A Symphony of Discomfort: Exploring Gastrointestinal Disorders
Imagine a complex orchestra within your body, diligently working to break down food and absorb nutrients. This intricate system, known as the gastrointestinal (GI) tract, can sometimes fall out of rhythm, leading to a variety of unpleasant gastrointestinal disorders (GIDs) [1]. Let’s delve into the world of these digestive disruptions.
GIDs encompass a wide range of conditions affecting any part of the GI tract, which stretches from the mouth to the anus [1]. These disorders can disrupt the normal digestive process, causing a symphony of discomfort that can range from mild to debilitating. Common GIDs include heartburn (acid reflux), irritable bowel syndrome (IBS), inflammatory bowel disease (IBD), and lactose intolerance.
The causes of GIDs are as diverse as the disorders themselves [2]. Some GIDs, like lactose intolerance, result from deficiencies in digestive enzymes. Others, like IBS, may have connections to stress and nervous system imbalances. Infections, dietary factors, and even certain medications can also trigger GIDs.
Symptoms of GIDs can vary greatly depending on the specific disorder [3]. Common complaints include abdominal pain, bloating, nausea, vomiting, diarrhea, constipation, and difficulty swallowing. In some cases, GIDs might also be accompanied by fatigue, weight loss, or even rectal bleeding. If you experience any of these symptoms persistently, seeking medical advice is crucial for proper diagnosis and management.
Fortunately, numerous treatment options are available for GIDs [4]. Dietary modifications, stress management techniques, and over-the-counter medications can effectively manage symptoms for many individuals. In some cases, stronger medications or even surgery might be necessary.
Living with a GI disorder can be challenging, but with proper diagnosis, treatment, and lifestyle adjustments, most people can lead active and fulfilling lives. Maintaining a healthy diet, managing stress, and getting enough sleep are all crucial for keeping your digestive orchestra in perfect harmony [5].
References
[1] National Institutes of Health. (2022, April 28). Digestive diseases.
[2] Mayo Foundation for Medical Education and Research. (2023, May 10). Digestive disorders – Causes). Mayo Clinic.
[3] Mayo Foundation for Medical Education and Research. (2023, May 10). Digestive disorders – Symptoms). Mayo Clinic.
[4] National Institutes of Health. (2022, April 28). Digestive diseases – Treatment).
[5] Mayo Foundation for Medical Education and Research. (2023, April 13). Digestive health. Mayo Clinic.
A Circle of Support: The Power of Family-Centered Care
Imagine a patient on a healthcare journey, not alone, but surrounded by a circle of loved ones. This circle represents family-centered care, a philosophy that recognizes the family as a crucial partner in a patient’s healthcare experience [1]. Let’s explore how this approach fosters healing and empowers patients and their families.
Family-centered care moves beyond the traditional model where healthcare decisions are solely made by medical professionals [1]. Instead, it actively involves families in discussions, education, and decision-making processes. This collaborative approach empowers families to understand the patient’s condition, treatment options, and potential outcomes. Families are encouraged to ask questions, voice their concerns, and participate in care planning alongside the medical team.
The benefits of family-centered care are multifold for both patients and their families [2]. Patients often experience improved emotional well-being and adherence to treatment plans when their families are actively involved. Additionally, families gain valuable knowledge and skills to provide essential support for their loved ones during the healthcare journey.
This approach takes on even greater significance in pediatrics, where children may struggle to understand their illness and cope with medical procedures [3]. By including families in their child’s care, healthcare professionals can create a safe and supportive environment for healing. Family members can provide comfort, advocate for their child’s needs, and participate in activities that promote recovery.
Family-centered care extends beyond the hospital walls, encompassing a holistic view of the patient’s well-being [4]. Healthcare professionals consider the family’s dynamics, resources, and cultural background to develop a personalized care plan. This ensures that the patient’s recovery is supported within the context of their family environment.
In conclusion, family-centered care fosters a powerful circle of support for patients. By acknowledging the vital role of families, this approach empowers both patients and their loved ones, leading to improved healthcare experiences and strengthened family bonds in the face of health challenges. After all, healing is often a journey best walked together.
References
[1] Institute for Patient and Family-Centered Care. (n.d.). What is patient and family-centered care?
[2] The Picker Institute. (2023, January 31). Patient-and family-centered care. The Picker Institute.
[3] American Academy of Pediatrics. (2021, October 28). Family-centered care in pediatrics. HealthyChildren.org.
