested pupillary light reflex

Exam Action

03/18/20 1:49 PM PDT

 Inspected left pupil and tested left pupillary light reflex

Exam Action

03/18/20 1:49 PM PDT

 Inspected fundus of right eye Neurological shadow health assessment Transcript

Exam Action

03/18/20 1:50 PM PDT

 Inspected fundus of left eye

Exam Action

03/18/20 1:52 PM PDT

Follow my finder with just your eyes

Question

03/18/20 1:54 PM PDT

Ok.

 Tested EOM to the upper right

Exam Action

03/18/20 1:55 PM PDT

 Tested EOM to the upper left

Exam Action

03/18/20 1:55 PM PDT

 Tested EOM to the lower left

Exam Action

03/18/20 1:55 PM PDT

 Tested convergence

Exam Action

03/18/20 1:55 PM PDT

 Tested EOM to the lower right

Exam Action

03/18/20 1:55 PM PDT

 Tested EOM to the lower center

Exam Action

03/18/20 1:55 PM PDT

 Tested EOM to the upper center

Exam Action

03/18/20 1:55 PM PDT

 Tested EOM to the upper center

Exam Action

03/18/20 1:55 PM PDT

Close your eyes and tell me if the touch is sharp, dull or soft

Question

03/18/20 1:56 PM PDT

Ok.

 Tested facial sensation: dull stimulus

Exam Action

03/18/20 1:56 PM PDT

Dull.

 Tested facial sensation: dull stimulus

Exam Action

03/18/20 1:57 PM PDT

Dull.

 Tested facial sensation: dull stimulus

Exam Action

03/18/20 1:57 PM PDT

Dull.

 Tested facial sensation: dull stimulus

Exam Action

03/18/20 1:57 PM PDT

Dull.

 Tested facial sensation: soft stimulus

Exam Action

03/18/20 1:57 PM PDT

Soft.

 Tested facial sensation: soft stimulus

Exam Action

03/18/20 1:57 PM PDT

Soft.

 Tested facial sensation: soft stimulus

Exam Action

03/18/20 1:57 PM PDT

Soft.

 Tested facial sensation: soft stimulus

Exam Action

03/18/20 1:57 PM PDT

Soft.

 Tested facial sensation: sharp stimulus

Exam Action

03/18/20 1:57 PM PDT

Sharp.

 Tested facial sensation: sharp stimulus

Exam Action

03/18/20 1:57 PM PDT

Sharp.

 Tested facial sensation: sharp stimulus

Exam Action

03/18/20 1:57 PM PDT

Sharp.

 Tested facial sensation: sharp stimulus Neurological shadow health assessment Transcript

Exam Action

03/18/20 1:57 PM PDT

Sharp.

 Inspected front of face for asymmetry and facial droop

Exam Action

03/18/20 1:58 PM PDT

 Inspected right side of face for asymmetry and facial droop

Exam Action

03/18/20 1:58 PM PDT

 Inspected back of head for asymmetry

Exam Action

03/18/20 1:58 PM PDT

 Inspected left side of face for asymmetry and facial droop

Exam Action

03/18/20 1:58 PM PDT

 Inspected front of face for asymmetry and facial droop

Exam Action

03/18/20 1:58 PM PDT

 Inspected left side of face for asymmetry and facial droop

Exam Action

03/18/20 1:58 PM PDT

 Inspected front of face for asymmetry and facial droop

Exam Action

03/18/20 1:58 PM PDT

is the volume the same in both ears or louder in one ear

Question

03/18/20 2:00 PM PDT

Ok.

Same in both ears.

 Performed Weber test with tuning fork

Exam Action

03/18/20 2:00 PM PDT

Tell me when you no longer hear the ringing

Question

03/18/20 2:01 PM PDT

Ok, I will.

Now.

 Tested gag reflex

Exam Action

03/18/20 2:02 PM PDT

 Tested trapezius muscle strength against resistance: 5 strength against resistance

Exam Action

03/18/20 2:02 PM PDT

 Tested sternocleidomastoid muscle strength against resistance – head turned to the right: 5 strength against resistance

Exam Action

03/18/20 2:03 PM PDT

 Tested sternocleidomastoid muscle strength against resistance – head turned to the left: 5 strength against resistance

Exam Action

03/18/20 2:03 PM PDT

 Inspected mouth

Exam Action

03/18/20 2:04 PM PDT

 Inspected mouth: pushed tongue left with tongue blade

Exam Action

03/18/20 2:04 PM PDT

 Inspect mouth: pushed tongue right with tongue blade

Exam Action

03/18/20 2:04 PM PDT

 Inspect mouth: lifted tongue with tongue blade

Exam Action

03/18/20 2:04 PM PDT

 Inspected mouth: depressed tongue with tongue blade Neurological shadow health assessment Transcript

Exam Action

03/18/20 2:04 PM PDT

Spirituality worldview essay

discussion question for weekly assignment/ What would spirituality be according to your own worldview? How do you believe that your conception of spirituality would influence the way in which you care for patients?

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Discussion

Based on my worldview, I perceive spirituality as the broad concept of connections with a perspective that is physical realm. Spirituality gives purpose and meaning to human life. The concept of spirituality focuses on a higher power that transcends conscious and physical restraints, seeks resolution, and inspires hope. I believe that I am on this world to serve God who created me. We all live in a physical realm that follows the rules of science to include gravity, time and space. However, there are events that occur outside the realm of science and could be considered as miracles. Such events are best explained as divine interventions, thereby validating my views on spirituality (Huff, Kline & Peterson, 2015) Spirituality worldview essay. As a nurse, I understand that every person has a unique understanding of spirituality that gives them belief, love, peace, faith and hope in the midst of suffering. Through incorporating an awareness of spirituality into my nursing care, I am able to provide holistic care that places patients at the center of the healing experience. A key way of doing this in the professional environment is to be purposeful and offer my presence. Through emotional presence even when conducting technical nursing tasks, I expect to create an environment where patients feel comfortable and are able to express themselves thereby helping in influencing care approaches for the best outcomes v. For instance, I can offer to be there for my patients, hold their hands, listen to their concerns, and extend the opportunity are some of the best strategies for helping patients to cope through their illness (Puchalski, 2001). In this respect, I perceive spirituality as belief in a divine being, and view spirituality as an important tool for delivering holistic care.

References

Huff, R., Kline, M. & Peterson, D. (2015).
Health promotion in multicultural populations: a handbook for practitioners and students
(3
rd
ed.). Thousand Oaks, CA: SAGE Publications, Inc.

Puchalski, C. M. (2001). The role of spirituality in health care.
BUMC Proceedings
, 14, 352-357 Spirituality worldview essay.

