[ANSWERED 2023] Conduct research on approaches to risk management processes, policies, and concerns in your current or anticipated professional arena to find an example of a risk management plan
Conduct research on approaches to risk management processes, policies, and concerns in The purpose of this assignment is to analyze a health care risk management program. The concepts in this assignment will be expanded on in the Topic 2 assignment and the Topic 3 benchmark assignment. Conduct research on approaches to risk management processes, policies, and concerns in your current or anticipated professional arena to find an example of a risk management plan. Look for a plan with sufficient content to be able to complete this assignment successfully. In a 1,000‐1,250-word paper, provide an analysis of the risk management plan that includes the following: Description of the health care organization to which the plan applies and the role risk management plays in that setting. Summary of the type of risk management plan you selected (new employee, specific audience, community‐focused, etc.) and your rationale for selecting that example. Description of the standard administrative steps and processes in a typical health care organization’s risk management program compared to the administrative steps and processes you identify in your selected example plan. (Note: For standard risk management policies and procedures, look up the Medicare Improvement for Patients and Provider Act (MIPPA)-approved accrediting body that regulates the risk management standards in your chosen health care sector, and consider federal, state, and local statutes as well.) Evaluation of your selected risk management plan’s compliance with the standards of its corresponding MIPPA-approved accrediting body relevant to privacy, health care worker safety, and patient safety. Analysis of the key agencies and organizations that regulate the administration of safe health care in your current or future area of concentration and an evaluation of the roles each one plays in the risk management oversight process. Proposed recommendations or changes you would implement in your risk management program example to enhance, improve, or secure the compliance standards. Proposed recommendation or changes you would implement to build and support a culture of compassion and concern for patients and health care employee safety. Base your response on the Christian worldview principle that work within the public arena should be performed with compassion, justice, and concern for the common good. In addition to your textbook and the GCU “Statement on the Integration of Faith and Work,” you are required to support your analysis with at least three credible health-related resources. Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion. You are required to submit this assignment to LopesWrite. A link to the LopesWrite technical support articles is located in Class Resources if you need assistance. Benchmark Information This benchmark assignment assesses the following programmatic competency: BS Health Sciences 3.2 Discuss compliance with risk management protocol. Expert Answer and Explanation Risk Management Program Analysis Managing risks is a vital part of how healthcare works, ensuring that everyone involved benefits. Having effective criteria for risk management is crucial for the organization to achieve its goals and other important aspects, contributing significantly to its success. In essence, risk management involves evaluating risks and finding solutions to reduce these risks (Hick et al., 2020). Properly communicating about these risks is also a key part of a risk management plan. Nurses Service Organization (NSO) and Healthcare Providers Service Organization (HPSO) can provide valuable insights for developing effective management programs. Description of the Healthcare Organization The plan for managing risks serves as a useful tool for putting the overall risk management program into action within both inpatient and outpatient healthcare organizations. This program provides essential structure and guidelines applicable to the organization’s clinical and business services. Its aim is to enhance the quality of patient care while ensuring a safe working environment for the staff (Johnson et al., 2020). Following the principles of the risk management plan, the emphasis is on providing a simultaneous, thorough, and organized approach to decrease instances of risk for all involved parties. Activities within risk management encompass identifying, analyzing, investigating, and evaluating risks to assess the effectiveness of implemented changes (Johnson et al., 2020). These steps are then followed by choosing and applying the most suitable method to effectively address, manage, reduce, eliminate, or transfer issues related to unintentional injuries in the healthcare setting. Summary of Selected Risk Management Plan The primary aim of the chosen risk management program is to safeguard nursing staff, patients, and healthcare visitors from unintentional injuries. Additionally, the program is designed to protect the intangible and financial assets of the organization, including its standing in the community and reputation. Unintentional injuries, a significant form of healthcare-acquired illness, affect a considerable number of individuals in the healthcare sector (Hick et al., 2020). Hospital-acquired infections or illnesses impose unnecessary financial strain on the hospital and consume resources that could otherwise be used for the treatment and care of deserving patients. In the hospital setting, various inadvertent injuries such as patient falls, late diagnosis, and misdiagnosis pose risks to patients. The identified risk management program provides an analysis of the authorities involved and the roles that the risk manager plays in ensuring the program’s effectiveness. The organization appoints and empowers the risk manager to guarantee the program’s effectiveness and align the final outcomes with the projected goals (Hick et al., 2020). The program includes a governing body with roles and responsibilities that can be communicated verbally or through a written transcript. The risk manager is responsible for creating, implementing, and evaluating the program’s effectiveness, following set standards for quality, infection control, and patient safety management. Standard Administrative Steps and processes In a standard healthcare organization, the established administrative procedures follow a specific intervention model before resolution or elimination. The medical facility, which provides healthcare services, employs staff, including nurses and physicians, who interact with patients. These staff members adhere to company policies that define acceptable and unacceptable practices (Tuck & Hough, 2017). The staff and affected patients or interested parties are the
Assignment Evidence-Based Project, Part 5: Recommending an Evidence-Based Practice Change
Assignment Evidence-Based Project, Part 5: Recommending an Evidence-Based Practice Change The collection of evidence is an activity that occurs with an endgame in mind. For example, law enforcement professionals collect evidence to support a decision to charge those accused of criminal activity. Similarly, evidence-based healthcare practitioners collect evidence to support decisions in pursuit of specific healthcare outcomes. In this Assignment, you will identify an issue or opportunity for change within your healthcare organization and propose an idea for a change in practice supported by an EBP approach. To Prepare: Reflect on the four peer-reviewed articles you critically appraised in Module 4, related to your clinical topic of interest and PICOT. Reflect on your current healthcare organization and think about potential opportunities for evidence-based change, using your topic of interest and PICOT as the basis for your reflection. Consider the best method of disseminating the results of your presentation to an audience. Create an 8- to 9-slide PowerPoint presentation in which you do the following: Briefly describe your healthcare organization, including its culture and readiness for change. (You may opt to keep various elements of this anonymous, such as your company name.) Describe the current problem or opportunity for change. Include in this description the circumstances surrounding the need for change, the scope of the issue, the stakeholders involved, and the risks associated with change implementation in general. Propose an evidence-based idea for a change in practice using an EBP approach to decision making. Note that you may find further research needs to be conducted if sufficient evidence is not discovered. Describe your plan for knowledge transfer of this change, including knowledge creation, dissemination, and organizational adoption and implementation. Describe the measurable outcomes you hope to achieve with the implementation of this evidence-based change. Be sure to provide APA citations of the supporting evidence-based peer-reviewed articles you selected to support your thinking. Add a lessons learned section that includes the following: A summary of the critical appraisal of the peer-reviewed