Tag: Nursing

  • [Solved] Nursing Homework

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    – ## PsychosocialNursingReflectionPaperAssignment1.docx **## PsychosocialNursingReflectionPaperAssignment1.docx** **Psychosocial Nursing Reflection Paper Assignment** Objectives 1. Consider future nursing opportunities in relation to clinical findings, including current issues in mental health care…

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    – ## PsychosocialNursingReflectionPaperAssignment1.docx

    **## PsychosocialNursingReflectionPaperAssignment1.docx**

    **Psychosocial Nursing Reflection Paper Assignment**

    Objectives

    1. Consider future nursing opportunities in relation to clinical findings, including current issues in mental health care and potential applications for advocacy and support related to clients with mental health diagnoses and their families.
    _(Human Flourishing)_

    Assignment

    Write a 500-word reflection paper based on the information you gathered at your mental health rotation OR with a Med/Surg, etc. patient, OR the movie (options listed in D2L and only if you haven’t had your mental health rotation/Med/Surg pt).

    **Introduction and Nursing Diagnoses**

    Include basic client information (without identifiers) and psychiatric diagnosis/diagnoses as well as pertinent physical diagnoses.

    Relay your top two priority nursing diagnoses (from your clinical observation sheet) and briefly discuss your rationale for these.  Ideally, you will have one 3-Part and one “Risk For”. Diagnoses are often appropriate in mental health patients but must exclude evidence. If there’s evidence then it happened, and it’s no longer a “risk for” because it really exists. Nursing diagnoses must be formatted correctly, whether they have 2 (risk for) or 3 parts. Rationale should include observations, quotations, reports from staff or family, or other sources that led you to choose these diagnoses. This section should take up approximately half a page or 125 words.

    **Reflection**

    Based on the diagnoses identified, use the next page (around 250 words) to reflect on your ideas of how to provide the best care for this client and their family. Consider whether you think they are currently receiving the best possible care and what other supports and resources might better help them. Consider the following questions:

    What are the barriers to implementing the nursing interventions you listed in your clinical assignment?

    What ethical principles apply to these considerations?

    What resources are available in your community for this patient and/or their family?

    *Chapters 34-36 in your textbook provide information about group and family therapy as well as integrative treatment options that might support your discussion.

    Considerations

    Ethical Principles

    1. Autonomy- Respecting the rights of others to make their own decisions.

    2. Beneficence- The duty to act to benefit or promote the health and well-being of others.

    3. Nonmaleficence- Doing no harm to the patient

    4. Justice- The duty to distribute resources or care equally, regardless of personal attributes

    5. Fidelity- Maintaining loyalty and commitment to the patient and doing no wrong to the patient

    6. Veracity- The duty to communicate truthfully

    Varcarolis’ page 93 (9th edition)

    [https://nurse.org/education/nursing-code-of-ethics/](https://nurse.org/education/nursing-code-of-ethics/)

    Patients’ rights are discussed on page 96 in the 9th edition.

    **Nursing Care Plan**

    Take approximately the final half page (125 words) to create a nursing care plan for your client. Choose the primary nursing diagnosis of the two you gave at the beginning of the paper and provide a brief rationale for your choice. State one (or two) relevant goals for your care plan and the method of evaluation you will use to determine the effectiveness of your plan. Use the table (SEE TEMPLATE) to fill in your proposed interventions and rationales. See the site below for examples.

    [https://nurseslabs.com/category/nursing-care-plans/mental-health-psychiatric/](https://nurseslabs.com/category/nursing-care-plans/mental-health-psychiatric/)

    **References**

    This is on its own page. Perfection will not make or break you. Just make an effort at the rules. If you go on in your nursing education, which I hope you do, this will be something you have to know. We’ll start slowly in this program. Two or three references are fine, and your textbook can be one of them. The rules are here:
    [https://owl.purdue.edu/owl/research_and_citation/apa_style/apa_formatting_and_style_guide/reference_list_basic_rules.html](https://owl.purdue.edu/owl/research_and_citation/apa_style/apa_formatting_and_style_guide/reference_list_basic_rules.html)

    **## PsychosocialNursingReflectionPaperAssignment1.docx**

    **Psychosocial Nursing Reflection Paper Assignment**

    Objectives

    1. Consider future nursing opportunities in relation to clinical findings, including current issues in mental health care and potential applications for advocacy and support related to clients with mental health diagnoses and their families.
    _(Human Flourishing)_

    Assignment

    Write a 500-word reflection paper based on the information you gathered at your mental health rotation OR with a Med/Surg, etc. patient, OR the movie (options listed in D2L and only if you haven’t had your mental health rotation/Med/Surg pt).

    **Introduction and Nursing Diagnoses**

    Include basic client information (without identifiers) and psychiatric diagnosis/diagnoses as well as pertinent physical diagnoses.

    Relay your top two priority nursing diagnoses (from your clinical observation sheet) and briefly discuss your rationale for these.  Ideally, you will have one 3-Part and one “Risk For”. Diagnoses are often appropriate in mental health patients but must exclude evidence. If there’s evidence then it happened, and it’s no longer a “risk for” because it really exists. Nursing diagnoses must be formatted correctly, whether they have 2 (risk for) or 3 parts. Rationale should include observations, quotations, reports from staff or family, or other sources that led you to choose these diagnoses. This section should take up approximately half a page or 125 words.

    **Reflection**

    Based on the diagnoses identified, use the next page (around 250 words) to reflect on your ideas of how to provide the best care for this client and their family. Consider whether you think they are currently receiving the best possible care and what other supports and resources might better help them. Consider the following questions:

    What are the barriers to implementing the nursing interventions you listed in your clinical assignment?