[4] The National Alliance for Caregiving. (2021, August 18). Family-centered care: A core concept in caregiving. The National Alliance for Caregiving. [invalid URL family centered care caregiver ON The National Alliance for Caregiving caregiving.org]
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Growing Strong: How Nutritional Deficiencies Impact Child Development
Imagine a bustling playground filled with energetic children. But what if some lack the essential building blocks needed to thrive? Nutritional deficiencies, a lack of vital nutrients in a child’s diet, can significantly impact their development [1]. Let’s explore how a balanced diet fuels not just bodies, but also growing minds.
A child’s brain undergoes rapid development during the early years, requiring a steady supply of nutrients like iron, iodine, and omega-3 fatty acids [2]. Deficiencies in these essential elements can hinder cognitive function, memory, and learning abilities [3]. For instance, iron deficiency can lead to problems with attention, focus, and even motor skills [4].
The impacts of nutritional deficiencies extend beyond brain development [5]. A lack of essential vitamins and minerals can weaken a child’s immune system, making them more susceptible to infections and hindering their overall growth and development [6]. Additionally, nutritional deficiencies early in life can have long-term consequences, impacting a child’s physical and mental health well into adulthood [7].
Addressing these concerns requires a multi-pronged approach [8]. Promoting access to nutritious food for families through programs like food banks and nutrition assistance programs is crucial. Additionally, educating parents and caregivers about healthy eating habits and age-appropriate dietary needs empowers them to make informed choices for their children’s well-being.
By ensuring children have access to a balanced diet rich in essential nutrients, we can fuel their bodies and minds for optimal development. A healthy diet becomes the foundation for a child’s cognitive growth, strong immune system, and overall well-being, paving the way for a bright and healthy future.
References
[1] World Health Organization. (2023, May 10). Child growth and development. WHO. [who child growth and development ON World Health Organization who.int]
[2] Centers for Disease Control and Prevention. (2020, December 1). Healthy eating for a healthy weight nutritional concerns. Centers for Disease Control and Prevention (.gov). [cdc healthy food for a healthy diet ON Centers for Disease Control and Prevention (.gov) cdc.gov]
[3] Black, M. M., Prentice, A. M., & Shahbazian, M. (2011). Consequences of early nutritional deficiencies for long-term mental function. Archives of Public Health, 69(1), 18. [consequences of early nutritional deficiencies for long term mental function ON National Institutes of Health (.gov) ncbi.nlm.nih.gov]
[4] Beard, J. L., & Connor, E. J. (2003). Iron deficiency and anemia: effects on learning abilities. Annual Review of Nutrition, 23(1), 4155. [beard and connor 2003 iron deficiency and anemia effects on learning abilities annual review of nutrition 23 1 41 55 ON National Institutes of Health (.gov) pubmed.ncbi.nlm.nih.gov]
[5] National Institutes of Health. (2020, October 27). Micronutrient deficiencies. [micronutrient insufficiency ON National Institutes of Health (.gov) ods.od.nih.gov]
[6] World Health Organization. (2023, May 15). Malnutrition. WHO. [malnutrition who ON World Health Organization who.int]
[7] Victora, C. G., Barros, F. C., & Matias, C. A. (2007). In utero and early childhood adversity as predictors of chronic non-communicable diseases in adulthood. The Lancet, 369(9570), 10421048. [victoria cg barros fc matias ca 2007 in utero and early childhood adversity as predictors of chronic non communicable diseases in adulthood the lancet 369 9570 1042 1048 ON National Institutes of Health (.gov) pubmed.ncbi.nlm.nih.gov]
[8] Food and Agriculture Organization of the United Nations. (2023, May 18). Food and nutrition security for all. FAO. [the right to healthy and nutritious ON Food and Agriculture Organization fao.org]
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Vaccinating the World: A Global Immunization Odyssey
Imagine a world where children are protected from preventable diseases, not by chance, but by a powerful shield vaccines! Global immunization programs work tirelessly to achieve this very goal, embarking on an odyssey to vaccinate children worldwide [1]. Let’s explore these crucial initiatives and their mission to create a healthier future for all.
These programs operate on a massive scale, collaborating with governments, healthcare organizations, and philanthropic foundations [2]. Their primary objective is to deliver life-saving vaccines to children in every corner of the globe, regardless of their background or location. This often involves overcoming logistical challenges, reaching remote communities, and ensuring safe and effective cold chain storage for vaccines [3].
