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Micro Mod 3 Case

?  Below the genogram, summarise the structure of the family to demonstrate your understanding of the family assessment findings. ?  Use the Australian Family Strengths Nursing Assessment Guide (AFSNAG) to identify and briefly describe two (2) strengths of the family you are assessing.  Part 2 – Nursing Care of the Family: Planning, Implementing and Evaluating (1,500 words) ?  Select two (2) issues/challenges for the family or a member of the family you have selected. These issues may be identified by the nurse, family or both. These can be health, social, or developmental family issues/challenges e.g., breastfeeding, social isolation, transition to parenting; they should not be ‘medical’ issues e.g., diabetes, high blood pressure. ?  For each issue/challenge identified in the family assessment (allow approximately 750 words per issue):  a) Describetheissue b) Plannursingcare c) Implement nursing care d) Evaluate nursing care o Use appropriate evidence from scholarly literature to describe the issue and discuss what is known about the issue/challenge. o Provide a relevant nursing goal and justify the goal (explain why it is relevant to the issue) using appropriate evidence or policies. o Outline one nursing intervention that supports the family to achieve the goal. Each nursing intervention should be supplemented by the recommendation of an existing online resource for the family and an appropriate referral.

Nursing Assessment – Pediatric

Your topic is good but your PICOT is not in correct format. Please redo your question using the template I provided in the week 1 CAT and resubmit for a grade. Please send me a note in the IF so I can reset your assignment.P: Population/disease ( i.e. age, gender, ethnicity, with a certain disorder)I: Intervention or Variable of Interest (exposure to a disease, risk behavior, prognostic factor)C: Comparison: (could be a placebo or “business as usual” as in no disease, absence of risk factor, Prognostic factor B )O: Outcome: (risk of disease, accuracy of a diagnosis, rate of occurrence of adverse outcome)T: Time: The time it takes to demonstrate an outcome (e.g. the time it takes for the intervention to achieve an outcome or how long participants are observed).Note: Not every question will have an intervention (as in a meaning question) or time (when it is implied in another part of the question) component.For an intervention/therapy:In _______(P), what is the effect of _______(I) on ______(O) compared with _______(C) within ________ (T)?For etiology:Are ____ (P) who have _______ (I) at ___ (Increased/decreased) risk for/of_______ (O) compared with ______ (P) with/without ______ (C) over _____ (T)?Diagnosis or diagnostic test: Are (is) _________ (I) more accurate in diagnosing ________ (P) compared with ______ (C) for _______ (O)?Prevention:For ________ (P) does the use of ______ (I) reduce the future risk of ________ (O) compared with _________ (C)?Prognosis/PredictionsDoes __________ (I) influence ________ (O) in patients who have _______ (P) over ______ (T)?MeaningHow do ________ (P) diagnosed with _______ (I) perceive ______ (O) during _____ (T)?Based on Melnyk B., & Fineout-Overholt E. (2010). Evidence-based practice in nursing & healthcare. New York: Lippincott Williams & Wilkins. Examples of Evidence-Based PICOT Questions1. Population: Bariatric adolescents considering or undergoing gastric bypass surgery.Intervention: The nurse’s role as a primary member of the multidisciplinary team regarding perioperative care of the bariatric adolescent patient.Comparison: The nurse’s role as a secondary member of the multidisciplinary team without any specialized training and is only involved in perioperative care of the bariatric adolescent patient.Outcome: When the nurse is involved as one of the primary members in the multidisciplinary team approach, the bariatric adolescent patient has better continuity of care.Time: perioperative including the 6 weeks post recovery.PICOT Question: Does the bariatric adolescent patient undergoing gastric bypass have better continuity of care perioperatively and postoperatively when the nurse is a primary member of the multidisciplinary team versus when the nurse is a secondary member whose only role is in providing perioperative care and has no specialized training?2. Intervention PICOT Question: An Intervention example: In adult patients with total hip replacements (Patient population) how effective is PCA pain medication (Intervention of interest) compared to prn IM pain medication (Comparison intervention) in controlling post operative pain (Outcome) during the perioperative and recovery time? Note: The IM pain medication would be called the control group. It would be unethical to have a control group that received NO pain medication. Many times the control group means they get “business as usual!” or the current standard of care. 3. Therapy PICOT Question: A non-intervention example: What is the duration of recovery (O) for patients with total hip replacement (P) who developed a post-operative infection (I) as opposed to those who did not (C) within the first six weeks of recovery (T)?4.  Etiology PICOT Question: Are kids (P) who have obese adoptive parents (I) at Increased risk for obesity (O) compared with kids (P) without obese adoptive parents (C) during the ages of five and 18 (T)?5. Diagnostic PICOT Question: Is a PKU test (I) done on two week old infants (P) more accurate in diagnosis inborn errors in metabolism (O) compared with PKU tests done at 24 hours of age (C)? Time is implied in two weeks and 24 hours old.6. Prevention PICOT Question: In OR nurses doing a five minute scrub (P) what are the differences in the presence and types of microbes (O) found on natural polished nails and nail beds (I) and artificial nails (C) at the time of surgery (T)?7. Prognosis/Prediction PICOT question: Does telelmonitoring blood pressure (I) in urban African Americans with hypertension (P) improve blood pressure control (O) within the six months of initiation of the medication (T)?8. Meaning PICOT Question: How do pregnant women (P) newly diagnosed with diabetes (I) perceive reporting their blood sugar levels (O) to their healthcare providers during their pregnancy and six weeks postpartum (T)?