    What ethical principles apply to these considerations?

    What resources are available in your community for this patient and/or their family?

    *Chapters 34-36 in your textbook provide information about group and family therapy as well as integrative treatment options that might support your discussion.

    Considerations

    Ethical Principles

    1. Autonomy- Respecting the rights of others to make their own decisions.

    2. Beneficence- The duty to act to benefit or promote the health and well-being of others.

    3. Nonmaleficence- Doing no harm to the patient

    4. Justice- The duty to distribute resources or care equally, regardless of personal attributes

    5. Fidelity- Maintaining loyalty and commitment to the patient and doing no wrong to the patient

    6. Veracity- The duty to communicate truthfully

    Varcarolis’ page 93 (9th edition)

    [https://nurse.org/education/nursing-code-of-ethics/](https://nurse.org/education/nursing-code-of-ethics/)

    Patients’ rights are discussed on page 96 in the 9th edition.

    **Nursing Care Plan**

    Take approximately the final half page (125 words) to create a nursing care plan for your client. Choose the primary nursing diagnosis of the two you gave at the beginning of the paper and provide a brief rationale for your choice. State one (or two) relevant goals for your care plan and the method of evaluation you will use to determine the effectiveness of your plan. Use the table (SEE TEMPLATE) to fill in your proposed interventions and rationales. See the site below for examples.

    [https://nurseslabs.com/category/nursing-care-plans/mental-health-psychiatric/](https://nurseslabs.com/category/nursing-care-plans/mental-health-psychiatric/)

    **References**

    This is on its own page. Perfection will not make or break you. Just make an effort at the rules. If you go on in your nursing education, which I hope you do, this will be something you have to know. We’ll start slowly in this program. Two or three references are fine, and your textbook can be one of them. The rules are here:
    [https://owl.purdue.edu/owl/research_and_citation/apa_style/apa_formatting_and_style_guide/reference_list_basic_rules.html](https://owl.purdue.edu/owl/research_and_citation/apa_style/apa_formatting_and_style_guide/reference_list_basic_rules.html)

  • [Solved] Bj blank bid powepoint week 6

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    Bj blank bid powerpoint weeek 6

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  • [Solved] Psychiatric Mental Health Practicum

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    **Please use this topic: Electroconvulsive Therapy (ECT) in the Treatment of Severe Depression.** What is your topic? Who is affected by this topic? How does it affect the community as a whole? Cost Associated to the issues Short-term effects versus long-term effects **References** Chaudhri, S. I., …

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    **Please use this topic: Electroconvulsive Therapy (ECT) in the Treatment of Severe Depression.**
    What is your topic?
    Who is affected by this topic?
    How does it affect the community as a whole?
    Cost Associated to the issues
    Short-term effects versus long-term effects
    **References**
    Chaudhri, S. I., Amin, A., Panjiyar, B. K., Al-taie, D. S., AlEdani, E. M.,  Gurramkonda, J., & Hamid, P. (2024). A Comparison of the Efficacy and  Adverse Effects of Ketamine and Electroconvulsive Therapy in the  Management of Treatment-Resistant Depression: A Systematic Review.  Cureus. [https://doi.org/10.7759/cureus.55596](https://doi.org/10.7759/cureus.55596)
    Deng, Z.-D., Robins, P. L., Regenold, W., Rohde, P., Moritz Dannhauer, & Lisanby,  S. H. (2023). How electroconvulsive therapy works in the treatment of  depression: is it the seizure, the electricity, or both?  Neuropsychopharmacology, 49(1), 150–162. [https://doi.org/10.1038/s41386- 023-01677-2](https://doi.org/10.1038/s41386-023-01677-2)
    Guo, Q., Wang, Y., Guo, L., Li, X., Ma, X., He, X., Li, J., Zhang, X., & Shang, S. (2024). Long-term cognitive effects of electroconvulsive therapy in major  depressive disorder: A systematic review and meta-analysis. Psychiatry  Research, 331, 115611. [https://doi.org/10.1016/j.psychres.2023.115611](https://doi.org/10.1016/j.psychres.2023.115611)
    Petrucci, A. B. C., Fernandes, J. V. A., Reis, I. A., da Silva, G. H. S., Recla, B. M. F.,  de Mendonça, J. C., Pedro, V. C. S., D’Assunção, L. E. N., & Valiengo, L. da  C. L. (2024). Ketamine versus electroconvulsive therapy for major depressive episode: An updated systematic review and non-inferiority meta-analysis.  Psychiatry Research, 339, 115994.  [https://doi.org/10.1016/j.psychres.2024.115994](https://doi.org/10.1016/j.psychres.2024.115994)
    Ren, L., Yu, J., Zeng, J., Wei, K., Li, P., Luo, J., Shen, Y., Feng Lv, & Min, S. (2024). Comparative efficacy and tolerability of different anesthetics in  electroconvulsive therapy for major depressive disorder: A systematic review  and network meta-analysis. Journal of Psychiatric Research, 171, 116–125. [https://doi.org/10.1016/j.jpsychires.2024.01.031](https://doi.org/10.1016/j.jpsychires.2024.01.031)
    Karrouri, R., Hammani, Z., Benjelloun, R., & Othman, Y. (2021). Major depressive disorder: Validated treatments and future challenges. _World journal of clinical cases_, _9_(31), 9350.
    Nygren, A., Reutfors, J., Brandt, L., Bodén, R., Nordenskjöld, A., & Tiger, M. (2023). Response to electroconvulsive therapy in treatment-resistant depression: nationwide observational follow-up study. _BJPsych Open_, _9_(2), e35.
    Zhong, M., Liu, Q., Li, L., Tang, V. M., Wong, A. H., & Liu, Y. (2023). Evaluating the effect of electroconvulsive therapy (ECT) on post-traumatic stress disorder (PTSD): A systematic review and meta-analysis of five studies. _Journal of Psychiatric Research_, _164_, 37-45.
    Verwijk, E., Spaans, H. P., Comijs, H. C., Kho, K. H., Sienaert, P., Bouckaert, F., … & Kok, R. M. (2015). Relapse and long-term cognitive performance after a brief pulse or ultra-brief pulse right unilateral electroconvulsive therapy: a multicenter naturalistic follow up. _Journal of Affective Disorders_, _184_, 137-144.
    Gergel, T. (2022). ‘Shock tactics’, ethics and fear: an academic and personal perspective on the case against electroconvulsive therapy. _The British Journal of Psychiatry_, _220_(3), 109-112.
    Łysik, A., Logoń, K., Szczygieł, A., Wołoszczak, J., Wrześniewska, M., & Leszek, J. (2025). Innovative approaches in the treatment-resistant depression: exploring different therapeutic pathways. _GeroScience_, 1-16.

