Nursing Multidimensional Care2

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Assignment-Interpersonal Psychotherapy

Using Yalom’s The Gift of Therapy,  Wheeler’s Psychotherapy for the Advanced Practice Nurse, (Barry and Wheeler) Chapter 9, Interpersonal Psychotherapy, and

the following journal article

Markowitz & Weissman, Interpersonal Psychotherapy: Past, Present, and Future

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3427027/

After reading The Wheeler Chapter and the information from Markowitz and Weissman the nurse therapist has knowledge that  Peplau based her theory on the work of Sullivan. Interpret Yalom’s work and how it is applicable for the APRN. Please view the slide information about Peplau’s work below:

https://www.slideshare.net/AnnHinnenSparks/peplau-interpersonal-relations-pptppx-

The introduction of your paper should include:

Describe the interpersonal psychotherapy occurring in your clinical setting. If this is not occurring, describe how you will incorporate this into practice.

This paper should provide an overall reflection of the student’s clinical interpersonal psychotherapy experience and should demonstrate the student’s ability to process a therapeutic session; the student is expected to obtain skills to conduct psychotherapy this semester.  The format of this paper is left to the discretion of the student as long as all requirements are included and APA 7th edition format is followed.  Required readings support your work, however, you should use evidence-based journals and advanced practice nursing literature to inform and support your paper. Citations of references using APA 6th edition style are to support the analyses and interpretation of group dynamics. The paper should be under 20  pages.

1.  Provide the setting, population, background information where the individual therapy occurs

2. Give case examples that illustrate the use of interpersonal psychotherapy

3. Describe the differences in approach when using IPT as compared to psychodynamic psychotherapy and the reason the approach works in this setting.

4. Describe the psychiatric issues in your case study and how IPT is helpful

5. Describe how the IPT approach compares to Peplau’s Interpersonal Model

Interpersonal Psychotherapy paper Rubric (worth 15% of your grade)
Objective

Each section worth 20 points

 Excellent (16-20 points) Good (11-15 points) Fair (6-10 points) Poor (0-5 points)
1. Provide the setting, population, background information where the individual therapy occurs

 

        
2. Give case examples that illustrate the use of interpersonal psychotherapy

 

        
3. Describe the differences in approach when using IPT as compared to psychodynamic psychotherapy and the reason the approach works in this setting.

 

 

 

        
4. Describe the psychiatric issues in your case study and how IPT is helpful and Describe how the IPT approach compares to Peplau’s Interpersonal Model

 

 

 

        
5. APA format, citations.  

A N P CASE STUDY

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QUESTION 1

1. Kari is a relatively healthy 42-year-old female with well-managed diabetes. She reports occasional alcohol intake, smokes cigarettes only when drinking, and exercises 3-4 times a week. She has a history of mild myopia, which she has corrected with glasses and contacts since she was 14 years old. Kari has been having trouble seeing at night. It has been gradually getting worse and she was tripped on a rug and bumped into a few walls within the last week. She has also noticed that small text seems blurrier than usual. Kari always makes sure to schedule annual visits to her eye doctor. Luckily, it’s almost time for this year’s check-up because she thinks she might need a new prescription for her glasses and contacts.   Kari’s mild myopia means:

    Light is focused on the fovea centralis.
    She has trouble focusing on objects close to her face.
    Light is focused behind her retina.
    She has trouble seeing objects at a distance.

1 points   

QUESTION 2

1. Of the limited history you are given, which item could NOT be related to the vision issues she is experiencing?

    Diabetes
    Exercising 3-4 times a week
    Smoking tobacco
    Alcohol intake

1 points   

QUESTION 3

1. Myopia becomes more prevalent as one ages.  

True

False

1 points   

QUESTION 4

1. Kari has two grandparents who had glaucoma in their lifetime. Do any of Kari’s symptoms support a diagnosis of glaucoma? If so, which one(s)?