Reflective Spirituality Paper

You have been assigned required readings on spirituality in your course. You may choose one or more chapters from each assigned book to read. You will then write a reflection paper regarding your thoughts, meaningful ideas, feelings, and/or reactions, and the application of these to nursing practice or your own spiritual growth and self-care.

1. Paper is typed in at least 3 pages, double spaced and turned in on time via D2L or email to your professor, with coversheet title page in APA format; thoughtful, suitable title

10 Points

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2. Introductory paragraph is attention-getting

10 Points

3. Spelling, grammar, mechanics, and usage are correct throughout paper

10 Points Reflective Spirituality Paper

4. Thoughts are expressed in a coherent and logical manner.

20 Points

5. Viewpoints and interpretations are insightful, demonstrating an in-depth reflection.

20 Points

6. Concluding paragraph sums up information, reiterates ideas and opinions, and leaves reader with a call to action or something meaningful to remember

10 Points

7. Pertinent reference sources are skillfully woven throughout paper without over use of quotations but, rather, attempt to paraphrase

10 Points

8. References are properly cited in APA format with no plagiarism. Reflective Spirituality Paper

5 Points

9. At least 3 references are cited in paper, including a reference from current class assigned chapter readings in Mauk, a reading in an assigned chapter in White, and one journal article of your own choice.

5 Points

Total

100 Possible Points

Actual Points =

References:

 

Reflective Spirituality Paper

This paper reflects on Readings in E. G. White, The Ministry of Healing. The selected chapters include Helping the Tempted; Mind Cure; Extremes in Diet; Stimulants and Narcotics; and lastly Liquor Traffic and Prohibition.

For the mind-cure, the body and the mind are closely connected. Therefore, when the body is affected, the mind also is affected and vice versa. This means that human beings should strive to take care of their mind because the mind can eventually lead to numerous physical conditions. Similarly, the mental state can affect the recovery process (White et al., 2018). From this reading, I have learned the importance of taking care of the patients’ mind and mental health conditions during their treatment. Ensuring that patients are in a good mood and their right mind condition can go a long way in facilitating patients’ recovery. Similarly, improving the mental condition of my patients can go a long way in giving patients the strength and will to fight the disease process. For example, when a patient is has a positive mind, they are more willing to adhere to the prescribed treatment. Reflective Spirituality Paper

The second chapter is “helping the tempted”. This chapter encourages people to be sympathetic and empathic towards each other (White et al., 2018). The nursing profession is a calling that requires nurses to show compassion and empathy towards the patients. Therefore, from this chapter, we learn how to provide compassionate care to patients without judging them and regardless of how difficult the patient is. Also, this chapter has strongly improved my ability to collaborate and partner with other healthcare providers. Even when facing difficult colleagues, I will endeavor to try to understand them and overlook their shortcomings. This will significantly improve my relationship with my peers and nurse leaders and thus improve care delivery.

The third chapter is “Extremes in Diet”. From this chapter, I have learned the importance of feeding the body with the right diet without starving or overfeeding. Human beings should ensure that the body is fed with the right nutrients (White et al., 2018). Reflective Spirituality Paper. From this chapter, I learned that the diet should contain all the essential nutrients. This is in line with my belief that a healthy diet not only prevents people from diseases but also improves immunity. Moving forward, I plan to advocate for a proper and healthy diet for my patients and at the same time educate my patients regarding the importance of consuming the appropriate diet.

Lastly, chapters “stimulants and narcotics” and “liquor traffic and prohibition” emphasize the importance of staying away from drugs and liquor. Generally, evidence has shown that drugs such as narcotics have harmful effects on the body. Some drugs are even associated with numerous mental disorders (Tsai et al., 2019). Therefore, these two chapters have significantly impacted my personal growth. It was enlightening to discover that even stimulants such as coffee can be addictive. From now on, I plan to reduce the amount of stimulants that I take because stimulants such as coffee can also be addictive. I also plan to actively educate my friend, community members, and my patients about the risks and dangers associated with taking narcotics. I also plan to encourage my friends and patients to always uphold the laws that prohibit things such as driving while drunk. Reflective Spirituality Paper.

 

References

Tsai A, Alegría M & Strathdee A. (2019). Addressing the context and consequences of substance use, misuse, and dependence: A global imperative.
PLoS Med
, 16(11).

White, E. G., & Writings, E. G. W. (2018). The Ministry of Healing. 1905.
http://www. centrowhite. org. br/files/ebooks/egw-English/books/The% 20Ministry% 20of% 20Healing. pdf Acesso em
,
5
, 127. Reflective Spirituality Paper

Depressive Disorders Essay

Depression

Depression affects both the mental and physical wellbeing of an individual.it is considered to be one of the leading causes of disability with 300 million people estimated to suffer from the disorder globally. The Center for Disease and Control and Prevention (CDC) reported 10.4% and 5.5% of women and men respectively to have had depression between 2013 to 2016. Depression is a mode disorder that results in persistent feelings of sadness and loss of interest. It affects the feelings, thoughts, and actions which interfere with the normal functioning and conducting of activities. According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), major depressive disorder is characterized by depressed mood, loss of pleasure and interest in activities, change of appetite and weight, sleep disturbance, loss of energy or fatigue, psychomotor agitation and feelings of worthlessness (American Psychiatric Association, 2013). Other symptoms include recurrent suicidal thoughts and reduced ability to make decisions, concentrate or think and five of them should be persistent for at least two weeks Depressive Disorders Essay.

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HPI and clinical impression

The patient is a 21-year-old female African American patient who was found in his room attempting to commit suicide using benzodiazepenes and opioids medications. She confesses to have had suicidal thoughts since the age of 12 years as she was transitioning from childhood to adolescent stage. She does not like her body type and considers herself not to be beautiful. She was bullied in high school and has always felt worthless, unloved and lonely. Recently, she broke up with her boyfriend which was very traumatic Depressive Disorders Essay. Her depressive symptoms include feelings of worthlessness, insomnia, lack of concentration, anhedonia, loss of appetite and weight as well as feelings of sadness for the last two months. She also experiences persistent suicidal thoughts and has attempted suicide on three occasions.

