Tag: study

Community Demographic Study

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Community Demographic Study on Liberty University

This document outlines a school’s demographic study from an institution located in Lynchburg, Virginia, and the surrounding community. The institution is known as Liberty University, a private evangelical Christian university. The institution serves various students and a wide range of courses, from college to Ph.D. levels. Liberty school has approximately 15,000 regular students, with 94,000 students for online courses. The higher education center provides all the necessary services regarding quality education for all students. The information has been presented into three main parts. That is demographic data analysis, demographic data report, and implications.  The discussion examines ethnicity and race, income, gender, race, socioeconomic status, unemployment rates, education level, and religion in these analyzed areas. The research aimed to explore adequate information as the central part of the school-community alignment resource project while ensuring that all the needed information is made available for further evaluations.

Demographic Data Report

Liberty University Demographic Data

VariablePopulationPercentage
Race/Ethnicity  
White480070%
Hispanic/Latino20005%
Black12002%
Asian10000.5%
Two or More Races12002%
Others600015%
              Other Languages apart from English  
Spanish2100
Other1200
Ages (18 – 24 years old)3440
Gender 
Males5400
Females9600
Religion 
Baptist9000
Catholic3040
Protestant1060
Others1000
Unemployment rate80%
Educational Level80%
Socioeconomic /Income Status65%
GRAND TOTAL344

N/B: The data presented above outlines the internal study of Liberty University. The represented number of school enrolments reflects information from August 6, 2018.

Liberty University Gender Demographic Data by Age

AgeMale PopulationFemale Population
15 – 19 years17, 93623,112
20 – 25 years9, 20114, 132
26 – 34 years24, 00321, 122
35 – 40 years20, 58823, 003
41 – 45 years19, 40122, 874
46 – 50 years19, 60621, 306
51 – 60 years17, 32218, 173
61 – 70 years21, 10423, 142
71- 80 years12, 04515, 134
Over 80 Years5, 13210, 143
TOTAL239, 099383,051

N/B: The gender data presented was collected from The United States Census Bureau for 2015.

Race in Liberty University

RacePopulationPercentage
White101, 11279%
African American30, 1323.9%
Hispanic10, 1122.1%%
Asian10, 4081.7%
Other Races43,7650.8%
American Indians2, 0130.5%
Two or more Races1,1130.2%

N/B: The race data presented was gathered from The United States Census Bureau for 2015.

Language Spoken at Texas apart from English

LanguagePopulationPercentage
Spanish49,53880%
French24, 62210%
Italian13, 4908%
Chinese3, 4902%
Total91, 240100%

Note: The information presented is based on the languages spoken in Lynchburg, Virginia, collected from United States Census Bureau in 2015.

Demographic Data Analysis

The shown information reveals the data analysis from Liberty University in Lynchburg, Virginia. The private institution with learners for a different course and degree programs. It offers an explicit platform for data collection, especially among online learners (Porter & Whitcomb, 2005). The data gathered portrays the current school semester. As indicated in Table I, the Latino population is the highest in the school. The white comes second with approximately eight percent of the entire population. Other races such as Blacks, Asian, and other mixed ones constitute the remaining percentage of the school population. As a result, it is worth noting that most students at Liberty University.

Additionally, in terms of language spoken by students apart from English, most learners are well vast with the Spanish. The institution’s demographic information reveals that 80% of the school population speaks Spanish fluently (Xia et a., 2017). On the other hand, 10% of the school’s population can speak French, the Chinese and Italian can be spoken by 5% each of the entire population. The school’s location has also played a significant role in determining the type of language that is predominant in it. Besides, this is just fallacious.  In terms of gender, demographics presented that there are more female students as compared to the male ones. From a total of 300 students, there are 230 female students and 70 males for the entire school population. This constitutes 60% and 40% school population for females and males respectively. Moreover, in terms of religion, Evangelical Christian is seen as the most predominant one with a total percentage of 96% of the overall school population. Besides, based on the school’s nature, private catholic institutions, it is worth noting that faith played a part in influencing students.

Community Data Analysis

The selected school, Liberty University for the study, is located in Lynchburg, Virginia. The predominant race in Lynchburg, Virginia, is whites. It has a population of 79% whites of the overall school according to United States Census Bureau. Other significant populations and groups are the whites that constitute 15%; however, the latter represents the larger population if compared to Whites. Other minor races include African American, Asian, Hispanic, and American Indian (Xia et al., 2017).  They constitute approximately 10% of the overall community population. Interestingly, in terms of language spoken in the region rather than English, Spanish is widely spoken in the region with an 80% (U.S. Religion Census 2010). As demonstrated by statistics from the information presented, Spanish is regarded as the common language among the community members.

The predominant gender in Lynchburg, Virginia, is the females, and they constitute 60% of the total population. On the other, males constitute 40% of the entire population.  Therefore, the mean average for Liberty University is 25 years old (Porter & Whitcomb, 2005).  Baptist, which is also the predominant faith in the region, constitutes approximately 54% of the overall population. The second and other most practiced religion in the region is Catholic and Protestant. They include 18% and 16% respectively of the general population (Xia et a., 2017). Notably, religious preferences such as Muslim, Orthodox among others, make up the remaining percentage. It is also evident from the study that most people in the region have a higher learning education, with few with Ph.D. degrees.  Overall, in terms of unemployment rates, the population lies at a 6% unemployment rate though the government provided the largest platform for employment opportunities.

Implications

The selected school, Liberty University, was a private evangelical Christian university located in Lynchburg, Virginia. It offers learning services for the over six hundred-degree courses. The school’s demographic population reveals that approximately 85% of its entire students enrolled are Whites. Other races include Latinos and a mixture of Asians, African Americans, and others. The 2015 United States census revealed that the population of Whites is the largest group in the region. The entire population estimates 68% of the overall country’s population.

Nonetheless, it estimated that 80% of the Virginia population other languages apart from English. According to Marks (2014), these considerations have had a significant impact on the performance of English and other courses for the quality education among students. It has also been found that some English speakers experience difficulties in understanding classroom lessons that are done in English because of the mutual interactions with other races. The same is also common in English written examinations. Marks (2014), in his study, has revealed that the support of the management is significant in influencing English students to master their learning concepts adequately. Fostering the importance of collaboration and management body is essential for positive interaction. Additionally, in terms of leadership aspects and implications for a culturally diverse community, it is the school administrators’ role to ensure that teachers are capable of managing conflicts that stem out among students. In their study, Bumpass & Lu (2019) held that the nature of school leadership has a significant influence on the expectations of learners and the overall performance of learners and the institution as a whole.