 

1 points   

QUESTION 5

1. Kari’s ophthalmologist measures her intraocular pressure and finds that it is normal. With this information, which of the following diagnoses can be ruled out?

    Myopia
    Glaucoma
    Hyperopia
    Cataracts

1 points   

QUESTION 6

1. During her annual visit, her doctor asks Kari for more specific information regarding her current symptoms. Which of the following symptoms would NOT be suggestive of cataracts?

    Loss of peripheral vision
    Faded colors
    Trouble with bright lights
    Halos around lights

1 points   

QUESTION 7

1. A cataract consists of clouding in which structure?

    Sclera
    Retina
    Cornea
    Lens

1 points   

QUESTION 8

1. Over the next several months, Kari’s eyes begin to look like this: Considering her history and symptoms, which of the following conditions is most likely?

    Cataracts
    Hyperopia
    Presbyopia
    Glaucoma

1 points   

QUESTION 9

1. If Kari is diagnosed with glaucoma, what is the most likely treatment? Describe the treatment briefly, in your own words.

 

1 points   

QUESTION 10

1. If Kari is diagnosed with cataracts, what is the most likely treatment? Describe the treatment briefly, in your own words.

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1 points   

QUESTION 11

1. Maddie is a 6-year-old female with no prior history of major medical issues. She complained of right ear pain after an awkward head-first fall from a diving board yesterday. She landed in the pool and did not seem to have any apparent physical injuries, so her parents assumed she had headache from the impact and gave her acetaminophen. However, the pain persisted for a full day, so her parents have taken her to her pediatrician. Her parents have noticed that she is less responsive when speaking to her from her right side and are worried that she has suffered hearing loss from the fall.   Maddie’s physician explains that there are different types of hearing loss. Damage to which of the following structures would cause conductive hearing loss?

    Tympanic membrane
    Vestibule
    Semicircular canals
    Cochlea

1 points   

QUESTION 12

1. Maddie’s physician explains that there are different types of hearing loss. Damage to which of the following structures would cause sensorineural hearing loss?

    Malleus
    Incus
    Cochlea
    Tympanic membrane

1 points   

QUESTION 13

1. When Maddie’s physician examines her ear, he explains to her parents that she has a perforated eardrum. Which of the following statements is NOT true?

    Maddie has sensorineural hearing loss due to the perforated eardrum.
    Maddie’s eardrum will likely heal on its own and she will not need surgery.
    Maddie is at higher risk for ear infections due to the perforation.
    A perforated “eardrum” means that there is a tear or hole in Maddie’s tympanic membrane.

1 points   

QUESTION 14

1. Maddie’s doctor performs tuning fork tests to help determine the source of her hearing loss. Which of the following tests compares bone conduction to air conduction?

    Weber test
    Rinne test

1 points   

QUESTION 15

1. If Maddie’s hearing loss persists after her perforation is healed, which of the following scenarios is likely?

    Maddie will likely lose hearing in her left ear, too, but less severely.
    Maddie suffered sensorineural AND conductive hearing loss from the head injury in the pool.
    Maddie will continue to lose hearing bilaterally as she ages.
    Her hearing loss is genetic and will be passed on to her future children.

1 points   

QUESTION 16

1. Medicine or surgery can often fix which type of hearing loss?

    Conductive hearing loss
    Sensorineural hearing loss

1 points   

QUESTION 17

1. Which of the following is a common cause of sensorineural hearing loss?

    Ruptured tympanic membrane
    Fluid trapped in the middle ear
    Aging
    Cerumen build up

1 points   

QUESTION 18

1. Identify and explain (in your own words) at least one possible complication of Maddie’s perforated eardrum.

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1 points   

QUESTION 19

1. Which of the following structures is not part of the physiology of hearing?

    Incus
    Cochlea
    Utricle
    Auditory canal

1 points   

QUESTION 20

1. A ruptured tympanic membrane DIRECTLY affects the movement/vibration of which ossicle?

    Malleus
    Anvil
    Incus
    Stapes

1 points   

Health Care Delivery Models And Nursing Practice

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Examine changes introduced to reform or restructure the U.S. health care delivery system. In a 1,000-1,250 word paper, discuss action taken for reform and restructuring and the role of the nurse within this changing environment.

