No plagiarism please.
Will need minimum of 150 words for each response, APA Style, double spaced, times new roman, font 12, and and Include: (1 reference for each response within years 2015-2018) with intext citations.
Peer Resp.#1
Pelvic pain can be caused by many reasons such as ovarian cysts, urinary tract infections, appendicitis, sexually transmitted infections, pelvic inflammatory disease (PID)…In this discussion, I will address PID as the cause of pelvic pain. PID is an infection or inflammation of the upper genital tract in women (Shen et al., 2016). For PID, it is considered acute if the symptoms last 30 days or less (Ferri, 2018). The condition is chronic if the symptoms last more than 30 days. PID is a sequela of sexually transmitted infections, so it is commonly diagnosed in young and sexually active women. Patients usually complain of lower abdominal pain, abnormal vaginal discharge/ bleeding, postcoital bleeding, dysuria, dyspareunia, or fever (Ferri, 2018). If a patient also complains of nausea and vomiting, we need to rule out peritonitis. Since the disease can cause infertility, ectopy pregnancy and can permanently damage other organs such as the uterus, ovaries, fallopian tubes, the patient needs to be referred to a gynecologist immediately to have a proper treatment (Shen et al., 2016). Some women may not have any symptoms, so we need to do a thorough history and physical examination, as well as offer STI screenings to avoid underdiagnosis. We can order basic labs and imaging studies such as urinalysis and urine culture, CBC, CMP, CRP, ESR, and ultrasound pelvic/transvaginal so that the patient can have them done before seeing the gynecologist. An endometrial biopsy or laparoscopy can be done by the gynecologist to confirm the diagnosis of PID (Ferri, 2018).
To write a referral to a specialist, we first need to include our information (name, address, phone, fax, email) and the specialist’s information. Second, the reason for consult/referral, the patient’s biographical data, chief complaint, history of present illness, past medical history, allergies, current medications, family history, social history, vital signs, review of system, and physical examination need to be addressed. Also, we need to include labs and imaging studies, treatment plan, diagnosis, and recommendations. After the patient has been seen and treated by the gynecologist, we are responsible for advising the patient to come back to see us for follow-ups. Since PID can be recurrent, the patient needs to be tested for gonorrhea and chlamydia three to six months after the treatment (Ferri, 2018). Her sexual partner needs to be treated as well to prevent her from being re-infected. Untreated gonorrhea and chlamydia can cause PID; therefore, it is essential for NPs to screen female patients aged less than 25 and those at increased risk for these infections to reduce the incidence of PID (Kreisel, Torrone, Bernstein, Hong, & Gorwitz, 2017). We also need to offer HIV and other STI screenings to all women with PID.
Peer Resp.#2
Endometriosis
Endometriosis is a painful disorder that results from the endometrium growing outside of the uterus. This generally involves the pelvic region, ovaries, fallopian tubes and the pelvic lining. It can affect areas outside of the pelvic region as well. Though the endometrium is displaced, it continues to act as normal by thickening, breaking down and then bleeding during menstruation. Unfortunately, there is no place for this to go and it becomes trapped. Eventually, this causes scarring and adhesion’s which cause pelvic organs to adhere together. All this together causes the pain and can lead to infertility (Mayo Clinic, 2018). I chose this subject because I had endometriosis. It is a horrible disorder and very painful. There were times that it felt like someone was stabbing my insides with a knife. I would ball up into the fetal position and cry until the pain went away. I eventually had to have a hysterectomy at the age of 29. This was horrible because we tried to have another baby, but it left me unable to have anymore. I was so bad that I had bleeding outside of my menstrual cycle and it was in my rectum. Before my surgery, I bleed for more than 2 weeks straight despite medications. He said if I did not have the surgery, I would eventually hemorrhage.
Endometriosis S/S
- Dysmenorrhea
- Chronic Pelvic Pain
- Dyspareunia
- Abdominal Pain
- Menorrhagia
- Backache (during menses)
- Perimenstrual Tenesmus
- Diarrhea
- Constipation
- Dyschezia
- Dysuria
- Hematuria
- Nausea
(Youngkin, Davis, Schadewald & Juve, 2013)
Referral Process
Endometriosis generally does not require a referral. With this being said, women may become infertile with this issue (Johns Hopkins, 2018). If the woman would like to have children and has infertility issues, she can be referred to a fertility specialist. Some women require hysterectomies if the disease is severe (Johns Hopkins, 2018). In some cases, the woman may need to be referred to a physician within the practice that performs this.
