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  • choose a case or disorder and Create a Focused SOAP Note/case presentation of a

    choose a case or disorder and Create a Focused SOAP Note/case presentation of a child or Adolescent. Use the attached template.

    Week (enter week #): (Enter assignment title)
    Student Name
    College of Nursing-PMHNP, Walden University
    PRAC 6665: PMHNP Care Across the Lifespan I
    Faculty Name
    Assignment Due Date
    Subjective:
    CC (chief complaint):
    HPI:
    Substance Current Use:
    Medical History:
    · Current Medications:
    · Allergies:
    Reproductive Hx:
    ROS:
    · GENERAL:
    · HEENT:
    · SKIN:
    · CARDIOVASCULAR:
    · RESPIRATORY:
    · GASTROINTESTINAL:
    · GENITOURINARY:
    · NEUROLOGICAL:
    · MUSCULOSKELETAL:
    · HEMATOLOGIC:
    · LYMPHATICS:
    · ENDOCRINOLOGIC:
    Objective:
    Diagnostic results:
    Assessment:
    Mental Status Examination:
    Diagnostic Impression:
    PRIMARY DIAGNOSIS
    3 DIFFERENTIAL DIAGNOSIS
    Reflections:
    Case Formulation and Treatment Plan:

  • Assessment Role-Play Instructions Read the following scenario: Mr. Robert McCl

    Assessment Role-Play
    Instructions
    Read the following scenario:
    Mr. Robert McClelland, an 81-year-old man, is a new admission from the local hospital to your long-term care facility. After Mr. McClelland’s last bout with pneumonia and congestive heart failure, his wife of 59 years has decided she is no longer able to care for him alone. Mrs. McClelland states, “He has just gotten too weak and can’t help me care for him. I am so afraid he will fall and hurt himself. I am so worn out trying to care for him myself. I have to bathe him and remind him to eat; sometimes, I’ve had to feed him myself, or he won’t eat. He can be so forgetful.”
    Given this information, there are two options that Mrs. McClelland is considering.
    Hire an in-home nurse to care for her husband.
    Place her husband in a nursing home.
    Write 200–250 words arguing for the option you think will be best. Use the discussion prompts to guide the content for your initial post. Then, respond to at least two of your peers’ posts.
    Discussion Prompts
    You are Mr. McClelland’s nurse. You are tasked with providing the information for both assisted health care options. Based on your assessment of Mr. McClelland’s symptoms and his wife’s concerns, publish a response to help them make the best decision for their situation.
    Find at least one resource to support your argument. Be sure to use APA (7th ed.) when citing this resource.
    Additionally, share your opinion about which option you believe is the best for Mr. and Mrs. McClelland’s situation, and explain why.

  • Please fill out the rest of the article matrix. All of the categories are based

    Please fill out the rest of the article matrix. All of the categories are based on the articles on the left hand side of the paper. If you do not have full access to those articles (there are 10 of them), please let me know so that I can attach a pdf file for you. I did not want to swamp the instructions with 10+ articles and confuse the writer, I figured you would all have access to different databases. There are two files that I attached, one is the document to fill out, and another is the example of an article matrix with all of the instructions. I cannot have more than 5 pages, reference page and title page not included. Maximum of 5 pages, and no less than 9-font times new roman single spaced.
    Here are the tips for ranking:
    Level 4 can be cohort study, case-control study, or cross-sectional. If it is cohort & case-control, it likely says so in the article. If it is cross-sectional, it will use stats such as multiple regression, logistic regression, odds ratio, relative risk in an attempt to “predict” the relationship (correlation). Here are a couple more resources-
    https://www.ncbi.nlm.nih.gov/books/NBK481614/
    Links to an external site.

    Links to an external site.
    Level 5 is only for the systematic review of studies (meaning the article must report that they analyze more than one study whether they are quantitative or qualitative studies.
    Any SINGLE study (either quantitative or qualitative) is level 6.
    Excluding the reference pages, ensure that the matrix is no more than 5 pages (of no less than font 9 –Times New Roman, single-spaced).

  • You are treating a 15-year-old female client for an eating disorder. She reveal

    You are treating a 15-year-old female client for an eating disorder. She reveals that she is pregnant and does not want you to share this information with her parents. What do you tell her?
    Following the session, the client’s mother, who has been waiting in the lobby, asks how the session went. What do you say?