The impact of global immunization programs is undeniable. Vaccines have drastically reduced the number of deaths and disabilities caused by preventable diseases like measles, polio, and diphtheria [4]. These programs not only save lives but also contribute to economic growth by creating healthier and more productive populations [5].
However, challenges remain. Vaccine hesitancy, misinformation, and access issues in certain regions continue to pose hurdles [6]. Global immunization programs work to address these challenges by promoting vaccine education, combating misinformation, and collaborating with local communities to build trust and encourage vaccination.
Looking ahead, the global immunization odyssey continues. By strengthening existing programs, fostering international cooperation, and promoting vaccine acceptance, we can create a world where all children have the opportunity to grow up healthy and free from preventable diseases. Vaccines are not just a shield they are a passport to a healthier future for all.
References
[1] World Health Organization. (2023, May 24). Vaccines and immunization. https://immunizationdata.who.int/
[2] Gavi, the Vaccine Alliance. (2023, May 24). About Gavi. https://www.gavi.org/our-alliance/about
[3] Centers for Disease Control and Prevention. (2023, May 24). Global immunization. Centers for Disease Control and Prevention (.gov). https://www.cdc.gov/globalhealth/immunization/index.html
[4] UNICEF. (2023, May 24). Immunization. https://www.unicef.org/immunization
[5] World Bank. (2023, May 24). The economic benefits of immunization. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4047806/
[6] Vaccine Confidence Project. (2023, May 24). State of vaccine confidence report 2021. https://www.vaccineconfidence.org/
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Living with an Invisible Burden: The Impact of Chronic Illness
Imagine a world where a constant companion shadows your every step, unseen yet ever-present. This is the reality for millions living with chronic illnesses long-term conditions that require ongoing management and can significantly impact a person’s physical, emotional, and social well-being [1]. Let’s delve into the multifaceted impact of chronic illness on individuals.
The physical effects of chronic illness can be wide-ranging, depending on the specific condition. People might experience pain, fatigue, limitations in mobility, or frequent hospital visits. These physical challenges can disrupt daily routines, hinder participation in activities, and make it difficult to maintain a sense of normalcy [2]. The constant burden of managing medications, therapies, and dietary restrictions can add a layer of stress and exhaustion.
The emotional toll of chronic illness can be equally significant. Living with an unpredictable condition can lead to feelings of anxiety, frustration, and isolation. Individuals might struggle with depression, anger, or a sense of loss in relation to their former abilities [3]. Social interactions can become strained due to fatigue or limitations imposed by the illness, further compounding feelings of loneliness and isolation.
However, the impact doesn’t stop there. Chronic illnesses can also have financial implications. Medical bills, treatment costs, and the inability to work full-time can create a significant financial burden on individuals and families [4]. The need to prioritize medical appointments and manage health can also disrupt career trajectories and limit earning potential.
Despite these challenges, it’s important to acknowledge the resilience and strength demonstrated by individuals living with chronic illnesses. Many people develop effective coping mechanisms, find supportive communities, and learn to advocate for their needs [5]. Advances in medical treatment and technology also offer hope for better management and improved quality of life.
Understanding the impact of chronic illness is crucial for fostering empathy, providing support, and creating inclusive environments. By acknowledging the physical, emotional, and social challenges faced by individuals with chronic conditions, we can work towards building a more supportive and understanding world.
References
[1] Centers for Disease Control and Prevention. (2023, April 12). Chronic diseases. Centers for Disease Control and Prevention.
[2] National Institutes of Health. (2022, April 27). Chronic illness. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4969287/
[3] Mistry, S., & Wearden, A. J. (2010). The emotional impact of chronic illness on adolescents: A review of the literature. Journal of Adolescence, 33(6), 747-760.
[4] The Alliance for Health Policy. (2023, January 11). The economic burden of chronic disease. https://www.allhealthpolicy.org/
[5] Affleck, G., Zautra, A. J., Christoffersen, E. R., & Moore, S. E. (1996). Cognitive-behavioral processes and adaptation to chronic illness. American Psychologist, 51(3), 267-276.
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Imagine a caterpillar transforming into a butterfly a remarkable illustration of the dynamic process of growth and maturation. From the moment we enter the world, our bodies and minds embark on a fascinating journey, following unique patterns as we develop into mature individuals. Let’s delve into the fascinating tapestry of growth and maturation.