  • [Solved] care plan

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  • [Solved] psycho

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  • [Solved] Help

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    In-depth study guidance and analytical solution covering Help.

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  • [Solved] Week 6 well child visit soap note

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    Use previous template with professor feed back to complete soap note. APA format 7th, use evidence based practice. Due in 24 hrs. \ wellchildexamsoapnotewk4template.docx](https://www.sweetstudy.com/files/wellchildexamsoapnotewk4template-docx "wellchildexamsoapnotewk4template.docx") \ PEDSSOAPNoteT…

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    Use previous template with professor feed back to complete soap note. APA format 7th, use evidence based practice. Due in 24 hrs.
    \
    wellchildexamsoapnotewk4template.docx](https://www.sweetstudy.com/files/wellchildexamsoapnotewk4template-docx "wellchildexamsoapnotewk4template.docx")
    \
    PEDSSOAPNoteTemplate9.5.2312.docx](https://www.sweetstudy.com/files/pedssoapnotetemplate9-5-2312-docx "PEDSSOAPNoteTemplate9.5.2312.docx")
    \
    Soapnotechecklist.docx](https://www.sweetstudy.com/files/soapnotechecklist-docx "Soapnotechecklist.docx")

  • [Solved] hello

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    **Change Agent Assignment: Part II of the Three-Part Course Project (200 points):** Now that you have researched your policy, it is time to take the role of a "change agent" and advocate for change by creating a case for your policy recommendations. Create a visual representation of a (one-page) fly…

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    **Change Agent Assignment: Part II of the Three-Part Course Project (200 points):**
    Now that you have researched your policy, it is time to take the role of a "change agent" and advocate for change by creating a case for your policy recommendations. Create a visual representation of a (one-page) flyer, brochure, or infographic that includes:
    – A clear title
    – A statement answering:
    – Why is the policy necessary?
    – What prompted your attention to implement change?
    – Relevant evidence
    – Data, statistics, trends, or other evidence you uncovered.
    – From a professional perspective, what recommendation(s) would you advocate for?
    – You can utilize your original 2-3 sources from the Week 5 Policymaking Charting Assignment OR find 2-3 additional sources. All material within the course room can be cited and referenced as needed.
    #### Writing Requirements
    – One page in length.
    – Integrate at least 2-3 sources. All material within the course room can be cited and referenced as needed.
    – At the bottom of your flyer, add references.
    – Follow appropriate APA citation guidelines. Here are two excellent resources: [Crediting Sources Made SimpleLinks to an external site.](https://www.brainshark.com/1/player/devry?pi=zH4z12VpxCza6A1z0&r3f1=&fb=0) and the [Writing CenterLinks to an external site.](https://mychamberlain.sharepoint.com/sites/StudentResourceCenter/WC/SitePages/Formatting-&-APA.aspx?source=https%3A%2F%2Fmychamberlain.sharepoint.com%2Fsites%2FStudentResourceCenter%2FWC%2FSitePages%2FForms%2FByAuthor.aspx).
    \
    POLI330_Week5_Assignment_Sample.docx](https://www.sweetstudy.com/files/poli330-week5-assignment-sample-docx-10322611 "POLI330_Week5_Assignment_Sample.docx")

  • [Solved] Post

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    See attachment – ## 7.DPOUT.pdf **## 7.DPOUT.pdf** Healthcare WHAT : REPLY to the TWO Discussion Posts FORMAT : APA with In-text Citation and Reference List REFERENCES : TWO Peer-Reviewed references minimum within last 5 years INCLUDE : Turnitin Report \* Please and THANK YOU * \_\_\______…