articles you previously submitted An explanation about what you learned from completing the evaluation table (1 slide) An explanation about what you learned from completing the levels of evidence table (1 slide) An explanation about what you learned from completing the outcomes synthesis table (1 slide) Expert Answer and Explanation I am currently working in a nursing and rehabilitation center, which mainly deals with patients with diverse needs. Our main task is to ensure that patients receive safe and quality care that will assist them regain independence and functionality like they were before their illness. The current organizational culture is unsupportive of the change with poor leadership, lack of accountability, and laxity by staff being some of the factors contributing to this culture. Currently the organization is having high number of cases of falls and other safety issues, which has drastically affected the facility’s rating, patient outcomes and to some extent even work satisfaction of the employees working within the facility. This problem can be attributed to lack of urgency shown by the staff when answering call-lights and alarms Scope: The issue mainly affects patients under admission, where at times they require help from the nurses but laxity of the nurses to respond to call lights and alarms, delay the help they require, which in most instances lead to adverse outcomes, like patient falls. The issue also mainly revolves around nursing unit, who are supposed to be at the forefront in responding to alarms and call lights. The change needed should therefore target at improving the response of nurses in tending to the sensory alarms and call lights to improve patient outcomes. The stakeholders involved in the change include the following; The organization leadership – The organization leadership should show interest in the change given the impact of the issue on the performance of the organization. In support of the change, they should allocate the necessary resources needed to implement the change, and also be at the forefront in leading the change. Another stakeholder are the nurses, nurse practitioners and physicians who are in charge of delivering care to patients. They are supposed to actively participate in resolving the issue with the aim of improving patient outcomes. Technicians will also be among the stakeholders involved. Their role will be to ensure that the monitoring systems are properly functional to avoid false positives and false negatives which end up causing alarm fatigue and laxity by nurses to respond (Baker & Rodger, 2020). Quality assurance team should also be part of the initiative, with their role being to provide oversight on whether the change is meeting the intended quality- related outcomes The patients are also key stakeholders involved given that impact of the change in their outcomes. Some of the risks attached to implementing the proposed change include change resistance from nurses which will affect the success of the project. The other risk is increased nurse workload from what is currently is due to the requirement to increase their level of responses to sensory alarms and call lights. As it currently is, the nurses and other care providers have a lax attitude to respond to call lights and sensory alarms. One of the main causes of laxity to respond to sensory alarms and call lights by nurses can be attributed to alarm fatigue (Baker & Rodger, 2020). Studies have indicated that sensory alarms fatigue is caused by faulty monitoring systems, inadequate training on how to respond to the sensory alarms and organizational factors including poor culture and leadership (Bach et al. , 2018). Therefore the evidence based change that is suggested is to train nurses and introduce an online monitoring system that will reduce the number of false alarms, in turn improving response times and reducing alarm fatigue. The suggested intervention is linked with various studies as being effective including studies by Bach et al. (2018) and Ruskin and Hueske-Kraus (2015). To facilitate knowledge transfer for the change the following plan will be used. The first step is knowledge creation which will entail collection of evidence on good practices which can assist to improve nurse response times to sensory alarms. Knowledge will be created by collecting evidence on the current practice and its impact on patient outcomes and comparing it with best practices, through which the change
[ANSWERED 2023] Patient AO has a history of obesity and has recently gained 9 pounds. The patient has been
Patient AO has a history of obesity and has recently gained 9 pounds. The patient has been For Week 2, you will examine how patient factors may influence pharmacokinetic and pharmacodynamic processes of pharmacotherapeutics used in the treatment of cardiovascular disorders. You also explore ways to improve drug therapy plans for cardiovascular disorders based on patient factors and overall health needs. When writing your Week 2 Assignment, consider the following scenario: Patient AO has a history of obesity and has recently gained 9 pounds. The patient has been diagnosed with hypertension and hyperlipidemia. Drugs currently prescribed include the following: Atenolol 12.5 mg daily Doxazosin 8 mg daily Hydralazine 10 mg qid Sertraline 25 mg daily Simvastatin 80 mg daily Evidence-based clinical practice guidelines are fundamental to clinical practice, as they assist providers with clinical decision making. I have attached some applicable guidelines below for your reference. I would strongly suggest you review the applicable guidelines prior to making treatment recommendations for the case study. 2014 Evidence-Based Guideline for Mgmt of HTN in Adults_JNC8.pdf 2017 ACC-AHA Guideline Mgmt HTN in Adults.pdf 2018 AHA-ACC Guideline on Mgmt Blood Cholesterol.pdf 2017 ACC-AHA-HFSA Guideline Mgmt HF.pdf ASH 2018 Guidelines Mgmt of VTE_Optimal Anticoag.pdf 2019 AHA-ACC-HRS Guideline for Mgmt A Fib.pdf 2017 AHA-ACC Guideline Mgmt Valvular Heart Disease.pdf Week 2: Cardiovascular System Alterations of the cardiovascular system can cause serious adverse events and may lead to death when not treated in a timely and safe manner. Unfortunately, many patients with cardiovascular disorders are unaware until complications appear. In clinical settings, patients often present with symptoms of several cardiovascular disorders, making it essential for you, as the advanced practice nurse, to be able to recognize these symptoms and recommend appropriate drug treatment options. This week, you examine the impact of patient factors that may lead to changes in pharmacokinetic and pharmacodynamic processes on patient drug therapy for cardiovascular disorders. You also explore ways to improve drug therapy plans for cardiovascular disorders based on patient factors and overall health needs. Learning Objectives Students will: Analyze the influence of patient factors on pharmacokinetic and pharmacodynamic processes Analyze the impact of changes in pharmacokinetic and pharmacodynamic processes on patient drug therapies Evaluate drug therapy plans for cardiovascular disorders Assignment: Pharmacotherapy for Cardiovascular Disorders …heart disease remains the No. 1 killer in America; nearly half of all Americans have high blood pressure, high cholesterol, or smoke—some of the leading risk factors for heart disease… —Murphy et al., 2018 Despite the high mortality rates associated with cardiovascular disorders, improved treatment options do exist that can help address those risk factors that afflict the majority of the population today. As an advanced practice nurse, it is your responsibility to recommend appropriate treatment options for patients with cardiovascular disorders. To ensure the safety and effectiveness of drug therapy, advanced practice nurses must consider aspects that might influence pharmacokinetic and pharmacodynamic processes such as medical history, other drugs currently prescribed, and individual patient factors. Reference: Murphy, S. L., Xu, J., Kochanek, K. D., & Arias, E. (2018). Mortality in the United States, 2017. Retrieved from https://www.cdc.gov/nchs/products/databriefs/db328.htm To Prepare Review the Resources for this module and consider the impact of potential pharmacotherapeutics for cardiovascular disorders introduced in the media piece. Review the case study assigned by your Instructor for this Assignment. Select one the following factors: genetics, gender, ethnicity, age, or behavior factors. Reflect on how the factor you selected might influence the patient’s pharmacokinetic and pharmacodynamic processes. Consider how changes in the pharmacokinetic and pharmacodynamic processes might impact the patient’s recommended drug therapy. Think about how you might improve the patient’s drug therapy plan based on the pharmacokinetic and pharmacodynamic changes. Reflect on whether you would modify the current drug treatment or provide an alternative treatment option for the patient. By Day 7 of Week 2 Write a 2- to 3-page paper that addresses the following: Explain how the factor you selected might influence the pharmacokinetic and pharmacodynamic processes in the patient from the case study you were assigned. Describe how changes in the processes might impact the patient’s recommended drug therapy. Be specific and provide examples. Explain how you might improve the patient’s drug therapy plan and explain why you would make these recommended improvements. Grading Rubric Explain how the factor you selected might influence the pharmacokinetic and pharmacodynamic processes in the patient from the case study you were assigned.