Telepsychiatric videoconferencing session

You are preparing to initiate a telepsychiatric videoconferencing session with Jarrett, a 16-year-old client who has recently been diagnosed with major depressive disorder, severe without psychotic features (F32.2)  following a suicide attempt. After a week of inpatient care, Jarrett returned home. He lives in a 2-bedroom apartment in a subsidized affordable housing development with his mother, stepfather, and two younger brothers. His father is currently not involved in his life. Due to the pandemic, he and his siblings are attending school virtually.

 

  1. Describe the ideal setting for your visit. What is or is not suitable to have in your workspace?
  2. How will you guide Jarrett in preparing his space for the session?
  3. How will you obtain consent? Who must consent to treatment?
  4. What additional requirements apply to adolescent telepsychiatry?
  5. How might you assess the impact of the social determinants of health on Jarrett’s treatment plan?
  6. How will you create a safety plan for Jarrett? Who should be involved in the plan?

Explore facilitating the autonomy of diverse older adults in health contexts

In order to explore facilitating the autonomy of diverse older adults in health contexts, we are invited to choose a diverse ageing population (E.g. First Nations People, LGBTIQA+, Refugees……) and make a presentation investigating healthy ageing in this specific population.

This presentation should include structures and supports* available to this population which may be local, state or national initiatives. These structures and supports are to be based in the Australian context.

The presentation must address all the following points:

•            What are the unique challenges faced by this specific diverse population, and how might these be relevant to people’s health as they age (cultural, spiritual, psychological, social and physiological health)?

•            What is the importance of the ageing person’s role in determining their own life and health context?

•            What services and initiatives (not for profit, NGO, government, private, other) are in place to address the challenges that might be experienced by this specific diverse ageing population?

•            How can nurses advocate for older consumers to ensure they have choice in relation to these services/initiatives?

Practicum goals of preventing spray of infection

Discuss the overall clinical/practicum goals of preventing spray of infection. Provide specific examples of how the purposes of preventing disease and the characteristics of the clinical/practicum setting align with ANA Public Health Nursing Standards.

Gastric tumors Irritation of ulcers

Most malignant colorectal carcinomas develop from Metastatic cells from gastric tumors Irritation of ulcers in the colon Adenomatous intestinal polyps Lesions caused by bacterial infections

Taking the role of a CHN nurse doing a community assessment on the LGBTQ community

Taking the role of a CHN nurse doing a community assessment on the LGBTQ community, please answer these questions (Please use references and specify where you used the references[use in-text citations if you feel like it makes this faster]):

  1. How do you intend to address the health need of your population? (ie. What is your plan? Write what your plan is in one to two sentences.)
  2. What resources will you need (personnel, equipment, money, etc.)?

Comprehensive pediatrics clinic

Jane brings her four-year-old named Tim to a comprehensive pediatrics clinic in order to assess his health status. Jane reports that Tim is very curious and smart and gets along socially with other children. Jane says that Tim’s preschool teacher suggested she take him to the doctor for a health screening because she has noticed his stools looking oily when he uses the bathroom.

Patient History:
Tim’s mother Jane is a former drug user and has no family in the area. For these reasons, along with the socioeconomic status of his household (below the poverty line), Tim had a difficult first few years of life. However, recently his mom got help from social services and has been drug-free for six months. They are living in a new rental home and Tim is adjusting well to his new living situation but is still struggling at school. He recently had several accidents and so they temporarily put him in pull-up diapers. He has also shown to be hesitant in engaging in physical activity and seems more tired and exhausted than a typical four-year-old should be.

Measurements & Vital Signs :

  • Age: 4.5 yrs
  • Height: 3 ft. 7 inch
  • Weight: 32 lbs.
  • Pulse: 108 bpm
  • Respiratory Rate: 30 breaths/min
  • Temperature: 99.1 degrees F
  • Blood pressure: 100/55 mmHg

Physical Exam:

  • General appearance: Good-natured, active, secure
  • Ear, Nose & Throat: Runny nose. Ears do not show sign of infection
  • Abdominal: Normal; no pain reported upon touching
  • Neuro: Normal
  • Respiratory: Cracking/wheezing sounds; slight cough
  • Cardio: Normal Nails:
  • Nails: normal in color but nail beds are slightly curved

1. Objective: This is the diagnosis of the patient – find the diagnosis listed as the admission diagnosis if the discharge diagnosis different from the admission diagnosis write both here.

2. Plan: what plan does the patient have include referrals, medications etc…

3. Assessment: all labs, test and any procedure done to make an assessment for the diagnosis

4. Subjective: This is everything that the patient describes (you may also want to research to see what other symptoms patient may have had for the dia

Promoting effective change in a healthcare environment

Whatever is good and perfect is a gift coming down to us from God our Father, who created all the lights in the heavens. He never changes or casts a shifting shadow. James 1:17 (New Living Translation)

  1. Consider the Scripture Application: How can this passage of scripture assist the nurse leader in promoting effective change in a healthcare environment that is constantly changing?

Description of postulated pathophysiologic mechanisms of the disorder

Compare/contrast Anorexia Nervosa and Bulimia Nervosa in terms of the following parameters:

  • Age-appropriate, culturally responsive, comprehensive assessment.
  • Description of postulated pathophysiologic mechanisms of the disorder- these should be linked to common symptoms observed in clients who present with this illness.
  • What behaviors on the part of the client (with either condition) would lead you to believe that they may be experiencing a psychiatric emergency?
  • Develop a general treatment plan for either disorder- what evidence-based psychotherapies would you plan to include? What evidence-based psychopharmacologic approaches (if any) would be appropriate?
  • Discuss any legal/ethical issues inherent in the care of the individual with either condition (Anorexia Nervosa or Bulimia Nervosa).
  • How would you know if the care of this client (either in an acute episode or chronic care) exceeded your clinical competence? How would you proceed with the client’s care in this case?
  • What other professionals would you consider including in the care/treatment of this client, and why?

The psychotherapy modalities

If you had the time and resources to be fully trained in one of the psychotherapy modalities discussed this semester, which modality would you choose and why? How would you integrate this modality into your future practice

Obtaining the vital signs of a newborn

  • A nurse is caring for a client with hemiplegia after an ischemic stroke. Provide three (3) teaching points to discuss to maintain overall mobility and strength.
  • 2. The nurse is obtaining the vital signs of a newborn infant. Identify the normal ranges for newborn vital signs and the nursing considerations when obtaining the vital signs of a newborn.

3.  A nurse is caring for a client who underwent hip arthroplasty. What are labs the nurse should monitor during the first 48 hours post-operative phase?

4.  A nurse is caring for a client who is receiving chemotherapy. The client’s absolute neutrophil count (ANC) is less than 1,000/mm3. What precautions should the nurse institute?

5.  A nurse is preparing a newborn for discharge that is diagnosed with hemophilia.  List three (3) teaching points the nurse should discuss with the family of the infant to prevent complications related to hemophilia.