[ANSWERED 2023] A Puerto Rican Woman With Comorbid Addiction
A Puerto Rican Woman With Comorbid Addiction A Puerto Rican Woman With Comorbid Addiction. The Assignment: Examine Case Study: A Puerto Rican Woman With Comorbid Addiction. You will be asked to make three decisions concerning the medication to prescribe to this client. Be sure to consider factors that might impact the client’s pharmacokinetic and pharmacodynamic processes. At each decision point stop to complete the following: · Decision #1 o Which decision did you select? o Why did you select this decision? Support your response with evidence and references to the Learning Resources. o What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources. o Explain any difference between what you expected to achieve with Decision #1 and the results of the decision. Why were they different? · Decision #2 o Why did you select this decision? Support your response with evidence and references to the Learning Resources. o What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources. o Explain any difference between what you expected to achieve with Decision #2 and the results of the decision. Why were they different? · Decision #3 o Why did you select this decision? Support your response with evidence and references to the Learning Resources. o What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources. o Explain any difference between what you expected to achieve with Decision #3 and the results of the decision. Why were they different? Note: Support your rationale with a minimum of three academic resources no more than five years old. Co-morbid Addiction (ETOH and Gambling) 53-year-old Puerto Rican Female BACKGROUND Mrs. Maria Perez is a 53 year old Puerto Rican female who presents to your office today due to a rather “embarrassing problem.” SUBJECTIVE Mrs. Perez admits that she has had “problems” with alcohol since her father died in her late teens. She reports that she has struggled with alcohol since her 20’s and has been involved with Alcoholics Anonymous “on and off” for the past 25 years. She states that for the past two years, she has been having more and more difficulty maintaining her sobriety since they opened the new “Rising Sun” casino near her home. Mrs. Perez states that she and a friend went to visit the new casino during their grand opening at which point she was “hooked.” She states that she gets “such a high” when she is gambling. While gambling, she “enjoys a drink or two” to help calm her during high-stakes games. She states that this often gives way to more drinking and more reckless gambling. She also reports that her cigarette smoking has increased over the past two years and she is concerned about the negative effects of the cigarette smoking on her health. She states that she attempts to abstain from drinking but that she gets such a “high” from the act of gambling that she needs a few drinks to “even out.” She also notices that when she drinks, she doesn’t smoke “as much” but enjoys smoking when she is playing at the slot machines. She also reports that she has gained weight from drinking so much- she currently weights 122 lbs., which represents a 7 lb. weight gain from her usual 115 lb. weight. Mrs. Perez is quite concerned today because she has borrowed over $50,000 from her retirement account to pay off her gambling debts. She is very concerned because her husband does not know that she has spent this much money. MENTAL STATUS EXAM The client is a 53 year old Puerto Rican female who is alert, oriented to person, place, time, and event. She is dressed appropriately for the weather and time of year. Her speech is clear, coherent, and goal directed. Her eye contact is somewhat avoidant during the clinical interview. As you make eye contact with her, she looks away or looks down. She demonstrates no noteworthy mannerisms, gestures, or tics. Her self-reported mood is “sad.” Affect is appropriate to content of conversation & self-reported mood. She visual or auditory hallucinations, no delusional or paranoid thought processes are readily appreciated. Insight and judgment are grossly intact, however, impulse control is impaired. She is currently denying suicidal or homicidal ideation. Diagnosis: Gambling disorder, alcohol use disorder Decision Point One: Select what the PMHNP should do: Naltrexone (Vivitrol) injection, 380 mg intramuscularly in the gluteal region every 4 weeks RESULTS OF DECISION POINT ONE Client returns to clinic in four weeks Mrs. Perez said that she felt “wonderful” as she has not “touched a drop” to drink since receiving the injection Client reports that she has not been going to the casino, as frequently, but when she does go she “drops a bundle” (meaning, spends a lot of money gambling) Client She is also still smoking, which has her concerned. She is also reporting some problems with anxiety, which also have her concerned Decision Point Two: Select what the PMHNP should do next: Add on Valium(diazepam) 5 mg orally TID/PRN/anxiety RESULTS OF DECISION POINT TWO Client returns to clinic in four weeks Mrs. Perez reports that when she first received the valium, it helped her tremendously. She states “I was like a new person- this is a miracle drug!” However, she reports that she has trouble “waiting” between drug administration times and sometimes takes her valium early Client is asking today for you to increase the valium dose or frequency Decision Point Three: Select what the PMHNP should do next: Continue current dose of Vivitrol, increase Valium to 10 mg orally TID/PRN/anxiety. Refer to counseling for her ongoing gambling issue Guidance to Student Anxiety is a common side effect of Vivitrol. Mrs. Perez reports that she is doing well with this medication, and like other side effects, the anxiety associated with this medication may be transient. The psychiatric mental health nurse practitioner should never
[ANSWERED 2023] Mrs. Adams a 68-year-old widow who was referred to case management upon discharge from the hospital based on her physician’s recommendation that she is not able to care for herself independently.