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    See attachment

    – ## 7.DPOUT.pdf

    **## 7.DPOUT.pdf**

    Healthcare

    WHAT : REPLY to the TWO Discussion Posts

    FORMAT : APA with In-text Citation and Reference List

    REFERENCES : TWO Peer-Reviewed references minimum within last 5 years

    INCLUDE : Turnitin Report

    \* Please and THANK YOU *

    \_\_\_____________________

    TayT

    Discussion Post Reply #1

    After reviewing Health Care: America vs. the World and completing the international healthcare quiz, I
    compared the U.S. healthcare system to Canada’s. While both countries are high-income nations with up-
    to-date medical technology, their approaches to healthcare delivery differ in structure, access, cost, and
    outcomes. The U.S. healthcare system uses a mixed public-private model. Programs like Medicare and
    Medicaid cover some, but the system lacks universal coverage, and over 27 million people remain
    uninsured (Tikkanen et al., 2020). In contrast, Canada uses a single-payer, publicly funded system that
    guarantees universal health coverage for all people, primarily funded through taxes (Gunja et al., 2023).
    The United States spends more money per capita, roughly 13,400 per person, then Canada, which spends
    6,300 per person (Tikkanen et al., 2020). Even with the U.S. spending more money per citizen, the life
    expectancy in the U.S. is 78.4 compared to Canada’s 82.6. It has higher rates of preventable deaths,
    primarily related to the inability to afford medical care (Gunja et al., 2023). In 2020, the U.S. had the
    highest infant mortality rate among high-income countries, with 5.4 deaths per 1,000 live births,
    compared to 4.5 in Canada. Chronic health conditions related to obesity, diabetes, and heart disease
    contribute to these outcomes (Gunja et al., 2023). Canada’s system provides care based on the need for
    services rather than the ability to pay, leading to greater access to needed healthcare. In the U.S.,
    insurance is often tied to employment status, with high deductibles creating high out-of-pocket costs and
    many barriers to health care (Tikkanen et al., 2020). Both Countries have pros and cons to their healthcare
    delivery systems; the U.S. is known for having cutting-edge medical technology, advancements in
    treatment options, and access to specialized care, but faces challenges with affordability and equal access
    to care. Canada offers more equitable access to care, but patients often face long wait times for
    procedures and to see specialists. I was surprised that despite spending nearly twice as much, the U.S.
    ranks lower in every primary health outcome than Canada. Canada’s system proves that delivering
    quality, cost-effective care is possible.

    ChJo

    Discussion Post Reply #2

    How are they similar?

    Healthcare in Canada and healthcare in United States share many similarities. Canada’s Universal
    coverage healthcare and healthcare in the United States are both financed through payroll deductions and
    taxes; 11% of Canada’s GDP goes to healthcare spending (Healthcare Funding Policy in Canada. n.d.)

    In both countries private insurance can be purchased for supplemental care. In a published report Cigna
    Healthcare (2023) reports that most Canadians have private health insurance to gain access to a wider
    range of services and benefits that Canada’s universal coverage healthcare does not provide. In Canada
    private insurance gives Canadians access to an expanded network of health care providers and the wait
    time to see a specialist is shorter. Like the United States, primary care providers in Canada have private
    practices and are paid fee for service (Robinson, 2021).

    How are they different?

    Hospitals in Canada are budgeted by the provinces they are in while in the US most of the hospitals
    function as businesses; large hospital systems function like fortune 500 corporations. According to Brill
    (2013) MD Anderson’s revenue in 2013 was $531 million, which is a profit margin of 26% on revenue of
    $2.05 billion. In the city of Houston, only one hospital named Ben Taub is funded by taxpayers.

    The Canadian government regulates prescription prices while here in the United States prescriptions
    prices are regulated by the drug manufacturers. The US government tries to influence the price, regulating
    what amount Medicare will pay. To offset the high price of prescriptions many HMO plans pay most of
    the cost for their employees; this leaves a small co-pay, which is paid by the employee who needs the
    medication. The medication must be approved by the HMO, additionally, the medication must be
    approved for the individual. Robinson (2021) states some United State citizens travel to Canada and
    Mexico to purchase medications abroad where they are cheaper.

    How successful is each system in keeping patients healthy?

    In Canada rationing occurs for imaging and elective surgical procedures such as hip replacements,
    cataracts, cardiovascular. On a personal note, my aunt who lived in Canada was misdiagnosed and later
    died. X ray equipment rather than an MRI or PETS scan was used to determine if her cancer had spread,
    additionally she had to wait many months to see a specialist. Here in the US, coverage is compromised
    due to cost to the patient. Brill (2013) recants the story of a 42-year-old from Ohio who sought treatment
    at MD Anderson Cancer Center in Houston for non-Hodgkin’s lymphoma. He was not unable to buy
    comprehensive health insurance. The cost to see a specialist and devise a treatment plan costs $48,900.
    due in advance. The treatment plan which includes chemotherapy costs $83,900.

    How has the structure of this healthcare system impacted patient mortality rates?

    Despite the numerous similarities between Canada and the United States Universal Health Coverage in
    Canada has reduced that country’s mortality rates. According to Rudiger (2023) the United States spends
    twice as much per capita on healthcare as Canada or France, yet pre-COVID-19 mortality rate from
    treatable causes was over a third higher in the United States than in Canada and twice as high as those of
    France. ** No number assigned to the actual mortality rate. Mortality rates are specific to race, attitudes
    about the heathcare system and its intent to help, age, gender, and socioeconomic class. The
    generalization that rates in Canada are lower than they are in the US is predicated on there being less
    obstacles to access care in Canada. The access of care goes beyond provider availability**

    Which system is more expensive to operate?

    Granted, Canada and France have smaller populations than the United States. In 2021, the US health
    sector has a greater share of the economy than in comparable countries, The United States is 18.3% of the
    GDP, while the average country is less than 12% of GDP. Rudiger (2023) states that health system
    failures, economic and social structures are the culprit for poor and unequal health outcomes in the United
    States.

    What surprised you about what you learned?