–Levels of Achievement: Excellent 23 (23%) – 25 (25%) The response accurately and completely explains in detail how the factor selected might influence the pharmacokinetic and pharmacodynamic processes in the patient. Good 20 (20%) – 22 (22%) The response provides a basic explanation of how the factor selected might influence the pharmacokinetic and pharmacodynamic processes in the patient. Fair 18 (18%) – 19 (19%) The response inaccurately or vaguely explains how the factor selected might influence the pharmacokinetic and pharmacodynamic processes in the patient. Poor 0 (0%) – 17 (17%) The response inaccurately and vaguely explains how the factor selected might influence the pharmacokinetic and pharmacodynamic processes in the patient, or is missing. Feedback: Describe how changes in the processes might impact the patient‘s recommended drug therapy. Be specific and provide examples.–Levels of Achievement: Excellent 27 (27%) – 30 (30%) The response accurately and completely describes in detail how changes in the processes might impact the patient‘s recommended drug therapy. Accurate, complete, and aligned examples are provided to support the response. Good 24 (24%) – 26 (26%) The response accurately describes how changes in the processes might impact the patient‘s recommended drug therapy. Accurate examples may be provided to support the response. Fair 21 (21%) – 23 (23%) The response inaccurately or vaguely describes how changes in the processes might impact the patient‘s recommended drug therapy. Inaccurate or vague examples are provided to support the response. Poor 0 (0%) – 20 (20%) The response inaccurately and vaguely describes how changes in the processes might impact the patient‘s recommended drug therapy, or is missing. Inaccurate and vague examples may be provided to support the response, or is missing. Feedback: Explain how you might improve the patient‘s drug therapy plan,
[ANSWERED 2022] A 46-year-old female reports pain in both of her ankles, but she is more concerned about her right ankle. She was playing soccer over the weekend and heard a “pop.” She is able to bear weight, but it is uncomfortable
A 46-year-old female reports pain in both of her ankles, but she is more concerned about her right ankle. She was playing soccer over the weekend and heard a “pop.” The body is constantly sending signals about its health. One of the most easily recognized signals is pain. Musculoskeletal conditions comprise one of the leading causes of severe long-term pain in patients. The musculoskeletal system is an elaborate system of interconnected levers that provides the body with support and mobility. Because of the interconnectedness of the musculoskeletal system, identifying the causes of pain can be challenging. Accurately interpreting the cause of musculoskeletal pain requires an assessment process informed by patient history and physical exams. In this Discussion, you will consider case studies that describe abnormal findings in patients seen in a clinical setting. To prepare: Your Discussion post should be in the Episodic/Focused SOAP Note format rather than the traditional narrative style Discussion posting format. Refer to Chapter 2 of the Sullivan text and the Episodic/Focused SOAP Template in the Week 5 Learning Resources for guidance. Remember that all Episodic/Focused SOAP notes have specific data included in every patient case. Review the following case study: Case 1: Back Pain A 42-year-old male reports pain in his lower back for the past month. The pain sometimes radiates to his left leg. In determining the cause of the back pain, based on your knowledge of anatomy, what nerve roots might be involved? How would you test for each of them? What other symptoms need to be explored? What are your differential diagnoses for acute low back pain? Consider the possible origins using the Agency for Healthcare Research and Quality (AHRQ) guidelines as a framework. What physical examination will you perform? What special maneuvers will you perform? Case 2: Ankle Pain A 46-year-old female reports pain in both of her ankles, but she is more concerned about her right ankle. She was playing soccer over the weekend and heard a “pop.” She is able to bear weight, but it is uncomfortable. In determining the cause of the ankle pain, based on your knowledge of anatomy, what foot structures are likely involved? What other symptoms need to be explored? What are your differential diagnoses for ankle pain? What physical examination will you perform? What special maneuvers will you perform? Should you apply the Ottawa ankle rules to determine if you need additional testing? Case 3: Knee Pain A 15-year-old male reports dull pain in both knees. Sometimes one or both knees click, and the patient describes a catching sensation under the patella. In determining the causes of the knee pain, what additional history do you need? What categories can you use to differentiate knee pain? What are your specific differential diagnoses for knee pain? What physical examination will you perform? What anatomic structures are you assessing as part of the physical examination? What special maneuvers will you perform? With regard to the case study you were assigned: Review this week’s Learning Resources, and consider the insights they provide about the case study. Consider what history would be necessary to collect from the patient in the case study you were assigned. Consider what physical exams and diagnostic tests would be appropriate to gather more information about the patient’s condition. How would the results be used to make a diagnosis? Identify at least five possible conditions that may be considered in a differential diagnosis for the patient. Post an episodic/focused note about the patient in the case study to which you were assigned using the episodic/focused note template provided in the Week 5 resources. Provide evidence from the literature to support diagnostic tests that would be appropriate for each case. List five different possible conditions for the patient’s differential diagnosis, and justify why you selected each. Rubric Detail Excellent Good Fair Poor Main Posting 45 (45%) – 50 (50%) “Answers all parts of the Discussion question(s) with reflective critical analysis and synthesis of knowledge gained from the course readings for the module and current credible sources. Supported by at least three current, credible sources. Written clearly and concisely with no grammatical or spelling errors and fully adheres to current APA manual writing rules and style. 40 (40%) – 44 (44%) “Responds to the Discussion question(s) and is reflective with critical analysis and synthesis of knowledge gained from the course readings for the module. At least 75% of post has exceptional depth and breadth. Supported by at least three credible sources. Written clearly and concisely with one or no grammatical or spelling errors and fully adheres to current APA manual writing rules and style. 35 (35%) – 39 (39%) “Responds to some of the Discussion question(s). One or two criteria are not addressed or are superficially addressed. Is somewhat lacking reflection and critical analysis and synthesis. Somewhat represents knowledge gained from the course readings for the module. Post is cited with two credible sources. Written somewhat concisely; may contain more than two spelling or grammatical errors. Contains some APA formatting errors. 0 (0%) – 34 (34%) “Does not respond to the Discussion question(s) adequately. Lacks depth or superficially addresses criteria. Lacks reflection and critical analysis and synthesis. Does not represent knowledge gained from the course readings for the module. Contains only one or no credible sources. Not written clearly or concisely. Contains more than two spelling or grammatical errors. Does not adhere to current APA manual writing rules and style. Main Post: Timeliness 10 (10%) – 10 (10%) Posts main post by Day 3. 0 (0%) – 0 (0%) N/A 0 (0%) – 0 (0%) N/A 0 (0%) – 0 (0%) Does not post main post by Day 3. First Response 17 (17%) – 18 (18%) “Response exhibits synthesis, critical thinking, and application to practice settings. Provides clear, concise opinions and ideas that are supported by at least two scholarly sources. Demonstrates synthesis and understanding of Learning Objectives. Communication is professional and respectful to colleagues. Responses to faculty questions are fully answered, if posed. Response is effectively written in standard, edited English. 15 (15%) – 16 (16%) “Response exhibits critical thinking and application to practice settings. Communication is professional and respectful to colleagues. Responses to faculty questions are answered, if
[ANSWERED 2023] ML is a 54 yo Hispanic female with hx of chronic shoulder and back pain that began 10 years ago when she was in a boating accident.