Mrs. Adams a 68-year-old widow who was referred to case management upon discharge Mrs. Adams a 68-year-old widow who was referred to case management upon discharge from the hospital based on her physician’s recommendation that she is not able to care for herself independently. Her diagnosis is diabetes, hypertension, and breast cancer. She is 5 days’ post-op from a right sided mastectomy. Mrs. Adams apartment is located in a low income area of the city where crime is prevalent. Upon assessment by the Community Health Nurse, Mrs. Adams apartment was in disorder with minimal airflow or light. Her cloths appeared unchanged and she had no food in the apartment. The small apartment also housed 3 cats and a small dog who Mrs. Adams considers family since the death of her husband 1 year ago. Mrs. Adams complains of pain and draining from her surgical site and a broken air conditioner. Using Nightingales Environmental Theory, what actions would the nurse take upon the first assessment? What are the five essential components of Nightingales Theory? Prioritize an appropriate care plan for Mrs. Adams? Apply Nightingale’s Environmental Theory to an area of your nursing practice, what patient population would benefit from this approach? Support this practice change with at least one evidenced-based article (this means current EBP of 5 years of less for the article.) The assignment should be completed in APA format, as an essay of between 1000 and 1500 words. The paper should include at least 2 outside references and the textbook. The paper should be in APA format with a title page, level headings, and reference page, please see the Shell that I have included in this module. 1st person is not acceptable in APA papers, make sure to keep this is 3rd person. EXPERT ANSWER AND EXPLANATION Case Study The plan of the recovery of a chronic patient involves several interventions, with one of the main ones being the configuration of the environment or setting of the patient to make it friendlier. Florence Nightingale, the founder of modern nursing, also called ‘The Lady with the Lamp’ from her service during the Crimean war had several views about the implication of sanitation to the nursing field (Idrees & Shah, 2017). Applying her environmental theory in the care of Mrs. Adams, a 68-year-old woman with hypertension, cancer of the breast, and diabetes can guide in the development of the best practice from her situation. Actions the Nurse would take upon the First Assessment Using Nightingale’s Environmental Theory Mrs. Adams is referred to case management upon discharge from hospital, but upon assessment of her living conditions, there are numerous elements that show that her current home is not the ideal place of care. Besides living with four animals, three cats and one dog, Mrs. Adam’s apartment shows that there is minimal light flow, limited food, and the clothes are barely changed. Also, the air conditioner is broken, and the place she lives in is a high crime area. The first action that the nurse in charge would take would be the assessment of the possibility of changing the environment, or her chances of moving to a better place. The following are some of the environmental factors that the nurse would consider as pointed out in the environmental theory by Florence Nightingale. Pure Fresh Air The air that the patient breaths should be made as clean as possible. Stuffy environments increase the chances of chilling, which could limit the chances of recovery. Also, to maintain the right concentrations of oxygen required in the body, the patient would have to ensure that the external environment is completely sanitized (AliSher et al. , 2019). Pure Water Pure water serves almost the same purpose as pure fresh air- making sure that the patient’s circulation is not contaminated with too much concentrations of unwanted substances. Impure water that is used for drinking purposes could lead to the absence of the right elements that would help in proper patient hydration (Mughal & Irshad Ali, 2017). In worse case scenarios, this impure water could lead to the addition of undesired elements to the body of the patient. Effective Drainage Effective drainage in the patient environment helps to ensure that their waste material is removed constantly from their residence. Lack of proper waste removal can lead to the build-up of undesired bacteria that could contribute to patient re-infection. Effective drainage can also help the patient feel more mentally comfortable with their environment. Cleanliness Nursing mainly entails preserving cleanliness of both the patient and their environment. According to the environmental theory, clean environments have a large mental implication to ensuring patient wellness (Couto et al., 2020). Cleanliness also prevents chances of re-infection and re-admissions. Light This is the last factor that should be considered in nursing according to the environmental theory. Direct sunlight has numerous health benefits such as helping in bone growth and development. Lighting up the room of a patient can also increase their mental alertness and wellness. Appropriate Plan of Care for Mrs. Adams In the plan of care for Mrs. Adams, the first step would be making suitable environmental adjustments that would contribute to improving her environment. For the patient to achieve a healing state, the introduction of a healthy environment is paramount. Having four pets could be disadvantageous to her given her economic conditions, as she would probably not be able to feed them well. These pets could roam around the streets and bring her a fourth disease, which would be problematic to her health. The plan of care should therefore include elimination of three of the pets to leave her with possibly a male cat. Also, general cleaning of her environment should be made to ensure that the surroundings are clean and safe for her to live in. In the plan of care, the possibility of moving to a new apartment where lighting, security, and clean water is in plenty should be made. Changing the environment could also help her make new friends and hence contribute to
[ANSWERED 2023] Use the Nursing Roles Graphic Organizer Template to differentiate how advanced registered nurse roles relate to and collaborate with different areas of nursing practice
Use the Nursing Roles Graphic Organizer Template to differentiate how advanced Nursing Roles Graphic Organizer Advanced registered nurses work in highly collaborative environments and must collaborate with interdisciplinary teams in order to provide excellent patient care. Besides knowing the role and scope of one’s own practice, it is essential to understand the role and scope of other nurse specialties to ensure effective collaboration among nurses, the organization, and other professionals with whom advanced registered nurses regularly interact. Use the Nursing Roles Graphic Organizer Template to differentiate how advanced registered nurse roles relate to and collaborate with different areas of nursing practice. Compare your future role with one of the following: nurse educator; nurse leader; family nurse practitioner; acute care nurse practitioner; graduate nurse with an emphasis/specialty in public health, health care administration, business, or informatics; clinical nurse specialist; doctor of nursing practice. Indicate in the appropriate columns on the template which roles you are comparing. Make sure to compare the following areas of practice in your graphic organizer: Ethics Education Leadership Public Health Health Care Administration Informatics Business/Finance Specialty (e.g., Family, Acute Care) Include any regulatory bodies or certification agencies that provide guidance or parameters on how these roles incorporate concepts into practice. You are required to cite three to five sources to assignment. Sources must be published within the last 5 years and appropriate for the assignment criteria and nursing content. Expert Answer