Evaluate the outcomes for nursing care of older people

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Assignment – Medical / Nursing tutors only


AIM:
People aged 65 years and older constitute 50% of health service users. As people age, they experience changes to their physical and mental function, and can experience many social changes in terms of family and career. For those requiring health services, these changes are further complicated by illness (Moyle, et al., 2014).
The aim of this assignment is to apply the theoretical knowledge gained from modules 1 and 2 of this course to a case study that you have encountered in a Bachelor of Nursing clinical placement. Examples of case studies may include (but are not limited to) the range of prevalent conditions examined in module 1 and 2:
· Falls and fractures
· Incontinence
· Delirium
· Alzheimer’s Disease and other dementias.
TASK INSTRUCTIONS:
You will need to describe the issues in your case study, and then undertake a process of analysis in order to generate a comprehensive nursing plan of care. Practising this process of analysis will help you to feel more confident in providing nursing care to an older person in the clinical setting.
Your case study must:
1. Reflect upon the impact that various stereotypes of older people may have on the older person and their nursing care;
2. Recommend the nursing requirements for older people diagnosed with, or at risk of, complex health conditions and/or cognitive decline; and
3. Evaluate the outcomes for nursing care of older people.
For this task you need to prepare a 2500 word written assignment in a case study format. There are two parts to this assignment. Part 1 is a case study(750 words) and Part 2 is a plan of care for the person (1750 words).
Review these guides to writing a case study:
· Griffith University Guide to Writing a Case Study
· Monash University How to Write the Case Study
· QUT Writing a Case Study Response
Part 1 – Case Study (750 words)
· Introduce the purpose of the case study.
· Briefly outline the main problems as you recall and reflect on the care of an older person (over 65 years or over 55 years if Australia’s First Peoples) who has at least two (2) co-morbidities which impact on their functional status in an acute care (hospital) setting.
· Write a case study based on this experience. In the case study:
· describe the impact that specific stereotypes of older people may have on the person, and
· identify a specific, and recent environmental change impacting this older person.
Part 2 – Care Plan (1750 words)
· Develop a plan of care for the person. In your plan you must:
· Identify and justify the top five objectives for nursing care,
· Describe and justify evidenced-based nursing interventions to achieve each objective, and
· Create and describe the evaluation criteria that you will use to judge whether the plan addressed the identified objectives.
Throughout your care plan it must be clear how your decisions have been informed by a critical analysis of the case, applying concepts (stereotypes, nursing requirements, outcomes) raised in modules 1 and 2. No fewer than 10 different sources from the scholarly literature should be sourced. NOTE: It is important that you maintain confidentiality as per University guidelines and include no identifying demographic information about patients, colleagues or institutions.
Additional information:
· Ensure that you use scholarly literature[footnoteRef:1] (digitised readings, research articles, relevant Government reports and text books) that has been predominantly published within the last 5 years. [1: Scholarly or peer-reviewed journal articles are written by scholars or professionals who are experts in their fields, as opposed to literature such as magazine articles, which reflect the tastes of the general public and are often meant as entertainment.]
· Use academic language[footnoteRef:2] and health specific terminology throughout. [2: Everyday language is predominantly subjective. It is mainly used to express opinions based on personal preference or belief rather than evidence. Written academic English is formal. It avoids colloquialisms and slang, which may be subject to local and social variations. Formal language is more precise and stable, and therefore more suitable for the expression of complex ideas and the development of reasoned argumentation.]
· Refer to the marking guidelines when writing your assignment. This will assist you in calculating the weightings of the sections for your assignment.
· You may use headings to organise your work and use the first person in your writing.
· State your word count (excluding your reference list) on the Assignment Coversheet.
Assignment 1, Case Study, Marking Guidelines

CRITERIA POSSIBLE MARK
CRITERION ONE: Introduction
1. The introduction provides a clear outline of the aim and key points to be developed in the case study (5 marks); /5
CRITERION TWO: Case Study Response
· The effect of ‘older person’ stereotypes on the individual is critically analysed (5 marks);
· The 5 most important nursing requirements are justified using literature/evidence from nursing and ageing sources (5 marks);
· The proposed nursing interventions are evidence-based and justified in relation to the needs of the older person described in the case study (5 marks);
· The evaluation criteria are relevant to the situation in the case, measurable and timely (5 marks).		 /20
CRITERION THREE: Research and use of evidence
· The proposed nursing interventions are evidence-based (10 marks),
· No fewer than 10 different sources from the scholarly literature are sourced (5 marks).		 /15
CRITERION FOUR: Academic Writing
· The writing is clear, concise and free of APA (6th ed) errors.
· Word limits for assessment items are strictly adhered to.
· The case study is well presented, with correct spelling, grammar, and well-constructed sentence and paragraph structure.		 /5
CRITERION FIVE: Conclusion
· The evaluation criteria logically state whether the plan of care has addressed the identified objectives. /5
Total Marks
[ weighted at 50%]		 /50

1

sychosis and schizophrenia

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Discussion
I want this assignment asap -PLAGIARISM MUST BE LESS THAN 10%
Sychosis and schizophrenia greatly impact the brain’s normal processes, which interferes with the ability to think clearly. When symptoms of these disorders are uncontrolled, clients may struggle to function in daily life. However, clients often thrive when properly diagnosed and treated under the close supervision of a psychiatric mental health practitioner. For this Assignment, as you examine the client case study in this week’s Learning Resources, consider how you might assess and treat clients presenting with psychosis and schizophrenia.

