Scenario Two:
Scenario Two:
Myrna Matthews went on her own to the Emergency Department of Midwest Hospital on August 10th. She complained of burning pain in her upper chest that had radiated down her right arm that evening as well at the previous evening. When she arrived at the Emergency Department at 11:25 PM, she was triaged by a nurse who took her vital signs, recorded her medical history, and made an assessment of her immediate medical needs. Although slightly elevated, Matthews' vital signs were within normal limits. The triage nurse classified Matthews as a ""category two"" patient, a non-threatening condition. She was told that she would have a long wait, as the emergency department was very busy. A social services representative spoke to Matthews between six to eight times during her wait. He felt she was in no apparent distress during those times that he had spoken to her. Following the 4-� hour wait, Myrna decided to leave without being treated. At this time, the social services representative told Ms. Matthews that a treatment room was ready for her and that she would be seen shortly. Mathews said that she had already waited long enough, and she was leaving. She said she would see her own doctor in the morning. Ms Mathews signed a release for leaving against medical advice (AMA). Mathews went to work the following day without seeing her own doctor. She died two days later from a heart attack.
Identify who may be negligent?
What duty did the party owe to the patient? The duty should be specific to this situation. Duty to provide good or competent care is not specific.
What was the breach of duty? This too should be specific to the situation.
What was the injury or harm?
Did the breach of duty cause the injury?
Are the essential elements of negligence/medical malpractice present? If they are not present, identify which of the elements are missing."
1. Find Out the Parties to the Contract Whom the Court May Treat as being at Their Negligent Best
The following parties may potentially be negligent:The potential negligent parties include the following.
The Triage Nurse: Responsible for making a decision on patients and which order they should be attended to in a certain facility.
The Social Services Representative: Monitoring patient’s affect and psychological condition, and ensuring they pay proper attention as and when they should.
2. On the basis of legal and ethical premises that stipulate the correct route outcome of professional practice, patient autonomy is the professional responsibility towards patient.
Triage Nurse:
Statutory requirement to assess the likely outcome for the patient and the state of any of their conditions in order of priority. Concerning the symptoms that Myrna and she is suffering from, the described burning chest pain that radiates to arm points possibly to myocardial infarction. Apparently, the role of the nurse was to label these signs as danger signs and respond adequately.
Social Services Representative:
The responsibility of checking up on the patients from time to time and inform them of their status and how long it will take to be attended to and where necessary extend a hand. Clinically, they should have had some alarm features of interventions or, worse, Myrna’s health deteriorating further.
3. Breach of Duty
Triage Nurse:
The breach was made if the nurse had not appropriately evaluate Myrna to be fit within higher than category two of symptoms. By standard application of the conventional triage procedures severe chest pain with radiation to the arm could be suggestive of an emergency condition.
Social Services Representative:
What I think never happens is if the representative does not track myrna condition over time and poorly transmit her symptom indicators to the medical personnel. Plus they should also have ensured that Myrna was taken for medical attention; if they did not or if they did not do it as they should then it would qualify to be a breach.
4. Injury or Harm
Myrna Matthews had a heart attack two days after she fainted in the pilot’s seat. But the injury that befell her is death by myocardial infarction; a condition that could have been prevented if tended to early enough.
5. Was the Injury of a Kind that the Breach of Duty Entails?
To determine causation:
Triage Nurse: If Myrna’s condition was not treated well and if appropriate care was not given to her then it may be the fact that she could not receive the appropriate and necessary critical care which might have over complicated her ailment.
Social Services Representative: This delay could be attributed to if the representative failed to record that the symptoms of the patient worsened or if he failed to assure the patient get a proper attention from the medical team.
6. Aspects of Negligence/Medical Malpractice that Nobody Can Dispute
The essential elements of negligence include:Negligence elements are as follows:
Duty of Care: The triage nurse and social services worker also had responsibilities of the care of Myrna.
Breach of Duty: This duty might have been breached if, for instance, the triage nurse at some point assigned Myrna’s condition wrongly or if the social services representative did not observe signs of distress or ensure that Myrna get the necessary attention in the right time.
Injury: Myrna about aactic entailment, had a heart attack and death.
Causation: How Myrna died as the consequence of the breach of the duty must be made very clear.