    According to Rudiger (2023) the Affordable Care Act of 2010 established private insurance marketplaces.
    ACA solidified insurance companies’ influence on how the public accesses care. As a result, there has
    been an increase in households covered by insurance which was nullified by deductibles, user fees, and
    claim denials, leaving two-thirds of insured people struggling to access care.

    **## 7.DPOUT.pdf**

    Healthcare

    WHAT : REPLY to the TWO Discussion Posts

    FORMAT : APA with In-text Citation and Reference List

    REFERENCES : TWO Peer-Reviewed references minimum within last 5 years

    INCLUDE : Turnitin Report

    \* Please and THANK YOU *

    \_\_\_____________________

    TayT

    Discussion Post Reply #1

    After reviewing Health Care: America vs. the World and completing the international healthcare quiz, I
    compared the U.S. healthcare system to Canada’s. While both countries are high-income nations with up-
    to-date medical technology, their approaches to healthcare delivery differ in structure, access, cost, and
    outcomes. The U.S. healthcare system uses a mixed public-private model. Programs like Medicare and
    Medicaid cover some, but the system lacks universal coverage, and over 27 million people remain
    uninsured (Tikkanen et al., 2020). In contrast, Canada uses a single-payer, publicly funded system that
    guarantees universal health coverage for all people, primarily funded through taxes (Gunja et al., 2023).
    The United States spends more money per capita, roughly 13,400 per person, then Canada, which spends
    6,300 per person (Tikkanen et al., 2020). Even with the U.S. spending more money per citizen, the life
    expectancy in the U.S. is 78.4 compared to Canada’s 82.6. It has higher rates of preventable deaths,
    primarily related to the inability to afford medical care (Gunja et al., 2023). In 2020, the U.S. had the
    highest infant mortality rate among high-income countries, with 5.4 deaths per 1,000 live births,
    compared to 4.5 in Canada. Chronic health conditions related to obesity, diabetes, and heart disease
    contribute to these outcomes (Gunja et al., 2023). Canada’s system provides care based on the need for
    services rather than the ability to pay, leading to greater access to needed healthcare. In the U.S.,
    insurance is often tied to employment status, with high deductibles creating high out-of-pocket costs and
    many barriers to health care (Tikkanen et al., 2020). Both Countries have pros and cons to their healthcare
    delivery systems; the U.S. is known for having cutting-edge medical technology, advancements in
    treatment options, and access to specialized care, but faces challenges with affordability and equal access
    to care. Canada offers more equitable access to care, but patients often face long wait times for
    procedures and to see specialists. I was surprised that despite spending nearly twice as much, the U.S.
    ranks lower in every primary health outcome than Canada. Canada’s system proves that delivering
    quality, cost-effective care is possible.

    ChJo

    Discussion Post Reply #2

    How are they similar?

    Healthcare in Canada and healthcare in United States share many similarities. Canada’s Universal
    coverage healthcare and healthcare in the United States are both financed through payroll deductions and
    taxes; 11% of Canada’s GDP goes to healthcare spending (Healthcare Funding Policy in Canada. n.d.)

    In both countries private insurance can be purchased for supplemental care. In a published report Cigna
    Healthcare (2023) reports that most Canadians have private health insurance to gain access to a wider
    range of services and benefits that Canada’s universal coverage healthcare does not provide. In Canada
    private insurance gives Canadians access to an expanded network of health care providers and the wait
    time to see a specialist is shorter. Like the United States, primary care providers in Canada have private
    practices and are paid fee for service (Robinson, 2021).

    How are they different?

    Hospitals in Canada are budgeted by the provinces they are in while in the US most of the hospitals
    function as businesses; large hospital systems function like fortune 500 corporations. According to Brill
    (2013) MD Anderson’s revenue in 2013 was $531 million, which is a profit margin of 26% on revenue of
    $2.05 billion. In the city of Houston, only one hospital named Ben Taub is funded by taxpayers.

    The Canadian government regulates prescription prices while here in the United States prescriptions
    prices are regulated by the drug manufacturers. The US government tries to influence the price, regulating
    what amount Medicare will pay. To offset the high price of prescriptions many HMO plans pay most of
    the cost for their employees; this leaves a small co-pay, which is paid by the employee who needs the
    medication. The medication must be approved by the HMO, additionally, the medication must be
    approved for the individual. Robinson (2021) states some United State citizens travel to Canada and
    Mexico to purchase medications abroad where they are cheaper.

    How successful is each system in keeping patients healthy?

    In Canada rationing occurs for imaging and elective surgical procedures such as hip replacements,
    cataracts, cardiovascular. On a personal note, my aunt who lived in Canada was misdiagnosed and later
    died. X ray equipment rather than an MRI or PETS scan was used to determine if her cancer had spread,
    additionally she had to wait many months to see a specialist. Here in the US, coverage is compromised
    due to cost to the patient. Brill (2013) recants the story of a 42-year-old from Ohio who sought treatment
    at MD Anderson Cancer Center in Houston for non-Hodgkin’s lymphoma. He was not unable to buy
    comprehensive health insurance. The cost to see a specialist and devise a treatment plan costs $48,900.
    due in advance. The treatment plan which includes chemotherapy costs $83,900.

    How has the structure of this healthcare system impacted patient mortality rates?