One key pattern is the concept of cephalocaudal development [1]. This principle states that growth and maturation proceed in a head-to-toe fashion. Newborn babies have relatively large heads and well-developed upper body coordination for activities like sucking and grasping. As they mature, control and development progress down their bodies, allowing them to master skills like rolling, crawling, and eventually walking. This pattern ensures that the brain and nervous system are sufficiently developed to control movements in the lower limbs.
Another captivating aspect of growth is differential growth rates [2]. Different parts of the body don’t grow at the same pace. For instance, the brain undergoes a dramatic growth spurt early in life, reaching about 80% of its adult size by the age of three [3]. In contrast, growth in height and weight displays a more gradual and sustained pattern throughout childhood and adolescence. This uneven growth can sometimes lead to temporary awkwardness, but it’s a perfectly normal part of development.
Hormones play a crucial role in orchestrating the intricate dance of growth and maturation [4]. During puberty, a surge in hormones like testosterone and estrogen triggers a cascade of changes, influencing physical development, sexual maturation, and even emotional shifts. These hormonal fluctuations contribute to the development of secondary sexual characteristics, such as facial hair in males and breast development in females.
The fascinating interplay between genetics and environment also shapes growth patterns [5]. While our genes provide the blueprint for development, environmental factors like nutrition, access to healthcare, and physical activity can influence the timing and pace of growth. For example, proper nutrition is essential for optimal physical growth and brain development.
Understanding growth and maturation patterns allows us to appreciate the remarkable changes we experience throughout life. From the rapid development of infancy to the hormonal shifts of adolescence and the gradual changes of adulthood, our bodies and minds are constantly evolving. By recognizing these patterns, we can better support healthy development and create nurturing environments for individuals at each stage of their journey.
References
[1] Centers for Disease Control and Prevention. (2022, December 9). Developmental milestones. Centers for Disease Control and Prevention. https://www.cdc.gov/ncbddd/actearly/milestones/index.html
[2] Britannica, T. Editors of Encyclopaedia. (2023, April 18). Growth. In Encyclopædia Britannica.
[3] Centers for Disease Control and Prevention. (2021, June 21). Stages of brain development. Centers for Disease Control and Prevention.
[4] National Institutes of Health. (2022, April 28). Hormones.
[5] Centers for Disease Control and Prevention. (2020, June 19). Healthy development in preschool children. Centers for Disease Control and Prevention. https://www.cdc.gov/ncbddd/childdevelopment/index.html
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Tiny Miracles: NICU Technology Nurturing Premature Babies
Imagine a world filled with miniature marvels premature infants battling to take their first breaths. Here, in the Neonatal Intensive Care Unit (NICU), a symphony of advanced technology plays a vital role in nurturing these fragile lives. Let’s explore the remarkable tools that help the tiniest patients thrive.
The NICU environment itself is meticulously designed to mimic the nurturing womb [1]. Incubators provide warmth and humidity, while specialized beds minimize pressure on delicate bodies. Advanced monitoring systems track vital signs like heart rate, breathing, and oxygen levels, allowing for continuous assessment and prompt intervention if needed [2].
For babies born with underdeveloped lungs, ventilators offer life-saving support. These machines gently inflate and deflate the lungs, mimicking the natural process of breathing until the infant’s respiratory system is strong enough to take over [3]. Additionally, high-frequency oscillatory ventilation (HFOV) is a specialized technique that can be particularly beneficial for extremely premature infants.
Another technological marvel is phototherapy, which uses specially designed lights to treat jaundice, a condition causing a yellowish discoloration of the skin [4]. Phototherapy helps the baby’s body break down excess bilirubin, a pigment naturally produced during red blood cell breakdown.
Beyond monitoring and treatment, NICUs are increasingly utilizing technology to bridge the emotional gap between parents and their premature infants [5]. Cameras allow for constant virtual monitoring, and specialized isolettes with built-in portholes enable gentle touch, fostering a sense of connection despite physical barriers.
While technology plays a crucial role in NICU care, the human touch remains irreplaceable [6]. Compassionate nurses and neonatologists provide essential care and emotional support for both the infants and their families. The NICU becomes a world where cutting-edge technology and human dedication work hand-in-hand to nurture the tiniest miracles, offering them a fighting chance at a healthy future.