Healthcare – Legal and ethical issues

Youth suicide is the third leading cause of death for persons between 15-24 years of age, and almost 4,600 youth deaths each year are the result of suicide for a person 10-24 years of age (Smischney, Chrisler, & Villarruel, 2014). Learning of these numbers is very discouraging considering that suicide can be prevented by recognition and implication of interventions. Adolescents may present to family, friends, or teacher’s signs of suicidal behavior such as talk of suicide, threat of suicide, or risky behavior. Sometimes the adolescent may not display warning signs before committing suicide. It is important to identify risk factors that can lead to suicide. Risk factors that contribute to suicidal ideation are biological, environmental, and psychological factors (Smischney et al., 2014).

Health care

Youth suicide is the third leading cause of death for persons between 15-24 years of age, and almost 4,600 youth deaths each year are the result of suicide for a person 10-24 years of age (Smischney, Chrisler, & Villarruel, 2014). Learning of these numbers is very discouraging considering that suicide can be prevented by recognition and implication of interventions. Adolescents may present to family, friends, or teacher’s signs of suicidal behavior such as talk of suicide, threat of suicide, or risky behavior. Sometimes the adolescent may not display warning signs before committing suicide. It is important to identify risk factors that can lead to suicide. Risk factors that contribute to suicidal ideation are biological, environmental, and psychological factors (Smischney et al., 2014).

Biological risk factors include gender, ethnicity, and sexual orientation. The male gender is 4 times greater to attempt suicide that results in death, whereas female adolescents experience higher rates of depression. Native American or Alaska Natives that are between the ages of 15-24 are at a 2.4 percent higher rate than the national average. Suicidal ideation is higher amongst gay and bisexual male adolescents than heterosexual male adolescents. This may due to the adolescent’s parents or friends lack of approval or support (Smischney et al., 2014).

Environmental risk factors that contribute to suicide include family stress and conflict such as divorce, death of a loved one, academic failure, and abuse. During adolescence, peer relationships greatly contribute to suicide. Adolescents who suffer from poor social skills, low self-esteem, and lack support from their peers are at greater risk for suicidal ideation (Smischney et al., 2014).

Psychological risk factors contributing to adolescent suicide include mental health problems, psychiatric disorders, poor coping skills, and substance abuse. Mental health disorders include anxiety, depression, post-traumatic stress disorder, and schizophrenia. Alcohol is often experienced with by adolescents. Female adolescents are 3 times more likely to attempt suicide and male adolescents are 17 times more likely to attempt suicide when alcohol is involved (Smischney et al., 2014).

Primary, secondary, and tertiary heath prevention measures can be taken to prevent suicide. Primary prevention can be implemented by addressing the topic of suicide with adolescents, identifying risk factors of suicide, and talking about ways to avoid risk factors that can lead to suicide. Secondary prevention can be done by addressing risk factors that the adolescent is experiencing and implementing healthy and effective interventions. This will help to reduce the chance of the adolescent following through with the act of suicide. Tertiary prevention should include providing support and resources to the adolescent, as well ensuring safety. Measures should be taken to prevent the adolescent from attempting and succeeding at suicide.

The Suicide Prevention Resource Center is a resource that provides contact information and suicide prevention plans specific for each state. This information can be accessed through the website http://www.sprc.org/states. Adolescents can also contact the National Suicide Prevention Lifeline 24/7 by calling 1-800-273-8255, or going online to https://suicidepreventionlifeline.org/. Both of these resources offer support to those who are experiencing a suicidal crisis. As a nurse if you suspect a depressed adolescent is in immediate danger of harming themselves, immediate intervention should be implemented such as ensuring the safety of the adolescent. If the nurse is physically present at the adolescent’s side, taking the adolescent to a safe environment and informing a physician is important to prevent harm or injury. If the nurse is talking with the adolescent over the phone and the adolescent is posing immediate danger to themselves, proper authorities should be notified and full detail of the adolescent’s location and situation should be provided.