Summary
Based on the information provided:In light of the information which you have given:
Potential Negligent Parties: The triage nurse’s goal and the social worker.
Duty of Care: To determine and analyze a patient state and schedule the necessary treatment (the triage nurse); for monitoring a constant state of a patient and for providing his/her treatment at the proper time (the social services representative).
Breach of Duty: Risk management: incorrect assessment of the severity of the case; inactivity in response to distress and lack of care provisions from the social services representative.
Injury: Primary site being the heart with the principal cause of death being myocardial infarction.
Causation: This could have possibly been caused by a delayed treatment by the defendant, breaches of duty which would have been fatal to a Myrna.
Examine change theories in scholarly literature
Examine change theories in scholarly literature. Develop a scenario and describe an application of a change theory from the perspective of an advanced practice nurse leader. Explain your rationale with a minimum of two scholarly sources.
Change Theory Analysis and Application in Advanced Practice Nursing
Change Theories Overview
Change theories are theories that help in explaining and leading change in organizations. However, these theories are valuable in the concept of nursing because it establishes ways in which practice changes can be managed, these changes making an impact on improving patient results and the healthcare organization. There are two dominant change theories as presented in the scholarly literature: namely Kurt Lewin’s Change Theory and John Kotter’s Eight-Step Change Model.
1. Kurt Lewin's Change Theory
Overview: Kurt Lewin’s Change Theory can be divided into three levels that are mentioned below:
Unfreeze: A known technique to transform is to prepare for the change, which means that one needs to identify the all-important necessity for change and someone to whom change is important.
Change: The act of making the change and moving to the new state.
Refreeze: The proactivity of institutionalising the change to become stable in the organisation.
2. Among the many models there is John Kotter’s Eight-Step Change Model.
Overview: Some of the fields that Kotter has identified key scale leadership model and that work can be outlined as;
Create a Sense of Urgency: Emphasise on the significance of the change.
Form a Powerful Coalition: Ensure that you find a group of people that will spearhead the change.
Create a Vision for Change: Learn how to construct a vision and a plan.
Communicate the Vision: Educate all the stakeholders about the vision that has been set.
Empower Action: Nothing should hinder the process and one should be motivated to perform.
Generate Short-Term Wins: Work for small and sure successes and have some small success parties.
Consolidate Gains and Produce More Change: Capitalise on this to make further changes.
Anchor the Changes in Corporate Culture: Lastly, guarantee for retention of the changes.
:Pk:Scenario and Application of Change Theory
Scenario: Poor Glycemic Control in a Community Health Clinic
Background: A formal and experienced APN works in a clinic for community health and realizes that current guidelines of clinic for diabetes management are not efficient and patients are not gaining the best possible results. New procedures of diabetes management based on evidence are adopted by the APN, such as the patient’s monitoring, education, and individualization of treatment.
Application of Change Theory
Change Theory Chosen: Years of studying business change and management lead John Kotter to develop the Eight-Step Change Model.
1. Establish a Feeling of Appropriate Fear
Application: The APN leader analyzes the patients’ results and presents the problem of diabetes care in the clinic to the clinic’s personnel and clients. Providing information that shows high frequency of complications and inadequate glycaemic control stirs up the need to implement a new procedure.
Rationale: Another element, highlighted by Kotter (1996) among the six sources for attaining support, is the need to create urgency, which is also core for the change process.
2. Form a Powerful Coalition
Application: The APN also collaborates with nutrition support specialists, physicians, other dietitians and nursing to perform the transition to the new protocol. This team shall also assist in the coordination of the change process as shall be illustrated below.
Rationale: The key message that Kotter brings to the focus is that there should always be a powerful coalition that would manage and sponsor the change process (Kotter, 1996).
3. Develop a Framework for Transformation
Application: Out of this is developed a realistic vision of the next APN diabetes management protocol based on a set of patient outcome objectives, interventions, and probed benefits. A written record of this vision is made and disseminated to all members of staff.
Rationale: It creates focus towards which all the efforts are being directed and inspires staff, as pointed out by Kotter (1996).
4. Communicate the Vision
Application: Thus, the APN is responsible for alerting the new protocol, educating the staff and holding meetings, workshops, and educational sessions. Staff are engaged to consider their considerations since they are reliant on the service and to modify plan to precisely reflect implementation.
