[ANSWERED 2023] Mr. Akkad is a 76 year old Iranian male who is brought to your office by his eldest son for “strange behavior.”
Mr. Akkad is a 76 year old Iranian male who is brought to your office by his eldest son for “strange behavior.” To Prepare Review the interactive media piece assigned by your instructor. Reflect on the patient’s symptoms and aspects of the disorder presented in the interactive media piece. Consider how you might assess and treat patients presenting with the symptoms of the patient case study you were assigned. You will be asked to make three decisions concerning the diagnosis and treatment for this patient. Reflect on potential co-morbid physical as well as patient factors that might impact the patient’s diagnosis and treatment. Write a 1- to 2-page summary paper that addresses the following: Briefly summarize the patient case study you were assigned, including each of the three decisions you took for the patient presented. Based on the decisions you recommended for the patient case study, explain whether you believe the decisions provided were supported by the evidence-based literature. Be specific and provide examples. Be sure to support your response with evidence and references from outside resources. What were you hoping to achieve with the decisions you recommended for the patient case study you were assigned? Support your response with evidence and references from outside resources. Explain any difference between what you expected to achieve with each of the decisions and the results of the decision in the exercise. Describe whether they were different. Be specific and provide examples. BACKGROUND Mr. Akkad is a 76 year old Iranian male who is brought to your office by his eldest son for “strange behavior.” Mr. Akkad was seen by his family physician who ruled out any organic basis for Mr. Akkad’s behavior. All laboratory and diagnostic imaging tests (including CT-scan of the head) were normal. According to his son, he has been demonstrating some strange thoughts and behaviors for the past two years, but things seem to be getting worse. Per the client’s son, the family noticed that Mr. Akkad’s personality began to change a few years ago. He began to lose interest in religious activities with the family and became more “critical” of everyone. They also noticed that things he used to take seriously had become a source of “amusement” and “ridicule.” Over the course of the past two years, the family has noticed that Mr. Akkad has been forgetting things. His son also reports that sometimes he has difficult “finding the right words” in a conversation and then will shift to an entirely different line of conversation. SUBJECTIVE During the clinical interview, Mr. Akkad is pleasant, cooperative and seems to enjoy speaking with you. You notice some confabulation during various aspects of memory testing, so you perform a Mini-Mental State Exam. Mr. Akkad scores 18 out of 30 with primary deficits in orientation, registration, attention & calculation, and recall. The score suggests moderate dementia. MENTAL STATUS EXAM Mr. Akkad is 76 year old Iranian male who is cooperative with today’s clinical interview. His eye contact is poor. Speech is clear, coherent, but tangential at times. He makes no unusual motor movements and demonstrates no tic. Self-reported mood is euthymic. Affect however is restricted. He denies visual or auditory hallucinations. No delusional or paranoid thought processes noted. He is alert and oriented to person, partially oriented to place, but is disoriented to time and event [he reports that he thought he was coming to lunch but “wound up here”- referring to your office, at which point he begins to laugh]. Insight and judgment are impaired. Impulse control is also impaired as evidenced by Mr. Akkad’s standing up during the clinical interview and walking towards the door. When you asked where he was going, he stated that he did not know. Mr. Akkad denies suicidal or homicidal ideation. Diagnosis: Major neurocognitive disorder due to Alzheimer’s disease (presumptive) RESOURCES § Folstein, M. F., Folstein, S. E., & McHugh, P. R. (2002). Mini-Mental State Examination (MMSE). Lutz, FL: Psychological Assessment Resources. References Hussien, R. M., & Shoukry, A. A. (2020). Rivastigmine patch (Exelon patch) compared to melatonin patch in prevention of postoperative delirium in the elderly. Ain-Shams Journal of Anesthesiology, 12(1), 1-7. https://asja.springeropen.com/articles/10.1186/s42077-020-00087-6 Khoury, R., Rajamanickam, J., & Grossberg, G. T. (2018). An update on the safety of current therapies for Alzheimer’s disease: focus on rivastigmine. Therapeutic advances in drug safety, 9(3), 171-178. https://doi.org/10.1177%2F2042098617750555 Yoon, S. J., Choi, S. H., Na, H. R., Park, K. W., Kim, E. J., Han, H. J., … & Na, D. L. (2017). Effects on agitation with rivastigmine patch monotherapy and combination therapy with memantine in mild to moderate Alzheimer\’s disease: a multicenter 24?week prospective randomized open?label study (the Korean EXelon Patch and combination with mEmantine Comparative Trial study). Geriatrics & Gerontology International, 17(3), 494-499. https://doi.org/10.1111/ggi.12754 Rosenthal, L. D., & Burchum, J. R. (2021). Lehne’s pharmacotherapeutics for advanced practice nurses and physician assistants (2nd ed.) St. Louis, MO: Elsevier. Chapter 11, “Basic Principles of Neuropharmacology” (pp. 67–71) Chapter 12, “Physiology of the Peripheral Nervous System” (pp. 72–81) Chapter 12, “Muscarinic Agonists and Cholinesterase Inhibitors” (pp. 82–89) Chapter 14, “Muscarinic Antagonists” (pp. 90-98) Chapter 15, “Adrenergic Agonists” (pp. 99–107) Chapter 16, “Adrenergic Antagonists” (pp. 108–119) Chapter 17, “Indirect-Acting Antiadrenergic Agents” (pp. 120–124) Chapter 18, “Introduction to Central Nervous System Pharmacology” (pp. 125–126) Chapter 19, “Drugs for Parkinson Disease” (pp. 127–142) Chapter 20, “Drugs for Alzheimer Disease” (pp. 159–166) Chapter 21, “Drugs for Seizure Disorders” (pp. 150–170) Chapter 22, “Drugs for Muscle Spasm and Spasticity” (pp. 171–178) Chapter 59, “Drug Therapy of Rheumatoid Arthritis” (pp. 513–527) Chapter 60, “Drug Therapy of Gout” (pp. 528–536) Chapter 61, “Drugs Affecting Calcium Levels and Bone Mineralization” (pp. 537–556) Excellent Good Fair Poor Briefly summarize the patient case study you were assigned, including each of the three decisions you took for the patient presented. Be specific. Points Range: 18 (18%) – 20 (20%) The response accurately and thoroughly summarizes in detail the patient case study assigned, including specific and complete details on each of the three decisions made for the patient presented. Points Range: 16 (16%) – 17 (17%) The response accurately summarizes the patient case study assigned, including details on each of the three decisions