Include the following:

1. Outline a current or emerging health care law or federal regulation introduced to reform or restructure some aspect of the health care delivery system. Describe the effect of this on nursing practice and the nurse’s role and responsibility.

2. Discuss how quality measures and pay for performance affect patient outcomes. Explain how these affect nursing practice and describe the expectations and responsibilities of the nursing role in these situations.

3. Discuss professional nursing leadership and management roles that have arisen and how they are important in responding to emerging trends and in the promotion of patient safety and quality care in diverse health care settings.

4. Research emerging trends. Predict two ways in which the practice of nursing and nursing roles will grow or transform within the next five years to respond to upcoming trends or predicted issues in health care.

5)  Describe one innovative health care delivery model that incorporates an interdisciplinary care delivery team. Explain how this model is advantageous to patient outcomes.

You are required to cite to a minimum of three sources to complete this assignment. Sources must be from GCU library and published within the last 5 years and appropriate for the assignment criteria and relevant to nursing practice.

Prepare this assignment according to the guidelines found in the APA Style Guide.

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.

Rubic_Print_Format

Course Code Class Code Assignment Title Total Points
NRS-440VN NRS-440VN-O502 Health Care Delivery Models and Nursing Practice 165.0
Criteria Percentage Unsatisfactory (0.00%) Less Than Satisfactory (75.00%) Satisfactory (79.00%) Good (89.00%) Excellent (100.00%) Comments Points Earned
Content 80.0%
Current or Emerging Health Care Law or Federal Regulation and Effect on Nursing Practice, Role and Responsibility 20.0% Emerging health care law or federal regulation is omitted. The law or regulation presented is not relevant to health care. Emerging health care law or federal regulation is incomplete. Effect on nursing practice and nurse role and responsibility is partially described. Emerging health care law or federal regulation, and effect on nursing practice and the nurse role, and responsibility is summarized. There are some inaccuracies. Emerging health care law or federal regulation, and effect on nursing practice and the nurse role, and responsibility is described. Some information or detail is needed for clarity. Discussion on emerging health care law or federal regulation, and effect on nursing practice and the nurse role, and responsibility is well-developed.
Quality Measures Pay for Performance, Patient Outcomes, and Effect on Nursing Practice 20.0% Discussion on how quality measures and pay for performance affect patient outcomes, and how they affect nursing practice, expectations, and responsibilities of the nursing role, is omitted. Discussion on how quality measures and pay for performance affect patient outcomes, and how they affect nursing practice, expectations, and responsibilities of the nursing role, is incomplete. Summary on how quality measures and pay for performance affect patient outcomes, and how they affect nursing practice, expectations, and responsibilities of the nursing role, is presented. There are inaccuracies or slight omissions. Discussion on how quality measures and pay for performance affect patient outcomes, and how they affect nursing practice, expectations, and responsibilities of the nursing role, is presented. Some information is needed for clarity. A thorough and insightful discussion on how quality measures and pay for performance affect patient outcomes, and how they affect nursing practice, expectations, and responsibilities of the nursing role, is presented.
Professional Nursing Leadership and Management Roles 20.0% Discussion on professional nursing leadership and management roles and the imporantance of these roles in responding to emerging trends and patient safety and quality care is omitted. An incomplete discussion on professional nursing leadership and management roles and the imporantance of these roles in responding to emerging trends and patient safety and quality care is presented. A summary on professional nursing leadership and management roles, and the imporantance of these roles in responding to emerging trends and patient safety and quality care, is presented. There are inaccuracies or slight omissions. A discussion on professional nursing leadership and management roles, and the imporantance of these roles in responding to emerging trends and patient safety and quality care, is presented. Some detail or information is needed for clarity. A well-developed discussion on professional nursing leadership and management roles, and the imporantance of these roles in responding to emerging trends and patient safety and quality care, is presented. The discussion demonstrates a thorough understanding of the nursing profession in emerging trends and patient care in a diverse health setting.