ML is a 54 yo Hispanic female with hx of chronic shoulder and back pain that began 10 You are a new FNP in a restricted state and have your DEA license, and state furnishing for schedule II-V controlled substances. You are working at a busy family practice group, and you have a patient, ML, that is establishing care for the first time with your practice and comes to you with the following scenario: ML is a 54 yo Hispanic female with hx of chronic shoulder and back pain that began 10 years ago when she was in a boating accident. She lives in both US and Mexico, making regular visits across the border. Lately, she has stayed in the US due to Covid border crossing constraints, living with her daughter’s family. She had rotator cuff surgery in 2011 and reports to you that due to a long operation and poor positioning, she has suffered from not only pain, but also chronic numbness and tingling in her R shoulder. As “la abuela” (grandma), she is the primary caregiver of the children and homemaker for her family. Her pain is exacerbated with housework, and especially with the prolonged carrying of her grandchildren; one of which is 10 m.o. Currently, her med list is as follows Losartan 50 mg BID for HTN Gabapentin 300 mg po BID for pain Atorvastatin 40 mg daily for cholesterol Diazepam 5 mg po up to TID prn pain Norco 5/325 mg – takes up to two, sometimes up to 4-5x a day, prn pain She is a smoker, only smokes outside the house, and drinks 2-3 cans of beer on the weekends, but more on family celebrations. She denies recreational drugs and denies past overdoses. She has recently moved to CA more permanently to stay to take care of children during Covid/school closures. She asks you to refill all her meds for 6 months, like her doctor in Mexico did, so she doesn’t have to make another co-pay and come back and see you so often. It’s hard for her to get an appointment, and with Covid, her daughter has to take off of work to watch the kids so that she can come to you by bus (since there is only one family car). Here VS are 135/75, 80, 97.5, 20 and PE unremarkable other than R shoulder exam with pain with ROM, but full ROM, no tenderness, otherwise normal, back exam including SLR are normal/neg In 600 or fewer words, but a minimum of 250, please describe your approach with this patient. In your response, include the following: What concerns do you have about her current regimen, and what alternatives will you discuss and offer? What other screenings might you apply? What are your own ethical standards on this case that you might consider in addition to legal standards? Provide a sample of an appropriate pain contract that would suit this patient and address her specific safety concerns (cite it and attach the actual contract you found – you do not have to make your own – there are plenty online). Include your steps to ensure safe prescribing. Include the registry you will search prior to any prescribing; name the CA registry, and if you are in a different state, you should name that registry also. If you were to keep her current list, what are the laws surrounding refills and the amounts you are allowed to dispense with the schedule II and III medications in the state of CA? In your own state? Which medications on her list may you call into the pharmacy, and which would you need a written script or electronic order? What are some elements required to include on the prescription form (paper or electronic signature) for the scheduled medications? After you prescribe, how, when, and where would you (or your staff) go about making a report of your scheduled prescription in the state registry so that other prescribers and pharmacies could be aware? In restricted states, APRN prescribers must follow a standardized procedure or protocol for furnishing schedule II and III controlled substances with a patient-specific approach. Please outline the minimum required components of a protocol. You may outline this in bullet form. Alternatively, you may find an appropriate protocol, clinical guideline, or standardized procedure from a literature search and attach it in lieu of outlining your own protocol. Expert Answer and Explanation What concerns do you have about her current regimen, and what alternatives will you discuss and offer? What other screenings might you apply? What are your own ethical standards on this case that you might consider in addition to legal standards? The main concern in the current regimen of ML is the combination of medications she is taking. In addition, she also consumes alcohol every week. The danger of a potentially fatal overdose increases when opioids are used with other central nervous system depressants such as alcohol, benzodiazepines, or xylazine. Benzodiazepines increase the brain’s concentration of the inhibitory neurotransmitter GABA (National Institute on Drug Abuse, 2022). Concurrent use of opioids, benzodiazepines, and gabapentin among patients is linked to a number of negative consequences (Olopoenia et al., 2022). I will add urine drug testing. Urine test has been recommended for patients getting long-term opioid or benzodiazepine therapy, and it is a crucial part of monitoring patients undergoing long-term opioid therapy (Kale, 2019). In addition to legal standards in managing ML’s pain, I will incorporate an ethical patient-centered approach; it is based on a foundation of trust between patients and physicians and is one of the main goals of pain treatment. This type of therapy entails a thorough assessment to determine any possibly curable sources of pain, as well as quantifiable treatment results with an emphasis on function and quality of life optimization. It is the responsibility of clinicians to enhance patient safety (CDC, 2023). I will encourage the patient to try non-pharmacologic approaches to pain management. Pain and function may be improved by noninvasive, nonpharmacologic treatments,
[ANSWERED 2023] Jessica is a 30-year-old immigrant from Mexico City. She and her husband Marco have been in the United States for the last three years and have finally earned enough money to move out of their
Jessica is a 30-year-old immigrant from Mexico City. She and her husband Marco have been in the United States for the last three years and have finally earned enough money to move out of their Case Study: Fetal Abnormality Jessica is a 30-year-old immigrant from Mexico City. She and her husband Marco have been in the United States for the last three years and have finally earned enough money to move out of their Aunt Maria’s home and into an apartment of their own. They are both hard workers. Jessica works 50 hours a week at a local restaurant and Marco has been contracting side jobs in construction. Six months before their move to an apartment, Jessica finds out she is pregnant. Four months later, Jessica and Marco arrive at the county hospital, a large, public, nonteaching hospital. A preliminary ultrasound indicates a possible abnormality with the fetus. Further scans are conducted, and it is determined that the fetus has a rare condition in which it has not developed any arms and will not likely develop them. There is also a 25% chance that the fetus may have Down syndrome. Dr. Wilson, the primary attending physician, is seeing Jessica for the first time, since she and Marco did not receive earlier prenatal care over concerns about finances. Marco insists that Dr. Wilson refrain from telling Jessica the scan results, assuring him that he will tell his wife himself when she is emotionally ready for the news. While Marco and Dr. Wilson are talking in another room, Aunt Maria walks into the room with a distressed look on her face. She can tell that something is wrong and inquires of Dr. Wilson. After hearing of the diagnosis, she walks out of the room wailing loudly and praying aloud. Marco and Dr. Wilson continue their discussion, and Dr. Wilson insists that he has an obligation to Jessica as his patient and that she has a right to know the diagnosis of the fetus. He furthermore is intent on discussing all relevant factors and options regarding the next