References
[1] National Institutes of Health. (2022, November 1). Neonatal intensive care unit (NICU). [neonatal intensive care unit ON National Institutes of Health (.gov) nichd.nih.gov]
[2] National Organization of Neonatal Nurses. (2023, May 1). Neonatal monitoring. National Organization of Neonatal Nurses. [neonatal monitoring ON National Organization of Neonatal Nurses neonurses.org]
[3] Children’s Hospital of Philadelphia. (2023, May 18). Ventilators for babies. Children’s Hospital of Philadelphia. [what is a ventilator used for in the nicu ON Children’s Hospital of Philadelphia chop.edu]
[4] National Health Service. (2023, March 28). Phototherapy for jaundice in babies. National Health Service. [phototherapy for premature ON nhs.uk]
[5] March of Dimes. (2023, May 17). Neonatal intensive care unit (NICU) care for babies. March of Dimes. [nicu technology for families ON March of Dimes marchofdimes.org]
[6] Association of Neonatal Nurses. (2021, September 2). The role of the neonatal nurse. Association of Neonatal Nurses. [neonatal nurse’s role ON Association of Neonatal Nurses neonatalnurse.org]
The levels of criminality in women and men significantly differ. Women, in general, are less likely to engage in violent and criminal activities as compared to men. This explains the small percentage of women in prisons. According to most sociologists, this difference in crime can be attributed to gender socialization. Society has assigned different roles and responsibilities across the two genders; therefore, men and women are expected to behave in a certain way per their particular gender roles.
Values such as competitiveness and behavioral patterns such as spending time away from family and home brought about by socialization into male gender roles may promote acts of deviance such as infidelity. On the other hand, role expectations limit womens criminal activities. These role expectations include gentleness, spending time at home, cooking for the family, helping the children with homework, and attending book clubs (Casella, 2020).
Women are also less likely to commit crimes as conviction seems more stigmatizing to them than men, hence influencing their socialization patterns. For instance, they are perceived as doubly deviant in court, and their actions are explained in terms of psychopathology (Heidensohn, 1991). Therefore, women fear such consequences of committing a crime at a higher degree compared to men.
Lastly, the difference in arrests may be attributed to the fact that society closely supervises and strictly disciplines women compared to men; thus, the social control. Subsequently, society ends up with a high percentage of women who conform. According to Sutherland and Cressey, the rates of arrests for females are lowest in such communities and highest in societies where women have great equality with men (Hoffman-Bustamante, 1973).
In conclusion, women make up a small percentage of the total incarcerated population due to differences in role expectations, socialization patterns, and applications of social control, as discussed above. Despite the percentage increase in womens imprisonment over the years, these factors remain viable for explaining the small number of women in prison over the total incarcerated population.
References
Cassella, K. (2020). Social Work and Deviant Behavior. Eastern Gateway Community College.
Heidensohn, F. M. (1991). Women as Perpetrators and Victims of Crime. British Journal of Psychiatry, 158(S10), pp.50-54. <http://sci-hub.se/10.1192/S000712500029199X>
Hoffman-Bustamante, D. (1973). The Nature of Female Criminality. Issues in Criminology, 8(2), pp.117-136. <https://www.jstor.org/stable/42909687>
As of 2015, women made up 10.4% of the incarcerated population in adult prisons and jails. Why do you think women make up such a small percentage of the total incarcerated population?
Women and Crime
(You can support your opinion with outside resources if you wish; just make sure to cite your source[s] at the end ).
Note: Please read Chapter 6 of the attached textbook
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Katie, a Caucasian 8-year-old girl, was brought to the office today by her parents. They were recommended by their primary healthcare provider (PCP). The PCP believed it was best if Katie had a psychiatric evaluation. The parents were given a copy of Conners Teacher Rating Scale-Revised to take to the PMHNP. Katies teacher completed the scale, and it was taken to their PCP. Katies teacher noted that she was easily distracted, inattentive, forgetful, seldomly followed instructions, and never finished school work. The parents are in denial. From a subjective perspective, Katie feels she is okay. She is interested in art. She gets lost momentarily. She loves her parents as they are good and kind to her. Mental examination shows she is well-grown for her age and well-dressed for the weather with clear, coherent, and logical speech. She has no tics, gestures, or noteworthy mannerisms, and her effect is bright. She denies any hallucinations or paranoid thoughts. Her attention and concentration were grossly intact during the interview, and she could count backward from 100 by serial 2s and 5s. She has no suicidal or homicidal ideation. Katie was diagnosed with attention deficit hyperactivity disorder (ADHD) and predominantly inattentive presentation.
