Discussion: Cognitive Behavioral Therapy: Group Settings Versus Family Settings

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Discussion: Cognitive Behavioral Therapy: Group Settings Versus Family Settings

As you might recall from Week 5, there are significant differences in the applications of cognitive behavior therapy (CBT) for families and individuals. The same is true for CBT in group settings and CBT in family settings. In your role, it is essential to understand these differences to appropriately apply this therapeutic approach across multiple settings. For this Discussion, as you compare the use of CBT in group settings and family settings, consider challenges of using this approach with your own groups.

Learning Objectives

Students will:
  • Compare the use of cognitive behavioral therapy for groups to cognitive behavioral therapy for families
  • Analyze challenges of using cognitive behavioral therapy for groups
  • Recommend effective strategies in cognitive behavioral therapy for groups

To prepare:

  • Reflect on your practicum experiences with CBT in group and family settings.

Post an explanation of how the use of CBT in groups compares to its use in family settings. Provide specific examples from your own practicum experiences. Then, explain at least two challenges counselors might encounter when using CBT in the group setting. Support your response with specific examples from this week’s media.

NUCLEAR CARDIOLOGY

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The Discussion Section question is:  

Add a comment pertaining to the effect of workload on coronary blood flow. Please detail our potential to image the ratio of decrease blood flow for  diagnostic value. Add to to the DICUSSION PANNEL for this unit.

Here some example for you :

1- The effect of workload on coronary blood flow and our potential to image the ratio of decrease blood flow for diagnostic value:

According to The Journal of the American Association, coronary blood flow is determined by the rate at which blood flows out of the coronary arteries to other parts of the body. For example, during rest, the amount of blood flows through the coronary arteries is 225 ml per minute which is 4-5% of total cardiac output. During stress, the blood flow is faster and the heart muscle contracts during systole. As a result, during diastole, the cardiac muscle relaxes to allow the flow of blood through the body without any resistance. One significant effect on coronary blood flow is the workload the heart is subjected to during stress. With an increase in stress rate, the heart reacts to pump blood in a faster rate to ensure oxygen is supplied to the rest of the body. When imaging, the vasodilator stress agents are helpful in decreasing the blood flow and relaxing the heart muscle. These pharmacological agents help when measuring the supply to the heart and viewing the heart’s workload.

2- The following is regarding the effect of workload on coronary blood flow and our potential to image the ratio of decrease blood flow for diagnostic value:

The heart is a very smart organ with very smart systems. An auto-regulatory mechanism known as coronary autoregulation is constantly maintaining the interaction of pressure and resistance of coronary blood flow. Decreases in pressure are compensated for by decreases in resistance and conversely, increases in pressure by increases in resistance so that flow remains constant for a give cardiac workload. This regulatory mechanism operates within the range of physiologic arterial pressures but fails during hypotension when flows become strongly dependent on the driving pressure.

For imaging purposes, pharmacological vasodilator stress agents seek to maximally lower the vascular resistance through relaxation of the vascular smooth muscle cell at the level of the microcirculation, thereby uncoupling coronary flow (supply) and myocardial work (demand). With the help of such pharmacological agents, imaging can take place in order for diagnostic purposes.

References

Schelbert H. R. (2010). Anatomy and physiology of coronary blood flow. Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology, 17(4), 545–554. doi:10.1007/s12350-010-9255-x

3- The effect of workload on coronary blood flow and our potential to image the ratio of decrease blood flow for diagnostic value:

Blood flow to the heart mainly occurs during diastole, the great majority of blood flow to the left ventricle occurs during diastole. The diastolic pressure from the aorta propels blood through the coronary circulation. The more coronary blood flow to the left ventricle means the longer time that diastole will last. The right ventricle receives blood equally during both systole and diastole. Diastole lasts for about two thirds of the cardiac cycle. The coronary arties through the myocardium are compressed during ventricular contraction when fibers are thickening and are unable to fill.  The pressure within the left ventricle offers resistance to this flow. Blockage of coronary arteries can reduce coronary blood flow at rest, resulting in a buildup of a clot, and also anything that causes arteries to constrict and not allow the vasodilatation to even improve coronary blood flow.

For imaging potential of decreased blood flow, pharmacological vasodilator stress agents can be utilized to cause a lower vascular resistance through relaxation of the smooth muscles of the heart during a nuclear stress test. This can lead to measuring the supply and demand of the heart, it is which these pharmacological stress agents that when can possibly use to help increase the potential to image the ratio of decreased blood flow for diagnostic reasons and value.

Module 06 Written Assignment – Care Of A Patient With Prenatal Complications

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Scenario: A gravida two, para-one 34 year old woman comes into the office for pre-natal care. She is 28 weeks pregnant. Her blood pressure is 160/90 with a weight of 220 lbs and a height of 5’1. Her previous blood pressure at her visit 4 weeks ago was 122/ 78. Her previous weight was 210 lbs. She reports a history of gestational diabetes. Her fasting glucose is 150.

What focused assessments would you expect the practical nurse to perform? What important data would need to be communicated to her health care team?