  • Julie has been the executive director of the Maternal-Newborn Service for 5 year

    Julie has been the executive director of the Maternal-Newborn Service for 5 years and reports to the chief nursing officer (CNO). The four other executive directors of service-lines include Tim, who is the executive director of Medical-Surgical Services; Janice, who is the executive director of Critical and Emergency Services; Fred, who is the executive director of Surgical Services; and Gabriella, who is the executive director of Rehabilitation and Outpatient Services. All of the executive directors with the exception of one are about the same age (mid-to late 30s or early 40s), educated at the master’s in nursing (MSN) level (except for Julie, who has a PhD in nursing leadership), and have significant clinical experience in their service-line areas. Janice is in her late 20s, has a master’s in business administration (MBA), and is also quite experienced in critical care services.
    The five executive directors work well together as a team, but do not respect the opinion, direction, and leadership of the CNO, who has been in her position for 30 years. The team perceives her to be out of date, although the physicians at the hospital are quite supportive of her. They often meet to determine ways they can work around her to accomplish their individual and collective goals. The CNO reports to the CEO, along with the chief financial officer (CFO) and the chief operations officer (COO). The CNO, CEO, CFO, and COO have all worked together for approximately 7 years. The rest of the executive team has little interaction with the executive directors, with the exception of the budget season when the executive directors work closely with the CFO and COO to develop and negotiate the budgets and approved number of full-time equivalents (FTEs) for each clinical area.
    One summer, Julie goes on vacation, and while away she receives a call from Gabriella, who informs her that huge changes have taken place. The president of the healthcare system has terminated the CEO and the CNO and has fired a new CEO. The new CEO was a CFO and COO in his previous employment, but has no experience as a CEO. He has a master’s degree in hospital administration.
    The reporting structure has also been changed. All of the executive directors, the CFO, and the COO will all now report directly to the new CEO. There will not be a designated CNO because all of the executive directors will fill that role. The new changes will take place immediately. The communication to the organization and the public indicates, “Changes were needed to position the organization for growth in current and future service-lines and expansion into new markets. The CEO and CNO have decided to pursue other career opportunities.”
    At first Julie is very impressed with the new CEO, who is young, enthusiastic, and very financially savvy. He meets with the executive team every Monday morning to review the previous week’s performance in each service-line and to share plans for the upcoming week, He meets with each of his direct reports once per month and reviews the budget, productivity, patient outcome indicators, and satisfaction levels of staff and physicians. Julie seems to appreciate the direct communication style of the new CEO.
    After a few months, Julie detects a change. As budget constraints become more apparent, the executive team is requested to tighten the belt. The proposed budget for the next year must be cut 10% across the board, and the capital budget requests become very competitive. Although Julie’s area has the greatest percentage of admission and discharges as compared to the other service areas, the reimbursement rates for her patients are significantly less than that of patient in her colleague’s service areas. Due to the way contracts have been negotiated for Medicaid and Medicare patients, Julie’s area actually loses money-the cost to provide the services for 48% of the patient is more than the reimbursement rate. When this issue is discussed week after week at the Monday report, Julie begins to see a change in the group dynamics among her colleagues. Janice is emerging as the most powerful of the executive directors, and her areas contribute the most of the hospital’s revenue picture. Janice often “hangs out” with the CEO and the two of them meet daily at the end of the day. The other executive directors notice the change as well, but no one feels it as much as Julie.
    Julie never knows what to expect from the CEO. At one meeting he can be very kind and supportive, but at the next meeting he can be accusatory, belittling, and angry that her area is losing money-not because of productivity, but because of the revenue levels. He demands that she decrease staffing levels to cut expenses, and Julie tries to explain that doing so would out the areas out of compliance with required nurse-to-patient ratios. This rationale is not received well, and more pressure is placed on Julie to reduce staffing expenses. The CEO wants her to change the staff mix, using fewer RNs and adding more nursing assistants to cut expenses. Some of the meetings are brutal, and Julie often leaves feeling “beaten: and humiliated.
    Julie is upset with the CEO, but after a few hours of reflective thinking after meetings with the CEO, she blames herself, thinking she should be more prepared, better able to articulate the area’s needs, and better able to manage the CEO’s aggressive nature. She dreads meetings with him, but then when the next meeting comes, he is either absolutely supportive and understanding or absolutely unsupportive and aggressive. She never knows what to expect. When she spoke with her colleagues about their relationship with the CEO, they all expressed that he was fine with them. She also met with the CFO to discuss her area’s revenue, expenses, and productivity levels. The CFO was helpful and explained that the biggest problem is the way the contracts have been negotiated and that the revenue level is not in Julie’s control. He indicated that the hospital decided to negotiate a low rate for maternity and newborn services in order to get a higher rate for critical care patients.
    The situation begins to escalate for Julie beyond the one-on-one meetings with the CEO. He begins to attack and belittle her in the Monday meetings in front of her peers, laugh at comments she makes on any subject, and makes a point of reminding her peer that Julie’s area is a revenue loser. At one meeting, the CEO distributed an article that he liked from the Harvard Business Review but did not give one to Julie. When she asked if he had another copy for her, he answered, “What, little Miss PhD, I assumed you’d already know all about this.” Her peers said nothing, but Julie noticed they simply hung their heads, except for Janice who was chuckling with her hand over her mouth.
    Julie, at wit’s end, finally confided to Gabriella that she was considering leaving the organization. She felt absolutely defeated and could never predict what to expect from the CEO. Gabriella listened carefully and then said, “Julie, don’t you see what is going on here? You are the classic abused woman. The CEO beats you up and you go away blaming yourself and promising to be better, He then feels guilty and treats you better the next time, but the cycle continues over and over. Now he is becoming more aggressive and humiliating to you in public. You have a choice. You can leave, but you will never see this issue to closure and it might affect your work in the future…of you can choose to break the cycle.”
    Question 1:
    Gabriella indicates that Julie is functioning in a way similar to “abused woman syndrome.” Considering the 10 principles discussed in this chapter (attached), what do you think are the dynamics among the executive directors and CEO in this case?
    Question 2:
    When working in such a dysfunctional relationship and organization, what do you think are Julie’s best options to heal herself and mange her professional career?
    Question 3:
    What leadership theory/theories is/are in use here?