[ANSWERED 2023] Select a family other than your own and seek permission from the family to conduct an interview. Utilize the interview questions complied in your interview questionnaire to conduct a family-focused functional assessment
Select a family other than your own and seek permission from the family to conduct an interview. Utilize the interview questions complied in your interview questionnaire Understanding family structure and style is essential to patient and family care. Conducting a family interview and needs assessment gathers information to identify strengths, as well as potential barriers to health. This information ultimately helps develop family-centered strategies for support and guidance. This family health assessment is a two-part assignment. The information you gather in this initial assignment will be utilized for the second assignment in Topic 3. Develop an interview questionnaire to be used in a family-focused functional assessment. The questionnaire must include three open-ended, family-focused questions to assess functional health patterns for each of the following: Values/Health Perception Nutrition Sleep/Rest Elimination Activity/Exercise Cognitive Sensory-Perception Self-Perception Role Relationship Sexuality Coping Select a family other than your own and seek permission from the family to conduct an interview. Utilize the interview questions complied in your interview questionnaire to conduct a family-focused functional assessment. Document the responses as you conduct the interview. Upon completion of the interview, write a 750-1,000-word paper. Analyze your assessment findings. Submit your questionnaire as an appendix with your assignment. Include the following in your paper: Describe the family structure. Include individuals and any relevant attributes defining the family composition, race/ethnicity, social class, spirituality, and environment. Summarize the overall health behaviors of the family. Describe the current health of the family. Based on your findings, describe at least two of the functional health pattern strengths noted in the findings. Discuss three areas in which health problems or barriers to health were identified. Describe how family systems theory can be applied to solicit changes in family members that, in turn, initiate positive changes to the overall family functions over time. Cite at least three peer-reviewed or scholarly sources to complete this assignment. Sources should be published within the last 5 years and appropriate for the assignment criteria. Expert Answer and Explanation Family Health Assessment When working with patients, providers have to involve the patients’ family members because they offer support needed for the patient recovery. They not only make decisions, but they provide emotional support which the patient needs as they go through the illness-health process. Rather than treat a single patient, providers may instead focus on managing the health needs of the entire family unit. In this case, they perform family health assessment to determine the family’s health needs. These assessment is intended to explore various aspects of the health needs including health behaviors, and administer care that meets these needs (Goergen et al., 2016). It is imperative to examine such an assessment, and apply the Family Systems Theory (FST) to bring change in a selected family. Family Structure The family selected for the interview comprises of a couple, their three children, and a paternal grandmother. The children are all female with the eldest one being aged 12 years, the younger one being aged 9 years while the other is aged 5 years. The grandmother who is 66 years old widow no longer works, and because there was no one to look after her, she came to live with the family. The couple is doing well career-wise considering that the father is a practicing lawyer while the mother is a medical doctor (Goergen et al., 2016). The Family Health Behaviors The family, during the interview, answered assessment questions including questions related to the health perceptions. According to the family, they have never had any major health event. However, the grandmother has a history of smoking, and she has hypertension, and she tend to experience abnormal heart rhythms. None of the other members of the family use behavior-altering substances, and the parents practice good health behaviors (Goergen et al., 2016). When asked about diet, the couple stated that they are aware of the role diet plays in helping improve individuals’ health. Thus, they eat balanced diet, and they prefer home-made food over the food prepared in fast-food stores. The family also prefer to buy organic food products because they are healthy (Richards et al., 2018). The couple, still, did respond to the questions concerning the amount of hours they sleep. While the children go to bed early, and sleep for more than 8 hours a day, the couple sleep for not more than 7 hours. They stated that their busy work schedules leaves them with limited time to have enough sleep. The grandparent has a problem with elimination considering that she urinates more frequently, than she used to do. However, no any other individual has experienced elimination issues apart from the few cases of diarrhea in the family (Dorell et al., 2017). The family is serious about maintaining healthy lifestyle, and the parents engage in fitness activities in their respective workplaces. The children are taking swimming lessons, and they therefore swim on weekends (Khatiban, Tohidi, & Shahdoust, 2019). The family maintained that they are cognitively aware, and they can logically think, and get to know their environment. The senses of everyone in the family are sound, and no one in the family requires hearing aid or eye glasses. No member has anosmia either. The couple has healthy sex lifestyle, and they are able to effectively deal with the marital issues. However, they have not had any serious marital issue. Besides, they can effectively cope with challenges (Khatiban et al., 2019). Strengths linked to Functional Health Patterns The family exhibits strengths when it comes to the way it handles health issues. The fact that the couple participates in workplace-based physical activities, and eats healthy meals, shows that the family can continue adopting behaviors which promote health. Because the children are active, their risk of developing health conditions is slim. However, the grandparent is hypertensive, and this is the main concern for the couple because they feel that her condition may worsen to the level where she may require admission into the hospital. This fear can result to stress which can emotionally and
How often do you engage with or witness death in your work?