step, including abortion. Marco insists on taking some time to think of how to break the news to Jessica, but Dr. Wilson, frustrated with the direction of the conversation, informs the husband that such a choice is not his to make. Dr. Wilson proceeds back across the hall, where he walks in on Aunt Maria awkwardly praying with Jessica and phoning the priest. At that point, Dr. Wilson gently but briefly informs Jessica of the diagnosis and lays out the option for abortion as a responsible medical alternative, given the quality of life such a child would have. Jessica looks at him and struggles to hold back her tears. Jessica is torn between her hopes of a better socioeconomic position and increased independence, along with her conviction that all life is sacred. Marco will support Jessica in whatever decision she makes but is finding it difficult not to view the pregnancy and the prospects of a disabled child as a burden and a barrier to their economic security and plans. Dr. Wilson lays out all of the options but clearly makes his view known that abortion is “scientifically” and medically a wise choice in this situation. Aunt Maria pleads with Jessica to follow through with the pregnancy and allow what “God intends” to take place and urges Jessica to think of her responsibility as a mother. Assignment Based on “Case Study: Fetal Abnormality” and other required topic study materials, write a 750-1,000-word reflection that answers the following questions: What is the Christian view of the nature of human persons, and which theory of moral status is it compatible with? How is this related to the intrinsic human value and dignity? Which theory or theories are being used by Jessica, Marco, Maria, and Dr. Wilson to determine the moral status of the fetus? What from the case study specifically leads you to believe that they hold the theory you selected? How does the theory determine or influence each of their recommendations for action? What theory do you agree with? Why? How would that theory determine or influence the recommendation for action? Remember to support your responses 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. This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion. You are required to submit this assignment to LopesWrite. Refer to the LopesWrite Technical Support articles for assistance. Rubric Criteria Total200 points Criterion 1. Unsatisfactory 2. Less Than Satisfactory 3. Satisfactory 4. Good 5. Excellent Recommendation for Action Recommendation for Action 0 points Explanation of how the theory determines or influences each of their recommendations for action is insufficient. Explanation is not supported by topic study materials. 26 points Explanation of how the theory determines or influences each of their recommendations for action is unclear. Explanation unclearly supported by topic study materials. 30 points Explanation of how the theory determines or influences each of their recommendations for action is clear. Explanation is supported by topic study materials. 34 points Explanation of how the theory determines or influences each of their recommendations for action is clear and demonstrates an understanding of the theory. Explanation is supported by topic study materials. 40 points Explanation of how the theory determines or influences each of their recommendations for action is clear, insightful, and demonstrates a deep understanding of the theory and its impact on recommendation for action. Explanation is supported by topic study materials. Documentation of Sources Documentation of Sources (citations, footnotes, references, bibliography, etc., as appropriate to assignment and style) 0 points Sources are not documented. 6.5 points Documentation of sources is inconsistent or incorrect, as appropriate to assignment and style, with numerous formatting errors. 7.5 points Sources are documented, as appropriate to assignment and style, although some formatting errors may be present. 8.5 points
[ANSWERED 2023] Patient HL comes into the clinic with the following symptoms: nausea, vomiting, and diarrhea. The patient has a history of drug abuse and possible Hepatitis C
Patient HL comes into the clinic with the following symptoms: nausea, vomiting, and diarrhea. The patient has a history of drug abuse and possible Hepatitis C Patient HL comes into the clinic with the following symptoms: nausea, vomiting, and diarrhea Pharmacotherapy for Gastrointestinal and Hepatobiliary Disorders Gastrointestinal (GI) and hepatobiliary disorders affect the structure and function of the GI tract. Many of these disorders often have similar symptoms, such as abdominal pain, cramping, constipation, nausea, bloating, and fatigue. Since multiple disorders can be tied to the same symptoms, it is important for advanced practice nurses to carefully evaluate patients and prescribe a treatment that targets the cause rather than the symptom. Once the underlying cause is identified, an appropriate drug therapy plan can be recommended based on medical history and individual patient factors. In this Assignment, you examine a case study of a patient who presents with symptoms of a possible GI/hepatobiliary disorder, and you design an appropriate drug therapy plan. To Prepare Review the case study assigned by your Instructor for this Assignment Reflect on the patient’s symptoms, medical history, and drugs currently prescribed. Think about a possible diagnosis for the patient. Consider whether the patient has a disorder related to the gastrointestinal and hepatobiliary system or whether the symptoms are the result of a disorder from another system or other factors, such as pregnancy, drugs, or a psychological disorder. Consider an appropriate drug therapy plan based on the patient’s history, diagnosis, and drugs currently prescribed By Day 7 of Week 4: Write a 1-page paper that addresses the following: Explain your diagnosis for the patient, including your rationale for the diagnosis. Describe an appropriate drug therapy plan based on the patient’s history, diagnosis, and drugs currently prescribed. Justify why you would recommend this drug therapy plan for this patient. Be specific and provide examples. Please review the rubric. Case Study Assigned Patient HL comes into the clinic with the following symptoms: nausea, vomiting, and diarrhea. The patient has a history of drug abuse and possible Hepatitis C. HL is currently taking the following prescription drugs: Synthroid 100 mcg daily Nifedipine 30 mg daily Prednisone 10 mg daily Reminder: The School of Nursing requires that all papers submitted include a title page, introduction, summary, and references. The Sample Paper provided at the Walden Writing Center offers an example of those required elements (available at http://writingcenter.waldenu.edu/57.htm). All papers submitted must use this formatting. Rubric Detail Excellent Good Explain your diagnosis for the patient, including your rationale for the diagnosis. 23 (23%) – 25 (25%) The response accurately and clearly explains in detail the diagnosis for the patient, including an accurate and thorough rationale for the diagnosis that supports clinical judgment. 20 (20%) – 22 (22%) The response provides a basic explanation of 1-2 diagnoses for the patient, including an accurate rationale for the diagnosis that may support clinical judgment. Describe an appropriate drug therapy plan based on the patient’s history, diagnosis, and drugs currently prescribed. 27 (27%) – 30 (30%) The response accurately and completely describes in detail an appropriate drug therapy plan based on the patient’s history, diagnosis, and drugs currently prescribed. 24 (24%) – 26 (26%) The response describes a basic explanation of the appropriate drug therapy plan based on the patient’s history, diagnosis, and drugs currently prescribed. Justify why you would recommend this drug therapy plan for this patient. Be specific and provide examples. 27 (27%) – 30 (30%) The response provides an accurate, clear, and detailed justification for the recommended drug therapy plan for this patient. The response includes specific, accurate, and detailed examples that fully support the justification provided. 