A predominant theme in research and practice today is obesity, which is increasing at an alarming rate worldwide in all ages. As a future nurse practitioner:
1. How would you approach or discuss the topic of obesity and diet with your adult or geriatric patients?
2. What are the possible health consequences of obesity and what factors need to be taken into consideration when treating the obese patient who also has multiple comorbidities (e.g., hypertension, diabetes, high cholesterol)?
Requirements: 4 paragraphs
Discussion 7
Darlene, age 32 years, has been having back pain for a number of years, ever since suffering a compressed L2 disc as the result of a motor vehicle accident that led to surgery and extensive physiotherapy. Now she is missing time from work as a secretary because of constant pain. Darlene has been referred to you for chronic pain.
1. As the nurse practitioner working with Darlene, what aspects of disorders of pain are important to understand?
2. How would you effectively manage Darlene’s pain at this time?
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Clinical: State Health Improvement Program- Obesity and Tobacco Prevention Program Purpose: Students will be able to describe population health issues such as obesity and tobacco use. Students will identify strategies at the individual/family, community and systems level for a comprehensive community health plan.Directions: As part of your clinical experience you will explore the Statewide Health Improvement Program that focuses on policy, systems, and environmental changes as an evidenced-based approach to the population-based issues of obesity and tobacco use.1.) Explore the MN Department of Health Website about the State Health Improvement Partnership. Read the SHIP fact sheets and explore 2-3 science-based strategies. Minnesota Department of Health State Health Improvement Program 2.) Review examples in the MN State Health Improvement Partnership 2018- 2019 Report to the Legislature, beginning on page 29. Select one local community site participating in this program and identify an evidence-informed policy, program, or system’s change that is being used. 3.) Then submit 300-600 words with the following:
Describe in a paragraph one of the strategies that you identified at the community level of practice.
Then, describe a different strategy at the system’s level of practice, and explain in one paragraph why this strategy is a more effective way to impact population health than requiring change from every single individual in the community
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1. Specify when to refer the patient after therapy and why? Provide rationale.
Given E.D.’s past medical records, her history of obesity and diabetes mellitus further worsens the symptoms of Onychomycosis. After completing her therapy, E.D. needs to receive follow-up treatment and care from different types of specialists in order to better manage her health conditions. A podiatrist needs to provide E.D. with assistance in maintaining hygiene and self-care practices for her infected feet (Nijenhuis-Rosien et. al, 2019, p. 2145). E.D. also needs to receive treatment from an endocrinologist in order to manage her diabetes mellitus. The endocrinologist needs to help E.D. implement self-care practices to improve her cardiovascular health, which will lead to reducing the severity of her Onychomycosis symptoms (Nijenhuis-Rosien et. al, 2019, p. 2145). E.D. should also receive guidance from a nutritionist in order to make important changes to her diet and physical health. E.D. should exercise regularly to reduce her obesity levels, and should make changes to her diet to improve her nutrition (Nijenhuis-Rosien et. al, 2019, p. 2145).
2. According to the recommended guidelines, what are the non-pharmacological approaches to Onychomycosis?
There are a number of alternatives that E.D. can implement based on recommended guidelines. One of the common non-pharmacological approaches is for E.D. to receive nail avulsions by removing her nail. This can occur through a number of different processes. Chemical removal is common if E.D. has thick nails, and can be carried out by using urea in order to enable the nail to easily be removed (Polat et. al, 2020, p. 219). The nail plate has to be removed in cases where E.D. has a severe infection. Other alternatives include laser treatment, in which a laser is used to kill cancerous or infected cells. Light energy treatment
called photodynamic therapy can also be used in order to use light to destroy
cancerous or infected cells. Nail avulsion can also occur through surgical or
mechanical removal processes (Polat et. al, 2020, p. 218).
3. Provide patient education. Keep in mind the past medical history of this patient.
Patient education would begin by informing E.D. about the way to keep her infected feet clean and dry. E.D. should be instructed to maintain hygiene practices in order to ensure that her nails are dry and clean at all times (Polat et. al, 2020, p. 218). This includes instructing E.D. about the correct way to rinse her infected feet, which includes cleaning in between the toes. E.D. should also be informed about the correct way to dry her feet area, and to use dry powders if she feels that she is sweating in her feet area during the day. Another aspect of E.D.’s self-care is to conduct a self-check of her nails to identify any signs and symptoms of deterioration (Polat et. al, 2020, p. 218). In the event that her feet worsen, E.D. needs to visit a physician to provide timely intervention. E.D. should also use barriers to protect her feet, such as flip-flops or shoes that prevent her infected from being exposed to contaminants. This is important in public spaces where infectious agents are found, such as the floors of public swimming pools. When clipping her nails, E.D. should disinfect the nail clippers with isopropyl alcohol to eliminate any infectious agents. E.D. also needs to regularly monitor her blood glucose levels, exercise regularly, and improve her nutrition to manage her diabetes mellitus and obesity (Polat et. al, 2020, p. 218).