How often do you engage with or witness death in your work? How has this experience or the lack of it shaped your view of death? How often do you engage with or witness death in your work? How has this experience or the lack of it shaped your view of death? Has it gotten easier or harder for you to accept the fact of death? As you explain, include your clinical specialty. Expert Answer and Explanation Reflection on Clinical Experience of Death I have had the opportunity of working with patients in labor and delivery unit, and during my practice within this unit, I witness the death of patients. Some patients died during delivery, and whenever I witnessed death of a patient, I would feel sad. The first time I witnessed a patient of a mother and her child, I was shocked. The incident was emotionally overwhelming, and I was angry that perhaps the hospital could have done enough to prevent the deaths (Robson & Williams, 2017). With time, however, I began accepting the death of patients as a reality for anyone working in the labor unit. This personal experience has shaped my views concerning death and dying. I have learned from such encounters that anyone can die, and when people die, they overcome pain and suffering. From my experience, still, I learned that the thought of dying invokes feelings such as fear and denial, and when one dies, those close to them experience sadness and anger. Furthermore, the experience of seeing patients die has taught me that one can die in any point in their life including during toddlerhood, and that appropriate clinical interventions can help reduce the risk of death (Robson & Williams, 2017). While I would experience difficult coping with death during my formative years of practice, I have experienced changes in terms of how I see death. Currently, I see death as part of the human experience because death is a natural process in which a person loses their physical body. Because I have worked with patients from diverse backgrounds, I have noted that death has some form of spiritual and cultural significance, and that culture and spirituality or religious beliefs can affect how individuals cope with death (Phan et al., 2021). References Phan, H. P., Ngu, B. H., Chen, S. C., Wu, L., Shih, J. H., & Shi, S. Y. (2021). Life, death, and spirituality: A conceptual analysis for educational research development. Heliyon, 7(5), e06971. Doi: https://doi.org/10.1016/j.heliyon.2021.e06971. Robson, K., & Williams, C. M. (2017). Dealing with the death of a long term patient; what is the impact and how do podiatrists cope?. Journal of foot and ankle research, 10, 36. Doi: https://doi.org/10.1186/s13047-017-0219-0. Alternative Expert Answer and Explanation Although patients come to hospitals for treatment expecting to recover from their illnesses, some clinical cases end with patients’ death. For providers, witnessing patients dying can be a difficult experience especially if they have established an emotional connection with the patients. During my practice as a Medsurg Nurse, I have witnessed the death of patients, and whenever I experienced a patient dying, it affected me emotionally (Robson & Williams, 2017). I would react with regret, blaming myself for not doing enough to prevent death. Although the death of patients still hurts, I feel I am emotionally prepared to deal with such an experience, more than I was when I first encountered the first incident. As a nursing professional, experiencing the loss of lives has shaped my perspective on health, illness, and death. One thing that I have learned particularly given my previous with death is that it can be difficult to stop death when it comes, and anyone working with the patient may watch helplessly as the patient dies. Previously, I experienced tension and anxiety every time I saw a patient dying, and I would have nightmares (Sartor, das Mercês, & Torrealba, 2021). Based on what I have experienced, I have become more open in terms of how I view death. Specifically, I consider it a normal human experience, and whenever it occurs, it serves as a reminder that it is an experience that awaits everyone including me. My personal experiences concerning the loss of patients’ lives have played a significant role in defining my perspectives on life. It is easier for me to accept death than it was previously because seeing a patient dying reminds me of my mortality as a person. It also reminds me of the need to treat everyone with respect, and dignity irrespective of their health status. Guided by this experience, therefore, I would be more respectful in terms of how I treat patients. References Robson, K., & Williams, C. M. (2017). Dealing with the death of a long term patient; what is the impact and how do podiatrists cope?. Journal of foot and ankle research, 10, 36. Doi: https://doi.org/10.1186/s13047-017-0219-0. Sartor, S. F., das Mercês, N. N. A., & Torrealba, M. N. R. (2021). Death in the Hospital: The Witnessing of the Patient with Cancer. Indian journal of palliative care, 27(4), 538–543. https://doi.org/10.25259/IJPC_119_21. Reflect on the analysis of the sin of suicide and, thus, euthanasia from the topic readings. Do you agree? Why or why not? Refer to the lecture and topic readings in your response. Expert Answer and Explanation Reflection on Christian View on EuthanasiaThe topic readings provide insight into the subject of the sin of suicide. From the perspective of the Christian faith, the penalty for sin is death, and death came upon humans because of their inequity or shortfall. Death, according to this faith however, is spiritually significant, and people can enjoy the fruits of living a righteous life even when they die (Goligher et al., 2017). If one lives a righteous life here on earth, they will enjoy eternal life. From the Christian worldview or biblical teachings, one can understand the meaning of life, sin and suicide or assisted death. The Christian faith views death as a natural process and in discussions involving death, the issue of good death arises. According to this faith, a good death is
[ANSWERED 2023] What are your thoughts on the harvesting of organisms such as whales, dolphins, seals, etc.?
What are your thoughts on the harvesting of organisms such as whales, dolphins, seals, etc.? Is hunting the only major issue that might threaten the existence of these organisms? Consider humanity as the ultimate predator. Many if not most of us, particularly in the United States, are quite comfortable with the harvesting of organisms like tuna, deer, ducks, or rabbits. Other countries and cultures, however, value species that rarely, if ever, find their way to the North American dinner plate. What are your thoughts on the harvesting of organisms such as whales, dolphins, seals, etc.? Is hunting the only major issue that might threaten the existence of these organisms? Should we limit ourselves to eating only certain organisms? Why, or why not? In what ways are you selective about the foods you eat? Your journal entry must be at least 200 words. No references or citations are necessary. Expert Answer and Explanation BIO 1302 Harvesting Organisms I believe that harvesting organisms is a necessity for human beings and cannot be avoided (Deckers, 2016). Organisms such as whales, seals and dolphins are essential sources of meat and can help feed a lot of people to avoid hunger. Just like any other fish, these organisms can also be harvested and used as food for human consumption. Oceans and other water bodies make up 71% of the world’s surface and only 29% of