Follow-up After Referral
It is known that 17-19% of women with endometriosis have spontaneous resolution of lesions. Many more women have a progression of lesions. This makes up 24-64% of the cases. Others remain stable. This is 9-59% of the cases. Follow-ups will depend on the treatment plans that are decided on. There should be, at the very least, a three-month follow-up to report any new, worsening or resolving symptoms. At the follow-up, side effects of treatment should be discussed as well. This follow-up can be used to discuss further pregnancy options if need be (Youngkin, Davis, Schadewald & Juve, 2013).
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Mn576 Discussion Board Depression Substance Abuse
/in Uncategorized /by developerNo plagiarism please.
Will need minimum of 300 words, APA Style, double spaced, times new roman, font 12, and Include: (3 references within years 2015-2018) with intext citations.
Depression is a common psychiatric disorder in children, adolescents, adults, and the elderly. Primary care providers, not mental health professionals, treat the majority of patients with symptoms of depression. Persons who are depressed have feelings of sadness, loneliness, irritability, worthlessness, hopelessness, agitation, and guilt that may be accompanied by an array of physical symptoms as well as substance abuse. Identifying patients with depression and substance abuse can be difficult in busy primary care settings where time is limited, but certain depression/substance abuse screening tools may help diagnose the disorder.
Discussion:
Discuss a screening tool that can be used in the primary care setting that can help with the identification of patients with depression and or substance abuse. What is your responsibility as a primary care provider to this patient once a disorder has been identified?
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Mn576 Discussion Board Fibrocystic Breasts Peer Response
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Will need minimum of 150 words for each response, APA Style, double spaced, times new roman, font 12, and and Include: (1 reference for each response within years 2015-2018) with intext citations.
Peer resp. #1
Fibrocystic change is categorized as a benign breast problem. Symptoms of fibrocystic change include breast tenderness, swelling, pain, or irregular menstrual cycles (Arslan Solmaz, 2018). Patients can feel lumps in their breasts. Movable lumps filled up with fluid are called cysts. The patients can find their breasts swollen or tender to touch. It happens when breast tissues become firm and rubbery like scar tissues. Fibrocystic change occurs mostly in women of child-bearing age, but they can affect any women (American Cancer Society, 2017). The changes in hormone related to menstruation can cause the lumps to get bigger and tenderer. Therefore, the symptoms are more noticeable just before the menstrual period starts. The patients may also feel a clear or cloudy nipple discharge. Hormonal abnormalities such as an excess of estrogen over progesterone or increased thyroid hormone activity are reported to be the cause of the fibrocystic change (Arslan Solmaz, 2018). A diagnosis is based on symptoms, history, and physical examination. A mammogram, ultrasound, or a biopsy will be needed to rule out cancer.
Treatment for fibrocystic change is necessary if the cysts cause discomfort. Medications include danazol, tamoxifen, hormonal therapies, or vitamin E (Talaei, Moradi, & Rafiei, 2017). The authors also mention that Metformin can help reduce the symptoms of fibrocystic change. Besides that, patients who take Metformin have a reduced mortality rate of cancer due to the medication’s antitumoral properties (Talaei, Moradi, & Rafiei, 2017). Another option is to have the cysts drained to reduce the pressure and pain, but the fluid can build up again (American Cancer Society, 2017). If that happens, the patients can choose surgery to remove the cysts. They can take pain medications such as ibuprofen or acetaminophen for pain relief as well. They need to avoid caffeinated drinks such as coffee, tea, sodas, or chocolate since they can stimulate the symptoms (American Cancer Society, 2017). It is still controversial regarding if fibrocystic change is associated with increased risk of breast cancer, so they need to have a routine mammogram screening to detect cancer early (Arslan Solmaz, 2018).