Rationale: Since the vision will be communicated to multiple audiences, it very important that everyone understands it and adopts it fully (Kotter, 1996).
5. Empower Action
Application: The APN uncovers and eliminates the potential implementation challenges including using old equipment or lack of training. Workers are asked to become involved and responsible for the new protocol and attend the training sessions.
Rationale: The elements of Kotter’s model include mobilising staff and overcoming the barriers that stand in the way of change (Kotter, 1996).
6. Generate Short-Term Wins
Application: The APN monitors and fosters early outcomes, for example the patients’ compliant with the new protocol or patient satisfaction. All these are taken to the team to keep the motivation levels high.
Rationale: This is in agreement with Kotter’s (1996) short-term wins in relation to change, where short-term wins generate the necessary momentum plus keep focus on the pay offs from the change.
7. Sustain the Outcomes and Generate Still More Alteration
Application: Continued by the APN, the initial successes are used in the further change processes, for example, by optimising the protocol according to the feedback of the staff and patients. Other modifications are made in order to fine-tune its functioning of such a protocol.
Rationale: Applying and extending a set of early created successes contributes to continuing and enlarging the change process (Kotter, 1996).
8. This piece of work is an anchor for the changes in the corporate culture.
Application: The new protocol becomes a part of clinic’s routine and guidelines. The regular training and performance appraisal help in keeping the protocol implemented in practice, hence, part of the clinic culture.
Rationale: This paper will look at how anchoring of changes towards the organizational culture helps in maintaining such changes over a permanent period of time (Kotter, 1996).
References
Kotter, J. P. (1996). Leading Change. Harvard Business Review Press.
Lewin, K. (1951). Field Theory in Social Science: It is therefore convenient to recall some selected theoretical papers. Harper & Row.
What are the nurse assessments for a patient having a emergency c-section ?
What are the nurse assessments for a patient having a emergency c-section ?
Preoperative Assessments
Maternal Vital Signs:
Blood Pressure: Intramuscular, changes in blood pressure due to particular personality such as hypertensive or hypotensive patients should be noted because it affects anaesthesia and surgery operations.
Heart Rate: We also need to observe fluctuations in the rhythm; we can either face tachycardia or bradycardia, sometimes, this is connected with stress, sometimes, it indicates some certain conditions.
Temperature: It should be within normal limits, should it not be, because it affects the occurrence of fever complications.
Fetal Heart Rate:
Monitoring: Oversleeping or constant monitoring of fetal stress or abnormal heart rate that may in turn prompt some action.
Labor Progress:
Cervical Dilation and Effacement: Identify the level and status of the completed labor also whether there is a problem with the labor.
Contractions: control the speed and pressure of the contractions.
Pain Assessment:
Pain Level: Examine the resident’s pain level and if there is, administer any pain medication as may be required.
Laboratory Tests:
Blood Work: Ensure patient has had CBC, type cross match and any other tests that the patient may require.
Consent and Education:
Informed Consent: Determine whether the patient agreed to have the operation done, more so for the C-sections.
Patient Education: s: Inform concerning the surgical procedure, possible complications and the care to be provided to the patient and or the family after surgery.
Preoperative Preparation:
Preoperative Medications: Take any prophylactic antibiotics, antacids or any other medicines that surgeon may advice you to take.
Fasting Status: See that the patient has complied with the fasting rules that are usually a prerequisite before any investigation is done.
Intraoperative Assessments
Anesthesia Monitoring:
Vital Signs: He/She should also be monitoring the patent’s magnetic vital signs during the surgery.
Level of Consciousness: Tend to the patient, ensure that the patient is put to sleep so that the procedure is as smooth as could be.
Surgical Site:
Site Inspection: This area and any other problems or complications that may arise should be checked at the operation area.
Fetal Monitoring:
Heart Rate: The women should be supervised for fetal heart rate tracing throughout the session, so making a diagnosis of the status of the fetus can be made.
Fluid Balance:
Intravenous Fluids: Ensure that the patients intake and output balance do not arise to hypo or hyper hydration or any other complications.
Postoperative Assessments
Maternal Vital Signs:
Blood Pressure, Heart Rate, Temperature: Use success rate for any sign of complication including bleeding or infection.
Pain Management:
Pain Assessment: Admit patient to the hospital to assess pain and to adjust the dosage, if required.