the land where human beings reside (Williams, 2014). Be that as it may, it would be rationally impossible to harvest and complete all the whales or dolphins that reside in 71% of the ocean life on Earth. However, maritime laws can help mitigate the harvesting of species below certain measurements or ages. The strategy would only facilitate harvesting grown and old organisms, leaving the others to reproduce. It is important to note that hunting and harvesting of organisms alone cannot lead to an extinction event of the said animal. There are other key aspects that might lead to extinction, such as underwater volcanos, oil spillage and global warming (Conserve Energy Future, 2020). In this regard, human beings should not limit themselves to only eating certain organisms. The supply of organisms surpasses the demand present by human beings. It would not be viable to finish the available supply completely. I believe that the world has its own way of remaining sustainable and that every person can easily eat any food they want without necessarily causing an extinction. Personally, I am selective based on preference and familiarity in that I tend to avoid foods that are new to me. References Conserve Energy Future. (2020, July 17). Is Marine Life Dying? Causes, Effects and Solutions to Depleting Marine Life – Conserve Energy Future. https://www.conserve-energy-future.com/causes-effects-solutions-depleting-marine-life.php#:~:text=Today%2C%20marine%20life%20is%20facing,ocean%20dumping%20and%20many%20others. Deckers, J. (2016). The Consumption of Animal Products and the Human Right to Health Care. Nih.gov; Ubiquity Press. https://www.ncbi.nlm.nih.gov/books/NBK396511/ Williams, M. (2014, December 2). What percent of Earth is water? Phys.org. https://phys.org/news/2014-12-percent-earth.html#:~:text=In%20simplest%20terms%2C%20water%20makes,consists%20of%20continents%20and%20islands. Place your order now on the similar assignment and get fast, cheap and best quality work written from scratch by our expert level assignment writers. Other Solved Questions: SOLVED! How would your communication and interview SOLVED! Describe the difference between a nursing practice SOLVED! How do you think evidence from nursing journals SOLVED! Discuss how elimination complexities can affect SOLVED! Case C 38-year-old Native American pregnant ANSWERED! In a 1,000–1,250 word essay, summarize two [ANSWERED] Students will develop a 1,250-1,500 word paper that includes [ANSWERED] Post a description of the national healthcare ANSWERED!! Explain how you would inform this nurse ANSWERED!! In a 4- to 5-page project proposal written to the ANSWERED!! A 15-year-old male reports dull pain in both ANSWERED!! Should government continue to take an [ANSWERED] Mrs. Adams a 68-year-old widow who was [ANSWERED] Compare and contrast the various ways you can ANSWERED! Provide a summary of your learning style
[ANSWERED 2023] Select a research article other than the articles from your assignments, from the GCU library
Select a research article other than the articles from your assignments, from the GCU library TOPIC 2 DQ 1: Select a research article, other than the articles from your assignments, from the GCU library. Provide an overview of the study and describe the strategy that was used to select the sample from the population. Evaluate the effectiveness of the sampling method selected. Provide support for your answer. Include the article title and permalink in your post. TOPIC 2 DQ 2: Using the research article selected for DQ 1, identify three key questions you will ask and answer when reading the research study and why these questions are important. When responding to peers, provide other questions and answers that could be considered in relation to the peers’ studies. Expert Answer and Explanation TOPIC 2 DQ 1: Effectiveness of Sampling Method Used Overview of the Study The article by Griffiths et al. involves a study that investigates the relationship between nurse staffing and the occurrence of omissions. The objective of the study is to assess nursing care that is missed frequently in acute inpatient adult wards, and to determine the linkage between missed care and the levels of staffing (Griffiths et al., 2018). The background of the study is that there are numerous adverse patient outcomes that are directly associated with nurse staffing levels. The study utilizes a systematic review design, with the data sources being several databases including CINAHL and EMBASE (Griffiths et al., 2018). The study shows that there is a high level of association between low nurse staffing and high reports of missed care. Effectiveness of the Sampling Method Selected Systematic random sampling was applied when collecting data, and it was effective in collecting data from various databases to be used in the study. In this method, researchers select elements from a sampling frame that is ordered, which in this case is the databases (Javaid, Noor-ul-Amin, & Hanif, 2019). The method of sampling is easy to understand, and it helps in bringing a greater control of the sense of the process (Javaid, Noor-ul-Amin, & Hanif, 2019). Because of using this method, the researchers in the study were also able to reduce the risks through elimination of clustered selections. Given a chance to redo the study, I would be sure to use systematic random sampling method, as it is the only method that can give optimal results in a study of this nature. References Griffiths, P., Recio‐Saucedo, A., Dall’Ora, C., Briggs, J., Maruotti, A., Meredith, P., & Missed Care Study Group. (2018). The association between nurse staffing and omissions in nursing care: a systematic review. Journal of advanced nursing, 74(7), 1474-1487. Javaid, A., Noor-ul-Amin, M., & Hanif, M. (2019). Modified Ratio Estimator in Systematic Random Sampling Under Non-response. Proceedings of the National Academy of Sciences, India Section A: Physical Sciences, 89(4), 817-825. TOPIC 2 DQ 2: Key Questions When Reading the Article What are the researchers’ hypotheses? Asking oneself about the hypotheses of the researchers helps to study the mind of the researchers before and after the study is conducted. This question also allows one to put themselves into the perspective of the study as intended by the authors of the article. In some of the cases, asking oneself about the hypotheses of the researchers can help to identify the possibility of biases in a research. In this study Griffith et al. (2018) hypothesize that low levels of staffing are linked with poor patient outcomes, and the hypothesis is confirmed in the results. The fact that the hypothesis matches to outcomes could lead to questions of whether or not there is biases, but in this case, it is clear from the research procedure that there is no data manipulation. What is the unit of analysis? Asking oneself about the unit of analysis also helps to ensure effectiveness in managing the interpretations of the results. A failure to consider the units of a study would imply that the researcher does not understand the exact parameters being applied. How generalizable are the results? The generalizability of results is another aspect that is evident in studies that sound ‘too obvious (Pearl & Bareinboim, 2019).’ I would ask myself about the generalizability of the results as it would help me to assess whether or not the article is useful enough for me to make different inferences from the study topic. The article by Griffiths et al. does not have generalizable results as the results are full of details to describe the outcome of the study. References Griffiths, P., Recio‐Saucedo, A., Dall’Ora, C., Briggs, J., Maruotti, A., Meredith, P., & Missed Care Study Group. (2018). The association between nurse staffing and omissions in nursing care: a systematic review. Journal of advanced nursing, 74(7), 1474-1487. Pearl, J., & Bareinboim, E. (2019). Note on ‘‘Generalizability of Study Results ‘‘. Epidemiology, 30(2), 186-188. Alternative Expert Answer Artificial Neural Networks The article by Nina Shahid, Tim Rappon and Whitney Berta is about, “Applications of Artificial Neural Networks in Health Care Organizational Decision-Making: A Scoping Review.” According to the article, the healthcare industry is gradually evolving towards a patient-centered model of care delivery and, at the same time advocating for value-based practices (Shahid, Rappon, & Berta, 2019). Artificial neural networks (ANN) are essential in health care organizational decision-making through leveraging machine-learning techniques. With the advent of technology, healthcare facilities are increasingly adopting the use of ANN to inform health care decisions. Artificial intelligence is at the center of technology and potential future of technology as it holds the potential to offer health care delivery that is not only appropriate but also cost-effective. With the increased uptake of artificial intelligence in the healthcare industry, different health care management problems can be addressed (Shahid, Rappon, & Berta, 2019). To address the AI applications in healthcare, the research paper makes use of different research questions and sampling methods to collect data for analysis. The research paper makes use of the Arksey & O’Malley framework of 2005 to come up with the sampling methods used in the paper. The topic can be related to different multi-disciplinary subjects, and the frameworks used to identify the sampling methods identifies literature related to healthcare but from different databases. This method is effective as it is able to distinguish materials that
[ANSWERED 2023] Patient HM has a history of atrial fibrillation and a transient ischemic attack (TIA). The patient has been diagnosed with type 2 diabetes, hypertension
Patient HM has a history of atrial fibrillation and a transient ischemic attack (TIA). The patient has been diagnosed with type 2 diabetes, hypertension 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. Write a 2- to 3- page paper that addresses the following: Patient HM has a history of atrial fibrillation and a transient ischemic attack (TIA). The patient has been diagnosed with type 2 diabetes, hypertension, hyperlipidemia and ischemic heart disease. Drugs currently prescribed include the following: Warfarin 5 mg daily MWF and 2.5 mg daily T, TH, Sat, Sun Aspirin 81 mg daily Metformin 1000 mg po bid Glyburide 10 mg bid Atenolol 100 mg po daily Motrin 200 mg 1–3 tablets every 6 hours as needed for pain 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. Expert Answer and Explanation The presence of multiple disorders in patients is a chief contributor to lower quality of life, longer hospital stays, hospital admissions, and the loss of physical functioning. Most patients who have more than one chronic disease can also become victims of the severe effects polypharmacy, which can also affect their ability to take some of the recommended drugs (Mery, 2018). In the case of patient HM, who has hyperlipidemia, ischemic disease, hypertension, and diabetes and also a history of Transiet Ischemic Attack (TIA) and artrial fibrillation, there are multiple changes in the drug processes that can help him achieve a smooth recovery process despite the presence of influential factors such as age. How the Selected Factor has an Influence on the Pharmacodynamic and Pharmacokinetic Processes of Patient Age is a significant factor that may influence the pharmacokinetic and pharmacokinetic processes showed by patient HM. Specifically, patients who are at least 65 years may have a relatively slower reaction to drugs as their body cells have a higher death rate compared to the ‘birth’ rate, which largely influences the processes of drug absorption, drug metabolism, excretion, and distribution (Mercy, 2018). Ageing patients also have decreased body water, decreased lean body mass, higher levels of body fat, among other body compositions that make them relatively unhealthy compared to their younger counterparts (Shen Lu & Hughes, 2018). These factors are among the key contributors of lower organ functions among the older individuals. Some of the vital organs of the body such as the brain, lungs, kidney, and the heart may also be affected by this gradually decreasing organ function, causing abstract changes in wellness. Regarding the uptake of drugs, the liver is involved in the metabolism of all the drugs taken by mouth, and hence its malfunction may cause a defective uptake across the body (Rosenthal & Burchum, 2021). Hence, the factor of age is a significant influence on the various pharmacokinetic and pharmacodynamics processes of the patient. How Changes in the Processes may Impact the Recommended Therapy of the Patient If the process changes may lead to the defective function of the liver, the physician may have to revise the entire therapy plan of the patient to avoid including in the plan any drug that is taken orally. This is because all oral drugs cannot bypass the metabolism in the liver unless they are taken in the form that makes it easy to reach the target organs. For such cases, the patient may have to adopt i.v. and i.m. therapy where the drugs are delivered directly to the blood vessels and muscles respectively, making the bioavailability 100% (Rosenthal & Burchum, 2021). Also, the fact that the patient could develop resistance to some of the drugs such as metformin may require them to be given other alternatives that would enhance the action of metformin (Rosenthal & Burchum, 2021). Similarly, the patient may have to cut on the usage of warfarin as it is known to cause joint pains and discomfort to patients who are older than 65 (Rosenthal & Burchum, 2021). Lastly, since artenolol may be associated with kidney problems in older patients, the patient may have to reduce its dosage or find other suitable alternatives. Improving the Patient’s Drug Therapy Plan Increase the dosage of sum drugs such as metformin from its current dosage to 2500 mg po bid so as to improve its bioavalaility and hence its level of utilization by the patient (Wang et al., 2017). Decrease the Ibuprofen levels to 200mg bid Change Glyburide 10mg bid dosage to Byetta while monitoring symptoms Replace warfarin with Tylenol so as to reduce the chances of joint pain Only take aspirin when patient is anaemic Decrease atenolol levels to 50mg po daily so as to prevent the occurrence of kidney challenges. The dosage could also be titrated by 25mg monthly while monitoring the adverse effects but should not exceed 200mg. Conclusion The factor of age can affect the wellness of the patient in that it influences the utilization of drugs in multiple ways. Among the common ways in which age affects the pharmacokinetic and pharmacodynamics processes is the fact that some drugs such as atenolol, when taken by ageing patients can increase their susceptibility to joint problems. Ageing patients could also be victims of polypharmacy’s negative effects as they are often involved in treatment with multiple disorders. They could also experience other higher challenges such as neglect from family members.