Liberty University and the surrounding community is having diverse communities. The Latino is the most predominant. Thus, it is the management’s prerogative to appoint a principal with a diverse understanding of Whites to maximize the interaction between parents, teachers, and students. These leaders must be open-minded and committed to building relationships for a more inclusive learning platform. It is always essential to inculcate the importance of understanding among minority groups before making conclusions based on their differences in race and culture, among other pertinent issues (Madsen & Mabokela, 2014). Overall, leaders and principals for this community need to employ an unbiased attitude to foster fairness and equality. As minority groups mainly occupy Lynchburg, promoting an inclusive environment is necessary to overcome all the challenges these groups may face in their daily interactions. 

References

Bumpass, L., & Lu, H. (2019). Trends in cohabitation and implications for children’s family context in the United States. Population Studies, 54(1), 29-41.

Madsen, J., & Mabokela, R. (2014). Leadership challenges in addressing changing demographics in schools. NASSP Bulletin, 98(1), 75-96. doi: 10.1177/0192636513514110

Marks, G.N. (2014). Demographic and socioeconomic inequalities in student achievement over the school career. Australian Journal of Education, 58(3), 223-247. doi: 10.1177/0004944114537052

Porter, S. R., & Whitcomb, M. E. (2005). Non-response in student surveys: The role of demographics, engagement and personality. Research in higher education, 46(2), 127-152.

U.S. Religion Census (2010). Religious Congregations & Membership Study Association of Statisticians of American Religious Bodies. Retrieved from http://www.city-data.com/county/religion/El-Paso-County-TX.html

Xia, C., Conrad, F., Babarinde, O. A., Sebsbie, A. K., Makowka, E., Jackson, J., … & Clemons, B. (2017). The Demographics of Hispanics in Richmond, Virginia: A Pilot Study.

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Case study relates to any company involved in fraud or unethical behaviour

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Case Study 

(Individual) Case study relates to any company involved in fraud or unethical behaviour.

For the Case study, you should select an issue or find a problem that will be of current interest to controllers, perhaps based on a recent newspaper, journal article, media or actual situation from real life. A written case study should include: 

The title of the case study 

The group number and names of group members

The individual contribution of each group member.

Description of the case.

Analysis of the issues with recommendations and conclusion

Cite the sources of your information.

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Case Study: PICOT

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Case Study: PICO(T)

Scenario 1

P – Cardiac surgery patients

I – Pain management interviews

C – Extubating experience and pain experiences

O – Change in the intraoperative and postoperative pain management protocol from fentanyl to morphine.

PICO(T) Question 1:

In cardiac surgery patient pain management, how does extubating experience and pain experience change the pain management protocol related to postoperative and intraoperative to morphine from fentanyl?

Scenario 2

Your patient is a 50-year-old woman who is experiencing moderate depression. After researching the internet, she comes to your office. She says that she believes that St. John’s Wort (hypericum) is more effective for her symptoms of depression with less risk than conventional antidepressant medications. You would like to find some evidence to guide your advice to this patient.

P- A 50-year-old woman with moderate depression

I – Research on the internet about depression

C – symptoms of depression with less risk and conventional antidepressant medications

O- Various important pieces of evidence to guide your advice to the patient.

PICO(T) Question 2:

In a 50-year-old woman with moderate depression, what does research on the internet about depression reveal on the symptoms of depression with less risk versus conventional antidepressant medications for the formulation of amicable evidence to guide your advice to the patient?

Scenario 3

Your mother is a 72-year-old woman with osteoarthritis of the knees and moderate hypertension. You accompany her to her physician’s visit and request a prescription for one of the new COX-2 inhibitors. You have heard that they cause less GI bleeding than the NSAIDs she has been taking. Your mother is concerned that the new drugs will mean more out-of-pocket costs each month. You want to find the evidence to convince her of the correct drug to use.

P -A 72-year-old woman with osteoarthritis of the knees and moderate hypertension.

I – A visit and request a prescription for one of the new COX-2 inhibitors from her physician.

C- New COX-2 inhibitors on GI bleeding and the NSAIDs

O- New COX-2 inhibitors are effective in controlling GI bleeding than the NSAIDs

T- monthly

PICO(T) Question 3:

In the case of a woman, 72-years old, with osteoarthritis complications of the knees and moderate hypertension, how do the New COX-2 inhibitors versus the NSAIDS help manage GI bleeding?

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Theories used in the study are Expectancy-Value Theory

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Please provide at least 150-word response to each student response below. Be sure to research/cite/reference sources in each discussion.

1st Post:

The dissertation I used has the same topic I would like to use “A Case Study on Full-Time Faculty Perceptions of Classroom Assessment” (Pottinger, 2021).  

The literature review consisted of the following topics: “Introduction and Background, Gaps in the Literature, Theoretical Frameworks, Assessment, Method, Instrumentation, and Summary” (Pottinger, 2021, p. ix). The introduction included the purpose of the study which was to determine faculty perceptions of assessment, building on current assessment models, and the development of best practice assessment in online courses (Pottinger, 2021). The background information included the difference between formative and summative assessment (Pottinger, 2021). The researcher also indicated the desire to learn faculty perceptions of knowledge and use of formative assessment (Pottinger, 2021). Finally, the background included the correlation between formative assessment and teaching/learning (Pottinger, 2021). I consider the detailed introduction and background strong strengths of this literature review (Roberts & Hyatt, 2019). I agree with Pottinger (2021) that it is important to set up the literature review by restating the purpose and providing a strong background on assessment. I also hope to add information linking assessment to program/institutional accreditation and, therefore, the importance in conjunction with institutional effectiveness and the university’s strategic plan. Gaps in the literature revealed a lack of perceptions from faculty particularly those teaching the course (Pottinger, 2021). I’m not sure if I will include the specific assessment models since they may not be relevant to the population I select, whereas Pottinger’s sample used the Classroom Assessment Techniques model of assessment—CATs (Pottinger, 2021). 

Theories used in the study are Expectancy-Value Theory, Theory of Multiple Intelligences, Transformational Reflection Theory, and Transactional Distance theory (Pottinger, 2021). Another strength of the dissertation was the pyramid of hierarchy used to visually depict the amount of use of the theories and the importance of the theories in terms of assessment, teaching, and learning (Pottinger, 2021). 

The only weakness I can identify is the lack of information on the evolution of faculty roles and the possible reason why faculty may not be driving assessment in their respective institutions (Middaugh, 2010). 