Peer resp. #2
Fibrocystic breast is considered to be a non-proliferative lesion. It generally affects women between the ages of 25 and 50 and rarely affects women under age 20 (Arslan Solmaz, 2018). According to the Center for Disease Control (2018), fibrocystic breasts can have symptoms of feeling lumpy, tender to touch and sore and have cysts that are fluid filled sacs within the breast. Patient education would include that fibrocystic breast disease is usually benign and and may be due to hormonal imbalance. Follow up care would include sonography, mammography and possibly biopsy to ensure that the cysts are not cancerous (Talaei, Moradi and Rafiei, 2017). Treatments can include a fine needle aspiration to drain the cysts, or surgical incision. Over the counter Tylenol and Ibprofen can be used for pain control. Oral contraceptives can be taken for women to lower hormone levels associated with breast changes (Talaei, Moradi and Rafiei, 2017). Self management would include pain management, breast self exams, warm compresses and monitoring any cysts for and change in texture, size and if they are causing further pain.
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Mn576 Discussion Board Hep C And Baby Boomers Peer Response
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Will need minimum of 150 words for each response, APA Style, double spaced, times new roman, font 12, and and Include: (1 reference for each response within years 2015-2018) with intext citations.
Discussion:
Both the U.S. Preventive Services Task Force and the Centers for Disease Control and Prevention (CDC) recommend that all “baby boomers” – people born from 1945 through 1965 – get a hepatitis C test.
Peer Post. I need Peer Response for this post:
#1
Hepatitis C is a virus that affects the liver, in overtime this can lead to serious Health problems including the need for a liver transplant. Some people who contracts the hepatitis C virus are able to clear it from their system, but other people can have serious complications. These complications include chronic liver disease, cirrhosis, liver cancer and even a failure where a transplant would be needed to save your life. Recommendations from the centers for disease control and prevent parentheses CDC and parentheses, are for people born from 1945 to 1965 to become tested for the hepatitis C virus. It is believed that some baby boomers that have become infected during a period of time where in infection control and universal precautions were not set in place yet within the healthcare field (U.S. Preventive Services Task Force, 2016).
Symptoms of hepatitis C can include fever tiredness, upset stomach, nausea and vomiting, dark urine, Gray stool, joint pain, and yellow skin and eyes. Some people do not know they have been infected with hepatitis C, as it is also known as a silent virus. This is why it is extremely important for people especially born between 1945 and 1965 to be tested. Not only should baby boomers be tested, but also people who have received blood donations or organs before 1992, IV drug users, chronic liver disease and HIV or AIDS patients, exposure to hepatitis C or patient on hemodialysis (Centers for Disease Control and Prevention, 2016). Over the last few years there have been many advances for the medical treatment of hepatitis C. Some of these medications will treat the disease completely. And if some people aren’t aware that they have the virus, this is all the more reason to get tested.
One of the important guidelines changes regarding the treatment of hepatitis C is that treatment should be recommended to all patients, not just patients with advanced disease (American Association for the Study of Liver Diseases , 2017) (Centers for Disease Control and Prevention, 2016).
#2
Hepatitis is a viral illness. There are five different types: A-E. This discussion board will be focused on Hepatitis C (HCV). There are six different forms of Hepatitis C. Hepatitis C is primarily spread through IV blood and drug use. General Hepatitis symptoms include fatigue, decreased appetite, fever, nausea, RUQ pain, jaundice, liver enlargement, tenderness to the upper abdomen and itching. Hepatitis C can be confirmed through blood work. There will be antibodies to HCV noted with a second or third generation enzyme linked immunosorbent assay (ELISA) (Youngkin, Davis, Schadewald & Juve, 2013).
Hepatitis C Guidelines
Baby Boomers are five times more likely to contract Hepatitis C. It is important for this group to get tested as they are likely to not know that they are infected. It is common for people to live for decades with Hepatitis C and not have symptoms. Getting tested and then treated is crucial because this virus can cause liver damage, cirrhosis, and liver cancer. Hepatitis C is the leading cause of liver cancer and liver transplants. The CDC recommends that all Baby Boomers, those born between 1945-1965, be tested for Hepatitis C and then treated if indicated (CDC, 2018).