and Explanation Nursing Roles Graphic Organizer Comparing Nurse Leader and Nurse Educator Nursing Leader Nurse Educator Observations (Similarities/Differences) Ethics There are a considerable number of ethical roles for nurse leaders in the course of discharging the main mandate (Pawlow et al., 2018). In the future, as a nurse leader, I ought to pinpoint ethical conflicts. From which, I will act as a resource or mediatory voice for the interested parties alongside the nurses who are struggling with a conflict dilemma For example, I will assume the role of mediating conflicts within families or conflicts associated with patient arising when the prognosis is out-of-focus. Nurse educators are ethically required to expose their colleagues and students to comprehending and practice the ethical codes of conduct. The ethical codes of conduct are mutual across the nursing field (Pawlow et al., 2018). Therefore, it transpires that the nurse educators have to exposure their colleagues and nurses to the codes as part of the ethical role. There are a number of particular differences and similarities between the two roles. The nurse educators in most cases practice within the classroom setting while the nurse leader practice their ethical duties within the healthcare environment. There is a common similarity between the two roles as the nurse educators and nurse leaders assist their colleagues in comprehending ethical codes of conduct at their workplace. Education I will have the duty of initiating education programs toward patients and their families in relation to importance of primary patient-centered care, which will consist a wide variety of subjects such as the new emerging approaches toward management of lifestyle disease, especially diabetes. In addition, my roles in family education on new approaches against preventable diseases is a highly important part of any family nurse practitioner. The nurse educator has the duty of preparing students to assume the accountability and responsibility for maintaining and promoting healthcare alongside the management, diagnosis, and assessment of problems of the patient that consist the prescription and use of non-pharmacologic and pharmacologic interventions (Daley, Morgan, & Black, 2015). Both the nurse educators and leaders have the core role of educating people with an aim in advancing healthcare outcomes. Educators are confined to school setting while leaders have a wide scope of their influence in education. Leadership Leadership is a core mandate of the APRN. As a nurse leader, I will have the role of coming up with new ways of addressing the constantly emerging issues facing the nursing community, which are future-based. This include coming up with new policies to address the issues facing nursing continuum. Nurse educators provide fundamental comprehension of the principles in the process of decision in various roles (Pawlow et al., 2018). This includes establishing the set of standards that offer protection to the public, improving mobility and improving access to safe as well as quality care. There advances the innovative approaches toward addressing leadership within healthcare. The nurse leaders address a wide scope of issues facing community at large while educators’ scope is limited to students and their colleagues. Public Health As a nurse leader, the future role in public health will include research and evaluation and planning of health program, and promoting healthcare. The nurse educators have the role of teaching public and other nurses on health promotion and disease prevention across the life span (Pawlow et al., 2018). The nurse educators have unique knowledge and skills that they use to influence their students and other nursing professionals about the empowerment of patient into making lifestyle changes as well as better health choices that assist in the prevention of diseases. Both roles focus on healthcare promotion and creation of healthcare programs. The educators are more inclined to training perspective while the leader is more focused on assessing, planning and evaluating healthcare programs. Health Care Administration I will use the skills and knowledge for perspective authority. As a nurse leader, I oversee the administration particular levels of a controlled substances based on what condition they are in. I also have the role of admitting patient into facilities of health care. The nurse educator has the role of developing promotion or health education programs (Daley, Morgan, & Black, 2015). There also have the task of managing as well as the duty of carrying out administrative duties in relation to working with community stakeholders. The two roles concentrate on the promotion of healthcare. The educators develop programs that reflect the interest of community stakeholders, which is also common to leaders. Informatics Coordination and communication involved in the multidisciplinary team within the healthcare field are vital (Finnell et al., 2015). In
[ANSWERED 2023] Herzbergs two-factor theory speaks to issues relevant in both employee compensation
Herzbergs two-factor theory speaks to issues relevant in both employee compensation Herzbergs two-factor theory speaks to issues relevant in both employee compensation and benefits as it discusses why people choose a workplace, as well as what keeps employees Week 4 – Discussion 1 Herzberg’s Two-Factor Theory Herzbergs two-factor theory speaks to issues relevant in both employee compensation and benefits as it discusses why people choose a workplace, as well as what keeps employees satisfied and committed to their work. For more information on Herzberg’s two-factor theory, see the Frederick Herzberg motivational theory (Links to an external site.). Imagine that you are an HR manager in a contemporary firm and answer the following: Who are you trying to recruit to work for you (i.e., your audience)? What sort of compensation and benefits package would you ensure is in place to recruit the best candidates for the position? Week 4 – Discussion 2 Keeping Employees Motivated If you have taken the time to review Herzberg’s work, you may have learned that people accept a job and stay on the job for different motivational reasons. Job satisfaction is achieved through what Herzberg would categorize as motivational factors (personal growth; responsibility; the work itself; opportunities for achievement, advancement, recognition; and/or to make a positive difference) rather than hygiene factors (status, salary, job security, types of supervision, etc.). Using at least three comparison web examples from the industry you used in your “Herzberg’s Two-Factor Theory” discussion post this week, delineate a creative employee benefits plan designed to keep your best employees satisfied and motivated. Remember to include all of the links as well as references from the course text and other sources to support your rationale. Expert Answer and Explanation Week 4 – Discussion 1 Compensation and Benefit Packages As a Human Resource (HR), I am seeking to recruit individuals who have some key work qualities. These individuals should be fast learners, and have the necessary skills required for the job. For instance, they should effectively communicate, and have the ability to work with minimal supervision. Other qualities I am looking for include the ability to critically think as well as the ability to adapt based on the existing organizational needs. Because these candidates will work with client from diverse backgrounds, it would be imperative that they be culturally sensitive and know how to address the various cultural and spiritual needs of the diverse individuals (Youssef-Morgan & Stark.2020). For an organization, having a solid employee compensation program can be important in the sense that it can help attract employees. I would, for instance, have a base pay which would depend on the amount of time an employee would spend at work. In this case, I would sate