2nd Post:

The dissertation selected is from Warner (2019) on the corporate learner and asynchronous online learning. The literature review section for this dissertation is presented via the textbook checklist:

1. Yes, the review is comprehensive.

2. Yes, there is one primary and six secondary variables that are addressed.

3. Yes, the doctoral student has a balanced review of the citations combining key points with critical analysis.

4. Yes, Chapter 1 had key definitions, historical foundations, and research questions which segued logically into Chapter 2 literature review.

5. Yes, the review expanded on the variables, audience, and concepts.

6. Yes, between the first two chapters there is a good coverage of historical and current methodologies and theories.

7. Yes, the review used credible sources that were properly cited.

8. No, each section of the review built on the previous without presenting opposing views.

9. Yes, summaries and subsections are well structured.

10.  Yes, primary sources are well represented.

11.  No, minimal to no quotations are used. Paraphrasing and critical analysis used.

12.  No, primary sources that complement each other are presented separately.

13.  Yes, it is well written and is not just a catalog of sources.

The University that the doctoral student was in uses a similar format as Aspen University or the textbook (Roberts & Hyatt, 2018).

 3rd Post:

When writing the literature review, the dissertation student develops the review in a manner writing what journalists/authors have disclosed concerning a chosen topic. The dissertation student writes what is known about the topic in a manner to intrigue the reader. One of the goals requires writing carefully revealing points such as a bridge of the introduction chapter to the literature review. When reviewing a literature review, the dissertation student takes the opportunity to assess for common writing problems. 

For an example, the author of a massive topic and literature review will lose the reader/audience if the reading becomes easily disorganized. Zacharzuk-Marciano, 2017 provided mass information in the literature. The use of an employ table could have organized the mass literature. The use of subheadings could have supported the organization of information in the literature review for the reader. Zacharzuk-Marciano, 2017 provided headings with seldom use of subheadings. Overall, the literature provided a thorough synopsis of the problem with key focus points. With the literature review being massive, the author should be careful not to string together the works cited and control the amount of literature reviewed by avoiding including enormous pieces of literature read. 

4th Post:

For many writers, the literature review procedure might be a difficult undertaking. It necessitates extensive investigation, planning, and critical thought. Unfortunately, many writers struggle with common writing problems that can make the process even more difficult.  One of the most common writing problems in the literature review process is the lack of a clear focus. Writers often struggle to narrow down their topic and develop a clear thesis statement. Without a clear focus, the literature review can become unfocused and disorganized. Writers should take the time to brainstorm and develop a clear focus for their literature review before beginning the research process. 

Another common writing problem is the lack of organization. Writers often struggle to organize their research and ideas into a cohesive structure. Without a clear organizational structure, the literature review can become confusing and difficult to follow. Writers should take the time to create an outline and organize their research into a logical structure.  A third common writing problem is the lack of critical thinking. Writers often struggle to analyze and evaluate the research they have gathered. Without critical thinking, the literature review can become a summary of the research rather than an analysis of the research. Writers should take the time to think critically about the research and draw meaningful conclusions. 

Finally, writers often struggle with the lack of adequate citations. Without proper citations, the literature review can become plagiarized, and the writer can be accused of academic dishonesty. All sources utilized in the literature review should be correctly cited, therefore writers should take their time. In general, many writers find the process of conducting a literature review to be challenging. However, by taking the time to address these common writing problems, writers can ensure that their literature review is well-written and effective.

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Precedent study of New York City

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Precedent study of New York City

Since the late years of the 19th century, towards the early years of the 20th century, New York City has grown to become what it is currently. New York is the largest city in the United States, with an architectural marvel that has several historic monuments, many incredible skyscrapers, and wonderful buildings. Apart from the architectural marvels, the city has everything that could meet the needs of most people visiting the area. It is home to numerous parks, museums, shopping streets, and trendy neighborhoods. This paper presents the city’s history from the late nineteenth century to the present, thereby providing a roadmap describing its growth from what it used to be up to this point in time.

The formation of New York City resulted from voting by residents of the Bronx, Brooklyn, Queens, and Staten Island, to consolidate with Manhattan to form greater New York. These were independent cities before 1895, whose consolidation afterward led to the city occupying about 360 square miles from the previous 60 square miles.

Figure 1: The top view of New York City shows Brooklyn Bridge and the waterfront. In the foreground are Governors Island and Battery Park.

With the city’s expansion, the concerned authorities needed to organize it appropriately to handle the expected population explosion that could hit the country. For this reason, it was necessary to construct interstate highways and suburbs, ensure deindustrialization, and make other economic changes to accommodate the new developments in the city. The developments led to the elimination of chaotic and squalid urban centers, leading to the construction of skyscrapers, the opening up of the great suspension bridge, and the development of a subway system that is one of the longest in the world.

The developments of the New York City metropolis led to its consideration as the nerve center of America, which was achievable through the development of mighty public works buildings, including a great aqueduct system that ensures the city dwellers have access to clean water. Later, Clinton was one of the masterminds behind Manhattan’s modern-day grid system. This plan could organize the city appropriately despite the predicted population explosion.

Apart from ensuring the construction of numerous public works projects, the other project involved the construction of a housing scheme that could boost the health of the people living in the tiny tenement houses. The central park project was to be executed as a public park measuring 843 acres, whose vision was to boon the speculation on real estate and ensure green reforms in the region. The park was meant to provide playgrounds for the masses and offer work relief for the city in the mid-1980s. The execution of the different projects was necessary for the realization of the current developments in the city. It is possible to insinuate that the amenities have led to the tremendous development of the city into an aesthetically appealing city with efficient public service delivery.

Figure 2: 239th Street yard, NYC IRT Subway.

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Capstone Case Study of a Patient with Anemia

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Capstone Case Study of a Patient with Anemia

Anemia is a severe worldwide health condition affecting persons of all ages but mainly females of reproductive age. Iron deficiency anemia is one of the utmost prevalent roots of anemia witnessed in women, with menstruation being one of the primary reasons.

Extreme, prolonged, and uneven uterine bleeding, also recognized as menometrorrhagia, can bring about severe anemia. In this case report, the paper will present a case of a premenopausal woman leading to profound iron deficiency anemia with the utmost low hemoglobin.

Scrutiny of the worldwide anemia problem exposed that the occurrence of iron deficiency anemia, though lessening each year, stayed considerably high, impacting virtually one in every five women. Menstruation is mainly deemed liable for the exhaustion of body iron stores within premenopausal females. The percentage of menstruating females in the USA who hold minimal-to-lacking iron reserves is projected to vary from 20% to 65% (Chai et al., 2021).