Psychopharmacologic treatments

Depressive disorder can be treated pharmacologically using medication. Multiple types of antidepressants drugs are employed to alleviate the symptoms of depression. These include Selective serotonin reuptake inhibitors (SSRIs) such as paroxetine, vilazodone, citalopram, fluoxetine and escitalopram (Stahl, 2014). Other antidepressants include Serotonin-norepinephrine reuptake inhibitors (SNRIs), Tricyclic antidepressants, atypical antidepressants and Monoamine oxidase inhibitors (MAOIs) among others. In this case, the patient will be treated using citalopram 20mg. this drug presents fewer side effects and has been confirmed to produce positive outcomes to depression patients. The dosage will be increased to a maximum of 4omg if the initial dose does not cause optimal results. The therapeutic end points include restoration of normal sleeping patterns, moods and activities as well as elimination of suicidal ideations. Depressive Disorders Essay. This is because; serotonin blocks the neurotransmitter receptors at the neuronal synapse thus restoring the normal state of the brain functions.

Psychotherapy Treatment

Psychological interventions for depression include talk therapies involving the individual patient, groups and families. This approach will be based on cognitive behavior therapy which seeks to modify the emotions, thought processes and actions of a depressed patient (Gabbard, 2014). Individual therapy will entail training on multiple techniques such as resolution of personal issues, recovery from mental illness and creation of desired changes. On the other hand, the patient will engage in group therapies which will engage him in coping efficacy skills and activities as well as promote open sharing and acceptance Depressive Disorders Essay. Family therapy will help in identifying the patient’s social needs and strategies to facilitate recovery at home. Cognitive behavior therapy will run for six weeks and is expected to improve the quality of the patient’s life, eliminate negative thoughts and promote coping as well as improve the resolution of personal issues.

Medical Management needs

Medical management needs for depressed patients include actions that minimize the need for medical services. these needs support the primary care providers and caregivers in improving the condition of the patient. As such, a collaborative relationship between the psychiatrist and the primary caregiver will help in the identification of the client’s needs and enhance timely delivery and assessment which improves quick recovery. Moreover, sharing of the information particularly on the client’s mental and family history will help the psychiatric provide an appropriate diagnosis guided by evidence. In addition, this will help in identifying and resolving the challenges encountered during treatment often regarding the client’s adherence to the treatment plan, side effects of medication and the rate of recovery. Electronic monitoring off medication will also ensure no medical errors take place as they seek to identify the optima dosage tolerated by the patient (Sadock, Sadock and Ruiz, 2014).

Community support

The community offers diverse types of support to mental patients. This includes setting up rehabilitation and nursing homes as well as financing their medical services through different community programs. Consequently, they set up community agencies that advocate for creation of awareness on depression, educate people on mental wellness, provide information on prevention and treatment and also condemn stigmatization of depressed patients. The patient will therefore benefit from these services which include free counseling, social support and access of information. Depressive Disorders Essay.

Follow up plan

The patient will be expected to visit the clinic after every two weeks. If the progress will be positive and no therapeutic changes are proposed, she will then be given monthly appointments.

References

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.

Gabbard, G. O. (2014). Gabbard’s treatment of psychiatric disorders (5th ed.). Washington, DC: American Psychiatric Publications.

Sadock, B. J., Sadock, V. A., & Ruiz, P. (2014). Kaplan & Sadock’s synopsis of psychiatry: Behavioral sciences/clinical psychiatry (11th ed.). Philadelphia, PA: Wolters Kluwer Depressive Disorders Essay

Stahl, S.M. (2014). Prescriber’s Guide: Stahl’s Essential Psychopharmacology (5th ed.). New York, NY: Cambridge University Press.

To prepare for this Assignment:

Select an adult or older adult client with a depressive disorder you have seen in your practicum.

In 3 pages, write a treatment plan for your client in which you do the following:

Describe the HPI and clinical impression for the client.

Recommend psychopharmacologic treatments and describe specific and therapeutic endpoints for your psychopharmacologic agent. (This should relate to HPI and clinical impression.)

Recommend psychotherapy choices (individual, family, and group) and specific therapeutic endpoints for your choices Depressive Disorders Essay.

Identify medical management needs, including primary care needs, specific to this client.

Identify community support resources (housing, socioeconomic needs, etc.) and community agencies that are available to assist the client.

Recommend a plan for follow-up intensity and frequency and collaboration with other providers. Depressive Disorders Essay.

Spirituality Reflective Writing Essay

As God’s creation, I believe that we are all fearfully and wonderfully made in the image and likeness of God (Psalm 139:14).  The biblical worldview relates the human anatomy and physiology to God’s intricate design. As such, a relationship exists between the Christian faith and the study of the human structure and body functions. This paper examines the nervous system and depression as the…

Select a body system and identify one disease process that fascinates you most as a creation of God. Answer the following questions relating to the disease process.

1. What aspects of normal anatomy is interesting to you and why?

2. What factors have caused the damage to the normal anatomy and physiology?

3. How can we restore the healing process? Spirituality Reflective Writing Essay

4. What is the role of prayer, influence of religion and culture relating to this disease process?

5. Conclusion with a call to action or something meaningful to remember

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You have been assigned required readings on spirituality in your course. You may choose one or more chapters from each assigned book to read. You will then write a reflection paper regarding your thoughts, meaningful ideas, feelings, and/or reactions, and the application of these to nursing practice or your own spiritual growth and self-care.

1. Paper is typed in at least 2-3 pages, double spaced and turned in on time via D2L or email to your professor, with coversheet title page in APA format; thoughtful, suitable title 10 Points Spirituality Reflective Writing Essay

2. Introductory paragraph is attention-getting

10 Points

3. Spelling, grammar, mechanics, and usage are correct throughout paper 10 Points

4. Answers all questions and thoughts are expressed in a coherent and logical manner. 20 Points

5. Viewpoints and interpretations are insightful, demonstrating an in-depth knowledge, and understanding of the disease process and reflecting the role of prayer, region and culture influence on healing on the disease process. . 20 Points

6. Concluding paragraph sums up information, reiterates ideas and opinions, and leaves reader with a call to action or something meaningful to remember 10 Points

7. Pertinent reference sources are skillfully woven throughout paper without over use of quotations but, rather, attempt to paraphrase 10 Points

8. References are properly cited in APA format with no plagiarism. 5 Points

9. At least 3 references are cited in paper, including a reference from current class assigned chapter readings in Mauk, a reading in an assigned chapter in White, Anatomy & Physiology, and pathophysiology text and one journal article of your own choice. 5 Points Spirituality Reflective Writing Essay

relate it to Readings in E. G. White, The Ministry of Healing in the following chapters

Chapt 5 Healing of the Soul

Chapt 16 Prayer for the Sick

 

As God’s creation, I believe that we are all fearfully and wonderfully made in the image and likeness of God (Psalm 139:14).  The biblical worldview relates the human anatomy and physiology to God’s intricate design. As such, a relationship exists between the Christian faith and the study of the human structure and body functions. This paper examines the nervous system and depression as the creation of God.