Incision Site: Slap: increase wound dimensions, redness, swelling and foul smelling dehiscience; hematoma: any swelling over the closed surgical wound.
Uterine Tone:
Fundal Assessment: Light touching of the fundus to ensure that it has contracted well so as to prevent post partum hemorrhage.
Lochia:
Lochia Assessment: Protocol two: Monitor quantity, colour and nature of lochiae in order to identify and compare them with appropriate postnatal progress.
Postoperative Bleeding:
Assessment: Check increased amount of blood loss or foul smell as a complication of the process.
Mobility and Activity:
Early Ambulation: For: Encourage and assess early mobilization since this will assist in minimizing such contributors as formation of DVT.
Breastfeeding Support:
Lactation: Breast feeding should also be discussed and ensure that patient does know how to breast feed because if she had an emergency C-section she may need some assistance.
Emotional Support:
Mental Health: Give support and ask about PPD or PAT
Many bacteria and archaea are facultative anaerobes, meaning they can switch between aerobic respiration and anaerobic pathways
Many bacteria and archaea are facultative anaerobes, meaning they can switch between aerobic respiration and anaerobic pathways (fermentation or anaerobic respiration) depending on the availability of oxygen. This approach allows lets them get more ATP out of their glucose molecules when oxygen is around�since aerobic cellular respiration makes more ATP than anaerobic pathways�but to keep metabolizing and stay alive when oxygen is scarce.
Other bacteria and archaea are obligate anaerobes, meaning they can live and grow only in the absence of oxygen. Oxygen is toxic to these microorganisms and injures or kills them on exposure. For instance, the Clostridium bacteria that are responsible for botulism (a form of food poisoning) are obligate anaerobes^22squared. Recently, some multicellular animals have even been discovered in deep-sea sediments that are free of oxygen^{3,4}3,4start superscript, 3, comma, 4, end superscript. In lactic acid fermentation, \text{NADH}NADHstart text, N, A, D, H, end text transfers its electrons directly to pyruvate, generating lactate as a byproduct. Lactate, which is just the deprotonated form of lactic acid, gives the process its name. The bacteria that make yogurt carry out lactic acid fermentation, as do the red blood cells in your body, which don't have mitochondria and thus can't perform cellular respiration.
1. genes that have remained within a genome for extended periods and the genes which have been shifted horizontally between species.
2. Linking data from molecular biology and genetic coding, Substantiate the following regarding gene prediction.
3. In series cessation sensation determine the constituents of the four retort blends prepared and describe every single one of them.
4. Is it apt to conclude that the location of band in the mechanism of electrophoresis designates the dNTP employed as a series terminator in that blend.
5. State three valid deductions about open reading frame. Explain profoundly the concept of open reading frame.
6. Determine whether the following is true or false and explain your answer.
The role of sequence radioactive indicators is assumed by ddNTP.
7. What are applied in recognizing sequences that have the capacity to operate as a booster in vivo?
8. Identify a sheath of nuclei that have not been split into single cells.
9. Within Drosophila, only nuclei cells give rise to germline cells.
10. Denatured strands cannot be split. Justify or falsify."
https://www.coursehero.com/tutors-problems/Nursing/30674486-Directions-Initial-Post-There-are-times-when-a-nurse-must-provide-car/,"Directions:
Initial Post
There are times when a nurse must provide care for a client who is agitated and verbally or physically aggressive. The client may be psychotic, but the nurse must, in each case, remain in control of his/her own feelings, and intervene in the most appropriate manner.
After watching a segment regarding a violent client at Bellevue Hospital, answer the questions below. It's not necessary to critique the staff in the video, just think of how you might respond.
Violent Client at Bellevue Hosptial Video
Describe a time when a client was rude or verbally abusive to you. How did you react?
What skills were necessary to maintain a professional, caring, therapeutic relationship?
How did you best communicate with this client?
What did you learn from this experience?"
In interacting with the client who happens to be angry or violent, client care and safety of the professional are at risk. Here's a structured response based on the given directions:Here's a structured response based on the given directions:
Give an Instance Where the Client Was Vulgar or Even Physically Disparaging
Example Scenario:
In my practice, I recall having a client in the ED who responded aggressively in a very stressful situation. They were annoyed that they had to wait for a long time and turned on me swearing and ordering me around.