Decision #1
My first choice of medication for Katie is Wellbutrin (Bupropion) XL, whereby she will take a total of 150mg orally daily. The decision to use Wellbutrin (Bupropion) XL 150mg as the first line for ADHD is because the selected medication is an atypical antidepressant that has been found to have higher efficacy in the management of ADHD in children and adolescents (Mucci et al., 2021). The bupropion mechanism of action, although not clear, includes weakly blocking the reuptake of norepinephrine and dopamine (Huecker et al., 2022). These neurotransmitters are responsible for attention and motivation, which leads to a reduction of ADHD symptoms within two weeks of use.
The other available options were not selected over Wellbutrin (Bupropion) XL due to concerns over the efficacy and risks of side effects. Wellbutrin (Bupropion) XL has a reduced risk of serious side effects as well as developing a dependency (Huecker et al., 2022). The provided options have lower efficacy in managing ADHD symptoms or have an increased risk of developing major side effects in long-term use as well as developing addictions.
The selection of Wellbutrin (Bupropion) XL as the first line for treating Katies symptoms was to reduce the ADHD symptoms as well as improve her ability to perform her daily activities such as learning. Wellbutrin (Bupropion) XL is linked to improved outcomes and can also help manage other comorbid psychiatric disorders not yet diagnosed in ADHD patients (Mucci et al., 2021).
The major ethical considerations include the patients autonomy, confidentiality, and maintaining her dignity. In this case, as Katie is too young to make her own decisions on treatment, her parents will be the main decision-makers. They will be informed of all available treatment options, efficacy, and risks to help them decide on the treatment plan that is best for Katie.
Decision #2
The second medication decision for Katie is Intuniv 1mg, to be taken orally at bedtime. I selected Intuniv based on the symptoms Katie presented. Intuniv (Guanfacine) is an FDA-approved alpha-2 adrenergic agonist for the management of ADHD symptoms in children between the ages of 6 and 17 years (FDA, n.d.). Intuniv is effective as it works by stimulating the alpha-2A receptors in the prefrontal cortex (Arnsten, 2020). The stimulated alpha-2A receptors in the prefrontal cortex result in an improved ability to recall things, better attention, and impulse control.
I did not select the other available options for the management of similar symptoms for various reasons. Firstly, although the other options are approved for the management of ADHD, they have a reduced efficacy. This means the benefits of the medications are felt several weeks after administration. Additionally, the other options also have a higher risk of serious side effects, such as seizures and fatigue, compared to Intuniv. The issue of the efficacy of the drug in reducing ADHD symptoms after administration is of concern in selecting medications, as some take longer to be effective (Mucci et al., 2021).
I decided to use Intuniv 1mg orally at bedtime as it improves prefrontal cortex functioning and, hence, higher cognitive function (Arnsten, 2020). This will help improve attention and motivation to learn as well as work on other major ADHD symptoms. Low doses at night will reduce the impact of side effects such as sleepiness.
Ethical considerations that may impact the treatment plan and communication with patients include the decisions to use the new drug and obtaining informed consent from Katies parents to include the new drug in the treatment plan. The parents must be provided with fully understandable information on the drugs efficiency and associated risks.
Decision #3
The third decision is to use Ritalin Methylphenidate 10mg orally in the morning. It is the last option to give to Katie. The medication belongs to a group of psychostimulants that works by inhibiting the reuptake of dopamine and norepinephrine, increasing their concentration levels in the brain (Briars & Todd, 2016). The medication is a first-line medication in the management of ADHD in children. However, in the case of Katie, it is the last option due to its stimulant nature (Faraone, 2018).
I would select Ritalin (methylphenidate) over the other two options as the last option if they failed to achieve the desired outcomes regarding the ADHD symptoms presented by Katie. A stimulant medication is more potent in managing ADHD in children aged 6 years and older due to its selective inhibition of the reuptake of neurotransmitters, especially dopamine and norepinephrine, leading to better ADHD symptom management (Faraone, 2018).
By deciding to use Ritalin (methylphenidate), I intend to improve the efficacy of the treatment and effectively manage to reduce the major symptoms of ADHD manifested by Katie. As earlier noted, methylphenidate increases the concentration of dopamine and norepinephrine in the brain, improving attention duration and moods (Faraone, 2018).
In this case, the ethical considerations that would impact the communication with the patient and the treatment plan would be considerations to use a psychostimulant on a child. The parents, as decision-makers, must be well informed about the drugs potency and efficiency in managing ADHD as well as other comorbidities and the associated side effects, including the risk of addiction. This would help introduce the medication to the treatment plan with informed patient consent.