Learning Objectives

Students will:
  • Assess client factors and history to develop personalized plans of antipsychotic therapy for clients
  • Analyze factors that influence pharmacokinetic and pharmacodynamic processes in clients requiring antipsychotic therapy
  • Evaluate efficacy of treatment plans
  • Analyze ethical and legal implications related to prescribing antipsychotic therapy to clients across the lifespan

 
To prepare for this Assignment:

  • Review this week’s Learning Resources. Consider how to assess and treat clients requiring anxiolytic therapy.

The Assignment
Examine Case Study: Pakistani Woman with Delusional Thought Processes. You will be asked to make three decisions concerning the medication to prescribe to this client. Be sure to consider factors that might impact the client’s pharmacokinetic and pharmacodynamic processes.
At each decision point stop to complete the following:

  • Decision #1
    • Which decision did you select?
    • Why did you select this decision? Support your response with evidence and references to the Learning Resources.
    • What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.
    • Explain any difference between what you expected to achieve with Decision #1 and the results of the decision. Why were they different?
  • Decision #2
    • Why did you select this decision? Support your response with evidence and references to the Learning Resources.
    • What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.
    • Explain any difference between what you expected to achieve with Decision #2 and the results of the decision. Why were they different?
  • Decision #3
    • Why did you select this decision? Support your response with evidence and references to the Learning Resources.
    • What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.
    • Explain any difference between what you expected to achieve with Decision #3 and the results of the decision. Why were they different?
  • SAMPLE  ONLY

 
NURS 6630
WEEK SEVEN
Case 2: Volume 2, Case #11: The figment of a man who looked upon the lady
Introduction
Briefly, this is a scenario of a 42 year- old woman with a complex psychiatric history extending from depression, posttraumatic stress disorder, insomnia, visual hallucinations (little man)and impaired behavior with aggression. In the course of more than 36 months, the client was treated with Paroxetine (SSRI), Bupropion ( NDRI), Tiagabine, Ramelteon and , but finally a combination of Lexapro, Bupropion and quetiapine was able to decrease her symptoms . The client’s medical history includes diabetes, hypertension, CAD, hyperlipidemia, COPD, OSA, GERD, Glaucoma, overweight and a remote history of substance abuse.
Related Professional Questions
Certain medications or supplements can cause symptoms of mental illness and also due to her extensive medical history and usage of multiple medications I would ask the following questions:
1. Do you take any over -the – counter, herbal supplements or remedies and I would check for interactions with current medication regimen?
2. When and how often do you use your albuterol inhaler ? Some of the side effects of albuterol include anxiety, nervousness, and insomnia ( Cunha, 2016)
Sleep Hygiene: Do you keep regular sleep schedule ? Do you drink caffeine beverages close to bedtime?
Patient History
The patient may not be a reliable source of information, particularly that she has a significant mental illness that affects her functioning, hence verifying her responses with her direct family members, and mental social workers to get clues to the underlying or precipitating causes of mental crisis. Also checking facility records from previous encounters, or any psychiatric hospitalizations would be useful.
Diagnostics Testing
1. Thyroid Stimulating Hormone (TSH). Based on recent evidence, the prevalence of depressive symptoms in hypothyroidism was nearly 50%, and clinical depression occurs in more than 40% of people suffering from hypothyroidism ( Bhagwat, 2017)
2. Electrocardiogram (ECG) The client has cardiovascular diseases ( HTN, CAD), with risks of cardio complications. In the setting of taking antidepressants and antipsychotics, baseline ECG and possibly every three to six months would be appropriate.  Several atypical antipsychotics including quetiapine (Seroquel) are known to cause prolongation of the QT interval, hypothesized to occur via direct inhibition of the cardiac delayed potassium rectifier channel, which extends the ventricular repolarization process (Zhai et al., 2017)
Differential Diagnoses
1. Posttraumatic Stress Disorder ( PTSD)_
2. Major Depressive Disorder  (MDD)
3. Insomnia Disorder.
Pharmacotherapy Options for Sleep/ Wake cycle
1. Zolpidem (Ambien) 5mg oral at bedtime for Seven days.
Zolpidem is nonbenzodiazepine hypnotic, it works by enhancing GABA inhibitory actions that provide sedative hypnotic effects more selectively than other actions of GABA (Stahl, 2017). With its side effects of sedation,  low dose prescribed as the client has respiratory problems (sleep apnea OSA)).  Studies have shown that Zolpidem did not significantly worsen OSA as measured by the numbers and duration of pauses in breathing during sleep, but in one trial, it significantly lowered minimum oxygen levels during the night when compared with placebo ( Mason & Smith, 2015).
2. Trazadone 25 mg oral at bedtime for Thirty days.
Trazadone is a serotonin 2 antagonist/reuptake inhibitor, used in management of depression and insomnia. It is absorbed well, metabolized by CYP 450 3A4 with average half life of 6hrs. It has less side sedative effects compared to zolpidem (Stahl, 2017)
The best choice for the client would be Trazadone as there is no reliable evidence of dependence or withdraws and it can also work for the client’s depression.
Conclusion
The case was a perfect example how it is sometimes difficult to find effective pharmacological treatments of psychiatric illnesses. In the course of four years, the client was prescribed 5-6 medications targeting different neurotransmitters to improve the symptoms. Client’s polypharmacy increased risks of drug-drug interactions, and her medical comorbidities increased risks of adverse reactions. Lesson learned from this study was  that treatment  should be optimally initiated after diagnosis, and augment or switching to a new agent must be carefully  done in consideration of possible  side effects and better outcomes.
References
Bhagwat, N., Tayde, P., Sharma, P., Sharma, B., Dalwadi, P., Sonawane, A., … Varthakavi, P. (2017). Hypothyroidism and depression: Are cytokines the link? Indian Journal of Endocrinology and Metabolism, 21(6), 886. Retrieved from https://web-b-ebscohost-com.ezp.waldenulibrary.org/ehost/pdfviewer/pdfviewer?vid=7&sid=aeb79c1d-68dc-40a4-bd10-f956796bc9e8%40sessionmgr101
Cunha, J. (2016). Common Side Effects of Ventolin HFA (Albuterol Sulfate Inhalation Aerosol) Drug Center – RxList. Retrieved from https://www.rxlist.com/ventolin-hfa-side-effects-drug-center.htm
Mason, M., & Smith, I. (2015). Effects of opioid, hypnotic and sedating medications on obstructive sleep apnoea (OSA) in adults with known OSA | Cochrane. Retrieved from http://www.cochrane.org/CD011090/AIRWAYS_effects-opioid-hypnotic-and-sedating-medications-obstructive-sleep-apnoea-osa-adults-known-osa
Zhai, D., Lang, Y., Dong, G., Liu, Y., Wang, X., Zhou, D., … Zhang, R. (2017). QTc interval lengthening in first-episode schizophrenia (FES) patients in the earliest stages of antipsychotic treatment. Schizophrenia Research, 179, 70-74. Retrieved from https://resolver-ebscohost-com.ezp.waldenulibrary.org/openurl?ID=pmid%3a27727006&genre=article&atitle=QTc+interval+lengthening+in+first-episode+schizophrenia+(FES)+patien