the work rate at $15 an hour, and I would also consider paying $18 an hour for the over time. Based on the compensation program, still, the employees would receive bonuses based on how best they work as well as based on the amount of work they perform during a particular period (Grusky & Hill, 2018). Other than compensation, the employees would need various benefits. Considering the emphasis on the continuing education to improve organizational performance, part of the benefits include partially funded education to help employees pursue skill development opportunities so that the organization would benefit from these skills. Besides, they would have medical cover, and receive retirement funds every month (Bussin, 2015). This is to ensure that they don’t experience the burden associated with access to health care services. References Bussin, M. (2015). Expatriate Compensation. S.l: Knowres Publishing. Grusky, D. B., & Hill, J. (2018). Inequality in the 21st century: A reader. Boulder: Routledge. Youssef-Morgan, C. M., & Stark. E. (2020). Strategic human resource management: Concepts, controversies, and evidence-based applications. Retrieved from https://content.ashford.edu/ Week 4 – Discussion 2 Employee Benefits Plan Benefits Features of the Benefits Health Insurance American International Group Deductible of 1,200, paid on monthly basis. $5000 which the employee would be paying from their pockets. Coverage of the Dental Care Every employee would receive dental care amounting to $150, 000. The cost will go for checkup of the dental health problems as well as the treatment of the same (Bussin, 2015). Life Insurance which employee can either decide to have or not to have $320,000 deducted from the employee salaries. Eye care $12000 eye care for every employee. This money will cater for the eye checkup, and treatment of the eye issues. It will also cater for the purchase of the eye glasses (Grusky & Hill, 2018). Workers with Disability Would receive 5% of the average salary to help them with mobility. Holiday Incentives A total of 7 holidays which the company finances. This ranges from between $3000 to $5,000. Travelling allowance 8000 Partly funded education $ 360,000 is the amount which the organization pays. $123,000 is the amount which the employee is supposed to pay for the education (Youssef-Morgan & Stark. 2020). Paid benchmarking program $40,000 for each employee. This goes to funding the programs focused on helping employees learn about the new service delivery models, and the application of the same. Paid leave for every member of the staff The employees will continue receiving salaries even when they are on leave. However, this leave has to be certified and official for it to be considered legit. Paid maternal leave for the female employees. This is offered two months prior to birth and six months after birth. Thus, the mother would report to work after the eight month duration has elapsed. References Bussin, M. (2015). Expatriate Compensation. S.l: Knowres Publishing. Grusky, D. B., & Hill, J. (2018). Inequality in the 21st century: A reader. Boulder: Routledge. Youssef-Morgan, C. M., & Stark. E. (2020). Strategic human resource management: Concepts, controversies, and evidence-based applications. Retrieved from https://content.ashford.edu/ 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 Herzberg Two-Factor Theory Summary Herzberg’s Two-Factor Theory is a theory of motivation that suggests that
[ANSWERED 2023] Describe the selected environmental factor. Explain how the environmental factor
Describe the selected environmental factor. Explain how the environmental factor The growth, development, and learned behaviors that occur during the first year of infancy have a direct effect on the individual throughout a lifetime. For this assignment, research an environmental factor that poses a threat to the health or safety of infants and develop a health promotion that can be presented to caregivers. Create a 10-12 slide PowerPoint health promotion, with speaker notes, that outlines a teaching plan. For the presentation of your PowerPoint, use Loom to create a voice over or a video. Include an additional slide for the Loom link at the beginning, and an additional slide for references at the end. In developing your PowerPoint, take into consideration the health care literacy level of your target audience, as well as the demographic of the caregiver/patient (socioeconomic level, language, culture, and any other relevant characteristic of the caregiver) for which the presentation is tailored Include the following in your presentation: Describe the selected environmental factor. Explain how the environmental factor you selected can potentially affect the health or safety of infants. Create a health promotion plan that can be presented to caregivers to address the environmental factor and improve the overall health and well-being of infants. Offer recommendations on accident prevention and safety promotion as they relate to the selected environmental factor and the health or safety of infants. Offer examples, interventions, and suggestions from evidence-based research. At least three scholarly resources are required. Two of the three resources must be peer-reviewed and no more than 6 years old. Provide readers with two community resources, a national resource, and a Web-based resource. Include a brief description and contact information for each resource. Refer to the resource, \”Creating Effective PowerPoint Presentations,\” located in the Student Success Center, for additional guidance on completing this assignment in the appropriate style. Refer to the resource, \”Loom,\” located in the Student Success Center, for additional guidance on recording your presentation. 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. Expert Answer and Explanation Exposing infants to second hand poses a serious negative health impacts which can lead to death of the infant. Second hand smoke can be defined as smoke exhaled by a smoker combined with smoke emitted by the burning end of the cigarette. According to Faber et al. (2016) second hand smoke is responsible for approximately 166 ,000 global child deaths. This presentation will focus on different issues tackling the exposure of secondhand smoke on infants. Second hand smoking has serious health repercussions on infants. Some of them include;- second hand smoke can lead to sudden infant death syndrome. This is a phenomenon where an infant suddenly dies without any signs of preexisting medical condition and usually occurs while sleeping (Adams, Ward & Garcia, 2015). Researchers have attributed this phenomenon to respiratory issues with second hand smoking being a contributing agent it is also reported that a number of children who died from SID had high levels of nicotine found in their lungs (Fleming, Blair & Pease, 2015). Second hand smoke also puts children at risk of getting ear infections and other respiratory complications like bronchitis and pneumonia in infants. Second hand smoke can also trigger asthmatic attacks in asthmatic infants (Wang et al., 2016). Second hand smoking is known to be one of the issues that causes lower birth weight in infants which in most cases translates to poor health status for the infant (Banderali et al., 2015) Long term exposure of second hand smoke on infants also leads to poor brain development which may lead to learning disorders. It may also affect lung development leading to future respiratory complications. Second hand smoke can also cause infants to develop coughs. The health promotion plan which can be used by caregivers to help deal with secondhand smoke and its effects on infants will involve the following set of activities. Collection of evidence based information on the issue of second hand smoking and how it affects infants. This is to ensure that the health promotion is based on factual evidence with proved workable solutions that can assist in dealing with