The nervous system interests me because of its ability to control the overall functioning of the body. I am often fascinated by how it collects sensory input from the body and external environment, processed it, interprets and responds appropriately initiating actions. Moreover, it contains the brain which presents the most complex and largest organ in the human body that harbors more than 100 billion neurons. Another amazing thing about the anatomy of the nervous system is the spinal cord which is capable of transmitting signals at speeds of 100 meters per second (Tripathi & Sieber, 2020). How fast! It also has the nerves which are a collection of neurons that conduct impulses to and from the central nervous mechanism  Spirituality Reflective Writing Essay. Interestingly, the nervous system controls communication, breathing, swallowing, learning, reaction to stimuli, walking, speaking and generally all the activities of the body.

Depression is caused by the damage of the anatomy and psychology of the nervous system and particularly the brain. It occurs from the depression of dopamine, norepinephrine or serotonin neurotransmitters in the central nervous system. This is according to the monoamine-deficiency theory. The factors causing damage to the normal anatomy and physiology of the nervous system include genes and psychosocial stresses associated with family and environmental interactions; stress hormones and cytokines such as Corticotropin-releasing hormone (CRH) as well as mediating roles of monoamines that control sleep, appetite, attention, reward processing, cognition and mood. Other factors include substance abuse, sex hormones, and medical conditions Spirituality Reflective Writing Essay.

The healing process of depression seeks to restore the normal anatomy of the nervous system. This can be achieved through balanced dieting rich in vitamins B6, B12, and folate. Drinking plenty of water and fluids is also essential. In addition, pharmacological treatment of depression can be achieved through the administration of antidepressants which assist in balancing the brain chemicals, neurotransmitters which affect the emotions and moods. Selective serotonin reuptake inhibitors (SSRI) such as escitalopram are the most effective drugs for depression (Stahl, 2014).

As Christians, prayers play a vital role in healing. Illnesses are often considered as punishments for sins and hence, the Bible encourages Christians to offer prayers in faith so that they can be healed and their pain will be alleviated (Exodus 15:26). Notably, Christians ask for forgiveness from God through prayers with a belief that forgiveness and restoration of health will take placeSpirituality Reflective Writing Essay. On mental issues such as depression, God prayers offer emotional comfort and reduce the symptoms (Psalm 103:3, 4) (White & Writings, 2018). On the other hand, different cultures and religions own unique perceptions of nervous system diseases associating them with curses and punishments. Different health promotion strategies, approaches, interventions and perceptions also influence treatment of diseases.

In conclusion, I can term the nervous system as the most significant system of the body since it controls everything else. As such, maintenance of its health through prevention of injuries and disease is essential. Creation of awareness and provision of cultural sensitive services towards maintenance of health and elimination of mental diseases such as depression is a relevant step towards holistic and evidence-based practice.

References

Stahl, S.M. (2014). Prescriber’s Guide: Stahl’s Essential Psychopharmacology (5th ed.). New York, NY: Cambridge University Press. Spirituality Reflective Writing Essay

Tripathi, P., & Sieber, F. (2020). The Adult Central Nervous System: Anatomy and Physiology. In 
Essentials of Neurosurgical Anesthesia & Critical Care
 (pp. 3-13). Springer, Cham.

White, E. G., & Writings, E. G. W. (2018). The Ministry of Healing. 1905. 
http://www. centrowhite. org. br/files/ebooks/egw-english/books/The% 20Ministry% 20of% 20Healing. pdf Acesso em
, 
5
, 127. Spirituality Reflective Writing Essay

Becoming influential essay assignment sample

Deciding on My Message

Nursing is the most cared-for job since nurses are the most trusted healthcare professionals. They keep an eye on a patient all through the continuum of life. They give care, yet they likewise are advocates, scholars, and educators. Nursing is a noteworthy profession, and the nurses are the central core of the medicinal services system. In any case, in as much as the profession is indispensable in the public arena, it gets less credit than it should (Papandrea, n.d.). It views as a component of the lower level in the healthcare profession. Becoming influential essay assignment sample Thus, there emerges a circumstance where there is a shortage of nurses. Shortage of nurses is the point at which the interest for nursing professionals surpasses the supply. Shortage of nurses does not just emerge when nurses are in low numbers, yet could likewise happen when the pace of affirmation of students to the nursing schools goes down (AACNnursing, 2019). The shortage shows up due to insufficient staffing proportions in emergency clinics, the absence of arrangement programs for new graduates, and weak laborer retention incentives.

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My message would, in this way, look to address the shortage of the number of nurses in the region. By raising the issue, I would mean to bring issues to light to such a reality and along these lines talk about it to two noteworthy parties: the government and the youngsters who are yet to join nursing schools. If the government were to enough deal with the wages, training, working condition, and the executives of the nurses, an ever-increasing number of nurses would wish to stay in the profession. Such a move would likewise propel youngsters progressively to take up the course or profession, consequently tending to the nurse shortage issue, unequivocally. Becoming influential essay assignment sample

Deciding on How to Share My Message

 

The message target government and youngsters going to join establishments of higher learning. However, in addressing the issue, I would target the lawmakers, MPs, campaign gatherings, or the legislature, so the whole nursing system streamline. With that set up, it is anything but difficult to address youngsters and urge them to seek after nursing as a profession. With more students taking up nursing, it would mean there would be more graduates and facilitate the burden on the current obliged number of nurses (Gatchel, 2018). However, they would need to discover a spot where there is sufficient compensation, better working conditions, stable working timetables, appropriate move changes or more all legitimate apparatuses, units and hardware for the training.

           
In this case, I would address the nearby Member of Parliament (MP) as she can address the issue broadly. She controls what measure of cash assigned to the constituency, and she additionally seats the commission set up to convey such assets all through the territory. In my location to the MP, I would exhibit measurements on the number of nurses in the voting demographic, the total number of constituents and contrast that proportion and the WHO prescribed proportion. It would demonstrate that the region slacks in the number of nurses who should practice there (Poorchangizi & Farokhzadian, 2017). To address the issue, I would raise the issue of financing human services establishments, giving more up to date advances to the offices, improving the foundation, subsidizing mobile facilities and paying them the best possible levy, and in time.

           
Besides, I would approach her to campaign for nursing courses in the institutions of higher realizing with the goal that increasingly youngsters take up the course. I would expect a few challenges. The issue with that would be that such financing is not yielding foods grown from the ground; that case, I would ask the MP to follow up on the issue cautiously. Another challenge would be that practicing medicine could easily compare to nursing as that is the thing that we have grown up knowing (Hintistan & Topcuoglu, 2017). Nursing has not gotten the praise that it should and frequently lays in the shadows of practicing prescription. Nursing has advanced and is one of the essential jobs in the medicinal community. Organizing the profession will give it the regard it merits.