  • How long have you taken each these medications? Do you know why you are tak

    How long have you taken each these medications?
    Do you know why you are taking these medications?
    Who told you about the medications and why you need to take them? Were you able to ask any questions about the medications and if so were they answered so you understood what was said?

  • Topic Over the course of EDCO 716 I spent a good deal of time wrestling with a

    Topic
    Over the course of EDCO 716 I spent a good deal of time wrestling with a few topic ideas that I had for my dissertation. The problem that I had, and maybe many of you have had the same problem, is that my topic ideas were much too broad in scope, and of course the fact that I had ideas instead of a single idea. One thing I knew for sure, as I mentioned in my introduction discussion board post, I wanted to focus on combat veterans that are facing mental health challenges, and more specifically I wanted to focus on the combat veterans living in my local area here in western New York. I want to give local veterans a voice, and EDCO 716 really helped me to narrow down how I can best do that. With the help of Dr. Packer-Williams, my professor in EDCO 716, I was able to narrow down my topic to the following: A phenomenological study of rural New York state veteran attitudes towards telemental health during the Covid-19 pandemic. The Covid-19 pandemic hit hard in New York state, but not everyone experienced the pandemic in the same way. It is my desire to see how the mental health care of rural western New York combat veterans has been impacted by the Covid-19 pandemic, and I want to explore that through the lived experiences of the veterans themselves.
    Research Gap
    There is a plethora of research available on the subject of virtual mental health care. Much of that research is dedicated to examining the effectiveness of virtual mental health care in comparison to in-person mental health care. Virtual approaches to mental health care were birthed out of necessity as the demand for mental health care surpassed the supply of mental health care providers (Batastini et al., 2021; Dindo et al., 2021). There is perhaps no greater gap in the supply of mental health care than what has been found in rural communities (Dindo et al., 2021) Additionally, virtual approaches to mental health care addressed some of the logistical barriers faced by care seekers such as long commutes to treatment centers, work schedules, and childcare arrangements (Dindo et al., 2021; Lindsay et al., 2022). The Covid-19 pandemic and all of the ensuing in-person restrictions put into place by various governmental agencies further increased the need and demand for virtual mental health care services (Moring et al., 2020). While there is a great deal of literature addressing the topic of virtual mental health in relationship to rural communities and the Covid-19 pandemic individually, I have not yet found research that address all three elements together with a focus on combat veterans, and therein is the first identified research gap. The second research I have identified at this point is that there has not been a study conducted relative to virtual mental health care and the perceptions of said care as expressed by combat veterans residing in rural western New York. I am certain that these findings will be refined as I continue digging into the literature relative to my topic.