Research has determined that a premenopausal female’s iron storage volumes could be nearly two to three times below those in a female ten years post-menopause. Extreme and extended uterine bleeding that transpires at irregular and recurrent intervals may be witnessed in virtually a quarter of females who are 40–50 years old (Chai et al., 2021). Typically, women with menometrorrhagia bleed over 80 mL, or 3 ounces, throughout a menstrual cycle and are consequently at greater risk of experiencing iron deficiency and anemia.

The selected problem for this Capstone Case Study is a patient suffering from the effects of anemia. Anemia is a disorder wherein one lacks sufficient vigorous red blood cells to convey sufficient oxygen to the body’s organs. Consequently, individuals diagnosed with anemia always feel exhausted and lack physical strength. There are numerous kinds of anemia, each with its source. Iron deficiency anemia is prevalent

amongst non‐pregnant females of the reproductive stage or menstruating women globally, even though the commonness is most significant in low‐income backgrounds. Iron insufficiency anemia has been linked with an array of adverse health results that the compensation of iron stores by iron supplements has been deemed possible to solve.

Worldwide, around 29 % of non-pregnant females aged 15–49 are anemic, translating to approximately 500 million females (Stevens et al., 2022). Iron deficiency anemia is prevalent in the United States, with 12 % and 4 % occurrence among women (Stevens et al., 2022).

These statistics are even more significant in African-American women and are often a consequence of heavy menstrual bleeding. The primary objective of the capstone case study is to determine the efficiency of the iron supplement on a patient with anemia.

PICOT

The PICOT question is : How can patients with anemia use an iron supplement to

improve anemia compare to patients with anemia using no iron supplement in 15 weeks? The target population is non-pregnant women with anemia aged 15–49 years old. The intervention is the use of an iron supplement. Iron supplements can help reverse an iron deficiency when dietary changes alone are unsuccessful. Childbearing women of reproductive age who are menstruating are more disposed to low iron levels and ought to get their iron levels tested often. Women who menstruate are excessively affected by anemia because they lose blood through their periods. Actually, 29% of childbearing females and 38% of pregnant women globally are impacted by anemia (Stevens et al., 2022). The intervention compares childbearing women with anemia using an iron supplement to non-pregnant women without an iron supplement. The outcome is to improve anemia by using iron supplements for 15 weeks.

The Vulnerable Population

Anemia is a public health issue in developing nations, particularly for women. Females of childbearing age are experiencing a distinct epoch of menstruation and serve a vital role in the economy, family, and society. Consequently, their health status warrants exceptional attention.

Anemia in childbearing females threatens the mother’s health and has a bad influence on the subsequent generation when they become pregnant, like the augmented threat of preterm delivery and low birth mass. Worldwide, the anemia prevalence in women aged 15–49 improved slightly from 31% to 30% between 2000 and 2019 (Dündar, 2019). Internationally, regionally, and in virtually all nations, advancement on anemia in childbearing women aged 15– 49 years is inadequate to suit the World Health Assembly (WHA) worldwide nutrition goal to halve anemia occurrence by 2030.

Since anemia is considerably linked with mortality and morbidity amongst women of the procreative stage, recognizing the risk aspects of anemia stays a vital matter of public health. Because of the substantial menstruation losses and more critical physiologic requirements for iron, females of procreative age experience iron insufficiency anemia (Dündar, 2019). At a worldwide level, dominance and risk aspects of anemia stay impending pointers to inquire about efficient interventions and evaluate the advancement made to decrease the anemia rate. The contraception method was a substantial risk factor for reducing the anemia rate.

Education was also discovered to be a noteworthy aspect of anemia condition. Furthermore, the education level is confusing with socioeconomic status at large but may also be mirrored in the comparatively poor knowledge of nutritional practices.

Literature Review

A study by Fernández-Gaxiola & De-Regil (2019) was completed to evaluate the impacts of intermittent oral iron supplementation and its related damage amongst menstruating females, compared without intervention or regular supplements (Fernández-Gaxiola & De-Regil, 2019). Periodic iron supplementation decreased anemia and enhanced iron stores amongst menstruating females in populations with diverse anemia backgrounds. In contrast with an everyday supplement, intermittently, the supply of iron supplements is possibly as efficient in averting or managing anemia.

A study by Idemili-Aronu et al. (2020) shows that using iron for at slightest 90 days of pregnancy is a cost-efficient method of reducing iron insufficiency anemia, the prevalent type of anemia amongst females childbearing age (Idemili-Aronu et al., 2020). The study shows that numerous socio-demographic aspects, like the type of residence, maternal age, wealth, and education, are connected with maternal anemia. The study showed that compliance with the proposed use of micronutrients effectively protects against anemia.

Moreover, the study outcomes show that the wealthier, urban inhabitants and more learned women adapted to using iron supplements to improve their anemia condition.

According to a study by Mwangi et al. (2017), the commonness of iron deficiency in pregnant women regularly surpasses 50% in low-income nations. On top of the effects of swelling in blocking iron consumption, iron deficiency transpires since the diets of poor persons are monotonous. The study’s meta-analyses discovered that pregnancy iron supplements profit maternal well-being. The study recommends a general iron supplement of 30–60 mg/day during gestation though coverage is low in most nations. (Mwangi et al., 2017). The welfares of universal iron supplements probably differ from the commonness of iron insufficiency. As a

result, the balance between risks and benefit is possibly more promising in low-income nations than in high-revenue nations, regardless of the greater exposure to contagious pathogens.

Low et al., (2017) established that iron deficiency anemia is widespread amongst non-pregnant females of the procreative stage (menstruating females) globally, even though the prevalence is uppermost in lower-income backgrounds. Even though several tests from the study reported the impacts of iron in non-expectant females, they were never amalgamated in a systematic evaluation. The current systematic evaluation established that everyday iron supplements reduce the commonness of anemia and iron insufficiency, increase iron and hemoglobin stores, advance workout performance, and decrease symptomatic exhaustion (Low et al., 2017). The welfares come at the cost of augmented gastrointestinal symptomatic consequences.

Oral contraceptive usage has been linked with reduced blood losses in menstruation; therefore, it may independently decrease the threat of iron insufficiency and anemia in women. Producers have lately begun to comprise additional iron in placebo drugs of certain contraceptives (Fischer et al., 2021). A study found that ICOC holds the perspective to be a cost-efficient resolution to manage iron deficiency anemia and family planning needs. However, more demanding trials assessing the efficacy of ICOC on refining indicators of iron insufficiency and anemia and exploring the security of its intake amongst iron-replete populaces are reasonable.