My Message

Dear MP,

           
Nurses are the absolute most overworked professionals, yet they are not recognized as they should. Some state it is a profession; however, in the real sense, it is the most sincerely requesting employments ever. Nobody would comprehend what a nurse does until they have a nearby relative spend time in a clinic or have an attendant consideration for them at home. Nurses bring an expansiveness of mastery and learning while at the same time overseeing and assessing the treatment and care for such people Becoming influential essay assignment sample. They are the promoters for the debilitated; they moderate the advancement of a patient; comprehend side effects that may be warnings and what treatment should work. They are the connection between a patient and the specialist.

           
All such work block by a few issues which I trust you can work on. The fundamental issue for the present which I think could assist on a more extensive scale whenever tended to be the shortage of nurses in your constituency. Nurse shortage expands the outstanding burdens on the nurses, builds the hazard for mistakes and trading off the strength of patients, dangers wounds, and dangers were spreading contaminations to different patients or staff individuals and could bring about a lot increasingly negative results (Papandrea, n.d.). Like this, the shortage of nurses should be tended to, for the health and prosperity of your constituents and the constituency when all said in done.

           
First, I would ask you to organize the issue from a shortage of nurses, in the constituency as well as countrywide. To address the issue all the more proficiently, it requires more broadcast appointment. Also, on a constituency level, I would ask you to cater more funds for the improvement of the nursing offices in the supporters. I would likewise approach that more magnificent hardware for the said institutions be benefited to them when it is conceivable. Thirdly, I would request that you underscore to the youngsters that nursing is a fundamental profession in the public arena. It would take into account more students to take up nursing and seek after it as a profession. Furthermore, with improved offices, better pay, and better working conditions, a more significant amount of them would graduate and keep practicing. I accept the methodologies would address the issue of attendant shortage.

What Have I Learned from This Assignment?

I learned that nursing gets less praise than it should because it is hidden by the therapeutic profession. In any case, nursing is essential to the community, presumably significantly more than practicing medication. It is an emotional profession and requires a great deal of consideration to a patient. I have learned that nursing gets less consideration and inclusion because there exists a misguided judgment that nursing care is less significant. Becoming influential essay assignment sample The most notable individual is the patient and nurses carry out their responsibility to ensure the patients pull through their conditions. To ensure nursing gets the attention it merits, I will campaign for the improvement of their working conditions, pay, and the expansion in the equipment profited to them. Nurses help patients throughout the day and night long, and they, like this, require a great deal of consideration. Having it regarded by all will cover the issue of nurse shortage which emerges given the absence of consideration in the profession and the course in higher learning’s institutions. Becoming influential essay assignment sample

 

References

AACNnursing. (2019).
Nursing Shortage
. Retrieved from AACNnursing: https://www.aacnnursing.org/News-Information/Fact-Sheets/Nursing-Shortage

Gatchel, R. J. (2018). The importance of the profession of nursing in health care: Current and future issues.
Journal of Applied Biobehavioral Research
. Becoming influential essay assignment sample

Hintistan, S., & Topcuoglu, B. (2017). Professionalism Characteristics of Nurses Working in Internal Medicine Clinics.
Universal Journal of Public Health
, 46-53.

Papandrea, D. (n.d.).
What You Can Do About The Nursing Shortage
. Retrieved from Nurse: https://nurse.org/articles/nursing-shortage/

Poorchangizi, B., & Farokhzadian, J. (2017). The importance of professional values from clinical nurses’ perspective in hospitals of a medical university in Iran.
BMC Medical Ethics
. Becoming influential essay assignment sample

Worldview Analysis and Personal Inventory Essay

The nature of spirituality and ethics in the Christian perspective is dependent on the belief in a higher being, God. In the healthcare scenario, spirituality means that one believes that this higher being is the one that holds the key to health, wellness, and disease. To be deeply spiritual therefore means that one has the power to call upon God when they are sick and they get healed without even having to go to the hospital. In the same manner, the belief in God has the potential to heal anyone else that is prayed for in order that God can intervene and heal them. Christian spirituality teaches that God is above everything. He can conquer disease and restore wellness without having to take any medication at all. In fact, Christian spirituality maintains that…

Based on the required topic study materials, write a reflection about worldview and respond to following:

In 250-300 words, explain the Christian perspective of the nature of spirituality and ethics in contrast to the perspective of postmodern relativism within health care. Worldview Analysis and Personal Inventory Essay

In 250-300 words, explain what scientism is and describe two of the main arguments against it.

In 750-1,000 words, answer each of the worldview questions according to your own personal perspective and worldview:

What is ultimate reality?

What is the nature of the universe?

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What is a human being?

What is knowledge?

What is your basis of ethics?

What is the purpose of your existence?

Remember to support your reflection with the topic study materials.

While APA style is not required for the body of this assignment, solid academic writing is expected, and documentation of sources should be presented using APA formatting guidelines, which can be found in the APA Style Guide, located in the Student Success Center. Worldview Analysis and Personal Inventory Essay

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

 

Analysis of Worldview: Christian Perspective as Opposed to Postmodern Relativism in Healthcare

The nature of spirituality and ethics in the Christian perspective is dependent on the belief in a higher being, God. In the healthcare scenario, spirituality means that one believes that this higher being is the one that holds the key to health, wellness, and disease. To be deeply spiritual therefore means that one has the power to call upon God when they are sick and they get healed without even having to go to the hospital. In the same manner, the belief in God has the potential to heal anyone else that is prayed for in order that God can intervene and heal them. Christian spirituality teaches that God is above everything. He can conquer disease and restore wellness without having to take any medication at all. In fact, Christian spirituality maintains that for one to get sick, God has to allow it to either test his/ her faith or let him discover the power of God. This argument is supported by the case of Job in the Christian Holy Bible. As for ethics, the God of Christianity directs that all Christians must do good (beneficence) at all times (Gula, 2000) and shun doing evil (non-maleficence). Hence the greatest commandment that one should always love their neighbor as they love themselves. Worldview Analysis and Personal Inventory Essay

Contrasted with the Christian worldview, postmodern relativism is a cynical look at the reality of wellness and disease. It seeks to question reason and the scientific knowledge that informs modern medicine and treatment. Postmodern relativism would question medical and nursing interventions aimed at treating disease because according to it, all actions possess no certainty and their usefulness is only relative. In other words, there is nothing absolute or absolutely certain in healthcare, including the so-called evidence-based therapies. How an illness is understood in healthcare and how it is remedied is therefore dependent on how the person looking at it perceives it (Guignan, 2020).