24 (24%) – 26 (26%) The response provides a basic justification for the recommended drug therapy plan for this patient. The response includes only 1-2 examples that fully support the justification provided. Written Expression and Formatting – Paragraph Development and Organization: Paragraphs make clear points that support well developed ideas, flow logically, and demonstrate continuity of ideas. Sentences are carefully focused–neither long and rambling nor short and lacking substance. 5 (5%) – 5 (5%) Paragraphs and sentences follow writing standards for flow, continuity, and clarity. 4 (4%) – 4 (4%) Paragraphs and sentences follow writing standards for flow, continuity, and clarity 80% of the time. Written Expression and Formatting – English writing standards: Correct grammar, mechanics, and proper punctuation 5 (5%) – 5 (5%) Uses correct grammar, spelling, and punctuation with no errors 4 (4%) – 4 (4%) Contains a few (1–2) grammar, spelling, and punctuation errors Written Expression and Formatting – The paper follows correct APA format for title page, headings, font, spacing, margins, indentations, page numbers, running head, parenthetical/in-text citations, and reference list. 5 (5%) – 5 (5%) Uses correct APA format with no errors 4 (4%) – 4 (4%) Contains a few (1–2) APA format errors Total Points: 100 Fair Poor 18 (18%) – 19 (19%) The response inaccurately or vaguely explains the diagnosis for the patient, including an inaccurate or vague rationale for the diagnosis that may or may not support clinical judgment. 0 (0%) – 17 (17%) The response inaccurately and vaguely explains the diagnosis for the patient, including an inaccurate and vague rationale for the diagnosis that does not support clinical judgment, or is missing. 21 (21%) – 23 (23%) The response inaccurately or vaguely describes an appropriate drug therapy plan based on the patient’s history, diagnosis, and drugs currently prescribed. 0 (0%) – 20 (20%) The response inaccurately and vaguely describes an appropriate drug therapy plan based on the patient’s history, diagnosis, and drugs currently prescribed. 21 (21%) – 23 (23%) The response provides an inaccurate or vague justification for the recommended drug therapy plan for this patient. The response may include examples, which may inaccurately or vaguely support the justification provided. 0 (0%) – 20 (20%) The response provides an inaccurate and vague justification for the recommended drug therapy plan for this patient, or is missing. The response does not include examples that support the justification provided, or is missing. 3.5 (3.5%) – 3.5 (3.5%) Paragraphs and sentences follow writing standards for flow, continuity, and clarity 60%–79% of the time. 0 (0%) – 3 (3%) Paragraphs and sentences follow writing standards for flow, continuity, and clarity less than 60% of the time. 3.5 (3.5%) – 3.5 (3.5%) Contains several (3–4) grammar, spelling, and punctuation errors 0 (0%) – 3 (3%) Contains many (≥ 5) grammar, spelling, and punctuation errors that interfere with the reader’s understanding 3.5 (3.5%) – 3.5 (3.5%) Contains several (3–4) APA format errors 0 (0%) – 3 (3%) Contains many (≥ 5) APA format errors Expert Answer and Explanation Pharmacotherapy for Gastrointestinal
[ANSWERED 2023] JJ is a 48-year-old man who presents for evaluation of heartburn. He reports a burning feeling in his chest after eating. It is worse when he eats spicy foods or tomato sauce
JJ is a 48-year-old man who presents for evaluation of heartburn. He reports a burning feeling in his chest after eating. It is worse when he eats spicy foods or tomato sauce JJ is a 48-year-old man who presents for evaluation of heartburn. He reports a burning feeling in his chest after eating. It is worse when he eats spicy foods or tomato sauce. He is sometimes awakened at night with these symptoms. JJ’s profession is an over the road trunk driver which limits his food choices when on the road. He states he has tried over-the-counter antacids and histamine H2 receptor antagonists (H2RAs) for the past few weeks with partial relief. He is on no medications regularly. He does admit to sometimes taking ibuprofen or acetaminophen do to soreness from driving. His examination today is normal. An upper gastrointestinal (GI) x-ray series reveals gastroesophageal reflux. What lifestyle modifications do you recommend for JJ? What medication do you prescribe for JJ, including how long to use? What counseling points about this medication do you give JJ? Expert Answer and Explanation Gastroesophageal Reflux Disease JJ has had recurrent heartburn and has been diagnosed with gastroesophageal reflux disease. While medication can work, JJ needs to make lifestyle modifications as they will alleviate his symptoms. It is also important to counsel him so that he can understand his condition and how he can recover fully. Lifestyle Modifications One of the lifestyle modifications that JJ should make is dietary modification as these are the main sources of his issues. Yuan et al. (2019) note that JJ should avoid spicy food or other food that exacerbates his heartburn. In the future, although he can consume spicy foods it should be limited and he should go for smaller more frequent meals as compared to large ones. Another modification is elevating his bed, by about 6 inches. This will prevent acid from flowing back into the food pipe during sleeping. It is also necessary for JJ to avoid lying down for at least 2-3 hours after a meal as this will encourage digestion and will reduce the risk of reflux. If JJ is overweight, he should start losing some weight because excessive abdominal fat usually puts pressure on the stomach and worsens the symptoms he is experiencing (Clarrett & Hachem, 2018). If JJ smokes or uses alcohol, it is important to quit the two as this can play a great role in reducing the symptoms he is experiencing. Medication The best medication that can work on the symptoms is a proton pump inhibitor mainly used for gastroesophageal reflux disease. According to Kröner et al. (2021), this can be omeprazole, esomeprazole or lansoprazole. A common prescription can be 20 mg of omeprazole daily. It is also notable that the period of consuming the medication should be determined by the care provider. In many instances, proton pump inhibitor therapy is recommended for about 4 to 8 weeks but depends on the patient’s symptoms and their responses to the drugs. If the symptoms cease completely, it is possible to reduce the intake after 4 weeks or cease consumption completely. Counseling Points When communicating with JJ about his diagnosis it is important to insist that he takes the medicine as directed which is usually before a meal (Guadagnoli et al., 2022). Additionally, he should adhere to the days given to take the medication as skipping or taking too much will affect their action and might be ineffective in addressing the current symptoms. It is also vital to inform JJ of possible side effects of the PPIs. This includes headaches and diarrhea. Mentioning the effect of long-term use of the drugs is also critical as they can lead to issues such as vitamin B12 deficiency. This is why it is important to insist on lifestyle modification as it will eliminate the need for the drugs in future. The healthcare provider must also monitor JJ for improvement and encourage JJ to check his symptoms and if they do not improve he should seek further medical advice. This can include an adjustment of the dose or a complete change of the drugs (Guadagnoli et al., 2022). It is also significant to mention the use of over-the-counter pain relievers. JJ had mentioned his use of ibuprofen and acetaminophen which can both exacerbate the symptoms. He can instead choose different pain management strategies such as sleeping, resting, or trying to use herbal medicine. It is crucial for JJ to follow the suggestions for lifestyle modifications and to follow the medication regimen. This will successfully manage the symptoms and ensure that he avoids complications associated with chronic reflux. References Clarrett, D. M., & Hachem, C. (2018). Gastroesophageal Reflux Disease (GERD). Missouri Medicine, 115(3), 214–218. