You and your research team have concluded that the consistent use of high-energy drinks by adolescents negatively impacts memory retention.
Describe your strategy for bringing this to the attention of policymakers, such as your local school board or state legislators.
In earlier weeks, you were introduced to the concept of the captain of the ship. In this Assignment, you become the captain of the ship once again as you provide treatment recommendations and identify medical management, community support resources, and follow-up plans for a client with a schizophrenia spectrum/other psychotic disorder.
To prepare for this Assignment:
In 34 pages, write a treatment plan for your client in which you do the following:
People of Appalachian Heritage.
People of Arab Heritage.
Please read chapter 8 and 9 of the class textbook and review the attached PowerPoint presentations. Once done answer the following questions;
1. Give an overview of the Inhabited localities and topography of the Appalachian and Arab heritage.
2. Discuss any similarities in the beliefs of the Appalachian and Arab heritages regarding the delivery of healthcare.
3. How the religion or folks beliefs influence the delivery of healthcare in these two heritages.
You must cite or quote at least two evidence-based references (besides the class textbook) no older than 5 years old. Two replies to any or yours peers sustained with the proper reference (s) are required. An example of how to present the first page is attached for your guidance.
A minimum of 600 words excluding the first and references page is required.
76-year-old Iranian Male with Alzheimers Disease
BACKGROUND
Mr. Akkad is a 76 year old Iranian male who is brought to your office by his eldest son for strange behavior. Mr. Akkad was seen by his family physician who ruled out any organic basis for Mr. Akkads behavior. All laboratory and diagnostic imaging tests (including CT-scan of the head) were normal.
According to his son, he has been demonstrating some strange thoughts and behaviors for the past two years, but things seem to be getting worse. Per the clients son, the family noticed that Mr. Akkads personality began to change a few years ago. He began to lose interest in religious activities with the family and became more critical of everyone. They also noticed that things he used to take seriously had become a source of amusement and ridicule.
Over the course of the past two years, the family has noticed that Mr. Akkad has been forgetting things. His son also reports that sometimes he has difficult finding the right words in a conversation and then will shift to an entirely different line of conversation.
SUBJECTIVE
During the clinical interview, Mr. Akkad is pleasant, cooperative and seems to enjoy speaking with you. You notice some confabulation during various aspects of memory testing, so the PMHNP performs a Mini-Mental State Exam. Mr. Akkad scores 18 out of 30 with primary deficits in orientation, registration, attention & calculation, and recall. The score suggests moderate dementia.
MENTAL STATUS EXAM
Mr. Akkad is 76 year old Iranian male who is cooperative with todays clinical interview. His eye contact is poor. Speech is clear, coherent, but tangential at times. He makes no unusual motor movements and demonstrates no tic. Self-reported mood is euthymic. Affect however is restricted. He denies visual or auditory hallucinations. No delusional or paranoid thought processes noted. He is alert and oriented to person, partially oriented to place, but is disoriented to time and event [he reports that he thought he was coming to lunch but wound up here- referring to your office, at which point he begins to laugh]. Insight and judgment are impaired. Impulse control is also impaired as evidenced by Mr. Akkads standing up during the clinical interview and walking towards the door. When the PMHNP asked where he was going, he stated that he did not know. Mr. Akkad denies suicidal or homicidal ideation.
Diagnosis: Major neurocognitive disorder due to Alzheimers disease (presumptive)
Decision Point One #1
Select what the PMHNP should do:
Begin Exelon (rivastigmine) 1.5 mg orally BID with an increase to 3 mg orally BID in 2 weeks
RESULTS OF DECISION POINT ONE
Client returns to clinic in four weeks
The client is accompanied by his son who reports that his father is no better from this medication. He reports that his father is still disinterested in attending religious services/activities, and continues to exhibit disinhibited behaviors
You continue to note confabulation and decide to administer the MMSE again. Mr. Akkad again scores 18 out of 30 with primary deficits in orientation, registration, attention & calculation, and recall
Decision Point Two #2
Select what the PMHNP should do:
Increase Exelon to 4.5 mg orally BID
RESULTS OF DECISION POINT TWO
Client returns to clinic in four weeks
Clients son reports that the client is tolerating the medication well, but is still concerned that his father is no better
He states that his father is attending religious services with the family, which the son and the rest of the family is happy about. He reports that his father is still easily amused by things he once found serious
Decision Point Three #3
Select what the PMHNP should do next:
Increase Exelon to 6 mg orally BID
Guidance to Student
At this point, the client is reporting no side effects and is participating in an important part of family life (religious services). This could speak to the fact that the medication may have improved some symptoms. The PMHNP needs to counsel the clients son on the trajectory of presumptive Alzheimers disease in that it is irreversible, and while cholinesterase inhibitors can stabilize symptoms, this process can take months. Also, these medications are incapable of reversing the degenerative process. Some improvements in problematic behaviors (such as disinhibition) may be seen, but not in all clients.