Description of and Arguments against Scientism

Scientism is the belief that scientific knowledge is the ultimate medicine and panacea to all the problems of the world. This includes illness and disease. According to it, all knowledge in the world comes from science and scientific endeavours. Also, all phenomena on Earth and in the entire universe can be explained by science according to the philosophy of scientism. It is during the latter stages of the historical period known as “Renaissance” that scientism began to take root. As Christopher Columbus was discovering the America’s, Galileo Galilei and Rene Descartes were beginning to question knowledge that had been held as true for ages. These could be considered as the
de facto
founders of the scientism movement Worldview Analysis and Personal Inventory Essay. Up to the time that these men of science started to question assumptions like the flatness of the Earth, the word of the Church and the ancient philosophical thinkers was unchallenged and divine. All intellectuals believed these assumptions to be true so much so that anyone who questioned their veracity was considered to be insane. As a matter of fact, most of these early scientism advocates found themselves in jail for their observations. Luckily, their observations were factual scientific realities that would soon be proved to be true (Burnett, 2020).

Like any form of believe, cult, or movement; scientism also has arguments that are presented against it and its proponents. Two of these are worth discussing here. According to Crosby (2014), the free will of a human being is a phenomenon that even scientism cannot claim to be in a position to explain. To prove this point, the science of neurology and neurosurgery is still not capable of explaining the physiology behind the free will, morality, or right and good as functions of the human brain. Moreover, there are still huge areas of the brain whose functions science still cannot explain. Therefore, science still cannot purport to be able to explain in full the process of human thought and free will, as these appear to be extremely abstract phenomena devoid of any physical footprints. The second argument against scientism is its reliance on the replicability of observations. That an experiment in science can be replicated with the same results obtained in a different place is the very hallmark of science. This is the whole concept of reliability and validity of research findings. Hall (2018) posits that the absence of replicability of past observations does not necessarily mean no new knowledge is generated.

Ultimate Reality

So, what exactly is ultimate reality? According to the online Oxford dictionary, the word “ultimate” means “being or happening at the end of a process” or “final.” Therefore, ultimate reality is the absolute reality that remains after all beliefs, cults, assumptions, and conjectures have been removed. For example, the ultimate reality as at now is that the Earth is round, living things need oxygen gas to survive, a human being can only give birth to a human being and not a goat, and only human beings have the capacity to generate original speech (parrots can only copy!). Worldview Analysis and Personal Inventory Essay

The Nature of the Universe

The universe is everything that is in existence in whatever state it is in, on earth and beyond. As human beings, we occupy just a tiny speck in the universe that is planet Earth. We have not even been able to physically find out what is in existence in a neighboring planet in the solar system. Galaxies upon galaxies make up the entire universe. In a nutshell, therefore, the nature of the universe is still a mystery yet to be unravelled by humans on Earth.

A Human Being

A human being is part of the living things that are found on planet Earth. As things stand now, he is the most intelligent of all the animals found on Earth and endowed with the capacity to reason. Among all the animals and living things on Earth, it is only the human being that possesses free will and a sense of right and wrong. However, these special faculties are still not possible to explain using the current available knowledge, be it scientific or otherwise. Through his superior brain, the human being has been able to make sense of the Earth and use its resources in ways that can benefit him. He has been able to carefully study his body and identify how and when most of the diseases affecting it occur. In this manner, he has also tried and observed which interventions are able to treat these diseases and which ones cannot. However, despite all this ingenuity, the human being has not been able to to conquer death or prevent it.

Knowledge

Knowledge is an abstract concept whose presence can be demonstrated but whose exact existence cannot be physically proven. Human beings are not born with knowledge. They have to acquire it after being born. This is possible because the human brain is capable of learning and storing information learnt. However, physically demonstrating where knowledge resides in the human brain has not been possible to date. The best that can be presumed is where knowledge resides in the human brain. In fact, the abstract phenomenon that is knowledge is made even more complex by the reality of the dichotomy of mind and brain. The brain is a physical reality that can be touched, whereas the mind is an abstract reality that has no physical proof. Worldview Analysis and Personal Inventory Essay

My Personal Basis of Ethics

My personal basis of ethics leans more on the Christian worldview of doing only what is good to others (beneficence). It is informed by resisting the urge to bring harm upon others (non-maleficence), even if they have done something that hurts me. This is the unconditional love of the neighbor that Jesus taught as the greatest commandment in the Christian Holy Bible. My personal basis of ethics is also informed by the need to let others exercise their free will without constraints (autonomy). This is because human rights inform all of us that all human beings are born free and they must remain so without anyone curtailing their God-given freedom. Lastly, my personal basis of ethics is informed by the need to accord justice to everyone. I believe that resources should not only be shared equally, but also that all human beings should have access to basics of life and health wherever they are, regardless of their race, color, creed, religion, beliefs, culture, or socio-economic status.

The Purpose of My Existence

Following from my personal basis of ethics above, my belief of my purpose of existence also leans more on the Christian worldview of leaving the world better than I found it. I believe that I am in existence to do good and impact the world positively, touching the lives of fellow human beings through healing and alleviating suffering that is caused by disease. Worldview Analysis and Personal Inventory Essay

References

Burnett, T. (2020). What is scientism?
American Association for the Advancement of Science (AAAS)
. Retrieved 4 March 2020 from
https://www.aaas.org/programs/dialogue-science-ethics-and-religion/what-scientism

Crosby, J.F. (2014). Against scientism.
Public Disclosure: The Journal of the Witherspoon Institute
. Retrieved 4 March 2020 from

Against Scientism

Duignan, B. (2020).Postmodernism.
Encyclopedia Britannica
. Retrieved 4 March 2020 from
https://www.britannica.com/topic/postmodernism-philosophy

Gula, R.M. (2000). Spirituality and ethics in healthcare.
Health Progress
, 17-19. Retrieved 4 March 2020 from
https://www.chausa.org/docs/default-source/health-progress/spirituality-and-ethics-in-healthcare-pdf.pdf?sfvrsn=0

Hall, S. (April 5, 2018). The philosophical case against scientism.
Quillette
. Retrieved 4 March 2020 from
https://quillette.com/2018/04/05/philosophical-case-scientism/
  Worldview Analysis and Personal Inventory Essay

Caucasian Man With Hip Pain decision Tree case study essay

Complex Regional Pain Disorder White Male With Hip Pain

BACKGROUND

This week, a 43-year-old white male presents at the office with a chief complaint of pain. He is assisted in his ambulation with a set of crutches. At the beginning of the clinical interview, the client reports that his family doctor sent him for psychiatric assessment because the doctor felt that the pain was “all in his head.” He further reports that his physician believes he is just making stuff up to get “narcotics to get high.”

