Case Study: Establishing care

Case Study: Establishing care

Case Study: Establishing care

Respond to at least two of your colleagues who were assigned a different patient than you. Critique your colleague’s targeted questions, and explain how the patient might interpret these questions. Explain whether any of the questions would apply to your patient, and why.

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CASE STUDY 2

AG is a 54-year-old Caucasian male who was referred to the clinic to establish care after a recent hospitalization after having a seizure related to alcohol withdrawal. He has hypertension and a history of alcohol and cocaine abuse. He is homeless and is currently living at a local homeless shelter. He reports that he is out of his amlodipine 10 mg which he takes for hypertension. He reports he is abstaining from alcohol and cocaine but needs to smoke cigarettes to calm down since he is not drinking anymore.

The Communication Techniques

A nurse practitioner chooses to use the RESPECT Modell to communicate with the patient to stay productive and patient-centered in all her communication with the patient. RESPECTS stand for (Rapport, Empathy, Support, Partnership, Explanation, Cultural Competence, and Trust) (Ball, Dains, Flynn, Solomon, & Stewart, 2019). The nurse practitioner establishes rapport by seeking the patient’s point of view to avoid being judgmental. She asked the question of how the patient wanted to be addressed. The nurse practitioner shows empathy by asking the patient how he becomes homeless to understand how she can help him get his life back in order. The nurse practitioner supports the patient by asking him about his financial situation to direct him to the proper agency. The patient is at risk for cardiac diseases, lung cancer, and stroke, so the nurse practitioner partnered with the patient to help him stop smoking (Ball et al., 2019).The nurse practitioner needs to explain to the patient to know what cigarette smoking does to the body. Nicotine is a sympathomimetic medicine that releases catecholamines, increases heart rate and cardiac contractility, constricts cutaneous, and coronary blood vessels, and rapidly increases blood pressure (Benowitz, 2009). It is crucial to present the patient with evidence-based practice to address health risks across cultures, and it is essential to assure the patient that what he said will be kept confidential to establish trust (Ball et al., 2019).

The Risk Assessment Instrument

The CAGE questionnaire is a precise tool that has been used for many years to screen patients for addictive behaviors. The GAGE questions have been modified to apply to smoke behavior. The CAGE questions are as following: 1) Have you ever felt the necessity to cut down or control your smoking, but had trouble doing so? 2) Do you ever get angry or annoyed with people who criticize your smoking or demanding you quit smoking? 3) Do you feel guilty regarding your smoking or about something you did while smoking? And 4) Do you ever smoke within half an hour of waking up (Eye-opened)? The patient is screen positive to two yes responses. The CAGE instrument is used because it is nonthreatening. A study showed that the CAGE questionnaire was used in a medical outpatient embedded in a self-administered questionnaire regarding health habits. Most of the patients did not know that they were filling out an assessment for addictions. The patient must be willing to stop smoking for treatment to be effective (American Family Physician, 2000).

Targeted Questions

1) How do you want to be addressed?

2) How are you feeling?

3) How may we help you?

4) How do you become homeless and tell us about your financial situation?

5) Do you need help getting your prescription refill?

6) When was the last time you drink alcohol or use cocaine?

7) When was the last time you check your blood pressure and take your amlodipine medication?

8) When was the last time you had a seizure episode?

9) When do you start smoking and how many packs do you smoke a day?

10) How can we help you to stop smoking?

References

Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2019). Seidel’s guide to physical examination: An interprofessional approach (9th ed.). St. Louis, MO: Elsevier Mosby.Benowitz, N. L. (2009). Pharmacology of nicotine: addiction, smoking-induced disease, and therapeutics. Annual review of pharmacology and toxicology, 49, 57–71. doi:10.1146/annurev.pharmtox.48.113006.094742American Family Physician. (2000). Assessing Nicotine Dependence. Retrieved from https://www.aafp.org/afp/2000/0801/p579.html

Case Study: Establishing care

Case Study: Establishing care

You must proofread your paper. But do not strictly rely on your computer’s spell-checker and grammar-checker; failure to do so indicates a lack of effort on your part and you can expect your grade to suffer accordingly. Papers with numerous misspelled words and grammatical mistakes will be penalized. Read over your paper – in silence and then aloud – before handing it in and make corrections as necessary. Often it is advantageous to have a friend proofread your paper for obvious errors. Handwritten corrections are preferable to uncorrected mistakes.