the issue. Establishing the required resources needed for the health promotion is also an important activity. some of the resources which will be required include learning materials, financial support, treatment facilities to aid any patient who may require help in dealing with second hand smoking, experts to articulate on the matter, to list a few. For any health promotion activity, it is important to have measurable goals which are going to be used to measure the success of the health promotion (Fertman & Allensworth, 2016) . Having a system of evaluating the progress and impact of the health promotion is another important activity of the health promotion. Implementing the plan after ensuring that everything is properly set up is the last part of the health promotion plan. Some of the recommendations to protect infants from second hand smoke include; Making the house and its close environs a smoke free zone. Smoke from cigarettes takes time before it dissipates from the environment. Smoking within the house environs can put the infant at risk of being exposed to second hand smoke leading to the several detrimental health effects listed earlier. It is also recommended to avoid smoking in vehicles carrying infants and exposure to smoking areas. Such environments which have high concentration of second hand smoke may pose more severe health consequences on the infant. The community also needs to be informed on the negative effects of primary and second hand
[ANSWERED 2023] Tania Douglas is a 36-year-old attorney living in Miami. Dolores is in the second trimester of pregnancy with her first child, and though her pregnancy had been progressing normally
Tania Douglas is a 36-year-old attorney living in Miami. Dolores is in the second trimester of pregnancy with her first child, and though her pregnancy had been progressing normally Tania Douglas is a 36-year-old attorney living in Miami. Dolores is in the second trimester of pregnancy with her first child, and though her pregnancy had been progressing normally, recently she has noticed that she tires very easily and is short of breath from even the slightest exertion. She also has experienced periods of light-headedness, though not to the point of fainting. Other changes she has noticed are cramping in her legs, a desire to crunch on ice, and the fact that her tongue is sore. She doubts that all these symptoms are related to one another, but she is concerned, and she makes an appointment to see her physician. Upon examining Tania, her physician finds that she has tachycardia, pale gums and nail beds, and her tongue is swollen. Given her history and the findings on her physical exam, the physician suspects that Tania is anemic and orders a sample of her blood for examination. Th e results are shown below: Red Blood Cell Count 3.5 million/ mm3 Hemoglobin (Hb) 7 g/dl Hematocrit (Hct) 30% Serum Iron: Low Mean Corpuscular Volume (MCV): Low Mean Corpuscular Hb Concentration (MCHC): Low Total Iron Binding Capacity in the Blood (TIBC): High A diagnosis of anemia due to iron deficiency is made and oral iron supplements prescribed. Tania’s symptoms are eliminated within a couple of weeks and the remainder of her pregnancy progresses without difficulty. 1. What is Iron Deficiency Anemia (IDA)? Discuss its causes. 2. What are the diagnostic tests for IDA? What is the significance of the red blood cells indices for IDA? 3. How is IDA treated and prevented? 4. Provide patient education EXPERT ANSWER AND EXPLANATION Iron Deficiency Anemia (IDA) Definition and Etiology Camaschella (2017) posits that this is a disorder of the hematological system that results from inadequate iron supply to the bone marrow, with resultant impaired production of red blood cells along with deficient hemoglobinization. The resultant cells are therefore described as being microcytic and hypochromic, on the basis of the red blood cell indices as will be elucidated later. Notably, the extent of hypochromia and microcytosis corresponds to the chronicity and severity of the disease. Four major mechanisms, according to Hoffbrand & Moss (2015), are postulated to bear implications in the etiology, pathogenesis and subsequent course of iron deficiency anemia. This includes inadequate dietary intake of iron, impaired absorption of iron, increased losses and enhanced demand. Illnesses and socioeconomic factors contribute to inadequate feeding and thus deficiency while 8malabsorption is usually secondary to small bowel disorders and/or extensive bowel surgeries. Hemorrhage contributes to significant iron losses, while pregnancy is one of the states of increased demand (Hoffbrand & Moss, 2015). Diagnostics While the diagnosis of anemia is commonly made clinically, assessment of the specific type of anemia as well as severity needs laboratory diagnosis (Wu, Lesperance & Bernstein, 2016). As part of the initial diagnosis, performing complete blood count (CBC), bone marrow aspiration and iron studies. CBC provides information on the red cell indices and the state of other blood cell lines, which is important in knowing whether it is a pancytopenic process. Iron studies involves doing serum iron levels, serum ferritin and transferrin. The former is usually low while the remaining two are usually elevated (Wu, Lesperance & Bernstein, 2016). Bone marrow aspiration aids in gauging the marrow response to the anemia as well as assessing iron stores. Further tests to be done regarding etiology include stool culture and endoscopic procedures. Significance of Red Blood Cell Indices Red blood cell indices, as a component of complete blood count, provides a fast, easy to do laboratory technique of assessing the severity of anemia as well as (Wu, Lesperance & Bernstein, 2016). Iron deficiency anemia is associated with characteristic changes in the red cell morphology, size, hemoglobin content and number, and this is manifested in the indices as microcytosis, hypochromia and reduced absolute numbers of red cells. Treatment and Prevention According to Cantor et al. (2015) prevention of the disorder involves observance of hygienic dietary practices such as washing foods well enough as well periodic deworming of the at risk groups, feeding practices which should also revolve around iron rich foods such as spinach and meat and for pregnant women, IFAS should be provided and taken as prescribed. Therapy varies depending on severity, where oral iron supplementation is provided for mild to moderate cases in form of ferrous sulphate or gluconate, whereas parenteral iron is given for acute severe cases. In even more demanding scenarios, transfusion is recommended (Cantor et al., 2015). Patient Education IDA is the most prevalent anemia and educating the masses is an integral part of ensuring control and proper management of the disorder (DeLoughery, 2017). Measures patients should be taught include: Encouraging deworming for under 5 year old children as well as at risk adults. Healthy feeding practices involving eating iron rich foods such as fruits and vegetables. Prompt treatment and prevention of malaria in pregnancy in endemic areas. Advising taking of IFAS by pregnant women as prescribed by the practitioner. References Camaschella, C. (2017). New insights into iron deficiency and iron deficiency anemia. Blood reviews, 31(4), 225-233. Cantor, A. G., Bougatsos, C., Dana, T., Blazina, I., & McDonagh, M. (2015). Routine iron supplementation and screening for iron deficiency anemia in pregnancy: a systematic review for the US Preventive Services Task Force. Annals of internal medicine, 162(8), 566-576. DeLoughery, T. G. (2017). Iron deficiency anemia. Medical Clinics, 101(2), 319-332. Hoffbrand, A. V., & Moss, P. A. (2015). Hoffbrand’s essential haematology (Vol. 38). John Wiley & Sons. Wu, A. C., Lesperance, L., & Bernstein, H. (2016). Screening for iron deficiency. Policy Statement, 23, 171-177. 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 What is the main cause of IDA?