[ANSWERED 2023] Develop a business case for the economic initiative you proposed in Assessment 1. Examine the feasibility and cost-benefit considerations
Develop a business case for the economic initiative you proposed in Assessment 1. Examine the feasibility and cost-benefit considerations Assessment 2/6008 Developing a Business Case Develop a 4–7-page business case for the initiative you proposed in Assessment 1. Examine feasibility and cost-benefit considerations over a 5-year period, analyze ways to mitigate risks, and complete a cost-benefit analysis. Note: Each assessment in this course builds upon the work you have completed in previous assessments. Therefore, you must complete the assessments in the order in which they are presented. Assessment Instructions Develop a business case for the economic initiative you proposed in Assessment 1. Examine the feasibility and cost-benefit considerations of implementing your proposed initiative over the next five years. Analyze ways to mitigate risks and complete a cost-benefit analysis. Note: Remember that you can submit all, or a portion of, your draft business case to Smarthinking for feedback before you submit the final version for this assessment. If you plan on using this free service, be mindful of the turnaround time of 24–48 hours for receiving feedback. Requirements The requirements for your business case, outlined below, correspond to the scoring guide criteria, so be sure to address each main point. Read the performance-level descriptions for each criterion to see how your work will be assessed. In addition, be sure to note the requirements for document format and length and for supporting evidence. Analyze the potential economic opportunities and risks associated with your proposed initiative. How do the potential opportunities benefit your organization or care setting? How could potential risks pose a threat to the financial security of your organization or care setting? How do the potential economic opportunities compare to the potential economic risks? Propose ethical and culturally sensitive solutions that address the risks associated with your initiative to the future economic security of your organization or care setting. Which risks are potentially the most significant for your organization or care setting? How could you modify your proposed initiative to mitigate those risks? How have other organizations and experts in the field dealt with similar risks? How do ethics and equality factor into your proposed solutions? Are your solutions unfairly burdening or disadvantaging any specific groups? How will this proposal affect community health care delivery outcomes? What makes this a great opportunity for economic growth? What potential issues should be considered? Analyze the economic costs and benefits of your proposed initiative over a five-year period. Use the Cost-Benefit Analysis Template [XLSX]for your calculations. Add the worksheet to your business case as an appendix. Does your analysis warn against specific aspects of your proposed initiative? How would you recommend that your findings be incorporated into decisions about the feasibility of your proposed initiative? Propose ethical and culturally equitable ways of keeping costs under control, while maximizing the benefits of your initiative. What costs are you most likely to be able to control or reduce? How would you go about ensuring this? How could controlling or reducing these costs affect the benefits of your proposed initiative? What strategies could you employ to maintain or maximize these benefits, while controlling or reducing costs? How do you plan to ensure that any cost controls or benefit reductions are ethical and equitable? Justify the relevance and significance of the quantitative and qualitative economic, financial, and scholarly evidence you used to support your business case. This criterion applies to any evidence you cited throughout your business case. Your evidence should be persuasive and relevant to your findings, proposals, and recommendations. Consider one or more of the following questions when citing support evidence: How is the evidence relevant to your organization or care setting? How is the evidence relevant to your proposed economic initiative? How does the evidence illustrate a solution that has been successful in the past? How does the evidence illustrate that an initiative or solution is likely to be a net benefit to the organization or care setting? Write concisely and directly, using active voice. Proofread your document before you submit it to minimize errors that could distract readers and make it more difficult for them to focus on the substance of your business case. Apply current APA formatting to in-text citations and references. Example Assessment: You may use the following to give you an idea of what a Proficient or higher rating on the scoring guide would look like: Assessment 2 Example [PDF]. ADDITIONAL REQUIREMENTS Your assessment should also meet the following requirements: Format: Format your business case using APA current style. Use the APA Style Paper Template [DOCX]. An APA Style Paper Tutorial [DOCX]is also provided to help you in writing and formatting your business case. Be sure to include: A title page and references page. An abstract is not required. A running head on all pages. Appropriate section headings. Length: Your business case should be 4–7 pages in length, not including the title page and references page. Supporting evidence: Cite 4–5 authoritative and scholarly resources to support your business case. Be sure that your sources include specific economic data. Note: Faculty may use the Writing Feedback Tool when grading this assessment. The Writing Feedback Tool is designed to provide you with guidance and resources to develop your writing based on five core skills. You will find writing feedback in the Scoring Guide for the assessment, after your work has been evaluated. Portfolio Prompt: You may choose to save your business case to your ePortfolio. Competencies Measured By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and assessment scoring guide criteria: Competency 1: Analyze the effects of financial and economic factors (such as cost-benefit, supply and demand, return on investment, and risks) in a health care system on patient care, services offered, and organizational structures and operation. Analyze the potential economic opportunities and risks associated with a proposed initiative. Analyze the economic costs and benefits of a proposed initiative over a five-year period. Competency 2: Develop ethical and culturally equitable solutions to economic problems within a health care organization in an effort to improve the quality of care and
[ANSWERED 2023] You work at a small community-based hospital as a manager in the quality assurance department. One function of your job is to analyze internal data such as medical records
You work at a small community-based hospital as a manager in the quality assurance department. One function of your job is to analyze internal data such as medical records, patient surveys [ANSWERED 2023] You work at a small community-based hospital as a manager in the quality assurance department. One function of your job is to analyze internal data such as medical records. You work at a small community-based hospital as a manager in the quality assurance department. One function of your job is to analyze internal data such as medical records, patient surveys, and incident reports to track trends and help improve patient care delivery. Your supervisor just came back from a seminar on quality benchmarking and has asked about your thoughts on analyzing secondary data from the health care industry as a way to benchmark and measure the organization’s quality performance against its peers. You have been asked to prepare a report on the use of both secondary data and internal data as way to improve quality in your organization. Complete the following: Write a paper comparing and contrasting the collection of secondary data and their uses versus the analysis of current health care records and internal data such as incident reports and patient surveys. Explain how health care organizations use secondary data as a comparison to internal data. Assess the validity and reliability of primary and secondary data in conducting health care research. >expert answer Expert Answer and Explanation Healthcare Information System Management Benchmarking is one of the recent healthcare trends that is being accepted across many care continuums, where hospitals and departments analyze their competitors so as to find a ground for improvement. Similarly, hospital managers work hard to assess internal data and operations and to try to achieve improvement using these analyses. Small community-based facility Some experts refer to the process as internal benchmarking, as the facilities seek to improve their operations against their own set internal standards (Feibert, Andersen, & Jacobsen, 2019). In the analyses of my small