Marketing Segment and Perceptual Map

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Please respond to the following: “Marketing Segment and Perceptual Map”

  • Evaluate the value and utility afforded by Philip Kotler’s Segment-by-Segment Invasion Plan as a tool for mapping current and future market segment pursuits. Provide support for your rationale.
  • Assess the importance of a Perceptual Map for current and potential product offerings in the marketplace. Suggest one (1) way in which this instrument can be used by marketers to affect better product positioning outcomes within the health care industry.

Heart disease

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Discussion
Week 1 Project, you selected a particular health issue or health disease (for example, heart disease, cancer, or obesity) to act as a main theme or topic in this course. In each week of this course you completed assignments related to your selected health issue or health disease topic. Your assignments were supported by appropriate available data sources.
In this Project, you will assume the role of a public health educator presenting information about a health issue or health disease (preferably the topic that you have been discussing throughout the course).
Review your previous assignments, analyze your data and its findings, combine your information, and develop a 15–20 page research paper on your selected health issue or health disease that you studied throughout this course.
Using the readings for the week, the South University Online Library, and the Internet for research, select scholarly references to support your assertions. You have selected scholarly references for your previous assignments in this course. By now, you should have at least 7–10 scholarly references in support of your research paper.
Include the following components in your presentation:
Describe your program objectives and goals, the need, target audience, address the health problem, and any intervention strategies.
Introduce your planning strategies, implementation process, and research method. Explain, using scholarly information, why you have selected the research method and design.
Your research paper should include a developed budget plan and summary to justify your budget needs.
Include two public health models, explain the selected models, and conclude with pertinent information to address why these models are aligned with your public health evaluation program and evaluation processes.
Be sure to state major points clearly and support with specific details, examples, or analysis.
Support your statements by using scholarly literature and evidence-based information from at least 7 to 10 authoritative resources.
The CDC Self-Study Guide is an excellent resource tool to guide your work.
Submission Details:

  • Write a 15–20-page, double-spaced paper in Word format. Apply APA standards to citation of sources.
  • Use the following file naming convention: LastnameFirstInitial_W5_A2.doc.
  • Submit your document to the Submissions Area by the due date assigned

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