[ANSWERED] Students will develop a 1,250-1,500 word paper that includes the following information as it applies to the problem, issue, suggestion, initiative, or educational need profiled in the capstone change proposal
Students will develop a 1,250-1,500 word paper that includes the following information as it applies to the problem, issue, suggestion, initiative Students will develop a 1,250-1,500 word paper that includes the following information as it applies to the problem, issue, suggestion, initiative, or educational need profiled in the capstone change proposal. Benchmark – Capstone Project Change Proposal In this assignment, students will pull together the change proposal project components they have been working on throughout the course to create a proposal inclusive of sections for each content focus area in the course. At the conclusion of this project, the student will be able to apply evidence-based research steps and processes required as the foundation to address a clinically oriented problem or issue in future practice. Students will develop a 1,250-1,500 word paper that includes the following information as it applies to the problem, issue, suggestion, initiative, or educational need profiled in the capstone change proposal: Background Problem statement Purpose of the change proposal PICOT Literature search strategy employed Evaluation of the literature Applicable change or nursing theory utilized Proposed implementation plan with outcome measures Identification of potential barriers to plan implementation, and a discussion of how these could be overcome Appendix section, if tables, graphs, surveys, educational materials, etc. are created Review the feedback from your instructor on the Topic 3 assignment, PICOT Statement Paper, and Topic 6 assignment, Literature Review. Use the feedback to make appropriate revisions to the portfolio components before submitting. Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required. 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. Please refer to the directions in the Student Success Center. Expert Answer and Explanation Capstone Project Final Background The nursing shortage is one of the major issues that need immediate attention in the US and other parts of the world. According to Kim, Park, Han, Kim and Kim (2016), the US government employed more than 100,000 new nurses in 2002. However, the demand for nurses in the country was not affected by the move. The author argued that the government should do more to combat the problem in a move to improve patient outcome. One of the issues that were found to cause a nursing shortage in healthcare facilities is low employee satisfaction. Lisa, Cydne, Altair, Paul and Michael (2017) mentioned that the majority of nurses who leave the healthcare industry often do that because they are not happy with their current working environment. Also, low wages can be another key factor that leads to a nursing shortage within healthcare facilities. Lack of motivation programs in the facility can also be linked to the high rate of nurse shortage in the health care sector. The ever-increasing world population also causes the nursing shortage. The population of the world is growing, but few people are joining the nursing profession. Nurse shortage has many drastic effects on patients and hospitals. Alharbi (2017) reports that nurses often work for long hours without rest due to nurse shortage, and this can cause injury, fatigue, and tiredness among the nurses. Another effect of nurse shortage is employee dissatisfaction. Kim et al. (2016) argue that nurses are always dissatisfied in a working environment where they are overworked. Nursing shortage can also lead to medical errors and missed events because of fatigue and tiredness. As a result, care quality can be affected, and this can lead to patient dissatisfaction. Lastly, nurse shortage can cause an increased mortality rate and overcrowding of the emergency rooms (Tacy, 2016). Clinical Problem Statement The nursing shortage is one of the major problems affecting the healthcare sector. According to Nantsupawat et al. (2017), the nursing shortage causes the health industry about $400 million every year. Apart from the economic effect, the nursing shortage can lead to nurse burnout because the available few nurses are forced to work for long hours without rest. McKechnie (2016) argues that nurse shortage is the main reason for several cases of medical errors across healthcare institutions. When the nurses are fatigued and tired, they are most likely to conduct activities that may lead to medical errors and missed events. Thus, the healthcare sector should strive to reduce nurse shortage in a move to improve patient care. Purpose of the change proposal concerning providing patient care in the changing health care system. The sole purpose of this capstone project is to propose solutions that can be used to improve the number of nurses in the healthcare sector so that they can improve patient care by providing quality care. PICOT Question For patients admitted in ICU (P), does putting in place a fixed nurse staffing ratios (I) as compared to not having fixed nurse staffing ratios (C) affect patient outcomes(O) during their hospitalization period under intensive care (T)? Literature search strategy employed The search for articles published not later than five years were conducted via Grand Canyon University online library. These databases include the Wiley online library, National Institutes of Health library (NIH), and National Center for Biotechnology Information library (NCBI). Google Scholar was also used to search for the articles. Nursing shortage, staffing ratios, and nurse burnout are some of the search terms used in the strategy. To ensure that the search was exhaustive, variations of the terms were used. After the search for the articles, the resources found were evaluated. Evaluation of the Literature Eight articles were used to answer the PICOT question. An article by Alharbi (2017) concluded that poor leadership management could lead to low job satisfaction, medical errors, and high turnover. Also, an article by Kollman (2019) found that acuity-based staffing (ABS) can be used to improve patient outcome. Fischer (2016) concluded that the education of nurses could be used to improve the nursing shortage. Kim et al. (2016) noted in their study that high
[ANSWERED 2023] Choose one skin condition graphic (identify by number in your Chief Complaint) to document your assignment in the SOAP
Choose one skin condition graphic (identify by number in your Chief Complaint) to document your assignment in the SOAP Assignment 1: Lab Assignment: Differential Diagnosis for Skin Conditions Properly identifying the cause and type of a patient’s skin condition involves a process of elimination known as differential diagnosis. Using this process, a health professional can take a given set of physical abnormalities, vital signs, health assessment findings, and patient descriptions of symptoms, and incrementally narrow them down until one diagnosis is determined as the most likely cause. In this Lab Assignment, you will examine several visual representations of various skin conditions, describe your observations, and use the techniques of differential diagnosis to determine the most likely condition. To Prepare Review the Skin Conditions document provided in this week’s Learning Resources, and select one condition to closely examine for this Lab Assignment. Consider the abnormal physical characteristics you observe in the graphic you selected. How would you describe the characteristics using clinical terminologies? Explore different conditions that could be the cause of the skin abnormalities in the graphics you selected. Consider which of the conditions is most likely to be the correct diagnosis, and why. Search the Walden library for one evidence-based practice, peer-reviewed article based on the skin condition you chose for this Lab Assignment. Review the Comprehensive SOAP Exemplar found in this week’s Learning Resources to guide you as you prepare your SOAP note. Download the SOAP Template found in this week’s Learning Resources, and use this template to complete this Lab Assignment. The Lab Assignment Choose one skin condition graphic (identify by number in your Chief Complaint) to document your assignment in the SOAP (Subjective, Objective, Assessment, and Plan) note format rather than the traditional narrative style. Refer to Chapter 2 of the Sullivan text and the Comprehensive SOAP Template in this week’s Learning Resources for guidance. Remember that not all comprehensive SOAP data are included in every patient case. Use clinical terminologies to explain the physical characteristics featured in the graphic. Formulate a