Use a standard 10 to 12 point (10 to 12 characters per inch) typeface. Smaller or compressed type and papers with small margins or single-spacing are hard to read. It is better to let your essay run over the recommended number of pages than to try to compress it into fewer pages.

Likewise, large type, large margins, large indentations, triple-spacing, increased leading (space between lines), increased kerning (space between letters), and any other such attempts at “padding” to increase the length of a paper are unacceptable, wasteful of trees, and will not fool your professor.

The paper must be neatly formatted, double-spaced with a one-inch margin on the top, bottom, and sides of each page. When submitting hard copy, be sure to use white paper and print out using dark ink. If it is hard to read your essay, it will also be hard to follow your argument.

ADDITIONAL INSTRUCTIONS FOR THE CLASS

Discussion Questions (DQ)

Initial responses to the DQ should address all components of the questions asked, include a minimum of one scholarly source, and be at least 250 words.
Successful responses are substantive (i.e., add something new to the discussion, engage others in the discussion, well-developed idea) and include at least one scholarly source.
One or two sentence responses, simple statements of agreement or “good post,” and responses that are off-topic will not count as substantive. Substantive responses should be at least 150 words.
I encourage you to incorporate the readings from the week (as applicable) into your responses.
Weekly Participation

Your initial responses to the mandatory DQ do not count toward participation and are graded separately.
In addition to the DQ responses, you must post at least one reply to peers (or me) on three separate days, for a total of three replies.
Participation posts do not require a scholarly source/citation (unless you cite someone else’s work).
Part of your weekly participation includes viewing the weekly announcement and attesting to watching it in the comments. These announcements are made to ensure you understand everything that is due during the week.
APA Format and Writing Quality

Familiarize yourself with APA format and practice using it correctly. It is used for most writing assignments for your degree. Visit the Writing Center in the Student Success Center, under the Resources tab in LoudCloud for APA paper templates, citation examples, tips, etc. Points will be deducted for poor use of APA format or absence of APA format (if required).
Cite all sources of information! When in doubt, cite the source. Paraphrasing also requires a citation.
I highly recommend using the APA Publication Manual, 6th edition.
Use of Direct Quotes

I discourage overutilization of direct quotes in DQs and assignments at the Masters’ level and deduct points accordingly.
As Masters’ level students, it is important that you be able to critically analyze and interpret information from journal articles and other resources. Simply restating someone else’s words does not demonstrate an understanding of the content or critical analysis of the content.
It is best to paraphrase content and cite your source.
LopesWrite Policy

For assignments that need to be submitted to LopesWrite, please be sure you have received your report and Similarity Index (SI) percentage BEFORE you do a “final submit” to me.
Once you have received your report, please review it. This report will show you grammatical, punctuation, and spelling errors that can easily be fixed. Take the extra few minutes to review instead of getting counted off for these mistakes.
Review your similarities. Did you forget to cite something? Did you not paraphrase well enough? Is your paper made up of someone else’s thoughts more than your own?
Visit the Writing Center in the Student Success Center, under the Resources tab in LoudCloud for tips on improving your paper and SI score.
Late Policy

The university’s policy on late assignments is 10% penalty PER DAY LATE. This also applies to late DQ replies.
Please communicate with me if you anticipate having to submit an assignment late. I am happy to be flexible, with advance notice. We may be able to work out an extension based on extenuating circumstances.
If you do not communicate with me before submitting an assignment late, the GCU late policy will be in effect.
I do not accept assignments that are two or more weeks late unless we have worked out an extension.
As per policy, no assignments are accepted after the last day of class. Any assignment submitted after midnight on the last day of class will not be accepted for grading.
Communication

Communication is so very important. There are multiple ways to communicate with me:
Questions to Instructor Forum: This is a great place to ask course content or assignment questions. If you have a question, there is a good chance one of your peers does as well. This is a public forum for the class.
Individual Forum: This is a private forum to ask me questions or send me messages. This will be checked at least once every 24 hours.