Nijenhuis-Rosien, L., Kleefstra, N., van Djik, P.R., Wolfhagen, M.J.H.M., Groenier, K.H. (2019, Mar. 28). Laser therapy for onychomycosis in patients with diabetes at risk for foot ulcers: a randomized, quadruple-blind, sham-controlled trial. Journal of European Academy of Dermatology and Venereology, 33(11); 2143-2150.
Polat, A.K., Belli, A.A., Karaali, M.G., Aksu, A.E.K. (2020, Jul. 21). The attitudes, behaviors, and opinions about non-pharmacological agents in patients with tinea pedis. Journal of European Academy of Dermatology and Venereology, 21(7); 214-221.
Jennifer
1. Specify when to refer the patient after therapy and why? Provide rationale.
E.D. has a medical history that includes diabetes and obesity, which further worsens the onset of Onychomycosis. As a result, it is important for E.D. to immediately be referred to a specialized care clinic. E.D. needs to receive medical attention from a podiatrist that will provide directed care based on her health conditions and nail (Romero-Cerecero et. al, 2020, p. 1678). Additionally, an endocrinologist tis needed to conduct an evaluation of E.D. to provide follow-up care. This includes ongoing treatment for type 2 diabetes mellitus, which provides predisposition to dermatological diabetes. Since E.D. has diabetes metillus and onychomycosis, there can be worrisome symptoms in her feet if E.D. does not receive timely treatment. One of the recommended interventions is to make dietary changes by working closely with a nutritionist in order to reduce her body mass index and improve her diet (Romero-Cerecero et. al, 2020, p. 1678).
2. According to the recommended guidelines, what are the non-pharmacological approaches to Onychomycosis?
The CDC recommends a number of nonpharmacological treatments for
onychomycosis. One of the recommended approaches is laser treatment, in which the
fungal infection is surgically removed. Another recommended intervention is
photodynamic therapy, which occurs through a two-step process (Hassan et. al,
2020, p. 237). The first step features light energy treatment that destroys cancerous
cells along the nail. However, the second step is a form of pharmacological treatment,
in which photosensitizer drugs are used to treat the nail disorder. A third
approach is to conduct nail avulsion through mechanical, surgical, or chemical
processes (Hassan et. al, 2020, p. 236). If E.D. has thick nails, chemical
removal can be used with a compound of 40 to 50% urea in order to improve the
nail avulsion process (Hassan et. al, 2020, p. 236). In some cases where there
is severe infection, the nail plate can be removed, but E.D. would have to take
oral therapy to treat her symptoms.
3. Provide patient education. Keep in mind the past medical history of this patient.
There are a number of important aspects of the patient education process that are important to improve self-care practices. First, E.D. must maintain good hygiene to keep her nails clean and dry. E.D. needs to thoroughly wash her hands and clean in between her toes. E.D. needs to continue to monitor the progress of her nails and visit a physician immediately if any issues arise. Drying powders can be used to keep her feet dry. E.D. needs to avoid exposure to public spaces that can harbor bacteria, such as changing rooms, swimming pools, and gym lockers. It is important to use barrier methods in these areas by wearing flip flops or socks to avoid direct exposure to bacteria (Hassan et. al, 2020, p. 236). E.D. should also take measures to clean and disinfect her nail clippers with rubbing alcohol. E.D. should also avoid sources that could harbor bacteria, such as old shoes or footwear that is shared with family members. E.D. should work with a nutritionist to manage her weight through dietary interventions and regular physical exercise. E.D. should also monitor her blood sugar levels daily to reduce the impact that obesity and diabetes mellitus has on her onychomycosis symptoms (Hassan et. al, 2020, p. 236).
Hassan, N., Dhamija, P., Bharti, V., Vishwakarma, S., Mansoor, S., Iqbal, Z. (2020, Mar. 31). Clinical tools for successful treatment of onychomycosis: a narrative review. Journal of Drugs &
Therapy Perspectives, 36(21): 236-242.