Predict Change in Nursing Roles and Nursing Practice 20.0% Predictions for how the practice of nursing and nursing roles will grow or transform within the next 5 years to respond to upcoming trends or predicted issues in health care are omitted. Predictions for how the practice of nursing and nursing roles will grow or transform within the next 5 years to respond to upcoming trends or predicted issues in health care are incomplete. The predictions are unrealistic or lack evidence for support. Insert Satisfactory CoA summary on professional nursing leadership and management roles, and the imporantance of these roles in responding to emerging trends and patient safety and quality care, is presented. There are inaccuracies or slight omissions.Predictions for how the practice of nursing and nursing roles will grow or transform within the next 5 years to respond to upcoming trends or predicted issues in health care are summarized. The predictions are realistic, but there are inaccuracies or slight omissions. ntent 2 Descriptor Predictions for how the practice of nursing and nursing roles will grow or transform within the next 5 years to respond to upcoming trends or predicted issues in health care are discussed. The predictions are generally supported and realistic. Predictions for how the practice of nursing and nursing roles will grow or transform within the next 5 years to respond to upcoming trends or predicted issues in health care are thoroughly discussed. The predictions are based on evidence and highly relevant to emerging trends.
Organization, Effectiveness, and Format 20.0%
Thesis Development and Purpose 5.0% Paper lacks any discernible overall purpose or organizing claim. Thesis is insufficiently developed or vague. Purpose is not clear. Thesis is apparent and appropriate to purpose. Thesis is clear and forecasts the development of the paper. Thesis is descriptive and reflective of the arguments and appropriate to the purpose. Thesis is comprehensive and contains the essence of the paper. Thesis statement makes the purpose of the paper clear.
Argument Logic and Construction 5.0% Statement of purpose is not justified by the conclusion. The conclusion does not support the claim made. Argument is incoherent and uses noncredible sources. Sufficient justification of claims is lacking. Argument lacks consistent unity. There are obvious flaws in the logic. Some sources have questionable credibility. Argument is orderly but may have a few inconsistencies. The argument presents minimal justification of claims. Argument logically, but not thoroughly, supports the purpose. Sources used are credible. Introduction and conclusion bracket the thesis. Argument shows logical progression. Techniques of argumentation are evident. There is a smooth progression of claims from introduction to conclusion. Most sources are authoritative. Clear and convincing argument presents a persuasive claim in a distinctive and compelling manner. All sources are authoritative.
Mechanics of Writing (includes spelling, punctuation, grammar, language use) 5.0% Surface errors are pervasive enough that they impede communication of meaning. Inappropriate word choice or sentence construction is used. Frequent and repetitive mechanical errors distract the reader. Inconsistencies in language choice (register), sentence structure, or word choice are present. Some mechanical errors or typos are present, but they are not overly distracting to the reader. Correct sentence structure and audience-appropriate language are used. Prose is largely free of mechanical errors, although a few may be present. A variety of sentence structures and effective figures of speech are used. Writer is clearly in command of standard, written, academic English.
Paper Format (use of appropriate style for the major and assignment) 2.0% Template is not used appropriately, or documentation format is rarely followed correctly. Template is used, but some elements are missing or mistaken; lack of control with formatting is apparent. Appropriate template is used. Formatting is correct, although some minor errors may be present. Template is fully used; There are virtually no errors in formatting style. All format elements are correct.
Documentation of Sources (citations, footnotes, references, bibliography, etc., as appropriate to assignment and style) 3.0% Sources are not documented. Documentation of sources is inconsistent or incorrect, as appropriate to assignment and style, with numerous formatting errors. Sources are documented, as appropriate to assignment and style, although some formatting errors may be present. Sources are documented, as appropriate to assignment and style, and format is mostly correct. Sources are completely and correctly documented, as appropriate to assignment and style, and format is free of error.
Total Weightage 100%