community-based facility where my supervisor arrives from a seminar on quality benchmarking, there are several ideas I would help him understand about the use of secondary data to measure the performance of the organization against its peers. Both benchmarking and internal analyses are important in organizational growth and healthcare managers should focus in the specific strengths of these strategies to efficiently integrate them in healthcare. Contrasting Secondary Data and Uses with Internal Data and Current Healthcare Records Benchmarking as a way to set the Quality Standards Competitive benchmarking involves analyzing the processes of another organization and comparing its operations, goals, and standards with its own. For most small healthcare facilities, it is not easy to achieve growth without comparing their operations with larger and better-performing organizations (Buckmaster & Mouritsen, 2017). In some of the cases, people in small organizations believe that they are performing efficiently until they perform such benchmarking operations and realize that their peers have set higher standards in care which should be targets for their achievement. A good example is comparing the wait times that patient have in emergency rooms with those of other emergency rooms in different facilities. In the case where other organizations have generally smaller amounts of time spent in the ER waiting rooms, healthcare givers can borrow information such as the individual elements that help in reducing the wait time. This could be possibly factors that are present among the staff members such as their ability to be more focused in serving patients or other factors in the system such as the presence of better infrastructure to help serve the patients faster (Gonzalez, 2019). A collection of this kind of data helps the organization to drive the different ways in which they can set improvement strategies internally. Facility understands This way, the facility understands the threshold of different elements and standardizes them to be the target-setters in the organizations. Internal Healthcare Data Helps in Individualized Improvement While external benchmarking drives the achievement of different societal standards in healthcare, internal healthcare is useful in guiding healthcare managers to perform specific improvement of certain procedures (Purushotham et al., 2018). This is especially the case when a facility is known to have its own principles or strategies of operation which it believes to be effective. A good example of how internal healthcare data helps in individualized improvement in a healthcare firm is when the facility chooses to break down nursing shifts in unique timelines to try and solve the problem of staff fatigue and burnout. The problem may be specific for the firm, where its peers do not face the same difficulty, and hence utilizing a technique that is specific to the organization could be the most rational decision in driving improvement in the healthcare facility. Internal data that can be collected to aid in individualized improvement include patient records, administrative data, and healthcare giver reports. Healthcare Organizations Usage of Secondary Data as a Comparison to Internal Data Compare internal data elements Both secondary and internal data is crucial in organizational development and should be integrated into care facilities in a systematic way. One of the ways in which healthcare organizations use secondary data to compare internal data elements is assessing the societal standards by assessing performance among its peers. It would be useless to perform such analyses without comparison to internal data as it would lead to exaggerations or misplacement of the levels of action by the individual organizations. Among the advantages of integrating external benchmarking data in the facilities is the fact that it helps the healthcare providers to realize the value of the existing resources and how they can use them to achieve organizational growth. Very often, healthcare managers do not realize that they are endowed with numerous resources and that they have no reason to fail in the delivery of proper patient care. Unfortunately, problems in organizations make them believe that the organization is insufficient in driving the achievement of various goals of care. A close analysis of what their peers do to achieve the organizational standards they are in could serve a long way in opening their eyes to the resource endowment that is present in the organization. For example, in some of the healthcare organizations, there are no special operation officers
[SOLVED 2023] Research legislation that has occurred within the last 5 years at the state or federal level as a result of nurse advocacy
Research legislation that has occurred within the last 5 years at the state or federal level as a result of nurse advocacy. Describe the legislation and what was accomplished WEEK 4 DQ 1 Choose a legislator on the state or federal level who is also a nurse and discuss the importance of the legislator/nurse‘s role as advocate for improving health care delivery. What specific bills has the legislator/nurse sponsored or supported that have influenced health care. WEEK 4 DQ 2 Research legislation that has occurred within the last 5 years at the state or federal level as a result of nurse advocacy. Describe the legislation and what was accomplished. What additional steps need to be taken to continue advocacy for this issue? Advocacy Through Legislation Nurses often become motivated to change aspects within the larger health care system based on their real-world experience. As such, many nurses take on an advocacy role to influence a change in regulations, policies, and laws that govern the larger health care system. For this assignment, identify a problem or concern in your state, community, or organization that has the capacity for advocacy through legislation. Research the issue and use the “Advocacy Through Legislation” template to complete this assignment. You are required to cite to a minimum of three sources to complete this assignment. Sources must be published within the last 5 years and appropriate for the assignment criteria and relevant to nursing practice. 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. DQ 1: Expert Answer and Explanation Legislation Based on Advocacy Nurse advocacy focuses on various aspects of care, including the issues related to quality care, affordable medication availability of resources, among many others. In conjunction with legislators, the healthcare system needs to ensure that essential laws are passed that resolve the issues and advocacies presented by the nurses. One of the legislations within the recent five years as a result of nurse advocacy is the H.R. 3-116th Congress (2019-2020), the Elijah Cummings Lower Drug Cost Now Act (Bendix, 2019). The legislation focuses on the need to regulate and possibly lower the prices of prescription drugs to meet the affordability of the patients. Be that has it may, the healthcare sector has an increasing demand for medication with the complexity of illness and comorbidity. This has resulted in a consequent increase in medication pricing, leading to an uproar by both the patients and the nurses who tend to their daily needs as they recover. The Act focuses on the mitigation of prices on essential medication for chronic illness such as insulin (Bendix, 2019). The legislation accomplished to offer subsidies to the essential medication and mitigated the pricing of other medical supplies and drugs. Nurse advocacy is a continual process that requires constant evaluation and acting to facilitate the changes. Several additional steps need to be taken to ensure continued advocacy for this issue of drug pricing (Kang et al., 2019). For instance, there is a need to have oversight to correspond to pricing and market fluctuation. Additionally, the demand for medication also varies with changes in time. While the prices are subsidized, nurses need to ensure that there is a constant supply of the medication to meet the increasing demand. These measures are critical for the sector and improve the overall patient outcome and satisfaction. References Bendix, J. (2019). Healthcare policy in 2019: A look ahead. (2020). Retrieved 6 April 2020, from https://www.medicaleconomics.com/article/healthcare-policy-2019-look-ahead/page/0/2 Kang, S. Y., DiStefano, M. J., Socal, M. P., & Anderson, G. F. (2019). Using external reference pricing in Medicare Part D to reduce drug price differentials with other countries. Health Affairs, 38(5), 804-811. DQ2: Expert Answer and Explanation Nursing Advocacy Efforts in Massachusetts The signing into law, the Massachusetts’ bill, H.4228, in 2014 marked an important event in the advocacy role of the nurses in the state. This bill would put limit to the number of patients a nursing professional has to work with in emergency units. This legislation enforces a 1:1 nurse to patient ratio where nurses work with new mothers and newborn babies, and