    Despite the numerous similarities between Canada and the United States Universal Health Coverage in
    Canada has reduced that country’s mortality rates. According to Rudiger (2023) the United States spends
    twice as much per capita on healthcare as Canada or France, yet pre-COVID-19 mortality rate from
    treatable causes was over a third higher in the United States than in Canada and twice as high as those of
    France. ** No number assigned to the actual mortality rate. Mortality rates are specific to race, attitudes
    about the heathcare system and its intent to help, age, gender, and socioeconomic class. The
    generalization that rates in Canada are lower than they are in the US is predicated on there being less
    obstacles to access care in Canada. The access of care goes beyond provider availability**

    Which system is more expensive to operate?

    Granted, Canada and France have smaller populations than the United States. In 2021, the US health
    sector has a greater share of the economy than in comparable countries, The United States is 18.3% of the
    GDP, while the average country is less than 12% of GDP. Rudiger (2023) states that health system
    failures, economic and social structures are the culprit for poor and unequal health outcomes in the United
    States.

    What surprised you about what you learned?

    According to Rudiger (2023) the Affordable Care Act of 2010 established private insurance marketplaces.
    ACA solidified insurance companies’ influence on how the public accesses care. As a result, there has
    been an increase in households covered by insurance which was nullified by deductibles, user fees, and
    claim denials, leaving two-thirds of insured people struggling to access care.

  • [Solved] Week 6 Response 2

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    see attachment – ## Week6Response2.pdf **## Week6Response2.pdf** SOAP NOTE Diagnos tic Test Definition & How the Test Works Best Suited Conditions/ Diagnoses Special Considerations/ Instructions Pelvic Ultrasou nd – Abdomi nal Non-invasive imaging using sound waves over the abdomen to visualize pelv…

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    – ## Week6Response2.pdf

    **## Week6Response2.pdf**

    SOAP NOTE

    Diagnos
    tic Test Definition & How the Test Works

    Best Suited
    Conditions/
    Diagnoses

    Special Considerations/
    Instructions

    Pelvic
    Ultrasou
    nd –
    Abdomi
    nal

    Non-invasive imaging using sound
    waves over the abdomen to
    visualize pelvic organs.

    Large fibroids,
    adnexal masses,
    uterine
    enlargement

    Full bladder required to
    improve visualization.

    Pelvic
    Ultrasou
    nd –
    Transva
    ginal

    Insertion of a probe into the vagina
    to produce detailed images of
    uterus, ovaries, and adnexa.

    Fibroids, polyps,
    endometrial
    thickness, ovarian
    cysts

    Empty bladder preferred;
    patient may experience
    mild discomfort during
    insertion.

    Saline
    Infusion
    Sonohys
    terograp
    hy (SIS)

    Saline is infused into the uterine
    cavity during transvaginal
    ultrasound to improve visualization
    of the endometrium.

    Endometrial
    polyps,
    submucosal
    fibroids,
    intrauterine
    adhesions

    Contraindicated in
    pregnancy or active pelvic
    infection. Done in
    proliferative phase for
    best visualization.

    Hysteros
    copy

    Thin, lighted scope inserted
    through cervix into the uterus to
    directly visualize the endometrial
    cavity.

    Polyps,
    submucosal
    fibroids, abnormal
    uterine bleeding

    May be done in-office or
    OR setting; pre-procedure
    NSAIDs may help reduce
    discomfort.

    Hysteros
    alpingog
    ram
    (HSG)

    Contrast dye and X-ray used to
    assess uterine shape and fallopian
    tube patency.

    Infertility
    evaluation, uterine
    malformations

    Performed during early
    follicular phase;
    contraindicated in
    pregnancy or infection.

    Laparos
    copy

    Minimally invasive surgery using a
    camera inserted into the abdomen
    to directly visualize pelvic organs.

    Endometriosis,
    chronic pelvic
    pain, adnexal
    masses

    Requires general
    anesthesia; informed
    consent for risks.

    Demographic Data
    35-year-old African American female (HIPAA compliant)

    Subjective
    Chief Complaint (CC): Pelvic pain and irregular vaginal bleeding

    Endomet
    rial
    Biopsy
    (EMB)

    Tissue sample from endometrium
    obtained using suction catheter to
    evaluate histopathology.

    Abnormal uterine
    bleeding,
    endometrial
    hyperplasia or
    cancer

    Avoid during pregnancy;
    may cause cramping or
    spotting; schedule outside
    of menses.

    Colposc
    opy

    Visual inspection of cervix using a
    colposcope following abnormal Pap
    or HPV results; acetic acid
    enhances visualization of abnormal
    cells.

    Cervical dysplasia,
    follow-up to
    abnormal Pap/
    HPV

    Not first-line for pelvic
    pain; used only if
    abnormal cervical
    cytology is found.

    Endocer
    vical
    Curettag
    e (ECC)

    Scraping of endocervical canal with
    a curette to obtain tissue for
    histologic analysis.

    Evaluation of
    cervical dysplasia
    or cancer

    Often done in conjunction
    with colposcopy; may
    cause cramping.

    Dilation
    and
    Curettag
    e (D&C)

    Cervix is dilated and uterine lining
    is scraped to obtain tissue or stop
    bleeding.

    Heavy bleeding,
    incomplete
    miscarriage,
    diagnosis of
    endometrial
    pathology

    Requires sedation or
    anesthesia; informed
    consent essential; can be
    diagnostic and
    therapeutic.

    History of Present Illness (HPI):
    35-year-old African American female presents with a 6-month history of intermittent pelvic pain
    that is now constant and dull. She describes irregular spotting occurring between monthly
    menses, which are otherwise regular. No associated fever, chills, nausea, weight changes, or
    bowel or bladder symptoms.

    Additional HPI questions to ask:

    When did your last period start?

    How long is your typical cycle and flow?

    Any recent changes in pattern, severity, or associated symptoms?