Discussion: Diversity and Health Assessments

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Mainpost

Case study:

JC, an at-risk 86-year-old Asian male is physically and financially dependent on his daughter, a single mother who has little time or money for her father’s health needs. He has a hx of hypertension (HTN), gastroesophageal reflux disease (GERD), b12 deficiency, and chronic prostatitis. He currently takes Lisinopril 10mg QD, Prilosec 20mg QD, B12 injections monthly, and Cipro 100mg QD. He comes to you for an annual exam and states “I came for my annual physical exam, but do not want to be a burden to my daughter.”

Discussion: Diversity and Health Assessments

Introduction

Health care providers should exhibit knowledge of population diversity and treat all patients with respect regardless of their culture and belief system. This is essential in understanding patient’s lifestyle, and behavior which may affect their health care. Accepting patient’s culture in a nonjudgmental manner creates a unique relationship between the patient and the healthcare provider. Therefore, APRN’s should be cognizant of patient’s culture, beliefs, lifestyle, and socioeconomic status as it relates to healthcare. A culturally competent healthcare provider accustoms his/herself to the exclusive needs of patients with cultures that are different from his or her own. Being accustomed to the belief’s and values of a patient lays the foundation for a trusting patient-provider relationship (Ball et al., 2019).

Socioeconomic, Spiritual, Lifestyle, and Cultural Factors Associated with the Patient

The case study presents an 86-year-old Asian male that is physically and financially dependent on his daughter who is a single mother with little money to care for the patient’s healthcare needs.  Understanding the Asian culture is relevant to providing care to this elderly patient.  I will verify patient’s preferred language, ask about patient’s preference with a healthcare provider regarding race or ethnicity, gender, and age. Ensuring respect for this patient despite his financial and physical dependency will encourage a trusting relationship between the patient and the health care provider. Asian culture is known to teach respect for parents and family is a priority over self. Additionally, in Asian culture adult children are required to make financial, physical, and social sacrifices for their parents that are aging (Miyawaki, 2015). As a healthcare provider, I will welcome this patient, show respect by avoiding eye contact as some Asian countries consider making eye contact as rude. Maintaining eye contact is not done with individuals of East Asian cultural backgrounds. Also, the Japanese culture, teaches against maintaining   eye contact with others as it is believed to disrespectful (Uono & Hietanen, 2015).

I will make the patient understand that I am familiar with culture of adult children caring for their aged parents. I will explain to the patient that he should not consider himself a burden to his daughter as the daughter is maintaining the requirement of their culture. This will encourage a relaxing environment that will enable the patient to feel accepted and ready to relate with the health care provider. Respect for the patient’s spiritual and religious belief is also vital. The patient should be asked about any spiritual belief that may affect his healthcare when sick or dying. Also, the APRN should inquire about spiritual or religious groups that the patient may belong that could be supportive in providing some assistance to his healthcare. Spirituality and faith help Asian-Americans manage the turmoil of adapting to a new country, by providing a safe environment where immigrants can socialize and be of assistance to one another (Lee & Eun-Kyoung, 2017).

Sensitive Issues

I will inquire if the patient is compliant with taking his medications as prescribed and access for the use of over the counter, herbal, or traditional medications. This is especially important as the patient takes lisinopril 10mg QD, prilosec 20mg QD, B12 injections monthly, and cipro 100mg QD. To avoid drug interactions, it is important to ask about additional medications that the patient may be taking. Examples of Chinese herbal medicine include astragalus, ginger, licorice, panax ginseng, and schizandra. Traditional medicine is used across Asian societies for daily health maintenance, and treatment of certain medical conditions. Also, in China, Japan, and Korea, traditional medicine has become almost or equivalent to conventional medicine (Mu et al., 2020).