How I Reacted:
I was very much composed and tolerant to ensure that the man cools down too. That is why I understood the client’s irritation and tried not to take it to the heart while dealing with her. I ensured the situation was not heated and that the client was not frightened, this was especially due to the use of a gentle voice and my posture. What I specifically aimed at was to attend to the needs of the client while at the same time minimizing unnecessary contact between the client and others.
Specific competencies required to establish and sustain formal and informal professional and caring therapeutic relationship.
Active Listening: Take time to listen and respond to what the client is saying while also let the client know that their feelings are being heard with compassion. This is good in so far as it creates a positive rapport and assimilates the tension that is associated with conflict.
Emotional Regulation: Control your own feelings because you do not want the anger to rise up and who knows what you might do in a heat of the moments. Try not to freak out and always think of the best interest of the client.
Communication Skills: Compliance with the means of organizing the information flow to convey messages and instructions in simple language. Do not use provocative words to the other person it is not a good idea to make things worse intentionally.
De-escalation Techniques: Some of these include; setting an example by not getting angry, giving a choice or allowing discussion on other things that are possibly okay.
How I Explained it to the Clients
Effective Communication Strategies:
Empathy: Show an appreciation of the frustration that the client is having. For example, the words “I know that waiting can be very nerve wreaking, please don’t worry I am here to assist you. ”
Clarity: Ensure that the communication you are making gives the next course of action or if there will be a holdup. For example, ‘as much as possible, we are working on your concerns at the soonest time possible… I can report to you on this. ’
Non-threatening Body Language: Avoid being argumentative and avoid getting offend in order to subdue the conflict. Do not fold the arms or make jerky gestures with hands.
From the experience, the following lessons can be learned:
Lessons Learned:
Importance of Remaining Calm: Avoiding getting upset when being pressured also assists in handling pressure and not allowing it to result in a quarrel.
Value of Empathy: This paper argues that empathy and, in particular, recognition of the other party’s emotions can greatly contribute to the decrease of pressure and improvement of relations.
Need for Clear Communication: Simply giving explanations and status can therefore help in reducing the levels of distress that clients feel and also increase the levels of perceived control in the clients.
Effectiveness of De-escalation Techniques: Using appropriate de escalation measures can further enhance the interaction and also bring better outcomes in regards to safety.
Older people are at an increased risk for falling because of
Older people are at an increased risk for falling because of: An accumulation of cerumen in their ears Marked
decrease in height A shift in the center of gravity Postmenopausal symptoms"
According to the analysis of the main putative factors, older people are at an increased risk of fall because the centre of gravity changes. When a person gets older they experience some physical changes like loss of muscle mass and strength, stiffness of the bones and joints, poor postural control, altered sense of balance and they take longer time to regain balance after a slip all of which significantly raise the prospect of falling.
The other options may contribute to fall risk indirectly but are not the primary reasons:The other options may contribute to fall risk indirectly but are not the primary reasons:
Earwax (cerumen) build-up has impact on hearing and balance, but is more with sensory impairment.
Reduction in height of a significant margin is associated with spinal changes but does not result in falls.
The effects of menopause can include decreased bone density but the shift of gravity is much more threatening to the elderly and can cause falls.
How to identify best practices for triaging adolescents with co-occurring substance use and mental health concerns
How to identify best practices for triaging adolescents with co-occurring substance use and mental health concerns
1. Comprehensive Assessment
Multidisciplinary Approach: Employ mental health workers, substance use treatment experts, and doctors who will evaluate the mental health along with substance dependence.
Standardized Screening Tools: Some recommended assessment tools are CRAFFT, GAIN-SS or the PHQ-9 that can be used in screening for substance use and mental health disorders.
2. Integrated Care Models
Collaborative Care: Adopt models of care that permit the co-ordination of mental health and substance use treatment where both disorders exist.
Coordinated Treatment Plans: Assist the adolescent client in the development of individualized care plans that will include participation of the family, school, and different communities.
3. Risk Stratification
Severity Assessment: Evaluating the acuity level of the mental health and substance use disorder to decide on the level of care required (outpatient, intensive outpatient, residential treatment programme).