    Research Design
    My research design is qualitative, and more specifically it is a phenomenological study which I believe is the best approach by which I can give a voice to local combat veterans facing mental health challenges. Giving a voice to individuals is best done through a phenomenological study as it explores the lived experiences of those that have navigated a given phenomenon (Groenewald, 2004; Neubauer, Witkop, & Varpio, 2019). Groenewald (2004) highlights purposive sampling as the most logical approach to selecting subjects when conducting a phenomenological study. This makes sense because, as Groenewald (2004) also notes, in a phenomenological study it should be the phenomena being studied that should more so inform if not drive the selection of study subjects. In the case of my dissertation, an exploration of the veteran attitudes towards telemental health during the Covid-19 pandemic, it only makes sense that only individuals that are veterans and have been receiving telemental health during the Covid-19 pandemic be included in the research pool. To best garner the lived experiences of the selected subjects my intent is to conduct one-on-one in-person interviews. When in-person interviews are not possible I would attempt to conduct interviews over the phone.
    Introduction requirements
    CHAPTER ONE: INTRODUCTION
    Overview
    The purpose of Chapter One is to provide a framework for the research. The chapter should create reader interest, provide a foundation for the problem that necessitates the research, overview the context of literature in which the research is founded, identify the importance of the research for a specific audience, and briefly introduce the research via the research question(s). The Overview must clearly and concisely describe the contents and organization of the chapter. Remember that this is just an overview. Chapter One may vary in length from 10-15 pages for the final dissertation. You will go into more depth in Chapter Two.
    Background
    The Background section contains a summary of the most relevant literature and provides the historical (i.e., how the problem has evolved over time), social (i.e., contexts), and theoretical (e.g., important variables, the theoretical concepts, and the principles underpinning the research) contexts for the research problem. Each of the three contexts must be specifically examined using APA Level 2 headings for each. You should be sure to link and relate the background of the study to the proposed research. Questions that may be asked or addressed in this section may include, but are not limited to: What is the problem and why is it an interest? Who else is affected by the problem? What research has been done to investigate or address the problem? How will the proposed research extend or refine the existing knowledge in the area under study? Who will benefit or use the proposed research? What new information does the current research add to the body of existing literature regarding the topic? The majority of literature cited in this section should be no more than ten years old.
    Situation to Self. This section provides an opportunity for you to articulate your motivation for conducting the study and identify the philosophical assumptions (ontological, epistemological, rhetorical, axiological) you bring to the research and the paradigm (positivism/post-positivism, constructivism, participatory, and pragmatism) that will guide the study. Keep in mind that qualitative research is written in the first person rather than third person voice.
    Problem Statement
    “A problem might be defined as the issue that exists in the literature, theory, or practice that leads to a need for the study” (Creswell, 1994, p. 50). A problem statement summarizes “the context for the study” and the main problem the researcher seeks to address (Wiersma, 1995, p. 404). It identifies the general problem, the specific problem, the focus of the research, and the population sample. The problem statement draws from the background section; it includes current (i.e., ten years or less since publication unless otherwise approved by your Chair) literature (three to five citations) to show that the proposed research is significant and relevant to the field. It should be stated clearly and unambiguously in one to two paragraphs. You should state: “The problem is….” In one to two focused paragraphs, convince the reader why the particular issue or problem your study is investigating needs to be done.
    • Introduce the general topic needing more research, including relevant/recent statistics on the issue.
    • Summarize the recent research on the topic.
    • Explain how/why the current research is deficient or falls short.
    • Conclude with a focused statement identifying the problem in relation to your research design.
    Purpose Statement
    The purpose statement should follow the problem statement and clearly and succinctly state the focus and intentions of the proposed research. “The purpose statement should provide a specific and accurate synopsis of the overall purpose of the study” (Locke, Spirduso, & Silverman, 1987, p. 5) and begin with the following statement: “The purpose of this study is . . .” It foreshadows the research question(s), and the statement must be used consistently throughout the dissertation. You are encouraged to use the following template adapted from Creswell (2013):
    The purpose of this _________ (phenomenological, grounded theory, ethnographic, case, historical) study is to _______________ (understand? describe? develop? discover?) the _____________ (central phenomenon of the study) for _____________ (the participants) at __________ (the site). At this stage in the research, ___________ (central phenomenon) will be generally defined as ________________ (a general definition of the central concept). The theory guiding this study is (identify theory and cite theorist) as it (explain the relationship between the theory and your focus of inquiry).
    Although brief in nature, the problem and purpose statements are two very important aspects of the manuscriipt. These statements support the importance of the study and identify the goal of the research. All preceding writing within the manuscriipt should funnel into the problem and purpose statements, and all proceeding aspects of the manuscriipt should align with, support, and further expand upon the problem and purpose statements.
    Significance of the Study
    The significance of the study section contains a descriiption of the contributions that the study makes to the knowledge base or discipline, both theoretically and empirically (i.e., How does it relate to other studies that are similar or that investigate the same issue?) This section also includes a brief descriiption of the practical significance of the study; why it is important to the location, organization, general population, or sample being studied (e.g., Why and how does it affect them? How will it improve the conditions, lives, work environment, etc.? How can this study be used on a wider scale to affect change to help a wider group of people or the organization as a whole?). References are very important here to lend additional credence and support the study. All assertions in this section need to be well supported by the literature. Citations are needed.
    Research Questions
    The proposed research question(s) should be derived from the problem and purpose statements. A well-written research question is feasible, clear, significant, and ethical. In qualitative studies, research questions are often philosophical or pragmatic in nature and ask about meaning, process, perceptions, or behavior. Qualitative research questions are usually broader and become more specific as you move into the actual data collection/analysis process. Identify at least three research questions. If one central research question is used, the subsequent questions are called sub-questions. Include a brief descriiption and discussion of each one before moving to the next question, using the literature (including citations) to support the focus of the question. Remember that each research question will need to be addressed in the data collection, data analysis, and discussion sections of later chapters. Be sure these questions do not elicit simple yes/no responses. Note that traditional research hypotheses are not necessary or appropriate for most qualitative studies.
    Definitions
    Terms pertinent to the study should be listed and defined as the final section of Chapter One. All definitions in this section also need to be supported by the literature. Include terms that use abbreviations. Citations are needed. Dictionary definitions are not acceptable. Example:
    1. Attitude – Attitude is a psychological tendency that involves evaluating a particular object with some degree of favor or disfavor (Eagly & Chaiken, 1993).
    2. Interest – The combination of emotion and personal valuation of a task resulting in a desire for various levels of enjoyment (Ainley & Ainley, 2011).
    3. Etc…
    Summary
    Provide a chapter summary here. The Summary includes a succinct restatement of the problem and purpose of the study and provides a strong conclusion to the chapter.