Iron insufficiency anemia is a significant worldwide public health matter, particularly in young females. Though strategies differ, an oral iron supplement may be an efficient approach to manage and avert IDA. Certain specialists endorse 150–200 mg of essential iron daily, with the dosages separated throughout the day. In brief, the study suggests altering from routine to

alternate-day timetables and from separated to solitary morning dosages, raising iron immersion and decreasing impacts (Stoffe, 2020). Therefore, offering morning dosages of 60– 120 mg iron provided with absorbable acid on different days might be an optimum oral dosage treatment for females with iron insufficiency.

Strengths and Weaknesses of Selected Literature

The strength of the selected literature is that it is evidence-based, making it more reliable. The literature is from previously completed studies that followed reliable procedures to produce reliable results. Another strength of the selected literature it is not biased on the topic of discussion. Moreover, the selected literature provides extensive view and knowledge on the subject matter. The weakness of the literature is that it is not comprehensive since they fail to cover various elements in their discussion. Another weakness of the selected literature is that it does not provide new information on the topic.

Proposal

The proposed intervention to the issue of Iron deficiency anemia or patient with anemia is iron supplements. The paper will present a case of a premenopausal woman leading to profound iron deficiency anemia with the highest low hemoglobin. The patient will be provided with iron supplements to improve iron sufficiency. Evidence shows that iron supplement improves hemoglobin and decreases the incidence of anemia and iron insufficiency. A daily iron supplement will be given since it lessens the commonness of anemia and iron insufficiency, increasing iron and hemoglobin stores. An iron supplement of 30–60 mg/day is recommended.

Various resources are necessary to complete the research successfully to determine the efficiency of iron supplements in patients with iron deficiency anemia. Some of the necessary

resources include iron supplements and nursing care services. The feasibility of a nurse in an advanced role is practical. Nurses will provide a nursing care plan for the patient with anemia. There is a need for an iron supplement supply for the plan to be effective. Those involved in the whole plan include patients with anemia, nurses who will help implement the plan, and other staff who will offer critical support. The plan will take place within a hospital setting for 3 to 6 months.

References

Chai, A. L., Huang, O. Y., Rakočević, R., & Chung, P. (2021). Critical iron deficiency

anemia with record low hemoglobin: a case report. Journal of Medical Case Reports,

15(1). https://doi.org/10.1186/s13256-021-03024-9

Dündar, B. (2019). The Prevalence And Analysis Of Risk Factors For Postpartum Anemia In Women Without Prepartum Anemia. Haydarpasa Numune Training and Research Hospital Medical Journal. https://doi.org/10.14744/hnhj.2019.75436

Fernández-Gaxiola, A. C., & De-Regil, L. M. (2019). Intermittent iron supplementation for reducing anaemia and its associated impairments in adolescent and adult menstruating women. Cochrane Database of Systematic Reviews. https://doi.org/10.1002/14651858.cd009218.pub3

Fischer, J. A. J., Sasai, C. S., & Karakochuk, C. D. (2021). Iron-Containing Oral Contraceptives and Their Effect on Hemoglobin and Biomarkers of Iron Status: A Narrative Review. Nutrients, 13(7), 2340. https://doi.org/10.3390/nu13072340

Idemili-Aronu, N., Igweonu, O., & Onyeneho, N. (2020). Uptake of iron supplements and anemia during pregnancy in Nigeria. Journal of Public Health. https://doi.org/10.1093/pubmed/fdaa168

Low, M. S. Y., Speedy, J., Styles, C. E., De-Regil, L. M., & Pasricha, S.-R. (2017). Daily iron supplementation for improving anaemia, iron status, and health in menstruating women. Cochrane Database of Systematic Reviews, 4. https://doi.org/10.1002/14651858.cd009747.pub2

Mwangi, M. N., Prentice, A. M., & Verhoef, H. (2017). Safety and benefits of antenatal oral iron supplementation in low-income countries: a review. British Journal of Haematology, 177(6), 884–895. https://doi.org/10.1111/bjh.14584

Stevens, G. A., Paciorek, C. J., Flores-Urrutia, M. C., Borghi, E., Namaste, S., Wirth, J. P., Suchdev, P. S., Ezzati, M., Rohner, F., Flaxman, S. R., & Rogers, L. M. (2022). National, regional, and global estimates of anemia by severity in women and children for 2000–19: a pooled analysis of population-representative data. The Lancet Global Health, 10(5), e627–e639. https://doi.org/10.1016/S2214-109X(22)00084-5

Stoffe, N. (2020). Oral iron supplementation in iron-deficient women: How much and how often? Molecular Aspects of Medicine, 75, 100865. https://doi.org/10.1016/j.mam.2020.100865

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Primary Care II Case Study Proposal

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This is a continuation of the previous health program proposal, part one, which you submitted. Please approach this assignment as an opportunity to integrate instructor feedback from part I and expand on ideas adhering to the components of the MAP-IT strategy. Include necessary levels of detail you feel appropriate to assure stakeholder buy-in.

For this section of your assignment, include the following components:

7. Framework (minimum two paragraphs)

 Select and present an appropriate health promotion/disease prevention theoretical or conceptual model that best serves as the guiding framework for the proposal.

8. Outcomes (minimum two paragraphs)

 Thoroughly describe the intended outcomes concurrent with the SMART goal approach.

9. Detailed Plan (minimum three paragraphs)

 Provide a detailed plan for the evaluation of each outcome.

10. Barriers / Challenges (minimum two paragraphs)

 Thoroughly describe possible barriers/challenges to implementing the proposed project as well as strategies to address these barriers/challenges.

11. Conclusion (minimum two paragraphs)

· Conclude the paper with a conclusion paragraph. Don’t type the word “Conclusion”.

· In this section, you will share your insights about this strategy and your expectations regarding achieving your goals.

· This section should contain a well-rounded and comprehensive conclusion summarizing the paper and providing a call to action.

12. Reference

· APA/Formatting /References All information taken from another source, even if summarized, must be appropriately cited in the manuscript and listed in the references using the current APA 7th Edition of the manual.

Paper Requirements:

· Follow APA 7th Edition format guidelines.

· Use In-text citations properly.

· The final paper should be 12-14 pages long (not including the title and reference page).

· All papers must be written in the 3rd person.

· Your proposal must be a scholarly paper demonstrating graduate school-level writing and critical analysis of existing nursing knowledge about a Primary Care problem.

Clarity of Writing:

a. Use standard English grammar and sentence structure.

b. There should be no spelling errors or typographical errors.

c. The paper should be organized around the required components using appropriate headers.