Prioritization of Needs: Captive to the idea that some individuals should be given priority in treatment depending on factors like suicidal intent, serious substance use or other mutual intending life threatening issues, either physically or because of the dangers they pose to others.
4. Family Involvement
Family Education and Support: Involve families in the treatment process, thus educate them about the condition of an adolescent and include them in the decision-making process.
Family Therapy: Family therapy should also be considered when working with an adolescent because aspect of the family can stop the adolescent from recovering.
5. Continuity of Care
Follow-Up Care: If you triage someone, provide consistent and consistent care after the assessment, with subsequent evaluations of progress to make the necessary changes.
Transition Planning: As for discharge planning, there must be plans on how the adolescent client will be transferred to other levels of care or perhaps back to the community so he or she will always be supported.
6. Evidence-Based Interventions
Cognitive Behavioral Therapy (CBT): Integrate CBT in order to handle both substance dependence and mental illness, because this method is most efficient in conditions when both disorders are present.
Medication-Assisted Treatment (MAT): For teenagers with the severe substance use disorders consider MAT while careful on the side of effects on the mental health status.
7. Cultural and Developmental Considerations
Age-Appropriate Interventions: Education approaches should be developed to fit the age of adolescent client.
Cultural Competence: Make sure to respect the adolescent’s culture when assigning and implementing triage and treatment ,respect the community standards.
8. Training and Education
Staff Training: Informed health care practitioners about the nature of the combined condition in adolescents and intake and management methods.
Ongoing Education: Continuously brief the staff and bring new research and updated practices in the field of adolescent Mental health and substance use.
References
Winters, K. C. & Kaminer, Y. , 2018 Adolescent Substance Use/Screening and Assessing Adolescents for Substance Use Disorders. Journal of Child & Adolescent Substance Abuse, published online 30/12/ 2016, DOI 10. 108/009-0980-947.
Sterling, S. , Weisner, C. & Hinman, A (2010). Substance use treatment in adolescent health care: Systematic approaches. This article was published in the Current Psychiatry Reports with volume 12, number 5, pp. 366-373.
What are the roles of the professional nurse as seen by the student compared with those as seen by the experienced nurse?
What are the roles of the professional nurse as seen by the student compared with those as seen by the experienced nurse? What important factors can affect the transition from novice to experienced nurse?
Views of such professional roles as those of a professional nurse differ between students and practicing nurses. Such views change as nurses move from one level to another in terms of Benner’s "Novice to Expert” Model.
Roles of the Professional Nurse:Roles of the Professional Nurse:
Student Nurse’s Perspective:
Task-Oriented Care: Even happily divorced from theory, student often aims at comprehending technical skills, for example injections, wound care, etc.
Following Protocols: A lot of them rely on principles and procedures and are less confident on analysis or decision making.
Direct Supervision: Students are used to operating under strict observation and they are too careful when they are on their own assessments.
Experienced Nurse’s Perspective:
Holistic Care: RNs in this study consider their functions to involves meeting all the needs of the patients including physical, emotional, social, and spiritual needs.
Clinical Judgement: They act rationally on the basis of a certain amount of research, hunches and priorprocessing.
Leadership and Advocacy: Leadership roles are a key responsibility, as well as peer education, and workings as a patient advocate with other members of a professional staff.
Efficient Time Management: They are effective in handling several activities at the same time especially in consideration of patients’ safety and their well-being.
Factors Affecting the Transition from Novice to Experienced Nurse:Factors Affecting the Transition from Novice to Experienced Nurse:
Clinical Experience: Apol 4 OPCAP 2 Professional experience in the clinical setting is valuable in developing self-confidence and enhancing one’s ability to solve different clinical situations.
Mentorship and Support: Sophisticated knowledge of the part of the most experienced nurses assists the newly trained nurses to form critical thinking and apply the theoretical knowledge in practice.
Workplace Environment: It enhances the learning process and growth of workers to be laying down supportive ground that is fostered to be collaborative, while elevated levels of stress and poor teamwork may be convergence inhibitive to development.
Ongoing Education and Professional Development: Through these professions nor certifications, Continued Education, Certificates, and specialist CE’s, Nurses get advanced and updated knowledge.
Resilience and Adaptability: It is for this reason that the learners would need to build up their emotional capital to afford them a chance at handling some forms of stresses that come with practice.