Hepatitis C Risks
Like other illnesses, there are risk factors for Hepatitis C. Some of these include previous sexually transmitted diseases, HIV, Hepatitis B, more than one sexual partners, blood transfusion history, and IV drug use (Youngkin, Davis, Schadewald & Juve, 2013). It is now known that the most common contraction of Hepatitis C is through blood transfusions that were done in the 1970’s-1980’s. 8-10% of those transfused contracted Hepatis C. Therefore, baby boomers are at an increased risk of Hepatitis C. It was not until the 1990’s that more effective screening was performed before blood transfusions. This lowered the contraction rate to 5%. After 1993, the contraction rate was further reduced to <1%. Tattoos, piercings, needle sticks and acupuncture continue to be a risk factor to Hepatitis C (C. Everett Koop Institute, 2018).
Hepatitis C Ramifications When Not Treated
Individuals that are infected with Hepatitis C can have negative effects if not tested and treated. If not treated, Hepatitis C can cause liver damage, cirrhosis of the liver and liver cancer. Ultimately death can occur. Those infected may not know that they are infected, and they have a risk of infecting others (CDC, 2018).
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Mn576 Discussion Board Peer Response Primary Care And Disease Affecting Women
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Will need minimum of 150 words for each response, APA Style, double spaced, times new roman, font 12, and and Include: (1 reference for each response within years 2015-2018) with intext citations.
Discuss a primary care-focused visit devoted to wellness and or disease affecting women and health-enhancing strategies that you would include in the visit.
Peer 1 Response
One primary care-focused visit devoted to wellness is the annual wellness visit (AWV). Components of this visit should include updating immunizations and suggesting needed immunizations, blood pressure checks to screen for hypertension, obesity counseling if needed, and any counseling for tobacco and alcohol use. Also important is doing a functional status review, screening for fall risk and cognitive abilities for seniors (Adler, 2017). If the patient were a senior with a chronic problem it would be good to do problem-focused physical exam and explore any patient concerns, if any. The Medicare Annual Wellness Visit is still an underutilized benefit for seniors, even though it can offer many benefits to increase a person’s preventive care. According to (Harvard Men’s Health Watch, 2017), this visit does not focus on a physical exam, but is instead a conversation with your health care provider about important health issues. This visit provides time for the patient to plan with their health care provider a healthy future. Other health-enhancing strategies focused on in this visit are a vision test, to detect if the patient needs glasses, a stronger prescription, or have signs of an eye disease. A balance test will be done to help gauge the risk for falls, as well as a hearing evaluation to see if the patient would benefit from a formal hearing test.
Another part of the AWV is developing a personalized plan to address ways the patient can stay active and maintain their current health. One primary care assessment that should be done at every visit is a depression screening. This doesn’t have to be a long questionnaire, the Patient Health Questionnaire (PHQ-2) is a good screening tool. It consists of just 2 questions from the PHQ-9. If the patient screens positive with the PHQ-2, the full PHQ-9 can be completed. According (Fuchs, Haradhvala, & Uebelacker, 2015), the PHQ-2 has demonstrated strong validity and high sensitivity for detecting major depression in primary care.
Peer 2 Response
Women’s health care is a detailed visit that is focused on many different aspects of care. For example, women need education on special topics at all ages of life. One of the major concerns for aging women is osteoporosis. Osteoporosis is a disease of the bones that occurs when there is bone loss, or the body makes too little bone, or both loss and decreased production (NOF, 2018). This conditon causes bones to become extremely fragile, which increases the risk of fracture. Fractures can occur following a fall or injury, or in severe cases even from a minor bump to the area (NOF, 2018). Osteoporotic bones have a honeycomb appears due to the loss in bone density. For women over 50, the risk of osteoporosis increases and the provider should order a bone density scan to monitor the structure of the bone. Bone density scans are the only diagnostic testing for osteoporosis prior to a broken bone (NOF, 2018). The diagnostic test for bone density is done through x-ray called a Dexa Scan. Dexa stands for dual energy x-ray absorptiometry. (NOF, 2018). Dexa scans should be conducted every 1-2 years depending on patient history and risk factors. The Dexa scan results are determined by a T-score. Normal T-score results are -1.0 and anything above -1.0 are mild to severe osteoporosis (NOF, 2018). One of the medications used to treat osteoporosis is Actonel. Actonel is an oral medication that is taken daily. The mediation is designed to slow bone loss and even help to prevent fractures. (Actonel, 2017). One of the side effects that needs to be discussed with patients is that is can cause GI upset, so it the patient has a history of GI issues, another medication is most likely the better option.