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SUBJECTIVE

The client reports that his pain began about 7 years ago when he sustained a fall at work. He states that he landed on his right hip. Over the years, he has had numerous diagnostic tests done (x-rays, CT scans, and MRIs). He reports that about 4 years ago, it was discovered that the cartilage surrounding his right hip joint was 75% torn (from the 3 o’clock to 12 o’clock position). He reports that none of the surgeons he saw would operate because they felt him too young for a total hip replacement and believed that the tissue would repair with the passage of time. Since then, he reported development of a strange constellation of symptoms including cooling of the extremity (measured by electromyogram). He also reports that he experiences severe cramping of the extremity. He reports that one of the neurologists diagnosed him with complex regional pain syndrome (CRPS), also known as reflex sympathetic dystrophy (RSD). However, the neurologist referred him back to his family doctor for treatment of this condition. He reports that his family doctor said “there is no such thing as RSD, it comes from depression” and this was what prompted the referral to psychiatry. He reports that one specialist he saw a few years ago suggested that he use a wheelchair, to which the client states “I said ‘no,’ there is no need for a wheelchair, I can beat this!” Caucasian Man With Hip Pain decision Tree case study essay

The client reports that he used to be a machinist where he made “pretty good money.” He was engaged to be married, but his fiancé got “sick and tired of putting up with me and my pain, she thought I was just turning into a junkie.”

He reports that he does get “down in the dumps” from time to time when he sees how his life has turned out, but emphatically denies depression. He states “you can’t let yourself get depressed… you can drive yourself crazy if you do. I’m not really sure what’s wrong with me, but I know I can beat it Caucasian Man With Hip Pain decision Tree case study essay.”

During the client interview, the client states “oh! It’s happening, let me show you!” this prompts him to stand with the assistance of the corner of your desk, he pulls off his shoe and shows you his right leg. His leg is turning purple from the knee down, and his foot is clearly in a visible cramp as the toes are curled inward and his foot looks like it is folding in on itself. “It will last about a minute or two, then it will let up” he reports. Sure enough, after about two minutes, the color begins to return and the cramping in the foot/toes appears to be releasing. The client states “if there is anything you can do to help me with this pain, I would really appreciate it.” He does report that his family doctor has been giving him hydrocodone, but he states that he uses is “sparingly” because he does not like the side effects of feeling “sleepy” and constipation. He also reports that the medication makes him “loopy” and doesn’t really do anything for the pain Caucasian Man With Hip Pain decision Tree case study essay.

MENTAL STATUS EXAM

The client is alert, oriented to person, place, time, and event. He is dressed appropriately for the weather and time of year. He makes good eye contact. Speech is clear, coherent, goal directed, and spontaneous. His self-reported mood is euthymic. Affect consistent to self-reported mood and content of conversation. He denies visual/auditory hallucinations. No overt delusional or paranoid thought processes appreciated. Judgment, insight, and reality contact are all intact. He denies suicidal/homicidal ideation, and is future oriented.

Diagnosis: Complex regional pain disorder (reflex sympathetic dystrophy)

Decision Point One

Select what the PMHNP should do:

mg BID on day 2 and 3; followed by 25 mg BID on days 4-7; followed by 50 mg BID thereafter

y 25 mg to a max dose of 200 per day Caucasian Man With Hip Pain decision Tree case study essay

Neurontin 300 m 
 
 // 
Complex Regional Pain Disorder

Complex Regional Pain Disorder White Male With Hip Pain

 

Decision Point One

Savella 12.5 mg once daily on day 1; followed by 12.5 mg BID on day 2 and 3; followed by 25 mg BID on days 4-7; followed by 50 mg BID thereafter

BID on day 2 and 3; followed by 25 mg BID on days 4-7; followed by 50 mg BID thereafter Caucasian Man With Hip Pain decision Tree case study essay

RESULTS OF DECISION POINT ONE

· 
 Client returns to clinic in four weeks

· 
 Client comes into the office to without crutches but is limping a bit. The client states that the pain is “more manageable since I started taking that drug. I have been able to get around more on my own. The pain is bad in the morning though and gets better throughout the day”. On a pain scale of 1-10; the client states that his pain is currently a 4. When asked what pain level would be tolerable on a daily basis, the client states, “I would rather have no pain but don’t think that is possible. I could live with a pain level of 3.”. When questioned further, the PMHNP asks what makes the pain on a scale of 1-10 different when comparing a level of 9 to his current level of 4?”. The client states that since using this drug, I can get to a point on most days where I do not need the crutches. ” The client is also asked what would need to happen to get his pain from a current level of 4 to an acceptable level of 3. He states, “If I could get to the point everyday where I do not need the crutches for most of my day, I would be happy.”

· 
Client states that he has noticed that he frequently (over the past 2 weeks) gets bouts of sweating for no apparent reason. He also states that his sleep has “not been so good as of lately.” He does complain of nausea today Caucasian Man With Hip Pain decision Tree case study essay

· 
 Client’s blood pressure and pulse are recorded as 147/92 and 110 respectively. He also admits to experiencing butterflies in his chest. The client denies suicidal/homicidal ideation and is still future oriented

Decision Point Two

Decision Point Two

Continue with current medication but lower dose to 25 mg twice a day

RESULTS OF DECISION POINT TWO

· 
 Client returns to clinic in four weeks

· 
 Client comes to office today with use of crutches. He states that his current pain is a 7 out of 10. “I do not feel as good as I did last month.”

· 
 Client states that he is sleeping at night but woken frequently from pain down his right leg and into his foot

· 
 Client’s blood pressure and heart rate recorded today are 124/85 and 87 respectively. He denies any heart palpitations today

· 
Client denies suicidal/homicidal ideation but he is discouraged about the recent slip in his pain management and looks sad Caucasian Man With Hip Pain decision Tree case study essay

Decision Point Three

Change Savella to 25 mg orally in the MORNING and 50 mg orally at BEDTIME

Guidance to Student

The client has a complex neuropathic pain syndrome that may never respond to pain medication. Once that is understood, the next task is to explain to the client that pain level expectations need to realistic in nature and understand that he will always have some level of pain on a daily basis. The key is to manage it in a manner that allows him to continue his activities of daily living with as little discomfort as possible. Next, it is important to explain that medications are never the final answer but a part of a complex regimen that includes physical therapy, possible chiropractic care, heat and massage therapy, and medications. Savella is a SNRI that also possesses NMDA antagonist activity which helps in producing analgesia at the site of nerve endings. It is specifically marketed for fibromyalgia and has a place in therapy for this gentleman Caucasian Man With Hip Pain decision Tree case study essay. Tramadol is never a good option along with other opioid type analgesics. Agonists at the Mu receptors does not provide adequate pain control in these types of neuropathic pain syndromes and therefore is never a good idea. It also has addictive properties which can lead to secondary drug abuse. Reductions in Savella can help control side effects but at a cost of uncontrolled pain. It is always a good idea to start with dose reductions during parts of the day that pain is most under control. The addition of Celexa with Savella needs to be done cautiously. Both medications inhibit the reuptake of serotonin and can, therefore, lead to serotonin toxicity or serotonin syndrome. Caucasian Man With Hip Pain decision Tree case study essay