What brief negotiated interview(NBI) model /questions should be asked when conducting brief interviews with adolescents with SBI, comorbid Substance use, and mental health
What brief negotiated interview(NBI) model /questions should be asked when conducting brief interviews with adolescents with SBI, comorbid Substance use, and mental health"
Build Rapport:
“Let me ask you something: Do you mind if I know what you’ve been getting upto lately?”
“How satisfied are you with your substance use and mental health status in the present time?”
Explore Pros and Cons:
“If you choose to use [substance], may I know what you enjoy regarding it?”
“Are there some aspects you do not prefer or are afraid of?”
Provide Feedback:
“I want to restate what you have told me: You think that substance use or mental health concerns interfere with things such as [school, relationships or mood]. Honestly, do you agree?”
Assess Readiness to Change:
“On a scale or 1-10 how ready are you to make change in [substance use or mental health]?
“While hearing many questions my favorite one is, ‘why did you choose that number and not a lower one?”
Negotiate a Plan:
‘There are several questions that should be asked to the patient, for example ‘What do you believe are the tiny measures that you can take to begin feeling better?’
“In what ways do you or can others assist in bringing those changes?”
Tatiana is receiving a sports physical to participate in cross-country running.
Tatiana is receiving a sports physical to participate in cross-country running. She receives her exam from a single provider, who is examining all of the athletes one after the other in the nurse's office at school. Which of the following is a problem with this exam format for sports physicals?"
The main problem with this exam format for sports physicals, where a single provider examines all the athletes one after the other in a school setting, includes:The main problem with this exam format for sports physicals, where a single provider examines all the athletes one after the other in a school setting, includes:
1. Lack of Privacy and Confidentiality:Lack of Privacy and Confidentiality:
The environment could be uncomfortable and possibly lack the private space for the athlete to discuss matters of health-consciousness as well as any health problems the athlete may have in their lifetime which may seem to hamper on-route communication in between the athlete and the provider. Lack of confidentiality may make the athlete very reluctant to reveal something about her/himself.
2. Time Constraints and Thoroughness:
When the exams are set in succession within a short period, the provider might process the test carelessly. It means that the overall or at least the purely formal assessments can be fully or partially completed, raising the likelihood of overlooking crucial health problems.
3. Inconsistent Medical Records and Follow-Up:Inconsistent Medical Records and Follow-Up:
These exams may not be documented in the athlete’s medical record or even if documented could be separated from the main medical record of the athlete and hence could have gaps in treatment. Thirdly, the follow-up on the complaints that have been discovered might not be done, or will be done after a long delay if the provider is not from the regular athlete’s healthcare practiioner.
4. Generalized Approach:
That is, a group exam setting may not fit well the particular needs of each athlete (for present complaints or new conditions), or specific cross-country running risks factors that may require different approaches.
https://youtu.bewatch?Grfhyty
https://youtu.bewatch?Grfhyty
The novel coronavirus pandemic started in Wuhan, China, in December 2019 and has spread dramatically around the world since then, despite quarantine and containment measures. This new viral disease is the third most common viral disease in the twenty-first century after Severe Acute Respiratory Syndrome (SARS) and Middle East Respiratory Syndrome (MERS). According to the World Health Organization (WHO), as of September 26, 2020, about 213 countries all around the world have been affected by this disease, resulting in 32,700,000 confirmed cases and more than 993,000 deaths. In Iran, as the 13th country affected by this disease, the number of cases on the same date has reached more than 439,000 cases and the number of deaths has reached more than 25,000, which is unprecedented in the history of Iran, and of course, this statistic is changing every day [7]. Coronavirus Disease 2019 (COVID-19) pandemic has placed a heavy burden on the health care system, particularly on nurses who are faced with the greatest challenges regarding the unprecedented outbreak of coronavirus worldwide . COVID-19 has created unprecedented professional, social, and psychological challenges for nurses . By recognizing the sources of health care workers' concerns, health care managers and leaders can provide targeted approaches to address these concerns and provide specific support to their health care workforce. This study can guide nursing managers in this regard.
1.The _________ sequencer discriminates _________ motifs from _________ background
conformations through demanding that motifs transpire in various input series and tend not
to be _________ duplicated in any single chain. What transpires as the length of the motif
increases?
2.Which polymerase is instigated by PF3 collection for reparation of DNA damage?