    History of fibroids, endometriosis, or STIs?

    Past Medical History (PMH):
    G2P2 via NSVD (ages 10 and 8). No chronic conditions, surgeries, or STIs. No allergies.
    normal.

    Family History:
    Mother: hypertension. No breast, uterine, or ovarian cancer in family.

    Social History:
    Non-smoker. Social alcohol use. Sexually active with one male partner. Works full time. Diet
    average, exercises occasionally. No IPV. Inconsistent contraceptive use.

    Review of Systems (ROS):

    • General: No weight change or fatigue
    • GI: No constipation or bloating
    • GU: Pelvic pain and irregular bleeding; no dysuria or hematuria
    • GYN: No vaginal discharge
    • Breasts: No lumps or nipple changes
    • Preventive: Pap up to date; HPV vaccinated; no colonoscopy yet

    Objective
    Vital Signs:

    Temp 98.6°F,

    BP 118/74,

    HR 78,

    RR 16,

    BMI 23.2

    Pelvic Exam Findings:

    • External genitalia normal
    • Speculum: Small amount of blood in vault; cervix smooth, no lesions
    • Bimanual: Uterus enlarged with palpable firm, irregular contour; no cervical motion

    tenderness (CMT); no adnexal masses or tenderness

    Assessment

    Differential Diagnoses:

    • Uterine fibroids (leiomyomas) – most likely due to enlarged, irregular uterus and
    intermenstrual bleeding.

    • Endometrial polyp – possible cause of spotting, especially if intracavitary lesion present.
    • Adenomyosis – less likely, as uterus typically diffusely enlarged and tender, which this

    patient lacks.

    Presumptive Diagnosis: Uterine fibroids (leiomyomas)

    Confirmatory Diagnostic Test(s):

    • Transvaginal pelvic ultrasound – First-line to evaluate uterine size, fibroid location, and
    structure

    • Saline infusion sonohysterography – If concern for intracavitary lesion or endometrial
    pathology

    • CBC – To assess for anemia from blood loss

    Plan

    Diagnostic Plan:

    • Transvaginal ultrasound
    • CBC
    • Consider referral to GYN depending on findings

    Treatment Plan:

    • Ibuprofen 600 mg PO q6h PRN for pain (NSAID)
    • Combined oral contraceptives (COCs) to help regulate menses and reduce bleeding
    • Ferrous sulfate 325 mg PO daily if anemia confirmed

    Education:

    • Discussed fibroids: common, benign smooth muscle tumors of the uterus
    • Reviewed risks and benefits of COCs (e.g., DVT risk, nausea, breast tenderness)
    • NSAID education: take with food to minimize GI upset
    • Nutritional support: increase iron-rich foods if anemic
    • Potential for surgical management if symptoms worsen (e.g., myomectomy or hysterectomy)

    Follow-Up Plan:

    • Return in 4 weeks to review ultrasound results and labs
    • Refer to GYN if large fibroids or unresponsive to medical management

    Potential Complications if Untreated:

    • Progressive anemia
    • Increased pelvic discomfort
    • Possible impact on fertility or future pregnancy
    • Fibroid growth requiring more invasive treatment

    National Guidelines Comparison:
    According to the American College of Obstetricians and Gynecologists (ACOG), transvaginal
    ultrasound is the first-line diagnostic tool for uterine fibroids. Initial management for
    symptomatic fibroids can include NSAIDs and hormonal therapy. Surgical options are reserved
    for refractory cases or patients desiring definitive treatment.

    **## Week6Response2.pdf**

    SOAP NOTE

    Diagnos
    tic Test Definition & How the Test Works

    Best Suited
    Conditions/
    Diagnoses

    Special Considerations/
    Instructions

    Pelvic
    Ultrasou
    nd –
    Abdomi
    nal

    Non-invasive imaging using sound
    waves over the abdomen to
    visualize pelvic organs.

    Large fibroids,
    adnexal masses,
    uterine
    enlargement

    Full bladder required to
    improve visualization.

    Pelvic
    Ultrasou
    nd –
    Transva
    ginal

    Insertion of a probe into the vagina
    to produce detailed images of
    uterus, ovaries, and adnexa.

    Fibroids, polyps,
    endometrial
    thickness, ovarian
    cysts

    Empty bladder preferred;
    patient may experience
    mild discomfort during
    insertion.

    Saline
    Infusion
    Sonohys
    terograp
    hy (SIS)

    Saline is infused into the uterine
    cavity during transvaginal
    ultrasound to improve visualization
    of the endometrium.

    Endometrial
    polyps,
    submucosal
    fibroids,
    intrauterine
    adhesions

    Contraindicated in
    pregnancy or active pelvic
    infection. Done in
    proliferative phase for
    best visualization.

    Hysteros
    copy

    Thin, lighted scope inserted
    through cervix into the uterus to
    directly visualize the endometrial
    cavity.

    Polyps,
    submucosal
    fibroids, abnormal
    uterine bleeding

    May be done in-office or
    OR setting; pre-procedure
    NSAIDs may help reduce
    discomfort.

    Hysteros
    alpingog
    ram
    (HSG)

    Contrast dye and X-ray used to
    assess uterine shape and fallopian
    tube patency.

    Infertility
    evaluation, uterine
    malformations

    Performed during early
    follicular phase;
    contraindicated in
    pregnancy or infection.

    Laparos
    copy

    Minimally invasive surgery using a
    camera inserted into the abdomen
    to directly visualize pelvic organs.