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Mn576 Discussion Board Pelvic Pain Peer Response
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Will need minimum of 150 words for each response, APA Style, double spaced, times new roman, font 12, and and Include: (1 reference for each response within years 2015-2018) with intext citations.
Peer Resp.#1
Pelvic pain can be caused by many reasons such as ovarian cysts, urinary tract infections, appendicitis, sexually transmitted infections, pelvic inflammatory disease (PID)…In this discussion, I will address PID as the cause of pelvic pain. PID is an infection or inflammation of the upper genital tract in women (Shen et al., 2016). For PID, it is considered acute if the symptoms last 30 days or less (Ferri, 2018). The condition is chronic if the symptoms last more than 30 days. PID is a sequela of sexually transmitted infections, so it is commonly diagnosed in young and sexually active women. Patients usually complain of lower abdominal pain, abnormal vaginal discharge/ bleeding, postcoital bleeding, dysuria, dyspareunia, or fever (Ferri, 2018). If a patient also complains of nausea and vomiting, we need to rule out peritonitis. Since the disease can cause infertility, ectopy pregnancy and can permanently damage other organs such as the uterus, ovaries, fallopian tubes, the patient needs to be referred to a gynecologist immediately to have a proper treatment (Shen et al., 2016). Some women may not have any symptoms, so we need to do a thorough history and physical examination, as well as offer STI screenings to avoid underdiagnosis. We can order basic labs and imaging studies such as urinalysis and urine culture, CBC, CMP, CRP, ESR, and ultrasound pelvic/transvaginal so that the patient can have them done before seeing the gynecologist. An endometrial biopsy or laparoscopy can be done by the gynecologist to confirm the diagnosis of PID (Ferri, 2018).
To write a referral to a specialist, we first need to include our information (name, address, phone, fax, email) and the specialist’s information. Second, the reason for consult/referral, the patient’s biographical data, chief complaint, history of present illness, past medical history, allergies, current medications, family history, social history, vital signs, review of system, and physical examination need to be addressed. Also, we need to include labs and imaging studies, treatment plan, diagnosis, and recommendations. After the patient has been seen and treated by the gynecologist, we are responsible for advising the patient to come back to see us for follow-ups. Since PID can be recurrent, the patient needs to be tested for gonorrhea and chlamydia three to six months after the treatment (Ferri, 2018). Her sexual partner needs to be treated as well to prevent her from being re-infected. Untreated gonorrhea and chlamydia can cause PID; therefore, it is essential for NPs to screen female patients aged less than 25 and those at increased risk for these infections to reduce the incidence of PID (Kreisel, Torrone, Bernstein, Hong, & Gorwitz, 2017). We also need to offer HIV and other STI screenings to all women with PID.
Peer Resp.#2
Endometriosis
Endometriosis is a painful disorder that results from the endometrium growing outside of the uterus. This generally involves the pelvic region, ovaries, fallopian tubes and the pelvic lining. It can affect areas outside of the pelvic region as well. Though the endometrium is displaced, it continues to act as normal by thickening, breaking down and then bleeding during menstruation. Unfortunately, there is no place for this to go and it becomes trapped. Eventually, this causes scarring and adhesion’s which cause pelvic organs to adhere together. All this together causes the pain and can lead to infertility (Mayo Clinic, 2018). I chose this subject because I had endometriosis. It is a horrible disorder and very painful. There were times that it felt like someone was stabbing my insides with a knife. I would ball up into the fetal position and cry until the pain went away. I eventually had to have a hysterectomy at the age of 29. This was horrible because we tried to have another baby, but it left me unable to have anymore. I was so bad that I had bleeding outside of my menstrual cycle and it was in my rectum. Before my surgery, I bleed for more than 2 weeks straight despite medications. He said if I did not have the surgery, I would eventually hemorrhage.
Endometriosis S/S
(Youngkin, Davis, Schadewald & Juve, 2013)
Referral Process
Endometriosis generally does not require a referral. With this being said, women may become infertile with this issue (Johns Hopkins, 2018). If the woman would like to have children and has infertility issues, she can be referred to a fertility specialist. Some women require hysterectomies if the disease is severe (Johns Hopkins, 2018). In some cases, the woman may need to be referred to a physician within the practice that performs this.