Grading Criteria (II)RatingsPts
Framework15 pts (Excellent)Thoroughly selected and present an appropriate health promotion/ disease prevention theoretical or conceptual model12 (Good)Briefly selected and present an appropriate health promotion/ disease prevention theoretical or conceptual model8 pts (Acceptable)Vaguely selected and present an appropriate health promotion/ disease prevention theoretical or conceptual model5 pts (Needs work)Poorly selected and present an appropriate health promotion/ disease prevention theoretical or conceptual model0 ptsDid not select and present a theoretical or conceptual model framework.15 pts
Outcomes10 pts (Excellent)Describe the outcomes in detail concurrent with the SMART goal approach.8 pts (Good)Briefly described the intended outcomes.6 pts (Needs work)Vaguely described the intended outcomes.4 pts (Poor)Poorly described the intended outcomes.0 ptsDid not describe the intended outcomes.10 pts
Detailed Plan25 pts (Excellent)Provided a detailed plan for evaluation for each outcome.20 pts (Good)Briefly provided a plan for evaluation for each outcome.15 pts (Needs work)Vaguely provided a plan for evaluation for each outcome.10 pts (Poor)Poorly provided a plan for evaluation for each outcome.0 ptsDid not. provide a detailed plan for evaluation for each outcome.25 pts
Barriers / Challenges15 pts (Excellent)Thoroughly described possible barriers/ challenges to implementing the proposed project as well as strategies to address these barriers/ challenges.12 pts (Good)Briefly described possible barriers/ challenges to implementing the proposed project as well as strategies to address these barriers/ challenges.9 pts (Needs work)Vaguely described possible barriers/ challenges to implementing the proposed project as well as strategies to address these barriers/ challenges.3 pts (Poor)Poorly described possible barriers/ challenges to implementing the proposed project as well as strategies to address these barriers/ challenges.0 ptsDid not describe possible barriers/ challenges to implementing the proposed project as well as strategies to address these barriers/ challenges.15 pts
Conclusion15 pts (Excellent)The essay has a clear format with anintroduction, body with clear transitions between evidence and supporting arguments and a conclusion. The information is presented in an orderly manner. All elements facilitate the flow of the information in the document.12 pts (Good)The paper has a clear format with an introduction, body with evidence and supporting arguments and a conclusion. All elements facilitate the flow of the information in the document, but may be missing transitions between sections, or has other small issues with organization.9 pts (Limited)The paper structure has one of these issues: The essay does not have a clear introduction or conclusion. OR The conclusion does not take into consideration the information presented. OR Evidence and supporting arguments are not aligned. OR The flow of the document is difficult to follow.5 pts (Needs work)The paper does not appear to have any structure. No introduction, progression of thought or defined conclusion.0 ptsNot submitted15 pts
WritingMechanics10 pts ( Excellent)Writing is entirely free of typos, spelling, grammatical, punctuation, or translation errors.8 pts ( Good)Minimal (1-3) typos, spelling,grammatical, punctuation, or translation errors.5 pts ( Needs work)Multiple (4-9) typos, spelling,grammatical, punctuation, or translation errors.2 pts ( Problematic)10 or more typos, spelling, grammatical, punctuation, or translation errors.0 ptsNot submitted10 pts
Information LiteracyCorrect application ofAPA 7th Edition10 pts ( Excellent)Flawless execution of APA. Correct formatting, setup, title page, and perfect citations and references.8 pts ( Good)Correct formatting, setup, title page, with minimal formatting or punctuation errors in the citations or references.6 pts ( Needs work)Correct formatting, setup, title page, but significant errors with citations and references.2 pts ( Problematic)Incorrect formatting, setup or missing title page, and/or problematic citations and references.0 ptsNot usedAPA style10 pts
THE MAXIMUM SCORE FOR THIS ACTIVITY IS 100 POINTS, ACCOUNTING FOR A TOTAL OF 15 PERCENT OF THE STUDENT’S FINAL GRADE.SCORE (POINTS):
GRADE (PERCENT):

Literature Review Template

Use the “Literature Review Template” as a guideline to help you sort through your thoughts, note important points and think through the similarities and differences:

You are organizing the review by ideas and not by sources . The literature review is not just a summary of the already published works, it is your synthesis and should show how various articles are linked.

Source/ReferenceProblem/PurposeSampleMethodsFindingsLimitations
Example et al., 2019Examine the work patterns of hospital staff nurses to identify a possible relationship between hours worked and frequency of errorsConvenience sample 24 nurses (LPNs, RNs with both ADN & BSN preparation) 1-26 years of experienceCompared three groups of nurses during eight cycles of medication administrationDistractionsFailure to follow thefive rights of medication administration or protocolLack of focusPoor communicationObserver influence may have affected behavior.Only one nurse observed at a time.Nurses not observed whilein the patient’s room

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Capstone Case Study: Breast Cancer

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Capstone Case Study: Breast Cancer

Breast cancer is one of the most prevalent cancers that affect women. Research suggests that breastfeeding could reduce the chances of being affected by this type of cancer among parous women. According to Anstey et al. (2017), breast cancer is the most commonly diagnosed cancer and leads to most death cases caused by cancer among women. Breastfeeding could reduce the chances of breast cancer by protecting breastfeeding mothers from some invasive breast cancer types (Anstey et al., 2017). However, a significant amount of evidence suggests that the reduction of chances of breast cancer among breastfeeding women highly depends on various factors with African American women being more affected by this cancer than Caucasian women; thus, studies may have varying results.

Women who breastfeed for more than twelve months are less likely to get breast cancer as the chances of being affected reduce by 26% (Breast Cancer Association Consortium, 2021). Breastfeeding is associated with hormonal changes and reduces the exposure to hormones such as estrogen to parous women that increase breast cancer growth. During breastfeeding, women shed breast tissue, removing damaged DNA and reducing the rate of developing breast cancer. The same studies reveal that few women (3%) develop breast cancer when breastfeeding while most women who develop cancer are over forty years with 5% of breast cancer patients being women below forty (Breast Cancer Association Consortium, 2021). 

PICOT Question

The PICOT question is: In parous women (P), how does breastfeeding (I) compared to not breastfeeding (C) affect the risk of developing breast cancer (O) in 2 years (T)? The population in this study is parous women, that is, those who have given birth. The intervention is breastfeeding, intended to reduce the vulnerability of developing breast cancer in parous women, while the comparison is parous women who do not breastfeed. The outcome of the intervention is the reduction or decrease of breast cancer among the parous women who have chosen to breastfeed their babies. The time taken for the intervention is breastfeeding for two years. The PICOT question does not consider the breast cancer risk in nulliparous women as these women cannot breastfeed when they have not given birth, therefore, cannot produce milk. 

