Case Study: A 25-year-old presented to the labor and delivery unit with complaints of uterine cramping and lower back pain. The client denied any vaginal bleeding and had a history of preterm birth at 32 weeks (about 7 and a half months) gestation with her last pregnancy. The baby from that pregnancy is three years old has no developmental issues. The client’s gestational age is 30 weeks (about 7 months). She is O+, and all other lab values are normal. No evidence of sexually transmitted infections (STI’s).

(Group Beta Strep is missing from the labs and most often is obtained at 35 – 37 weeks (about 8 and a half months) gestation. Without this information, it is often determined to treat the patient anyway, to protect a premature baby from the risk.)

• What additional information should the nurse obtain from the client?
• What nursing intervention is most appropriate in this situation?
• What screening tests should be obtained to determine the risk for preterm labor?
• If the client is in preterm labor, what medications would the nurse expect to be ordered, and what are the priorities for the nurse to assess post-administration? (Include dose, side effects and expected outcomes of the medication).

APA style

2 references within 5 years

150 words

1. Katiana 

Health is a multidimensional and complex concept that can be understood and studied from different perspectives, or paradigms. One of the most common paradigms used to understand health is the biomedical paradigm, which focuses on the physical and biological aspects of health, such as the absence of disease or injury. Another paradigm used to understand health is the biopsychosocial paradigm, which views health as the interaction between biological, psychological, and social factors (Figueroa, Frakt, & Jha, 2020). The biopsychosocial paradigm emphasizes the link between health and behavior, as it recognizes that behavior plays a significant role in maintaining and promoting health (Haigh et al., 2019). For example, behaviors such as regular physical activity, healthy eating, not smoking and taking preventative measures like getting regular checkups and screenings, are important for preventing chronic diseases, and it can also contribute to mental and emotional well-being. Conversely, behaviors such as substance abuse, lack of physical activity, and poor diet can lead to poor health outcomes.

The relationship between health and behavior is also linked to the social determinants of health. Social determinants of health are the social, economic, and environmental conditions that influence health and well-being. These conditions shape the opportunities and resources that individuals have for maintaining and promoting health (Figueroa, Frakt, & Jha, 2020). For example, if an individual does not have access to healthy food options, it can be difficult for them to maintain a healthy diet and ultimately affect their overall health. Additionally, if an individual lives in a community with high crime rates, they may not feel safe engaging in physical activity, which can negatively impact their health (Haigh et al., 2019). Understanding the link between health and behavior and how it is affected by social determinants of health can help us to develop policies and interventions that promote health equity and improve health outcomes for all individuals. It can also assist healthcare practitioners to take a holistic approach while treating the patient, not only treating the disease but also addressing the social and environmental factors that may be impacting their health.

References

Figueroa, J. F., Frakt, A. B., & Jha, A. K. (2020). Addressing social determinants of health. JAMA, 323(16), 1553. https://doi.org/10.1001/jama.2020.2436

Haigh, F., Kemp, L., Bazeley, P., & Haigh, N. (2019). Developing a critical realist-informed framework to explain how the human rights and social determinants of health relationship work. BMC Public Health, 19(1). https://doi.org/10.1186/s12889-019-7760-7

2. Elena

In this modern day, the health risk of people is more expanded than they used to be in the the shift in focus on health has moved from the physical aspect of it and now the mental health of people can now be related to their general physical health. The circumstances in which individuals are born, grow, live, work, and age are known as social determinants of health. They include of things like socioeconomic level, education, the physical environment and neighborhood, employment, social support networks, and access to medical treatment. The ability of people to obtain health services and to meet their fundamental needs, such as fresh water and safe housing, which are crucial to keeping healthy, is affected by income level, educational achievement, race and ethnicity, and health literacy (Amezcua, et al, 2021). Some of the underlying social factors that affect health, such as poverty, are more prevalent in rural areas.