Follow-up After Referral
It is known that 17-19% of women with endometriosis have spontaneous resolution of lesions. Many more women have a progression of lesions. This makes up 24-64% of the cases. Others remain stable. This is 9-59% of the cases. Follow-ups will depend on the treatment plans that are decided on. There should be, at the very least, a three-month follow-up to report any new, worsening or resolving symptoms. At the follow-up, side effects of treatment should be discussed as well. This follow-up can be used to discuss further pregnancy options if need be (Youngkin, Davis, Schadewald & Juve, 2013).
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Mn576 Discussion Board Womens Healthvulnerable Population
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Will need minimum of 300 words, APA Style, double spaced, times new roman, font 12, and and Include: (3 references within years 2015-2018) with intext citations.
Discussion Board Question:
Explore federal agencies that are concerned with Women’s Health.
Which ones may be of benefit to vulnerable women populations
Use example: (Office on Violence Against Women ) https://www.dol.gov/wb/otherfedagencies.htm
(Domestic violence/Sexual assault victims).
Explore nonprofit agencies that are concerned with Women’s Health.
Share resources aimed to benefit women in your state or area ( My State: Florida).
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Mn576 Power Point Womens Health Screening Obesity
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Will need 10 presentation Slides, plus title, and reference Slide, APA Style, and (3 references within 5 years 2014-2018) with intext citations).
The purpose of this Assignment is for you to design a method of communicating age appropriate screening guidelines to the appropriate population. This can be a 10 slide PowerPoint presentation.
Directions:
1. Select a screening test and the age appropriate population at risk.
(I chose Obesity)
2. Introduce the screening and why you selected it.
(BMI Screening for obesity – Obesity can promote, diabetes, hypertension, heart disease just a few)
3. Outline the relevant group statistics related to the population as well as the impact of obesity on women’s health.
4. Discuss the issues impacting screening.
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Mn576 Written Assignment Health Promotion Chronic And Acute
/in Uncategorized /by developerNo plagiarism will be checked with turnitin.
APA style, font 12, double spaced with headers.
Will need Title page, Reference page, content 6 pages in length. Total of 8 pages.
Purpose
The purpose of this Assignment is for you to gain an understanding of health promotion, screening, diagnosis, and management of common women’s health acute and chronic illnesses and to compare and contrast common versus nontraditional treatment modalities.
Directions: Answer all questions
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Mn576 Written Assignment Vulnerable Female Populations Impacting Culturally Competent Delivery Of Womens Health Care
/in Uncategorized /by developerNo Plegarism please, assignment will be checked with Turnitin.
Will need minimum of 5 full pages, plus title, and reference page APA Style, double spaced, times new roman, font 12, and and (3 references within 5 years 2014-2018) with intext citations).
The purpose of this Assignment is for you to gain an understanding of the psychosocial needs of vulnerable female populations and issues impacting culturally competent delivery of women’s health care. This is a 5–6 page paper, excluding title page and references, written in 6th edition APA format. Please review the grading rubric in course resources.
Directions
1. Select a vulnerable female population ( I chose homeless women).
2. Introduce the group and why you selected it.
3. Outline the relevant group statistics related to the population as well as the impact of the group on women’s health.
4. Analyze the psychosocial needs of the selected group.
5. Discuss the issues impacting culturally competent care delivery for the group.
6. Describe the associated culturally and ethically competent care methods the Nurse Practitioner will employ in caring for the population.
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Mn577 Advanced Nursing Practice Discussion Board Adolescent Health Care
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Will need minimum of 300 words, APA Style, double spaced, times new roman, font 12, and Include: (3 references within years 2015-2018) with intext citations.
An adolescent’s concerns about privacy can prevent them from seeking primary health care, especially for specific sensitive health care services such as STI screening and family planning issues. Those with privacy concerns are also less likely to talk openly with a health care clinician about important health issues, such as substance use, mental health, and risky sex. Recognizing that confidentiality is critical to high-quality care for adolescent women, professional health care organizations have adopted policy statements and practice guidelines that support the provision of confidential services.
Discuss:
Discuss these guidelines and the laws in your state (my state – Florida) that address adolescent confidential health care.
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