3.Define coupled and allied response.
4.Justify the verdict below. Explain thoroughly.
It takes a lesser time if the DNA transmission is performed in mutual consignments.
5.Where are Decoy fragments which attach to Fas L observed in?
6.Naturally, ________ are non-________ and the series is more random than ________.
7.Render the trigger for ease in conducting sequencing of the entire gene.
8.Why is bacterial genome difficult to sequence?
9.Identify a Ubiquitin instigating enzyme and describe the entire mechanism.
10.True or false?
A dynamic target for anticancer drugs is the Ubiquitin-proteasome trail."
The _____ sequencer distinguish _____ motifs from _____ background conformations in that motifs are required to be present in several input strings and not _________ repeated in one string. When the length of the motif is increased what happens?
Answer: The motif sequencer differentiate between accurate binding motifs and random conformations because these motifs must exist in all the input series and the motifs should not be repeated too many times in a single chain. The longer the motif is, the higher the levels of sequence recognition and selectivity, but it becomes rather difficult to discern and analyze the motifs.
Which polymerase is initiated by the PF3 collection for the repair of DNA damage?
Answer: This paper proves that PF3 collection initiates DNA polymerase for the repair of DNA damage. In particular, DNA polymerase III in bacteria or DNA polymerase ε and δ in eukaryotic cells are involved in the repair of DNA damage.
Explain the meanings of the terms ‘coupled’ and ‘allied’ response.
Answer: This means that two or more biological processes or reactions are connected so that the outcome of the first process affects the second, the second affects the third, and so on in a chain like manner. Allied response is a concept that encompasses processes which may act in synergy, or in close temporal association, to produce a particular biological effect and, whilst they may be sequential, this is not a necessary requirement.
Justify the verdict below. Explain thoroughly.
Verdict: It takes a short time if the DNA transmission is done in mutual consignments.
Justification: In mutual consignments, or in parallel processing of samples or sequences, transmission and sequencing of DNA can be performed at the same time for different samples or sequences. This parallelization makes the total time taken to process the samples to be less than the time that would be taken when each sample is processed in isolation.
Where are Decoy fragments which bind to Fas L found?
Answer: Decoy fragments that bind to Fas L (Fas Ligand) are found on the cell surface or in the extracellular matrix. These decoy receptors are capable of binding to FasL so as to deny Fas L the chance of binding to its natural receptor thus preventing apoptosis.
Of course, ________ are non-________ and the series is rather more randomized than ________.
Answer: Of course, gene sequences are not identical and the series is not as regular as coding sequences series.
To facilitate this, the trigger should be rendered for easy sequencing of the whole gene.
Answer: The reason why it is easy to conduct sequencing of the entire gene is due to the fact that there are enhanced sequencing technologies that are in use today including a new generation sequencing (NGS) which is a high throughput and accurate method of sequencing the entire genome or gene.
How is it that bacterial genome is having such a hard time being sequenced?
Answer: Bacterial genomes is a challenge due to size, the complexity and the high level of repeats and hence, their sequencing is challenging. Also, the differences in GC content and the presence of mobile elements are other factors that may affect the sequencing process.
Name one Ubiquitin activating enzyme and explain the whole process.
Answer: The E1 enzyme or also known as Ubiquitin-activating enzyme is the first enzyme involved in the starter step of the Ubiquitination process. The mechanism involves:
Activation: Ubiquitin is first activated by E1 in an ATP-dependent manner, and then forms a ubiquitin-E1 complex.
Conjugation: Activated ubiquitin is then passed over to an E2 enzyme (Ubiquitin-conjugating enzyme).
Ligation: The E3 enzyme (Ubiquitin ligase) helps in the process of transferring of Ubiquitin from E2 to target protein and this attachment is covalent in nature.
Polyubiquitination: The protein can be tagged with multiple ubiquitin molecules in order to form a polyubiquitin chain which targets the protein to be degraded by the proteasome.
True or false? A moving target for anticancer drugs is the Ubiquitin-proteasome pathway.
Answer: True. The Ubiquitin-proteasome system is one of the most promising targets for anticancer drugs because it controls protein degradation and turnover that is a critical factor in cell cycle and apoptosis. The normal functioning of this system can have impact on cancer cell survival and growth.