differential diagnosis of three to five possible conditions for the skin graphic that you chose. Determine which is most likely to be the correct diagnosis and explain your reasoning using at least three different references, one reference from current evidence-based literature from your search and two different references from this week’s Learning Resources. Week 4: Assessment of the Skin, Hair, and Nails Something as small and simple as a mole or a discolored toenail can offer meaningful clues about a patient’s health. Abnormalities in skin, hair, and nails can provide non-invasive external clues to internal disorders or even prove to be disorders themselves. Being able to evaluate such abnormalities of the skin, hair, and nails is a diagnostic benefit for any nurse conducting health assessments. This week, you will explore how to assess the skin, hair, and nails, as well as how to evaluate abnormal skin findings. Properly identifying the cause and type of a patient’s skin condition involves a process of elimination known as differential diagnosis. Using this process, a health professional can take a given set of physical abnormalities, vital signs, health assessment findings, and patient descriptions of symptoms, and incrementally narrow them down until one diagnosis is determined as the most likely cause. In this Lab Assignment, you will examine several visual representations of various skin conditions, describe your observations, and use the techniques of differential diagnosis to determine the most likely condition. To Prepare Review the Skin Conditions document provided in this week’s Learning Resources, and select one condition to closely examine for this Lab Assignment. Consider the abnormal physical characteristics you observe in the graphic you selected. How would you describe the characteristics using clinical terminologies? Explore different conditions that could be the cause of the skin abnormalities in the graphics you selected. Consider which of the conditions is most likely to be the correct diagnosis, and why. Search the Walden library for one evidence-based practice, peer-reviewed article based on the skin condition you chose for this Lab Assignment. Review the Comprehensive SOAP Exemplar found in this week’s Learning Resources to guide you as you prepare your SOAP note. Download the SOAP Template found in this week’s Learning Resources, and use this template to complete this Lab Assignment. The Lab Assignment Choose one skin condition graphic (identify by number in your Chief Complaint) to document your assignment in the SOAP (Subjective, Objective, Assessment, and Plan) note format rather than the traditional narrative style. Refer to Chapter 2 of the Sullivan text and the Comprehensive SOAP Template in this week’s Learning Resources for guidance. Remember that not all comprehensive SOAP data are included in every patient case. Use clinical terminologies to explain the physical characteristics featured in the graphic. Formulate a differential diagnosis of three to five possible conditions for the skin graphic that you chose. Determine which is most likely to be the correct diagnosis and explain your reasoning using at least three different references, one reference from current evidence-based literature from your search and two different references from this week’s Learning Resources. Week 4: Assessment of the Skin, Hair, and Nails Something as small and simple as a mole or a discolored toenail can offer meaningful clues about a patient’s health. Abnormalities in skin, hair, and nails can provide non-invasive external clues to internal disorders or even prove to be disorders themselves. Being able to evaluate such abnormalities of the skin, hair, and nails is a diagnostic benefit for any nurse conducting health assessments. This week, you will explore how to assess the skin, hair, and nails, as well as how to evaluate abnormal skin findings. NURS_6512_Week_4_Assignment_1_Rubric NURS_6512_Week_4_Assignment_1_Rubric Criteria Ratings Pts This criterion is linked to a Learning Outcome Using the SOAP (Subjective, Objective, Assessment, and Plan) note format: · Create documentation, following SOAP format, of your assignment to choose one skin condition graphic (identify by number in your Chief Complaint). · Use clinical terminologies to explain the physical characteristics featured in the graphic. 35 to >29.0 pts Excellent The response
[ANSWERED 2023] Identify a quality improvement opportunity in your organization or practice. In a 1,250-1,500 word paper, describe the problem
Identify a quality improvement opportunity in your organization or practice. In a 1,250-1,500 word paper, describe the problem or issue and propose a quality improvement initiative based on evidence-based practice Identify a quality improvement opportunity in your organization or practice. In a 1,250-1,500 word paper, describe the problem or issue and propose a quality improvement initiative based on evidence-based practice. Apply “The Road to Evidence-Based Practice” process, illustrated in Chapter 4 of your textbook, to create your proposal. Include the following: Provide an overview of the problem and the setting in which the problem or issue occurs. Explain why a quality improvement initiative is needed in this area and the expected outcome. Discuss how the results of previous research demonstrate support for the quality improvement initiative and its projected outcomes. Include a minimum of three peer-reviewed sources published within the last 5 years, not included in the course materials or textbook, that establish evidence in support of the quality improvement proposed. Discuss steps necessary to implement the quality improvement initiative. Provide evidence and rationale to support your answer. Explain how the quality improvement initiative will be evaluated to determine whether there was improvement. Support your explanation by identifying the variables, hypothesis test, and statistical test that you would need to prove that the quality improvement initiative succeeded. 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 Problem or Issue in Practice or Organization 7.5 points Significance of Quality Improvement in Practice or Organization 15 points Demonstration of Support from Previous Research 22.5 points Steps Necessary to Implement Quality Improvement Initiative 22.5 points Evaluation of Quality Improvement 22.5 points Identification of Variables, Hypothesis Test, and Statistical Test 15 points Thesis Development and Purpose 10.5 points Argument Logic and Construction 12 points Mechanics of Writing 7.5 points Paper Format 7.5 points Documentation of Sources 7.5 points Total 150 points Expert Answer and Explanation Quality Improvement Proposal Pediatric care centers are crucial in addressing the health needs of children, but they face issues that risk plaguing the entire healthcare industry. Among these issues include care variation, communication breakdown across patients and between providers, patient discharge variations, and avoidable medical errors. The initiation of quality improvement initiatives helps to address some of these issues by devising strategies to better-face the associated challenges (Randmaa, 2016). Following its quality improvement initiative regarding communication errors, Duke Children’s Hospital in Durham, NC was among the facilities that won the 2013 Pediatric Quality Award Winners (Children’s Hospital Association, 2020). Nurse leasers and other people who are vision bearers in hospitals are expected to lead in these quality improvement projects, which would not only help in saving the associated monetary damages, but would also add to the patient satisfaction. Overview of the Problem and the Setting in which the Problem Occurs Communication errors in facilities often have the impact of creating teamwork breakdowns, which results in medical errors as well as poor patient outcomes. Also, facilities with communication breakdowns often have higher costs of care as well as prolonged length of stay. Among the common causes of communication errors in healthcare is the lack of proper education among healthcare providers as well as among patients. Whenever the patients, for instance, are unable to interpret the message of the healthcare givers, they often create a communication gap that leads to ineffective healthcare. Also, healthcare givers who do not have the right education about dealing with different patient care outcomes are likely to result in communication errors (Boling, 2020). There are many settings for the problem to occur, but most of the time, communication errors happen where there is interaction between people in the healthcare set up. For instance, during patient discharge, the healthcare providers give various instructions