    Endometriosis,
    chronic pelvic
    pain, adnexal
    masses

    Requires general
    anesthesia; informed
    consent for risks.

    Demographic Data
    35-year-old African American female (HIPAA compliant)

    Subjective
    Chief Complaint (CC): Pelvic pain and irregular vaginal bleeding

    Endomet
    rial
    Biopsy
    (EMB)

    Tissue sample from endometrium
    obtained using suction catheter to
    evaluate histopathology.

    Abnormal uterine
    bleeding,
    endometrial
    hyperplasia or
    cancer

    Avoid during pregnancy;
    may cause cramping or
    spotting; schedule outside
    of menses.

    Colposc
    opy

    Visual inspection of cervix using a
    colposcope following abnormal Pap
    or HPV results; acetic acid
    enhances visualization of abnormal
    cells.

    Cervical dysplasia,
    follow-up to
    abnormal Pap/
    HPV

    Not first-line for pelvic
    pain; used only if
    abnormal cervical
    cytology is found.

    Endocer
    vical
    Curettag
    e (ECC)

    Scraping of endocervical canal with
    a curette to obtain tissue for
    histologic analysis.

    Evaluation of
    cervical dysplasia
    or cancer

    Often done in conjunction
    with colposcopy; may
    cause cramping.

    Dilation
    and
    Curettag
    e (D&C)

    Cervix is dilated and uterine lining
    is scraped to obtain tissue or stop
    bleeding.

    Heavy bleeding,
    incomplete
    miscarriage,
    diagnosis of
    endometrial
    pathology

    Requires sedation or
    anesthesia; informed
    consent essential; can be
    diagnostic and
    therapeutic.

    History of Present Illness (HPI):
    35-year-old African American female presents with a 6-month history of intermittent pelvic pain
    that is now constant and dull. She describes irregular spotting occurring between monthly
    menses, which are otherwise regular. No associated fever, chills, nausea, weight changes, or
    bowel or bladder symptoms.

    Additional HPI questions to ask:

    When did your last period start?

    How long is your typical cycle and flow?

    Any recent changes in pattern, severity, or associated symptoms?

    History of fibroids, endometriosis, or STIs?

    Past Medical History (PMH):
    G2P2 via NSVD (ages 10 and 8). No chronic conditions, surgeries, or STIs. No allergies.
    normal.

    Family History:
    Mother: hypertension. No breast, uterine, or ovarian cancer in family.

    Social History:
    Non-smoker. Social alcohol use. Sexually active with one male partner. Works full time. Diet
    average, exercises occasionally. No IPV. Inconsistent contraceptive use.

    Review of Systems (ROS):

    • General: No weight change or fatigue
    • GI: No constipation or bloating
    • GU: Pelvic pain and irregular bleeding; no dysuria or hematuria
    • GYN: No vaginal discharge
    • Breasts: No lumps or nipple changes
    • Preventive: Pap up to date; HPV vaccinated; no colonoscopy yet

    Objective
    Vital Signs:

    Temp 98.6°F,

    BP 118/74,

    HR 78,

    RR 16,

    BMI 23.2

    Pelvic Exam Findings:

    • External genitalia normal
    • Speculum: Small amount of blood in vault; cervix smooth, no lesions
    • Bimanual: Uterus enlarged with palpable firm, irregular contour; no cervical motion

    tenderness (CMT); no adnexal masses or tenderness

    Assessment

    Differential Diagnoses:

    • Uterine fibroids (leiomyomas) – most likely due to enlarged, irregular uterus and
    intermenstrual bleeding.

    • Endometrial polyp – possible cause of spotting, especially if intracavitary lesion present.
    • Adenomyosis – less likely, as uterus typically diffusely enlarged and tender, which this

    patient lacks.

    Presumptive Diagnosis: Uterine fibroids (leiomyomas)

    Confirmatory Diagnostic Test(s):

    • Transvaginal pelvic ultrasound – First-line to evaluate uterine size, fibroid location, and
    structure

    • Saline infusion sonohysterography – If concern for intracavitary lesion or endometrial
    pathology

    • CBC – To assess for anemia from blood loss

    Plan

    Diagnostic Plan:

    • Transvaginal ultrasound
    • CBC
    • Consider referral to GYN depending on findings

    Treatment Plan:

    • Ibuprofen 600 mg PO q6h PRN for pain (NSAID)
    • Combined oral contraceptives (COCs) to help regulate menses and reduce bleeding
    • Ferrous sulfate 325 mg PO daily if anemia confirmed

    Education:

    • Discussed fibroids: common, benign smooth muscle tumors of the uterus
    • Reviewed risks and benefits of COCs (e.g., DVT risk, nausea, breast tenderness)
    • NSAID education: take with food to minimize GI upset
    • Nutritional support: increase iron-rich foods if anemic
    • Potential for surgical management if symptoms worsen (e.g., myomectomy or hysterectomy)

    Follow-Up Plan:

    • Return in 4 weeks to review ultrasound results and labs
    • Refer to GYN if large fibroids or unresponsive to medical management

    Potential Complications if Untreated:

    • Progressive anemia
    • Increased pelvic discomfort
    • Possible impact on fertility or future pregnancy
    • Fibroid growth requiring more invasive treatment

    National Guidelines Comparison:
    According to the American College of Obstetricians and Gynecologists (ACOG), transvaginal
    ultrasound is the first-line diagnostic tool for uterine fibroids. Initial management for
    symptomatic fibroids can include NSAIDs and hormonal therapy. Surgical options are reserved
    for refractory cases or patients desiring definitive treatment.