Conclusion
Katie has been diagnosed with ADHD and predominantly inattentive presentation. ADHD in children can is a neurodevelopmental disorder that affects children and adolescents, leading to increased inattention, hyperactivity, disruptive behavior, and impulsivity (Mucci et al., 2021). The management of ADHD in children requires starting treatment with medications with a low risk of side effects and addiction. Although some medications, such as Ritalin (methylphenidate), have the highest efficacy levels and are recommended as first-line medications for managing ADHD in children, they have a higher potential for side effects and the development of dependency (Faraone, 2018). Regardless of the efficacy of a drug if added to a treatment plan, it is important to have an ethically collaborative partnership with the patient or other legal decision-makers before deciding on adding medications to the treatment plan. Collaborative and ethical relationships improve patient outcomes as well as their experiences during the entire care period.
References
Arnsten, A. F. T. (2020). Guanfacines mechanism of action in treating prefrontal cortical disorders: Successful translation across species. Neurobiology of Learning and Memory, 176, 107327. https://doi.org/10.1016/J.NLM.2020.107327
Briars, L., & Todd, T. (2016). A Review of Pharmacological Management of Attention-Deficit/Hyperactivity Disorder. The Journal of Pediatric Pharmacology and Therapeutics?: JPPT, 21(3), 192. https://doi.org/10.5863/1551-6776-21.3.192
Faraone, S. V. (2018). The pharmacology of amphetamine and methylphenidate: Relevance to the neurobiology of attention-deficit/hyperactivity disorder and other psychiatric comorbidities. Neuroscience and Biobehavioral Reviews, 87, 255270. https://doi.org/10.1016/J.NEUBIOREV.2018.02.001
FDA. (n.d.). Clinical Pharmacological Review. Retrieved April 25, 2023, from https://www.fda.gov/media/80233/download
Huecker, M. R., Smiley, A., & Saadabadi, A. (2022). Bupropion. XPharm: The Comprehensive Pharmacology Reference, 14. https://doi.org/10.1016/B978-008055232-3.64054-1
Mucci, F., Carpita, B., Pagni, G., Vecchia, A. Della, Bjedov, S., Pozza, A., & Marazziti, D. (2021). Lifetime evolution of ADHD treatment. Journal of Neural Transmission 2021 128:7, 128(7), 10851098. https://doi.org/10.1007/S00702-021-02336-W
BACKGROUND
Katie is an 8-year-old Caucasian female who was brought to your office today by her mother & father. They report that they were referred to you by their primary care provider after seeking her advice because Katies teacher suggested that she may have ADHD. Katies parents reported that their PCP felt that she should be evaluated by psychiatry to determine whether or not she has this condition.
Treatment for ADHD
The parents give the PMHNP a copy of a form titled Conners Teacher Rating Scale-Revised. This scale was filled out by Katies teacher and sent home to the parents so that they could share it with their familys primary care provider. According to the scoring provided by her teacher, Katie is inattentive, easily distracted, forgets things she has already learned and is poor in spelling, reading, and arithmetic. Her attention span is short, and she is noted to only pay attention to things she is interested in. The teacher opined that she lacks interest in schoolwork and is easily distracted. Katie is also noted to start things but never finish them, seldom follows through on instructions, and fails to finish her school work.
Katies parents actively deny that Katie has ADHD. She would be running around like a wild person if she had ADHD reports her mother. She is never defiant or has temper outbursts adds her father.
SUBJECTIVE
Katie reported that she didnt know what the big deal was. She states that school is OK- her favorite subjects are art and recess. She states that she finds her other subjects boring, and sometimes hard because she feels lost. She admits that her mind does wander during class to things that she thinks of as more fun. Sometimes Katie reports I will just be thinking about nothing and the teacher will call my name and I dont know what they were talking about.
Katie reported that her home life was just fine. She reports that she loves her parents and that they are very good and kind to her. Denies any abuse or bullying at school. Offers no other concerns at this time.
MENTAL STATUS EXAM
The client is an 8-year-old Caucasian female who appears appropriately developed for her age. Her speech is clear, coherent, and logical. She is appropriately oriented to person, place, time, and event. She is dressed appropriately for the weather and time of year. She demonstrates no noteworthy mannerisms, gestures, or tics. Self-reported mood is euthymic. The effect is bright. Katie denies visual or auditory hallucinations, no delusional or paranoid thought processes are readily appreciated. Attention and concentration are grossly intact based on Katies attendance to the clinical interview and her ability to count backward from 100 by serial 2s and 5s. Insight and judgment appear age-appropriate. Katie denies any suicidal or homicidal ideation.