 References

National Suicide Prevention Lifeline, (n.d.). Get help. Retrieved from https://suicidepreventionlifeline.org/

Smischney, T. M., Chrisler, A., & Villarruel, F. A., (2014). Risk factors for adolescent suicide: Research brief. Retrieved from https://reachmilitaryfamilies.umn.edu/sites/default/files/rdoc/Adolescent%20Suicide.pdf

Suicide Prevention Resource Center, (2017). Organizations: States. Retrieved from http://www.sprc.org/states

Comprehensive Health Insurance PT 2

Youth suicide is the third leading cause of death for persons between 15-24 years of age, and almost 4,600 youth deaths each year are the result of suicide for a person 10-24 years of age (Smischney, Chrisler, & Villarruel, 2014). Learning of these numbers is very discouraging considering that suicide can be prevented by recognition and implication of interventions. Adolescents may present to family, friends, or teacher’s signs of suicidal behavior such as talk of suicide, threat of suicide, or risky behavior. Sometimes the adolescent may not display warning signs before committing suicide. It is important to identify risk factors that can lead to suicide. Risk factors that contribute to suicidal ideation are biological, environmental, and psychological factors (Smischney et al., 2014).

Biological risk factors include gender, ethnicity, and sexual orientation. The male gender is 4 times greater to attempt suicide that results in death, whereas female adolescents experience higher rates of depression. Native American or Alaska Natives that are between the ages of 15-24 are at a 2.4 percent higher rate than the national average. Suicidal ideation is higher amongst gay and bisexual male adolescents than heterosexual male adolescents. This may due to the adolescent’s parents or friends lack of approval or support (Smischney et al., 2014).

Environmental risk factors that contribute to suicide include family stress and conflict such as divorce, death of a loved one, academic failure, and abuse. During adolescence, peer relationships greatly contribute to suicide. Adolescents who suffer from poor social skills, low self-esteem, and lack support from their peers are at greater risk for suicidal ideation (Smischney et al., 2014).

Psychological risk factors contributing to adolescent suicide include mental health problems, psychiatric disorders, poor coping skills, and substance abuse. Mental health disorders include anxiety, depression, post-traumatic stress disorder, and schizophrenia. Alcohol is often experienced with by adolescents. Female adolescents are 3 times more likely to attempt suicide and male adolescents are 17 times more likely to attempt suicide when alcohol is involved (Smischney et al., 2014).

Primary, secondary, and tertiary heath prevention measures can be taken to prevent suicide. Primary prevention can be implemented by addressing the topic of suicide with adolescents, identifying risk factors of suicide, and talking about ways to avoid risk factors that can lead to suicide. Secondary prevention can be done by addressing risk factors that the adolescent is experiencing and implementing healthy and effective interventions. This will help to reduce the chance of the adolescent following through with the act of suicide. Tertiary prevention should include providing support and resources to the adolescent, as well ensuring safety. Measures should be taken to prevent the adolescent from attempting and succeeding at suicide.

The Suicide Prevention Resource Center is a resource that provides contact information and suicide prevention plans specific for each state. This information can be accessed through the website http://www.sprc.org/states. Adolescents can also contact the National Suicide Prevention Lifeline 24/7 by calling 1-800-273-8255, or going online to https://suicidepreventionlifeline.org/. Both of these resources offer support to those who are experiencing a suicidal crisis. As a nurse if you suspect a depressed adolescent is in immediate danger of harming themselves, immediate intervention should be implemented such as ensuring the safety of the adolescent. If the nurse is physically present at the adolescent’s side, taking the adolescent to a safe environment and informing a physician is important to prevent harm or injury. If the nurse is talking with the adolescent over the phone and the adolescent is posing immediate danger to themselves, proper authorities should be notified and full detail of the adolescent’s location and situation should be provided.

 References

National Suicide Prevention Lifeline, (n.d.). Get help. Retrieved from https://suicidepreventionlifeline.org/

Smischney, T. M., Chrisler, A., & Villarruel, F. A., (2014). Risk factors for adolescent suicide: Research brief. Retrieved from https://reachmilitaryfamilies.umn.edu/sites/default/files/rdoc/Adolescent%20Suicide.pdf

Suicide Prevention Resource Center, (2017). Organizations: States. Retrieved from http://www.sprc.org/states