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6140167/#:~:text=The%20primary%20acid%20suppressive%20medications Guadagnoli, L., Simons, M., McGarva, J., Taft, T. H., & van Tilburg, M. A. (2022). Improving Patient Adherence to Lifestyle Changes for the Management of Gastroesophageal Reflux. Patient Preference and Adherence, Volume 16, 897–909. https://doi.org/10.2147/ppa.s356466 Kröner, P. T., Cortés, P., & Lukens, F. J. (2021). The Medical Management of Gastroesophageal Reflux Disease: A Narrative Review. Journal of Primary Care & Community Health, 12, 215013272110467. https://doi.org/10.1177/21501327211046736 Yuan, L.-Z., Yi, P., Wang, G.-S., Tan, S.-Y., Huang, G.-M., Qi, L.-Z., Jia, Y., & Wang, F. (2019). Lifestyle intervention for gastroesophageal reflux disease: a national multicenter survey of lifestyle factor effects on gastroesophageal reflux disease in China. Therapeutic Advances in Gastroenterology, 12, 175628481987778. https://doi.org/10.1177/1756284819877788 Place your order now for a similar assignment and get fast, cheap and best quality work written by our expert level assignment writers.Use Coupon: NEW30 to Get 30% OFF Your First Order FAQs What Heartburn Medicine is Safe for Long-Term Use? SEO Meta Description: Are you wondering what heartburn medicine is safe for long-term use? This comprehensive guide covers everything you need to know about managing heartburn effectively and safely. Introduction Dealing with chronic heartburn can be a real challenge, and it’s essential to find a heartburn medicine that not only provides relief but is also safe for long-term use. In
[2023] A 27-year-old patient with a history of substance abuse is found unresponsive by emergency medical services (EMS) after being called by the patient’s roommate
A 27-year-old patient with a history of substance abuse is found unresponsive by emergency medical services (EMS) after being called by the patient’s roommate Scenario: A 27-year-old patient with a history of substance abuse is found unresponsive by emergency medical services (EMS) after being called by the patient’s roommate. The roommate states that he does not know how long the patient had been lying there. Patient received naloxone in the field and has become responsive. He complains of burning pain over his left hip and forearm. Evaluation in the ED revealed a large amount of necrotic tissue over the greater trochanter as well as the forearm. EKG demonstrated prolonged PR interval and peaked T waves. Serum potassium level 6.9 mEq/L. For this Discussion, you will examine the above case study and explain the disease that is suggested. You examine the symptoms reported and explain the cells that are involved and potential alterations and impacts. To prepare Post an explanation of the disease highlighted in the scenario you were provided. Include the following in your explanation: The role genetics plays in the disease. Why the patient is presenting with the specific symptoms described. The physiologic response to the stimulus presented in the scenario and why you think this response occurred. The cells that are involved in this process. How another characteristic (e.g., gender, genetics) would change your response. Place your order now for a similar assignment and get fast, cheap and best quality work written by our expert level assignment writers.Use Coupon Code: NEW30 to Get 30% OFF Your First Order FAQs What is the connection between stress and substance abuse? Stress and substance abuse are often interconnected in a complex relationship. Here are some key points to understand their connection: Self-Medication: Individuals experiencing stress may turn to substances such as alcohol, drugs, or cigarettes as a way to cope with their emotions or alleviate their stress temporarily. Substance use can provide a sense of relief or escape from overwhelming feelings. Biological Factors: Stress activates the body’s natural “fight or flight” response, releasing hormones like cortisol and adrenaline. Chronic stress can dysregulate the body’s stress response system, leading to changes in brain chemistry that may increase the likelihood of substance abuse. Psychological Factors: Stress can impair judgment, decision-making, and impulse control, making individuals more susceptible to engaging in risky behaviors like substance abuse. Moreover, stress can exacerbate underlying mental health conditions such as anxiety and depression, which are often co-occurring with substance use disorders. Social Factors: Social environments characterized by high levels of stress, such as dysfunctional families, poverty, or exposure to trauma, can contribute to the development of substance abuse issues. Peer pressure and social norms within certain groups may also influence substance use behaviors. Cycle of Addiction: Substance abuse can create a cycle where initial stress relief from using substances leads to increased tolerance and dependence, ultimately worsening stress levels as individuals experience negative consequences of their substance use. This can perpetuate a vicious cycle of stress and substance abuse. Withdrawal Symptoms: Abrupt cessation of substance use can lead to withdrawal symptoms, which can include increased stress, anxiety, and physical discomfort. Individuals may continue using substances to avoid or alleviate these withdrawal symptoms, further reinforcing the connection between stress and substance abuse. What are prevention suggestions and strategies pertaining to addiction? Prevention strategies for addiction aim to reduce the likelihood of individuals developing substance use disorders or engaging in other addictive behaviors. Here are some suggestions: Education and Awareness: Implement comprehensive educational programs in schools, communities, and workplaces to raise awareness about the risks and consequences of addiction. Provide information about the effects of various substances, signs of addiction, and available resources for help. Promotion of Healthy Lifestyles: Encourage and support the adoption of healthy lifestyle habits, including regular exercise, balanced nutrition, adequate sleep, and stress management techniques. Engage in activities that promote social connections, hobbies, and personal fulfillment as alternatives to substance use. Early Intervention: Identify and intervene early with individuals who exhibit risk factors for addiction, such as family history, mental health issues, trauma, or exposure to substance use. Provide access to screening, assessment, counseling, and support services to address underlying issues before they escalate into addiction. Limiting Access to Substances: Enforce policies and regulations aimed at restricting access to addictive substances, particularly among underage populations. Implement measures such as age restrictions for purchasing alcohol and tobacco, responsible prescribing practices for medications, and regulation of the availability of illicit drugs. Community Support and Involvement: Foster supportive and inclusive communities that provide positive social networks, mentorship, and opportunities for engagement and belonging. Develop community-based prevention programs, peer support groups, and alternative activities for at-risk individuals to promote healthy behaviors and discourage substance use. Family Support and Education: Offer support services and educational resources for families to enhance communication, parenting skills, and family dynamics. Address family-related risk factors such as dysfunction, trauma, neglect, and enabling behaviors, and promote healthy family relationships as protective factors against addiction. Media and Marketing Regulations: Advocate for responsible advertising and marketing practices that minimize the glamorization and normalization of substance use in media, entertainment, and advertising. Counteract misleading messages with evidence-based information about the risks and consequences of addiction. Treatment Accessibility: Improve access to affordable and evidence-based treatment options for individuals struggling with addiction. This includes detoxification programs, counseling, medication-assisted treatment, support groups, and rehabilitation services tailored to the specific needs of each individual. Collaboration and Coordination: Foster collaboration among various stakeholders, including government agencies, healthcare providers, educators, law enforcement, community organizations, and advocacy groups, to develop and implement comprehensive prevention strategies that address addiction from multiple angles. Continuous Evaluation and Adaptation: Regularly assess the effectiveness of prevention efforts through data collection, monitoring, and evaluation. Adjust strategies based on emerging trends, community needs, and feedback from stakeholders to ensure ongoing relevance and impact. What are the statistics for mental health and substance abuse? Here are some statistics regarding mental health and substance abuse as at 2022, Prevalence of Mental Health Disorders: According to the World