Ethical and Legal Implications of Prescribing Drugs Essay

Assignment Ethical and Legal Implications of Prescribing Drugs

2 – 3-page
paper
due on the ethical and legal implications of the scenario below:

“You see another nurse practitioner writing a prescription for her husband, who is not a patient of the nurse practitioner. The prescription is for a narcotic. You can’t decide whether or not to report the incident.”

• Explain the ethical and legal implications of the scenario you selected on all stakeholders involved, such as the prescriber, pharmacist, patient, and patient’s family. Ethical and Legal Implications of Prescribing Drugs
Essay
.

• Describe strategies to address disclosure and nondisclosure as identified in the scenario you selected. Be sure to reference laws specific to your state.

• Explain two strategies that you, as an advanced practice nurse, would use to guide your decision making in this scenario, including whether you would disclose your error. Be sure to justify your explanation.

•
Explain the process of writing prescriptions
, including strategies to minimize medication errors.

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References:

Drug Enforcement Administration. (n.d.-a). Code of federal regulations. Retrieved February 1, 2019, from https://www.deadiversion.usdoj.gov/21cfr/cfr/1300/1300_01.ht m

Institute for Safe Medication Practices. (2017). List of errorprone abbreviations, symbols, and dose designations. Retrieved from https://www.ismp.org/recommendations/errorprone-abbreviations-list •

Ladd, E., & Hoyt, A. (2016). Shedding light on nurse practitioner prescribing. The Journal for Nurse Practitioners, 12(3), 166–173. doi:10.1016/j.nurpra.2015.09.17

Rosenthal, L. D., & Burchum, J. R. (2018). Lehne’s pharmacotherapeutics for nurse practitioners and physician assistants. St. Louis, MO: Elsevier.

Sabatino, J. A., Pruchnicki, M. C., Sevin, A. M., Barker, E., Green, C. G., & Porter, K. (2017). Improving prescribing practices: A pharmacist‐led educational intervention for nurse practitioner students. Journal of the American Association of Nurse Practitioners, 29(5), 248–254. doi:10.1002/2327- 6924.12446 Ethical and Legal Implications of Prescribing Drugs Essay

 

Nurses have varying degrees of prescriptive authority over controlled substances, medications, medical services and medical devices. Ethical obligations also influence their prescriptions. Prescriptive regulations prevent medical errors which have become a major concern in the healthcare system. Approximately, over 250,000 deaths occurring in the United States annually are associated with medical errors. Moreover, the Centers for Disease Control and Prevention (CDC) ranked medical errors as the third top causes of death in 2016 after heart diseases and cancer (Sabatino et al., 2017). In order to understand the ethical and legal issues associated with prescription, this paper examines a case of prescription of a nurse to their husband who is not her patient. Ethical and Legal Implications of Prescribing Drugs Essay

Ethical and legal implications

The ethical and legal implications of this scenario include not documenting an evaluation of the patient as well as not reviewing their past medical history before prescribing. On the other hand, narcotics are controlled drugs whose prescriptions follow the Drug Enforcement Administration (DEA) procedure (DEA, n.d). As such, if the nurse is not authorized by DEA to prescribe controlled substances, she is definitely committing a legal crime. On the other hand, the nurse was not the patient’s nurse practitioner and did not consult before prescribing. Legally, prescribing should involve consultation and communication regarding the evaluation documentation and treatment and hence could cause medical errors Ethical and Legal Implications of Prescribing Drugs Essay. Prescribing controlled drugs such as narcotics to family members or friends risk prosecution for diverting controlled drugs or, at minimum, inappropriate prescribing of controlled drug (Ladd & Hoyt, 2016). Consequently, if the nurse uses the wrong prescription form, they can be accused of fraudulent activities.

Strategies to address disclosure and nondisclosure

Ethically, nurses are obligated to disclose information for informed decision-making of the patient. This supports the autonomy principle of ethics. Legally, the bill of rights advocates for full disclosure of medical errors (Ladd & Hoyt, 2016). In this case, the nurse should employ the ethical principles of beneficence, non-maleficence, justice and autonomy to disclose the situation to other medical workers and the patient. The two strategies that I would employ in this case include autonomy. Here, I would call the patient and explain the legal and ethical procedure involved in my case and acknowledge that it I committed an error that could cause him harm. I would also engage his nurse practitioner to explain the right procedure I should have employed and as well point out the possible implications. Furthermore, I would offer an apology for the medical error and offer to cover for the financial resources associated with the error. Ethical and Legal Implications of Prescribing Drugs Essay

Process of writing prescriptions

Following the process of writing prescriptions is important in eliminating medical errors. Prescriptions are written by qualified healthcare personnel. Notably, controlled substances are prescribed under specific conditions and by DEA certified nurses. The process of writing prescriptions involves filling and picking up prescriptive medications in a clear and legible manner. Prescriptions contain the name and address of the prescriber, the date of prescription, the name of the drug and its strength (Porter, 2017). A label of the administration instructions on the frequency and amount to be taken is also important.

In order to minimize medication errors, clear and complete information should be provided to the patients. The warnings, side effects and allergies should also be noted. The clarity of the prescription ensures that the pharmacist dispenses the correct drugs to patients. It is also essential for a prescriber of controlled drugs to be certified by DEA and follow the prescriptive guidelines provided to ensure safety and minimize the abuse of the drug. Ethical and Legal Implications of Prescribing Drugs Essay

References

Drug Enforcement Administration. (n.d.-a). Code of federal regulations. Retrieved February 1, 2019, from
https://www.deadiversion.usdoj.gov/21cfr/cfr/1300/1300_01.htm

Institute for Safe Medication Practices. (2017). List of errorprone abbreviations, symbols, and dose designations. Retrieved from
https://www.ismp.org/recommendations/errorprone-abbreviations-list

Ladd, E., & Hoyt, A. (2016). Shedding light on nurse practitioner prescribing. The Journal for Nurse Practitioners, 12(3), 166–173. doi:10.1016/j.nurpra.2015.09.17

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