  • Similarly, nurse-scholars can build a personal brand to add visibility and credi

    Similarly, nurse-scholars can build a personal brand to add visibility and credibility to their work. You can begin building your brand by developing and maintaining an academic portfolio. Such an activity can help share the results of your efforts and contribute to your success. Discuss, consider and share the strategies for building your portfolio in your career as a nurse.

  • Describe features of major dissociative disorders. How common are these types of

    Describe features of major dissociative disorders. How common are these types of disorders? What is a host personality and subpersonalities? What types of relationships might subpersonalities have with one another? Are there recommended treatments for dissociative disorders?

  • Reply to a classmate post “How Racist Are You?” Jane Elliot’s racism awareness m

    Reply to a classmate post
    “How Racist Are You?”
    Jane Elliot’s racism awareness method reveals a lot about the dynamics of racism within society. First, the training reveals that most people do not acknowledge the racism that happens every day in society. The discriminated group in this experiment initially does not believe that racism exists (Bryanweb, 2019). They believe that discrimination occurs for every person and that racism is not special in any way. They, however, complain about their discrimination but refuse to accept that this happens every day in society. As the experiment continues, some people choose to walk out while others learn the dynamics of discrimination. I believe this truly reflects how society perceives racism. Those who are privileged do not realize the extent of discrimination. On the other hand, the study by Carter and Murphy (2015) explores these differing perception and add the claim that Whites of low socioeconomic status (SES) are more likely to perceive discrimination claims by minorities as legitimate compared to their high SES counterparts. This finding reveals the variability that exists regarding racism within racial groups.
    Additionally, many people do not see the imbalance of power that occurs in discrimination. When blue-eyed people complain that they get discriminated against, they fail to realize the fact that discriminated groups have different power dynamics. For example, some complain that they are discriminated against because of their weight. However, they can do something about their weight unlike their natural skin pigmentation and associated race. I believe the fact that people refuse to acknowledge the presence and effect of racism reveals that society still has a long way to go. There are several racist situations I have observed myself and done nothing about. This is because we often fail to acknowledge the depth of this racism and hence do nothing about it. I believe that the experiment forces people to experience discrimination and hence brings up discussion concerning the need to do something to eliminate racism.
    Reference
    Bryanweb (2019, August 30). How racist are you? with Jane Elliott (shorter version). YouTube.https://www.youtube.com/watch?v=MJ1BQQpdX2c&ab_channel=bryanweb