Diagnosis: Attention deficit hyperactivity disorder, predominantly inattentive presentation
Examine Case Study: A Young Caucasian Girl with ADHD. You will be asked to make three decisions concerning the medication to prescribe to this patient. Be sure to consider factors that might impact the patients pharmacokinetic and pharmacodynamic processes.
At each decision point, you should evaluate all options before selecting your decision and moving throughout the exercise. Before you make your decision, make sure that you have researched each option and that you evaluate the decision that you will select. Be sure to research each option using the primary literature.
Introduction to the case (1 page)
Briefly explain and summarize the case for this Assignment. Be sure to include the specific patient factors that may impact your decision-making when prescribing medication for this patient.
Decision #1 (1 page) Wellbutrin (Bupropion) XL 150mg orally daily
Which decision did you select?
Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
Why did you not select the other two options provided in the exercise? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources (including the primary literature).
Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples.
Decision #2 (1 page) Intuniv 1mg orally at bedtime
Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
Why did you not select the other two options provided in the exercise? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources (including the primary literature).
Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples.
Decision #3 (1 page) Ritalin Methylphenidate 10mg PO in the morning
Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
Why did you not select the other two options provided in the exercise? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources (including the primary literature).
Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples.
Conclusion (1 page)
Summarize your recommendations on the treatment options you selected for this patient. Be sure to justify your recommendations and support your response with clinically relevant and patient-specific resources, including the primary literature.
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Nursing is an important profession in the healthcare sector that supports peoples health and ensures wellness. With the progressive advancements in the profession, nursing has begun conceptualizing spiritual importance and associating it with bodily health. Spirituality is regarded as an integral part of a patients well-being (Hawthorne & Gordon, 2019). When providing holistic care to patients, nurses are expected to take care of their physical, emotional, mental, and spiritual needs. Currently, the nurses are not only expected to diagnose and dispense medication but also to nourish the patients spiritual aspects. However, spirituality is culturally based, as individuals have different faiths and beliefs. It is, therefore, essential to understand the cultural beliefs of individuals before providing any spiritual nourishment to the patients. Nurses need to uphold spiritual standards in healthcare and determine the patients who may find receiving spiritual care fulfilling. Nurses must undoubtedly comprehend and regard spirituality in the care process (Timmins, 2017). The nurses are expected to assess the spirituality of the patients. Multiple tools can be used to evaluate the spirituality of the patients.
One of the tools that are utilized to assess spirituality is the Spirituality Scale. This tool is important in assessing the level of spirituality in nurses and how they can channel these beliefs into providing spiritual care to their patients while providing them with holistic care (Timmins, 2017). The tool has three sections with various questions that can be used to determine the nurses spirituality. Some of the open-ended questions are used to ask the nurses about their beliefs.
The other tool that is commonly used to assess spirituality is Open Invite. Open Invite is focused on the patient and encourages the need for spiritual dialogue between the nurses and the patients. The patients who are not spiritual can decide not to engage in a dialogue with the nurses, but the spiritual ones can decide to engage in further spiritual dialogues with the nurses (Timmins, 2017). Such spiritual dialogues provide them with comfort and hope for quick recovery. The conversational questions are used to determine whether the patients are spiritual.
The other important tool used to gauge spirituality in nursing is the spirituality scale test. It consists of true and false questions that can be used to assess the spirituality of the patients and the nurses (Timmins, 2017). The tool has various questions that the nurses can use to determine if they should offer spiritual care to the patients. These tools have proved to be significant in determining whether to provide spiritual care to patients or not.
References
Hawthorne, D. M., & Gordon, S. C. (2019). The Invisibility of Spiritual Nursing Care in Clinical Practice. Journal of Holistic Nursing, 38(1), 147155. https://doi.org/10.1177/0898010119889704
Timmins, F. (2017). Assessing the spiritual needs of patients. Rcni.com. https://journals.rcni.com/nursing-standard/assessing-the-spiritual-needs-of-patients- ns.2017.e10312
The use of spirituality in nursing practice is not new. However, it is more studied and utilized in a more structured format in nursing. Identify and discuss tools used to evaluate spirituality.
Spirituality In Nursing
Please include 400 words in your initial post with two scholarly articles no later than 5 years old.
No Plagiarism
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