The Vulnerable Population

Although all women can be affected by breast cancer, parous women over forty years are more vulnerable to this type of cancer. According to research conducted by the Breast Cancer Association Consortium in 2021, one in every eight women develops breast cancer once in their lifetime. Research shows that only 4.7% of cancers affecting breasts are found in women below forty with over 70% of breast cancers being diagnosed in women above fifty years (Heer et al., 2020). While research shows that Caucasian women are more likely to be diagnosed with this type of cancer, women of color, especially African American women are more likely to die from this type of cancer, which makes race a significant risk factor for breast cancer (Yedjou et al., 2019).

Breast cancer can be contributed by various risk factors with some being controllable and others being uncontrollable. Some of the breast cancer risk factors that can be controlled or changed include obesity, hormone replacement therapy, alcohol consumption, physical activity, breastfeeding, contraceptives, smoking, diet, and environmental pollutants among others. Risk factors associated with breast cancer that cannot be changed and are uncontrollable include breast density, family history, radiation, genetics, race, age, personal history, age of menstruation, age of first birth, diethylstilboestrol (DES) exposure, serum oestradiol level, atypical hyperplasia and age at menopause among others (Xiao et al., 2019). 

Literature Review

According to Stordal (2022), women in developed countries have a 15% likelihood of developing cancer because they have children at a later age and have few babies. However, this risk is reduced by 4.3% for every 12 months they breastfeed and further by 7.0 % for each birth (Stordal, 2022). The authors in this article state that breastfeeding reduces BCRA1 mutations and triple-negative breast cancer due to pregnancy changes such as cellular differentiation and RNA processing. According to the researchers, the longer women breastfeed, the greater the reduction in their vulnerability. 

Reducing postmenopausal hormone therapy is another intervention associated with a reduced risk of breast cancer. Rozenberg et al. (2021) state that a combination of hormonal therapy increases the chances of breast cancer while limiting the hormonal therapy reduces the risk. The article states that nonhormonal therapies and medications reduce the chances of this type of cancer. According to the researchers, hormonal therapy through birth control pills and other contraceptives releases hormones such as estrogen associated with breast cancer. Recent research shows that women who use hormonal contraceptives increase the risk of breast cancer. The authors propose the use of preventive endocrine medications that inhibit the production of excess estrogen that increases individuals’ vulnerability to breast cancer. The intervention laid out in this article says that since hormonal therapy is important in regulating conception and menstruation among other functions, it should not be completely avoided but should be used for the shortest time possible. 

The risk of breast cancer can be reduced through pharmacological interventions. Breast cancer can be prevented through the use of tamoxifen and raloxifene. These are drugs approved by the food and drug agency (FDA) as safe to reduce the vulnerability to breast cancer in women more likely to be affected by this cancer due to family history or other risk factors (Yao et al., 2019). Although some researchers find the use of pharmacological interventions such as tamoxifen and raloxifene as unhealthy practices, these drugs reduce the chances of breast cancer in women over forty years and those with a family history of this type of cancer. However, these drugs have side effects and cannot be used by every woman, and this is why most researchers discourage using these drugs to reduce the risk of breast cancer. It is advisable for women considering using these drugs to reduce their vulnerability to this cancer to consult a physician before they use them. 

According to Dimou et al. (2019), women who breastfeed for more than 12 months are 45% less susceptible to breast cancer when compared to parous women who choose not to breastfeed. This is because the longer a parous woman breastfeeds, the more the breastfeeding protects against breast cancer. According to the authors, breastfeeding also offsets the increased vulnerability to breast cancer as milk-delivery systems protect the women from precancerous cells especially in women who have several children or for a longer time. The authors suggest that the scientific evidence that shows that breastfeeding reduces the risk of cancer is growing significantly. According to the article, the menstrual cycle returns more often to parous breastfeeding women than those who do not breastfeed, reducing the effects of prolonged exposure to estrogen. 

Bilateral Risk-Reducing Mastectomy (BRRM) is a preventive intervention that reduces the risk of breast cancer in women who are at high risk of this cancer. According to Thorat and Balasubramanian (2020), women with a family history of breast cancer are likely carriers of BRCA mutations (BCRA1 and BCRA2 gene carriers). They are at a high risk of developing breast cancer. BRRM helps reduce the risk of breast cancer in these women by developing new and stronger preventive agents for the breasts of these women. According to the authors, BRRM reduces individuals’ vulnerability to breast cancer by 45% when taken for four years (Thorat & Balasubramanian, 2020). This intervention involves removing one or both breasts to protect women at high risk from developing this cancer due to the presence of BCRA mutations in their body, a personal history of breast cancer, or a family history with more than one close relative developing this type of cancer. 

Qiu et al. (2022) reviewed published literature on the association between breastfeeding and breast cancer. Although the researchers concluded that there is limited evidence that shows the relationship between breastfeeding and the risk of breast cancer, there were some studies that showed that there is a reduced number of breast cancer cases in parous women who breastfeed. The differentiation of breast cells reduces the chances of developing breast cancer in parous women as they are modified to produce milk after giving birth. This cell differentiation means that few breast cells and tissues are vulnerable to estrogen and other carcinogenic agents during breastfeeding, reducing the time these women are exposed to estrogen, which is associated with breast cancer. 

Strengths and Weaknesses of the Articles

The strength of Stordal (2020) is that the article has adequate statistics that support the conclusion that breastfeeding impacts the vulnerability to breast cancer but fails to sufficiently provide evidence how breastfeeding reduces this risk. Rozenberg et al. (2021) explain the impact of hormonal therapy on the risk of breast cancer but fails to provide nonhormonal therapies that can be used by parous women instead. The strength of Yao et al. (2019) article is that it offers an alternative to breastfeeding to lower the women’s vulnerability to breast cancer in women, but fails to point out the side effects of tamoxifen and ralofexene drugs. Dimou et al. (2019) supported their findings with statistics and percentages of the risk of breast cancer in women in developed countries but fail to compare the findings with statistics of breast cancer cases in developing countries. The strength of Thorat and Balasubramanian (2020) is that it focuses on gene mutations and the type of breast cancer they cause. However, this article focuses on genes and family history risk factors but ignores other risk factors. Lastly, the strength of Qui et al. (2022) is that it points out the link between breastfeeding with the risk of breast cancer. However, this source is limited, lacking statistics and figures to support breastfeeding intervention. 

Proposal

In parous women, breastfeeding can reduce the risk of breast cancer due to the constant shedding of breast tissue that removes damaged DNA in the breast that causes abnormal cell growth. This intervention only targets parous women, as nulliparous women cannot breastfeed. This intervention is very effective in pregnant women who have children while young. This intervention aims to remove damaged DNA in the breast and regulate estrogen action in breastfeeding women as low exposure to this hormone reduces the risk of this cancer (Breast Cancer Association Consortium, 2021). This intervention recommends that women breast their babies for at least two years as it benefits both the mother and the baby with the former reducing the risk of breast cancer and the latter developing a strong immune system. 