Scoring Rubric

Criteria Week 6: Care of a patient with prenatal complications  
Spelling and grammar is correct throughout the presentation. APA format is consistently done and correct. All information is referenced throughout the body of the presentation. Uses a minimum of 3 credible references. 0/1
Discusses the significance of the blood pressure. Outline what other assessments will be made by the nurse.

What will be reported based on this finding?

What condition are you assessing for? How urgent is the reporting of this problem?

 1.5/2
Discusses the significance of the blood glucose finding. Outline what other assessments will be made based on this finding.

What will be reported based on this finding?

What condition are you assessing for?

How urgent is the reporting of this problem?

 1.5/2
Briefly discuss the common findings of preeclampsia and nursing care and management of this disorder.

 

 2
Briefly discuss the common findings of gestational diabetes mellitus (GDM), and nursing care and management of this disorder. 2
Includes SBAR report for this patient.

In your SBAR you are diagnosing her problems-you cannot do that. Preeclampsia and Gestational Diabetes are suspected but need to be diagnosed with the recommendations for the labs and further evaluation.

 0/1
  5/10

Thanks Michael

A large portion of your power point has been copied from online sources such as mayo.org. Although the sources are on the reference slide there are no citations in the body of your work. Also, some of the information presented (and not cited) was from the American Heart Association-a great source but I want you looking at a pregnant woman and the guidelines are different.

A rule of thumb is that no more than 20% of work should be cited from a source. When I ut your slides into Grammarly up to 90% of many slides were directly copied from websites. This is why points have been deducted. The written assignments are to show me your knowledge and understanding of the material. I need to read your work, not copied work.

Evaluate legislative policies and regulations for health and nursing informatics

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Module 6: Policy and Regulation Supporting Informatics and Technology Integration
(Week 11)

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Laureate Education (Producer). (2018). Policy and Regulation [Video file]. Baltimore, MD: Author.

Learning Objectives

Students will:
  • Evaluate legislative policies and regulations for health and nursing informatics
  • Create fact sheets for health and nursing informatics
  • Analyze impact of legislative policies and regulations for clinical care, patient/provider interactions, and workflows
  • Evaluate healthcare organizational policies and procedures to address legislative policies and regulations

Due ByAssignmentWeek 11, Days 1–2Read/Watch/Listen to the Learning Resources.
Begin to compose your Assignment.Week 11, Days 3-6Continue to compose your Assignment.Week 11, Day 7Deadline to submit your Assignment.

Photo Credit: [Phil Roeder]/[Moment]/Getty Images

Learning Resources

Required Readings

McGonigle, D., & Mastrian, K. G. (2017). Nursing informatics and the foundation of knowledge (4th ed.). Burlington, MA: Jones & Bartlett Learning.
Chapter 8, “Legislative Aspects of Nursing Informatics: HITECH and HIPAA” (pp. 145–166)

American Association of Nurse Practitioners. (2018). MACRA/MIPS: The transition from fee-for-service to quality-based reimbursement. Retrieved from https://www.aanp.org/legislation-regulation/federal-legislation/macra-s-quality-payment-program 

Centers for Medicare and Medicaid Services. (n.d.). MACRA. Retrieved January 18, 2019, from https://www.cms.gov/medicare/quality-initiatives-patient-assessment-instruments/value-based-programs/macra-mips-and-apms/macra-mips-and-apms.html

HealthIT.gov. (2018a). Health IT legislation. Retrieved from https://www.healthit.gov/topic/laws-regulation-and-policy/health-it-legislation

HealthIT.gov. (2018b). Meaningful use and MACRA. Retrieved from https://www.healthit.gov/topic/meaningful-use-and-macra/meaningful-use-and-macra

U.S. Department of Health and Human Services. (n.d.). Laws & regulations. Retrieved September 27, 2018, from https://www.hhs.gov/regulations/index.html

Required Media

Laureate Education (Producer). (2018). Health Informatics & Population Health Analytics: Privacy, Security, and Ethics [Video file]. Baltimore, MD: Author.

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Assignment: Policy/Regulation Fact Sheet

As a professional nurse, you are expected to apply your expertise to patient care. On occasion, you will also be expected to share that expertise.

With evolving technology and continuous changes to regulations designed to keep up these changes, there is usually a need to share information and expertise to inform colleagues, leadership, patients, and other stakeholders.

In this Assignment, you will study a recent nursing informatics-related healthcare policy, and you will share the relevant details via a fact sheet designed to inform and educate.

To Prepare:

  • Review the Resources on healthcare policy and regulatory/legislative topics related to health and nursing informatics.
  • Consider the role of the nurse informaticist in relation to a healthcare organization’s compliance with various policies and regulations, such as the Medicare Access and CHIP Reauthorization Act (MACRA).
  • Research and select one health or nursing informatics policy (within the past 5 years) or regulation for further study.

The Assignment: (1 page)

Create a 1-page fact sheet that your healthcare organization could hypothetically use to explain the health or nursing informatics policy/regulation you selected. Your fact sheet should address the following:

  • Briefly and generally explain the policy or regulation you selected.
  • Address the impact of the policy or regulation you selected on system implementation.
  • Address the impact of the policy or regulation you selected on clinical care, patient/provider interactions, and workflow.
  • Highlight organizational policies and procedures that are/will be in place at your healthcare organization to address the policy or regulation you selected. Be specific.