to patients to enhance their wellbeing while away from the facility. If there is a communication challenge, it is likely that they cannot experience the right recovery. Why a Quality Improvement Initiative is needed in this Area and the Expected Outcomes A quality improvement initiative is needed in this area because this is an area of care where failure is likely to lead to numerous inefficiencies. If there is no intervention regarding communication errors, it is likely that a facility will be less capable of addressing the patient care demands. Clinicians who communicate wrongly do not have what it takes to listen, explain, and emphasize the effect of functional and biological outcomes. Also, the fact that clinicians have thousands of patient interactions in the course of their career means that a misunderstanding about a communication error may lead to lifelong effects on their career by repeating numerous mistakes on patients. Also, in healthcare, there are competing demands that show that communication errors leads to adverse effects on patient privacy, which has recently become a healthcare concern due to the introduction of technology and other modern means of communication. Solving communication errors helps in embracing better evidence-based practice and improving the care outcomes. How the Results of Previous Research Demonstrate Support for the Quality Improvement Initiative and the Projected Outcomes Omura et al. (2017) discusses about some of the implication of assertiveness communication training programs among nursing students and healthcare professionals. The research identifies communication errors as part of the reasons why there are numerous negative effects on patient safety. Healthcare providers should acquire the necessary skills to eliminate patient risk through improving the communication methods and avoiding the occurrence of communication errors (Omura et al., 2017). There is also evidence that interventions improve assertive communication is often more efficient in some groups. Also, teamwork in healthcare is only possible with the help of the relevant communication strategies. Grahramanian et
[ANSWERED 2023] Select a child or adolescent patient that you examined during the last 3 weeks who presented with a disorder for which you have not already created a Focused SOAP Note in Weeks 3 or 7
Select a child or adolescent patient that you examined during the last 3 weeks who presented with a disorder for which you have not already created a Focused SOAP Note in Weeks 3 or 7 Assignment 2: Focused SOAP Note and Patient Case Presentation For this Assignment, you will document information about a patient that you examined during the last 3 weeks, using the Focused SOAP Note Template provided. You will then use this note to develop and record a case presentation for this patient. Be sure to incorporate any feedback you received on your Week 3 and Week 7 case presentations into this final presentation for the course. To Prepare Review the Kaltura Media Uploader resource in the left-hand navigation of the classroom for help creating your self-recorded Kaltura video. Select a child or adolescent patient that you examined during the last 3 weeks who presented with a disorder for which you have not already created a Focused SOAP Note in Weeks 3 or 7. (For instance, if you selected a patient with anorexia nervosa in Week 7, you must choose a patient with another type of disorder for this week.) Create a Focused SOAP Note on this patient using the template provided in the Learning Resources. There is also a completed Focused SOAP Note Exemplar provided to serve as a guide to assignment expectations. Please Note: All SOAP notes must be signed, and each page must be initialed by your Preceptor. Note: Electronic signatures are not accepted. When you submit your note, you should include the complete focused SOAP note as a Word document and PDF/images of each page that is initialed and signed by your Preceptor. You must submit your SOAP note using SafeAssign. Note: If both files are not received by the due date, faculty will deduct points per the Walden Grading Policy. Then, based on your SOAP note of this patient, develop a video case study presentation. Take time to practice your presentation before you record. Include at least five scholarly resources to support your assessment, diagnosis, and treatment planning. Ensure that you have the appropriate lighting and equipment to record the presentation. The Assignment Record yourself presenting the complex case for your clinical patient. Do not sit and read your written evaluation! The video portion of the assignment is a simulation to demonstrate your ability to succinctly and effectively present a complex case to a colleague for a case consultation. The written portion of this assignment is a simulation for you to demonstrate to the faculty your ability to document the complex case as you would in an electronic medical record. The written portion of the assignment will be used as a guide for faculty to review your video to determine if you are omitting pertinent information or including non-essential information during your case staffing consultation video. In your presentation: Dress professionally and present yourself in a professional manner. Display your photo ID at the start of the video when you introduce yourself. Ensure that you do not include any information that violates the principles of HIPAA (i.e., don’t use the patient’s name or any other identifying information). Present the full complex case study. Include chief complaint; history of present illness; any pertinent past psychiatric, substance use, medical, social, family history; most recent mental status exam; current psychiatric diagnosis including differentials that were ruled out; and plan for treatment and management. Report normal diagnostic results as the name of the test and “normal” (rather than specific value). Abnormal results should be reported as a specific value. Be succinct in your presentation, and do not exceed 8 minutes. Specifically address the following for the patient, using your SOAP note as a guide: Subjective: What details did the patient provide regarding their chief complaint and symptomology to derive your differential diagnosis? What is the duration and severity of their symptoms? How are their symptoms impacting their functioning in life? Objective: What observations did you make during the psychiatric assessment? Assessment: Discuss their mental status examination results. What were your differential diagnoses? Provide a minimum of three possible diagnoses and why you chose them. List them from highest priority to lowest priority. What was your primary diagnosis, and why? Describe how your primary diagnosis aligns with DSM-5 diagnostic criteria and supported by the patient’s symptoms. Plan: In your video, describe your treatment plan using clinical practice guidelines supported by evidence-based practice. Include a discussion on your chosen FDA-approved psychopharmacologic agents and include alternative treatments available and supported by valid research. All treatment choices must have a discussion of your rationale for the choice supported by valid research. What were your follow-up plan and parameters? What referrals would you make or recommend as a result of this treatment session? In your written plan include all the above as well as include one social determinant of health according to the HealthyPeople 2030 (you will need to research) as applied to this case in the realm of psychiatry and mental health. As a future advanced provider, what are one health promotion activity and one patient education consideration for this patient for improving health disparities and inequities in the realm of psychiatry and mental health? Demonstrate your critical thinking. Reflection notes: What would you do differently with this patient if you could conduct the session over? If you are able to follow up with your patient, explain whether these interventions were successful and why or why not. If you were not able to conduct a follow up, discuss what your next intervention would be. Excellent Good Fair Poor Photo ID display and professional attire 5 (5%) – 5 (5%) Photo ID is displayed. The student is dressed professionally. 0 (0%) – 0 (0%) 0 (0%) – 0 (0%) 0 (0%) – 0 (0%) Photo ID is not displayed. Student must remedy this before grade is posted. The student is not dressed professionally. Time 5 (5%) – 5 (5%) The video does not exceed the 8-minute time limit. 0 (0%) – 0 (0%) 0 (0%) – 0 (0%) 0 (0%) – 0 (0%) The video exceeds the 8-minute time limit. (Note: Information presented after 8 minutes will not be evaluated for grade inclusion.) Discuss Subjective data: • Chief complaint • History of present illness (HPI) •