Furthermore, the functionality of the patient will be accessed to determine the level of dependency on the daughter. Activities of daily living like feeding, bathing, wearing clothes, grooming will be accessed. Asking about financial assistance with purchasing medications, proper feeding and housing is vital to ensure the overall needs of the patient are catered for. Due to socioeconomic status and financial constraint of the patient and his caregiver (daughter), I will recommend the help of a social worker to provide the services of a home health nurse and home health nursing assistant. This will ensure that patients’ needs are met, and the patient takes his medications in a timely manner thereby relieving the responsibility on the patient’s daughter.  In addition, the services of physical and occupational therapy will be sorted to help strengthen any weak muscles or extremities to ensure some dependence with physical activities. I will explain to the patient that my recommendation for a social worker is to help him meet his daily needs and not to disrespect him. This will maintain patients pride and ego.

Targeted questions to assess health risks

  1. Do you have health insurance, or do you pay out of pocket for your medications?
  2. Do you take your medications as prescribed?
  3. Do you check your blood pressure at home?
  4. Would you want to receive help with feeding, clothing, bathing, or moving around your home?
  5. Do you experience any pain or difficulty in urinating?
  6. In the las two weeks have you experienced sleep disturbances, decreased appetite, feeling of sadness, hopelessness, or guilt, thoughts of committing suicide and poor concentration.
  7. In what way do you think you are a burden to your daughter?
  8. How often do you eat and what type of food do you eat?
  9. Do you take any herbal, traditional or over the counter medications?

The questions above are used to access the patient’s access to his medications and if he is compliant with taking his medications. The need to access for patient’s knowledge about checking his blood pressure due to his history of hypertension. Accessing patient’s willingness to receive outside resources like home health assistance is essential to providing the needed healthcare. Question about urinating accesses the history of prostatitis. Accessing for depression in the elderly is crucial to determine the patient’s mental state. Elderly Asian immigrants in the US are at risk of depression (Seungah & Eun-Kyoung, 2017). Evaluating the patients feeding habits and if the patient takes any medication outside his prescribed medications determines the patient’s health risk.

References

Ball, J., Dains, J., Flynn, J., Solomon, B., Stewart, R. (2019). Seidel’s guide to physical examination: An interprofessional approach (9th ed.). St. Louis, MO: Elsevier Mosby.

Lee, R., Eun-Kyoung, O. (2017). Faith, spirituality, and values among Asian-American older adults: An exploratory factor analysis of the multidimensional measures of religion and spirituality. Mental Health, Religion & Culture, 19 (8), 920–931.    doi:10.1080/13674676.2017.1290593

Miyawaki, C. (2015). A review of ethnicity, culture, and acculturation among Asian caregivers of older adults. SAGE Journals. https://doi.org/10.1177/2158244014566365

https://journals.sagepub.com/doi/full/10.1177/2158244014566365

Ryu, S., & Lee, O. E.-K. (2016). Faith, spirituality, and values among Asian-American older adults: An exploratory factor analysis of the multidimensional measures of religion and spirituality. Mental Health, Religion & Culture, 19 (8), 920-931. https://doi- org.ezp.waldenulibrary.org/10.1080/13674676.2017.1290593

Uono, S., Hietanen, J. (2015). Eye contact perception in the West and East: A cross-cultural study. Plus One. https://doi.org/10.1371/journal.pone.0118094

Xin, B., Mu, S., Tan, T., Yeung, A., Gu, D., Feng, Q. (2020).  Belief in and use of traditional Chinese medicine in Shanghai older adults: A cross-sectional study. BMC Complement Medicine and Therapies 20 (128). https://doi.org/10.1186/s12906-020-02910-x. https://bmccomplementmedtherapies.biomedcentral.com/articles/10.1186/s12906-020-  02910-x