[ANSWERED 2023] Using the client family from your Week 3 Practicum Assignment, address in a progress note (without violating HIPAA regulations) the following
Using the client family from your Week 3 Practicum Assignment, address in a progress note (without violating HIPAA regulations) the following Assignment 1: Practicum – Assessing Client Family Progress Part 1: Progress Note Using the client family from your Week 3 Practicum Assignment, address in a progress note (without violating HIPAA regulations) the following: Treatment modality used and efficacy of approach Progress and/or lack of progress toward the mutually agreed-upon client goals (reference the treatment plan for progress toward goals) Modification(s) of the treatment plan that were made based on progress/lack of progress Clinical impressions regarding diagnosis and or symptoms Relevant psychosocial information or changes from original assessment (e.g., marriage, separation/divorce, new relationships, move to a new house/apartment, change of job) Safety issues Clinical emergencies/actions taken Medications used by the patient, even if the nurse psychotherapist was not the one prescribing them Treatment compliance/lack of compliance Clinical consultations Collaboration with other professionals (e.g., phone consultations with physicians, psychiatrists, marriage/family therapists) The therapist’s recommendations, including whether the client agreed to the recommendations Referrals made/reasons for making referrals Termination/issues that are relevant to the termination process (e.g., client informed of loss of insurance or refusal of insurance company to pay for continued sessions) Issues related to consent and/or informed consent for treatment Information concerning child abuse and/or elder or dependent adult abuse, including documentation as to where the abuse was reported Information reflecting the therapist’s exercise of clinical judgment Note: Be sure to exclude any information that should not be found in a discoverable progress note. Part 2: Privileged Note Based on this week’s readings, prepare a privileged psychotherapy note that you would use to document your impressions of therapeutic progress/therapy sessions for your client family from the Week 3 Practicum Assignment. In your progress note, address the following: Include items that you would not typically include in a note as part of the clinical record. Explain why the items you included in the privileged note would not be included in the client family’s progress note. Explain whether your preceptor uses privileged notes. If so, describe the type of information he or she might include. If not, explain why. Expert Answer and Explanation Assessing Client Family Progress Therapists are always required to develop documentation to explain the progress of their clients. The purpose of this assignment is to develop progress and privileged notes of a couple who came for therapy. Part 1: Progress Note Treatment Modality Used and Efficacy of Approach The treatment modality used is cognitive-behavioral therapy. Shayan et al. (2018) did a study and found that CBT is highly effective in treating people with post-traumatic stress disorder and other stress-related conditions. Progress Towards Goals The therapy’s goal is to change the clients’ thoughts and attitudes towards parenting and their financial conditions. The family agreed to attend ten therapy sessions to achieve this goal. Looking at the clients’ state of mind, there is no progress. Modification(s) of the Treatment Plan The therapy was modified in that both the counselor and the clients agreed to increase the number of sessions to fifteen. Role-playing was also included in the therapy. Role-playing can improve their social skills and improve their problem-solving skills (Khanjani Veshki et al., 2017). Clinical Impressions Regarding Diagnosis And/or Symptoms Based on the clients’ medical history, they might be suffering from the acute stress disorder. The stress is caused by a lack of financial support and balancing parenting and work. Relevant Psychosocial Information or Changes from Original Assessment The clients have no history of psychological problems. However, there is a history of alcoholism in the family, hence putting the clients at risk of suffering alcoholism. Safety Issues The father works at a security company as security personnel can lead to security issues because one must protect people or property from danger. Clinical Emergencies/Actions Taken The family has never experienced any form of a clinical emergency. Medications The clients have no history of physical or mental health problems, and therefore, they are not on any kind of medications. Treatment Compliance The clients have not been complying fully with treatment therapy. The father noted that the timing of the sessions does not align with his working schedule. He requested that the sessions be pushed to weekends and not weekdays. Clinical Consultations Clinical consultation occurred with the supervisor. The supervisor was asked whether the clients can change their therapy sessions from weekdays to weekends. Collaboration with Other Professionals I collaborated with my supervisor, a fellow counselor, on how to handle the clients’ financial woes. Professional collaboration is a significant practice in that it helps caregivers provide patient-centered care. Therapist’s Recommendations The therapist recommended that the clients be involved in role-playing and that their sessions should be increased to fifteen from ten. Role-playing would help clients practice new patterns or skills of interaction (Dattilio & Collins, 2018). For instance, they would practice talking to children and engaging them in decisions affecting their lives. The clients agreed to the recommendations but noted that the fees for the sessions should be reduced a bit. Referrals Made/Reasons for Making Referrals There were no referrals made during the treatment session. Termination The five more sessions could risk termination if the clients cannot pay for them or if their insurance program refuses to pay for them. Issues Concerning Informed Consent for Treatment Informed consent is a significant ethical code in healthcare practice. Before a therapist makes any recommendations, the client must be asked for informed consent. The clients were asked for their informed consent before the recommendations were implemented. Information Concerning Child Abuse During the assessment, it was found that the clients have not a history of child abuse or dependent adult abuse. Information reflecting the therapist’s exercise of clinical judgment Clinical judgment is clinical reasoning that allows caregivers to arrive at a conclusion based on subjective and objective data about the patient (Dickison et al., 2019). Based on the clients’ subjective and objective data, these patients have not prior physiological or mental healthcare issues. However, the clients have financial problems because they have to care