Romero-Cerecero, O., Islas-Garduno, A.L., Zamilpa, A., Tortoriello, J. (2020, Feb. 22). Effectiveness of an enecalin standardized extract of Ageratina pichinchensis on the treatment of onychomycosis in patients with diabetes mellitus. Journal of Psychotherapy Research, 34(7); 1678-1686
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Enjoy our bonus services. You can make a free inquiry before placing and your order and paying this way, you know just how much you will pay. diabetes mellitus further worsens the symptoms of Onychomycosis
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Assignment details: Obesity in the Adult Population and the Professional Nurse’s Role Paper
Using the information from this course, your assigned readings, and the article and websites linked below and using APA format write a 6-10 page paper (excludes cover and reference page) addressing obesity and the role of the professional nurse in addressing teaching and learning needs of patient(s) and families.
A minimum of three (3) current, professional references must be provided. Current references include professional publications or valid and current websites (such as those listed below) dated within 5 years. Additionally, a textbook that is no more than one edition old may be used.
Article:
McNeill, B. E. (2012).You “Teach” BUT Does Your Patient REALLY Learn? Basic Principles to Promote Safer Outcomes.Tar Heel Nurse,74(1), 9-16. Websites:
Centers for Disease Control and Prevention –Division of Nutrition, Physical Activity, and Obesity United States Department of Health and Human Services –Dietary Guidelines.gov United States Department of Health and Human Services –Healthy People.gov(select information from the 2020 topics and objectives) The paper consists of two (2) parts and must be submitted by the close of week six. Each part must be a minimum of three (3) pages in length.
Part 1
Explain the health problem specific to the adult population. Be sure to provide supporting evidence, including statistics. Examine the causative factors (include physical, social, and psychological factors). Elaborate on the consequences of obesity in the adult population. Consider the consequences in terms of physical, social and psychological effects. Discuss whether the effect(s) would be classified as short term or long term. Part 2
Develop a teaching plan to support the needs of a specific individual from the adult patient population. Be sure to include the following:
How will you assess the patient’s learning needs? Be sure to consider barriers in your response. What are the expected outcomes? Include realistic time frames. What information will you teach the patient and why are you selecting this information? Be sure to consider age, gender, culture, religious preferences and learning style. How will you evaluate the effectiveness of the teaching? Compose your work using a word processor (or other software as appropriate) and save it frequently to your computer. Use a 12 font size, double space your work and use APA format for citations, references, and overall format. Information on how to use the Excelsior College Library to help you research and write your paper is available through the Library Help for AD Nursing Courses page. Assistance with APA format, grammar, and avoiding plagiarism is available for free through the Excelsior College Online Writing Lab (OWL). Be sure to check your work and correct any spelling or grammatical errors before you submit your assignment.
You are required to submit your paper to Turnitin (a plagiarism prevention service) prior to submitting the paper in the course submission area for grading. Access is provided by email to the email address on record in your MyExcelsior account during week 2 of the term. Once you submit your paper to Turnitin check your inbox in Turnitin for the results. After viewing your originality report correct the areas of your paper that warrant attention. You can re-submit your paper to Turnitin after 24-hours and continue to re-submit until the results are acceptable. Acceptable ranges include a cumulative total of less than 15% for your entire paper, and no particular area greater than 2% (excluding direct quotes and/or references).
See the videos below for instructions on how to submit your paper to Turnitin and view your Originality Report. Video – Submitting a Paper Video – Viewing Your Originality Report
When you’re ready to submit your work for grading, go back to the top of this instruction set and click on the bolded title for the assignment to access the Submission Area of the assignment, then click Browse My Computer and find your file. Once you’ve located your file click Open and, if successful, the file name will appear under the Attached files heading. Scroll to the bottom of the page, click Submit and you’re done.
This activity will be assessed according to the NUR105 M6A3: Obesity in the Adult Population and the Professional Nurse’s Role Paper Rubric
Obesity is defined as a condition that leads to the accumulation of excess fats in adipose tissues causing abnormal functioning of body hence leading to health hazard. For the last four decades, prevalence of obesity among childhood and adult has increased significantly, thus evoking global concern(Hansen, Holme, Anderssen, & Kolle, 2013). Studies have shown that obesity is a risk factor that affects well-being and health of the society and population for a longer period and its consequence are unfavorable. Recent studies sounded a warning that most severe grade of obesity is increasing at alarming rate and causing the highest levels of anguish as well as initiating a serious health hazard in the society and population(Lee, Sheer, Lopez, & Rosenbaum, 2010). The appropriate and most effective method of distinguishing underweight, overweight and obesity in adults is the use of Body Mass Index (BMI). BMI is calculated based on weight (kg) divided by height (m) and squared. World Health Organization (WHO) have provide guidelines in which overweight and obesity is classified based on BMI cutoffs as shown in the table below.
Table 1: Classification of obesity in adults according to Body Mass Index (BMI)