An advanced nursing practitioner have the skills to coordinate the individuals involved in implementing the intervention. They can encourage parous women to join a breastfeeding support group to ensure the intervention is successful. Some of the resources that can be used in implementing this intervention include fact sheets, toolkits, reports, and published documents that support breastfeeding (Basree et al., 2019). The nurse can target women with low breastfeeding self-efficacy and the intervention should be introduced in the antenatal stage to ensure the mother is ready to breastfeed after giving birth. The nurse can also consider a follow-up to offer support and ensure that parous women breastfeed exclusively for six months and up to two years even after introducing food. The intervention should be implemented for two years after giving birth to ensure that it is effective. 

References

Andò, S., Gelsomino, L., Panza, S., Giordano, C., Bonofiglio, D., Barone, I., & Catalano, S. (2019). Obesity, leptin and breast cancer: epidemiological evidence and proposed mechanisms.  Cancers,  11(1), 62. https://doi.org/10.3390/cancers11010062

Anstey, E. H., Shoemaker, M. L., Barrera, C. M., O’Neil, M. E., Verma, A. B., & Holman, D. M. (2017). Breastfeeding and breast cancer risk reduction: Implications for black mothers.  American Journal of Preventive Medicine,  53(3), S40-S46. https://doi.org/ 10.1016/j.amepre.2017.04.024

Basree, M. M., Shinde, N., Koivisto, C., Cuitino, M., Kladney, R., Zhang, J., … & Ramaswamy, B. (2019). Abrupt involution induces inflammation, estrogenic signaling, and hyperplasia linking lack of breastfeeding with increased risk of breast cancer.  Breast Cancer Research,  21(1), 18. https://doi.org/10.1186/s13058-019-1163-7

Breast Cancer Association Consortium. (2021). Breast cancer risk genes—association analysis in more than 113,000 women.  New England Journal of Medicine,  384(5), 428-439.

Dimou, S., Mamakou, A., Konstantaki, E., & Spanou, M. (2019). The contribution of breastfeeding to the prevention of breast cancer.  European Journal of Midwifery,  3(November). https://doi.org/10.18332/ejm/114885

Heer, E., Harper, A., Escandor, N., Sung, H., McCormack, V., & Fidler-Benaoudia, M. M. (2020). Global burden and trends in premenopausal and postmenopausal breast cancer: a population-based study. The Lancet Global Health, 8(8), e1027-e1037. https://doi.org/10.1016/S2214-109X(20)30215-1

Qiu, R., Zhong, Y., Hu, M., & Wu, B. (2022). Breastfeeding and reduced risk of breast cancer: a systematic review and meta-analysis.  Computational and Mathematical Methods in Medicine,  2022.  https://doi.org/10.1155/2022/8500910

Rozenberg, S., Di Pietrantonio, V., Vandromme, J., & Gilles, C. (2021). Menopausal hormone therapy and breast cancer risk.  Best Practice & Research Clinical Endocrinology & Metabolism,  35(6), 101577. https://doi.org/ 10.1016/j.beem.2021.101577 

Stordal, B. (2022). Breastfeeding reduces the risk of breast cancer: A call for action in high‐income countries with low rates of breastfeeding.  Cancer Medicine. https://doi.org/ 10.1002/cam4.5288 

Thorat, M. A., & Balasubramanian, R. (2020). Breast cancer prevention in high-risk women.  Best Practice & Research Clinical Obstetrics & Gynaecology,  65, 18-31. https://doi.org/10.1016/j.bpobgyn.2019.11.006

Yao, J., Deng, K., Huang, J., Zeng, R., & Zuo, J. (2020). Progress in the understanding of the mechanism of tamoxifen resistance in breast cancer.  Frontiers in Pharmacology,  11, 592912. https://doi.org/10.3389/fphar.2020.592912

Yedjou, C. G., Sims, J. N., Miele, L., Noubissi, F., Lowe, L., Fonseca, D. D., … & Tchounwou, P. B. (2019). Health and racial disparity in breast cancer. Breast Cancer Metastasis and Drug Resistance, 31-49. https://doi.org/10.1007/978-3-030-20301-6_3

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Case Study 3: A man who is displaying symptoms of moderate anxiety

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Case Study 3: A man who is displaying symptoms of moderate anxiety

Your writing Assignment should:

  • follow the conventions of Standard English (correct grammar, punctuation, etc.);
  • be well ordered, logical, and unified, as well as original and insightful;
  • display superior content, organization, style, and mechanics; and;
  • use APA formatting and citation style.

Case Study 3: A man who is displaying symptoms of moderate anxiety

Allen, a university graduate aged 21 years, attends the pharmacy of the campus counseling health center and asks to speak to the pharmacist in private. He states he is worried about heart palpitations that he has been experiencing. He is visibly sweating and looks on edge. The pharmacist calls the provider on duty at the psychiatric clinic for the counseling health center and she arrives.

Assessment

As the PMHNP on duty, you invite Allen into the consultation room and ask him about his symptoms. He states that he has started a new job and that the palpitations start when he is feeling anxious. His symptoms are occurring most days of the week and he says it makes him “feel on edge.” He adds that he does not want to socialize with his co-workers. It is starting to affect his sleep and he does not know what to do. He also states that he has occasional pain in his chest.

Treatment options

Allen is demonstrating symptoms of moderate anxiety, given his desire to avoid socializing, and has a degree of functional impairment. However, as he has potential cardiac symptoms, these issues could be related to another condition.

When questioned, he confirms he has no other problems with his health, but you feel the patient needs further investigation. For example, tests to measure the electrical activity of his heart to rule out underlying cardiac problems should be considered. His presentation concerns you and you feel he needs these tests today to assess the differential diagnosis, as you are worried about his chest pain and palpitations.

Vitals:

  • 138/80
  • 4
  • 20
  • 78
  • 99%
  • 5’10”
  • 188 lbs.

Advice and recommendations

You encourage Allen by saying that it is great that he felt he could talk to a pharmacist about this, but explain that he would benefit from continued management with you as the PMHNP and possibly some additional psychotherapy. You explain that his symptoms could be related to anxiety and that you think he may need something to help him manage. He agrees to let you continue the assessment and design a treatment plan.

Use the Initial Psychiatric Assessment SOAP Note template to complete the documentation with the information provided, diagnose the patient and design a treatment plan.

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Case Study of Ms. H(Word document)

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Case Study of Ms. H(Word document)

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