At this point, the PMHNP could maintain the current dose until the next visit in 4 weeks, or the PMHNP could increase it to 6 mg orally BID and see how the client is doing in 4 more weeks. Augmentation with Namenda is another possibility, but the PMHNP should maximize the dose of the cholinesterase inhibitor before adding augmenting agents. However, some experts argue that combination therapy should be used from the onset of treatment.
Finally, it is important to note that changes in the MMSE should be evaluated over the course of months, not weeks. The absence of change in the MMSE after 4 weeks of treatment should not be a source of concern.
The Assignment
Examine Case Study: An Elderly Iranian Man With Alzheimers Disease.
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 clients pharmacokinetic and pharmacodynamic processes.
At each decision point stop to complete the following:
o Decision #1
o
Which decision did you select?
Why did you select this decision? Support your response with evidence and references to the Learning Resources.
What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.
Explain any difference between what you expected to achieve with Decision #1 and the results of the decision. Why were they different?
o Decision #2
o
Why did you select this decision? Support your response with evidence and references to the Learning Resources.
What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.
Explain any difference between what you expected to achieve with Decision #2 and the results of the decision. Why were they different?
o Decision #3
o
Why did you select this decision? Support your response with evidence and references to the Learning Resources.
What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.
Explain any difference between what you expected to achieve with Decision #3 and the results of the decision. Why were they different?
Also include how ethical considerations might impact your treatment plan and communication with clients.
Note: Support your rationale with a minimum of three academic resources.
Read Chapter 2 and watch Week 3 Lectures. Choose a contemporary moral issue in our society (course materials) and apply the ethical principle of Utilitarianism to approve this moral issue. You must pick a moral issue that you strongly support and apply the utilitarian claims (course materials) to back up your arguments. The paper must be done in MLA format with a minimum of 500 words (quotes are not included in the word count). This assignment is due on January 26th (10 Points off per day late) You must apply Bentham/Mill’s “Principle of Utility” (week 3 Lecture) for 50 points and Bentham’s Felicific Calculus for 50 points (under course materials)
Moral resilience has been defined as the capacity of an individual to sustain or restore their integrity in response to moral complexity, confusion, distress, or setbacks (Rushton, 2016a, p. 112a). Moral resilience is an evolving concept and other definitions have focused on the ability and willingness to speak and take right and good action in the face of an adversity that is moral/ethical in nature (Lachman, 2016, p. 122).
I would like to believe that nurses have innate and learned capacities that can be used to combat the negative of forces of moral distress, burnout, compassion fatigue, and incivility that plagues our nursing profession.
As a result of this one course in Ethics, you have been given some tools to develop critical thinking skills, use ethical decision making models to strengthen and clarify your values. I believe all of you will need to be on an intentional journey to use and leverage these skills to keep your nursing practice resilient and meaningful.
How do you see yourself cultivating moral resilience within yourself, with your colleagues and the organizations where you will work? What specific interventions can you envision for yourself as you continue your journey in the socialization of becoming a nurse? What contributions do you intend to create to make meaningful and sustainable change in your role as a nurse?
Do not use the Lachman and Rushton articles since they have already been referenced in the assignment stem, and Write this using academic considerations:
Describe a health promotion model used to initiate behavioral changes. How does this model help in teaching behavioral changes? What are some of the barriers that affect a patient’s ability to learn? How does a patient’s readiness to learn, or readiness to change, affect learning outcomes?
250 WORDS CITATION, REFERENCES, YOU CAN USE THIS WEBSITE
Whitney, S. (2018). Grand Canyon University (Ed). Health promotion: Health & wellness across the continuum. Retrieved from
Need help to reply three post.
DO NOT JUST REPEAT SAME INFORMATION, DO NOT JUST SAY I AGREE OR THINGS LIKE THAT. YOU NEED TO ADD NEW INFORMATION TO DISCUSSION.
1- Each reply should be at least 200 words.
2- One scholarly reference ( NO MAYO CLINIC/ AHA)
3- APA style needs to be followed.
4- Each response should have reference at the end
5- Reference should be within last 5 years
1. What is the difference between hospice and palliative care?
2. What is your view on hospice and/or Palliative care?
3. What is your view on euthanasia?
4. Do you have an advanced directive, living will or power of attorney?
A 63-year-old woman comes to your office because she’s been forgetting thingsa young mother comes in concerned because her baby fails to make eye contact and is unresponsive to toucha teenager comes in and a parent complains that the teen obsessively washes his hands.
An array of neurological conditions could be causing the above symptoms. When assessing the neurologic system, it is vital to formulate an accurate diagnosis as early as possible to prevent continued damage and deterioration of a patient’s quality of life.
This week, you will explore methods for assessing the cognition and the neurologic system.
A 47-year-old obese female complains of pain in her right wrist, with tingling and numbness in the thumb and index and middle fingers for the past 2 weeks. She has been frustrated because the pain causes her to drop her hair-styling tools.
January 23rd, 2020 