The impact of these difficulties may be exacerbated by the obstacles already existent in rural regions, such as the scarcity of nutritious food options and restricted public transportation take for instance a homeless person who does not have means to access healthcare the wellbeing of this person will be largely affected by the fact that their situation cannot allow them to access care services (Horwitz, et al, 2020). Most poor people struggle to survive and in most cases, their health is not a priority unless it is an emergency. The government should ensure that the mechanisms put in place to cater for this population receives the financial and social support needed to provide healthcare services.

References

Amezcua, Rivera, V. M., Vazquez, T. C., Baezconde-Garbanati, L., & Langer-Gould, A. (2021).

Health Disparities, Inequities, and Social Determinants of Health in Multiple Sclerosis

and Related Disorders in the US: A Review. JAMA Neurology, 78(12), 1515–1524. https://doi.org/10.1001/jamaneurol.2021.3416

Horwitz, Chang, C., Arcilla, H. N., & Knickman, J. R. (2020). Quantifying Health Systems’ Investment In Social Determinants Of Health, By Sector, 2017–19. Health Affairs (Millwood, Va.), 39(2), 192–196. https://doi.org/10.1377/hlthaff.2019.01246

Directions: 

Hypercholesterolemia (high cholesterol levels in the blood) is associated with various cardiovascular diseases such as atherosclerosis, stroke, and myocardial infarction. Research how hypercholesterolemia develops, as well as its complications.

Initial Post

A common treatment for hypercholesterolemia is a class of drugs called statins. In your post, address the following questions:

• Are statins the best course of treatment for hypercholesterolemia in adults? Why or why not?
• Should they be prescribed to adults with hypercholesterolemia with no evidence of heart disease?
• Should teenagers be prescribed statins if they are diagnosed with hypercholesterolemia? Why or why not?
• Is there a better solution for these situations?

Be sure to support your positions with APA formatted in-text citations and references from a credible resources.

Week 1 – Unconscious Bias

Our biases can be dangerous, even deadly — as we’ve seen in the cases of Michael Brown in Ferguson, Missouri, and Eric Garner, in Staten Island, New York. Diversity advocate Vernā Myers looks closely at some of the subconscious attitudes we hold toward out-groups.

Instructions:

1. View the How to Overcome our Biases? Walk Boldly Toward Them video.
2. Take the Implicit Association Test (IAT).
3. Post your reaction to the IAT results.
   • Do you agree or disagree? Why? Why not? 

The National Committee for Quality Assurance (NCQA) was formed to ensure quality of patient care and measurement of patient outcomes with set standards.

Healthcare Effectiveness Data and Information Set (HEDIS) is a performance measurement tool used by millions of health insurance plans. There are 6 domains of care:

• Effectiveness of Care.
• Access/Availability of Care.
• Experience of Care.
• Utilization and Risk Adjusted Utilization.
• Health Plan Descriptive Information.
• Measures Collected Using Electronic Clinical Data Systems

You may access the 6 domains of care by clicking this link:

(NCQA, n.d. https://www.ncqa.org/hedis/ Links to an external site.)

As an APN, productivity will be an important measurement for the practice to determine reimbursement and salary. Fee-for-service practices will require a set number of patients per day to maintain productivity. A capitated practice will require the APN to have a large panel of patients but also will focus on controlling costs. This can be accomplished through effective primary care that is accessible, convenient for the patients and has a method of measuring quality of care.

Write a formal paper in APA format with title page, introduction, the three required elements below, conclusion and reference page.

You are now employed as an NP in primary care. Choose one performance measure from one of the six domains of care, i.e. Adult BMI Assessment, Prenatal and Postpartum care, etc.

Develop three different patient interventions for that one performance measure and how you would specifically implement the intervention and measure the outcomes for that particular performance measure in clinical practice.

How would these primary care interventions result in improved patient outcomes and health care cost savings?

How can these interventions result in improved NP patient ratings?

References are needed for each question also