a 1:4 provider to patient ratio in surgical units. According to this bill, hospitals which violet this legislation would be liable to a fine of $25,000. This signing of this law was a result of persisted efforts partly influenced by the passage of a similar legislation in California in 2004 (Bill H.4228, 2014). While this bill is linked to favorable patient care outcomes, Massachusetts’ voters recently, voted against this bill. California has experienced a decline in the number of the mortality incidences since a similar law came to effect. In Massachusetts, the idea of enactment of the bill has been contentious, and this manifested when Massachusetts’ public rejected it in 2018, just less than four years after the passing of the bill into law (Bill H.4228, 2014). The Massachusetts’ nursing bodies such as the state’s American Nursing Association (ANA) wing can advance the advocacy objectives using key strategies. The nurse advocacy groups should target the public in the state, and select representatives who can act on the behalves of these groups to survey the opportunities as well as risks associated with the bill. The collected information should guide training processes as well as activities focused on helping create and implement public awareness campaign (Wright & Jaffe, 2014). Accordingly, the public will become sensitized on the benefits associated with the improvement of the nurse to patient ratio. References Bill H.4228 (2014). An Act Relative to Patient Limits in All Hospital Intensive Care Units. Retrieved from https://malegislature.gov/Bills/188/H4228. Wright, A. C., & Jaffe, K. J. (2014). Six steps to successful child advocacy: Changing the world for children. Los Angeles : SAGE. Assignment – Expert Answer and Explanation Advocacy through Legislation Advocacy Through Legislation Identify a problem or concern in your state, community, or organization that has the capacity to be advocated through legislation. Research the issue and complete the sections below. For each topic that requires the listing of criteria, a minimum of two criteria should be identified and discussed. Add
[ANSWERED 2023] Both psychoanalysis and Gestalt therapy consider that dream exploration can be used as an effective therapeutic technique
Both psychoanalysis and Gestalt therapy consider that dream exploration can be used as an effective therapeutic technique 5.1. Approaches to Dream Work Both psychoanalysis and Gestalt therapy consider that dream exploration can be used as an effective therapeutic technique. However, the two schools propose very different approaches to dream work. Which approach would you favour and why? The last post is due at the end of Sunday of this unit. Expert Answer and Explanation Psychoanalysis is a therapeutic method designed by Sigmund Freud. The primary assumption of psychoanalysis is that all individuals possess unconscious feelings, thoughts, memories, and desires (Safran et al., 2019). On the other hand, Gestalt therapy is a psychotherapy that stresses personal responsibility and gives weight to the client’s experience at the present (Wagner-Moore, 2004). I would select the approach to work with depending on the client I am handling. For instance, if a patient has trauma, I would select free speech therapy by Freud. In this form of therapy, the patient should lie on a couch and the therapist sits behind them capturing notes while the client freely talks about their nightmares, memories, and dreams (Safran et al., 2019). In bream work therapy, the patient will be asked by the counselor to share their dreams. Dreams represent the wish to achieve the unconscious desires and conflicts. I would select the psychoanalysis approach because through dreams I can identify the conflicts between the patient’s unconscious and conscious mind. Safran et al. (2019) note that dreams have both latent and manifest content that can help counselors identify what is wrong with their patients. This therapy is significant in determining the source of trauma and working with the client to solve it. References Safran, J. D., Kriss, A. & Foley, V. K. (2019). Psychoanalytic therapies. In D. Wedding & R. J. Corsini (Eds.), Current psychotherapies (11th ed.) pp. 21-58. Boston, MA: Cengage. Wagner-Moore, L. E. (2004). Gestalt Therapy: Past, Present, Theory, and Research. Psychotherapy: Theory, Research, Practice, Training, 41(2), 180. https://psycnet.apa.org/doi/10.1037/0033-3204.41.2.180 5.2. Interruptions to Contact vs. Ego Defense Mechanisms Gestalt therapy identifies a number of problematic patterns of interpersonal relationships called Interruptions/Resistances to Contact or Boundary Disturbances. These maladaptive interpersonal patterns are similar, though not identical, to some of the ego defense mechanisms identified in psychoanalysis. Based on your understanding of the psychoanalytical and the Gestalt concepts, which of the two sets of constructs do you find more useful for conceptualizing and addressing potential clients’ concerns? The last post is due at the end of Sunday of this unit. Expert Answer and Explanation 5.2. Interruptions to Contact vs. Ego Defense Mechanisms Based on my understanding of the two theories, I find psychoanalysis more useful for conceptualizing and addressing potential clients’ concerns. Ego-defenses can be defined as psychological strategies that are used to protect an individual from anxiety from unwanted feelings and thoughts in an unconscious manner (Freud, 1937). Defense mechanisms help remove unpleasant feelings by operating at unconscious level. Defense mechanisms, such as denial and repression can help a counselor identify the unpleasant feelings the patient is suppressing or denying (Freud, 1933). For instance, if a clients is suffering from grief, a counselor can identify this concern by listening to how the patient is denying the problem or suppressing it. Understanding defense mechanisms can help a therapist understand the client in depth. For instance, a counselor can conclude as a client is angry if the patient uses displacement to defend themselves from anxiety (Freud, 1937). Angry clients can displace their anger by taking it out on their family members or throwing things. After finding that the client has anger issues, the counselor can now work with them to help them control their anger and adapt good behaviors when they are angry (Freud, 1933). Ego defense mechanisms can also help a client clarify conflicting behavior. References Freud, A. (1937). The Ego and the mechanisms of defense, London: Hogarth Press and Institute of Psycho-Analysis. Freud, S. (1933). New introductory lectures on psychoanalysis. London: Hogarth Press and Institute of Psycho-Analysis. Pp. xi + 240. Assignment 2: Assignment 2: Humanistic Approaches Instructions Do NOT exceed one double-spaced page (two or three paragraphs) for each of your answers. Please format your assignment in Word (files with extension .doc or .docx), or Rich Text Format (files with extension .rtf). Include a title page and a reference page. An introduction/conclusion is not necessary. Organize the answers using APA style. Answer the following three short-answer questions (250 words for each answer, approximately 750 words per assignment): What are some of the possible cross-cultural limitations of the person-centred approach to counselling? Helping clients create meaning in their lives is arguably the ultimate goal of Viktor Frankl’s logotherapy; however, this process may appear quite abstract and esoteric to many clients and counsellors. Das (1998) articulated four specific steps that help make this process more concrete and relevant for both counsellors and clients. Briefly describe those four steps. Identify a hypothetical counselling scenario (client’s presenting concern) in which you would appropriately use the Gestalt empty-chair technique. In your answer, briefly describe how you would actually implement the empty-chair technique and provide a rationale for its use (i.e., what is the expected outcome of this intervention, given the hypothetical presenting concern you have selected). Information Regarding Citations Any sources used to support your Written Narrative should, of course, be cited using correct APA format. And although it can be a useful starting place to gather very general information, in order to later verify it with more substantial sources, no Wikipedia references will be accepted as scholarly citations. Here’s just one reason why: http://www.nbcnews.com/id/30699302/ns/technology_and_science-tech_and_gadgets/t/student-hoaxes-worlds-media-wikipedia/ IMPORTANT NOTES *The “Submit” button will appear 72 hours before the due date for this assignment. This means that you must upload the final draft of your assignment during this 72-hour period from when the button appears and the due date passes. Please do not email your submissions to your professor, either before or after the due date; all coursework should be submitted through the online course (Moodle). Notes: Please review Submitting Turnitin Assignments found