Develop cooperative relationships with clients when teaching concepts concerning pathological states to individuals and families

Select one of the case studies below, and include discussion of your strategy for winning the patients cooperation while teaching concepts concerning pathological states to them and their families.

Requirements

THE PAPER MUST HAVE AT LEAST 4 FULL PAGES OF ANALYTIC CONTENT

Make sure all of the topics in the case study have been addressed.

Cite at least three sources; journal articles, textbooks or evidenced-based websites to support the content.

All sources must be within five years.

Do not use .com, Wikipedia, or up-to-date, etc., for your sources.

Case Study 1

Concepts of Altered Health in Older Adults

Joseph P. is an 82-year-old male living at home. He is in overall good health and enjoys taking long walks as often as possible. During his walks, he likes to stop for a cold glass of fruit juice at the local cafeteria. On cold or rainy days, he rides a stationary bicycle at home for 30 minutes to “stay in good shape.”

What physiological factors would typically increase Joseph’s risk of falling while walking outdoors?

What are the common changes in blood pressure regulation that occurs with aging?

Joseph enjoys fruit juice when he walks. Considering the renal system in the older adult, why would dehydration be a particular concern?

Case Study 2

Structure and Function of the Kidney

Rivka is an active 21-year-old who decided to take a day off from her university classes. The weather was hot and the sun bright, so she decided to go down to the beach. When she arrived, she found a few people playing beach volleyball, and they asked if she wanted to join in. She put down her school bag and began to play. The others were well prepared for their day out and stopped throughout the game to have their power drinks and soda pop. Several hours after they began to play, however, Rivka was not feeling so good. She stopped sweating and was feeling dizzy. One player noted she had not taken a washroom break at all during the day. They found a shaded area for her, and one of the players shared his power drink with her. Rivka was thirstier than she realized and quickly finished the drink.

In pronounced dehydration, hypotension can occur. How would this affect the glomerular filtration rate of the kidney? What actions by the juxtaglomerular apparatus would occur to restore GFR?

What is the effect aldosterone has on the distal convoluted tubule? Why would the actions of aldosterone be useful to Rivka in her situation?

What does a specific gravity test measure? If someone tested the specific gravity of Rivka’s urine, what might it indicate?

Case Study 3

Disorders of Fluid and Electrolyte Balance

Amanda is an 18-year-old with anorexia nervosa. She was recently admitted to an eating disorders clinic with a BMI of 13.9, and although she was a voluntary patient, she was reluctant about the treatment. She was convinced she was overweight because her clothes felt tight on her. She complained that even her hands and feet “were fat.” One of her nurses explained that a protein in her blood was low. The nurse further explained that, as difficult as it may be to believe, eating a normal healthy diet would make the “fat hands and feet” go away.

What protein do you suspect the nurse was referring to? How would a deficiency in this protein contribute to edema?

What is the difference between the physiology of pitting and nonpitting edema?

Because of her weakened condition, Amanda was moved around the ward in a wheelchair when she was not on bed rest. How does this affect her edematous tissues?

Case Study 4

Disorders of Acid–Base Balance

Shauna is a healthy, fit 28-year-old who decided to go on a 2-week tour of Mexico for young singles. One hot afternoon in a small market community, she grabbed some fruit juice from a street vendor. Several hours later, she developed abdominal cramping and diarrhea. The diarrhea became so severe that she missed 3 days of the tour and stayed in her hotel room. By the end of her illness, she felt weak and tired. Her head ached, but the mild fever had disappeared, and she was able to join her new friends for the rest of the tour.

What is the acid–base imbalance Shauna might have experienced and its etiology?

What are the functions and importance of the bicarbonate buffer system in the body?

Case Study 5

Disorders of Renal Function

Fred, a fit and healthy 44-year-old, was working outside one warm summer afternoon. When he returned home by the end of the day, his lower back felt sore and he felt nauseated. His wife made him dinner, but he was not hungry and chose to go to bed instead. Fred’s symptoms progressed, and soon he was rolling on the bed with excruciating pain. He said his back hurt as well as his stomach and groin area. The pain would ease off only to return a short while later, and when it did, Fred would begin to sweat and run to the bathroom to vomit. His wife became concerned and started the car. When his symptoms abated, she helped him into the car and rushed him to the hospital.

At the hospital, an abdominal radiograph showed the presence of renal calculi in Fred’s right ureter (urolithiasis). What is the mechanism of stone formation in the kidney? What is the role of citrate in the kidneys?

Why would the administration of calcium supplements be useful for a patient with calcium oxalate stones?

Hydronephrosis can be a complication of renal calculi. What is hydronephrosis? How does back pressure occur in a kidney, and what physiological mechanism is responsible for nephron damage when back pressure is present?

Case Study 6

Acute Renal Injury and Chronic Kidney Disease

Will is a 68-year-old male with a history of hypertension. Eight months ago, he started regular dialysis therapy for ESRD. Before that, his physician was closely monitoring his condition because he had polyuria and nocturia. Soon it became difficult to manage his hypertension. He also lost his appetite, became weak, easily fatigued, and had edema around his ankles. Will debated with his physician about starting dialysis, but she insisted, before the signs and symptoms of uremia increased, the treatment was absolutely necessary.

What is the difference between azotemia and uremia?

Two years ago, Will’s physician told him to decrease his protein intake. In spite of what the physician ordered, Will could not stop having chicken, beef, pork, or eggs at least once a day. Why did his physician warn him about his diet?

Will’s feelings of weakness and fatigue are symptoms of anemia. Why is he anemic?

Knowing what you do about Will’s history, why is left ventricular dysfunction a concern for his physician?

Case Study 7

Disorders of the Bladder and Lower Urinary Tract

Alvita is a frail 89-year-old woman residing in a nursing home. She is able to move slowly around the residence with the use of a walker, but appreciates when her daughter is there to hold her arm and walk alongside her. When one of the health care staff changes Alvita, her daughter helps. Alvita’s incontinence has progressed, particularly over the last six years since she has resided in the nursing home. Alvita can smile at her lack of bladder control, however, and says that her incontinence really began when she was a young woman, just after the birth of her second daughter.

Alvita’s mobility is limited. How does this affect continence in the elderly?

Shortly after the birth of her second daughter, Alvita experienced mild incontinence, particularly after laughing or coughing. What was she experiencing? What is the pathophysiology behind this type of incontinence?

Assignment Requirements:

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Understanding of the basic theories and techniques of abnormal psychology.

Understanding of the basic theories and techniques of abnormal psychology.

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Case Analysis

Purpose

In this activity, you will demonstrate your understanding of the basic theories and techniques of abnormal psychology.

Guidelines

Gary is a 39-year-old male who comes into your office complaining of a variety of life stressors. To begin with, he lists the following:

weight gain of approximately twenty pounds

insomnia and interrupted sleep

decreased self-esteem

general fatigue

moodiness and irritability

anxiety

loss of appetite followed by increased eating

decreased libido

feelings of guilt stemming from loss of income due to economic troubles (business owner)

Gary has been married to his wife for twelve years. The marriage has had its ups and downs, but it is intact and relatively happy. Gary’s wife is a successful business owner with many irons in the fire and a healthy income (six figures). As is the case for Gary, his wife has to put the majority of her income back into her business ventures. The economy has taken a toll on the couple’s savings and investments, as well as on the way of life to which the two have been accustomed (doing and buying all they wanted—for an upper-middle income household).

Gary holds a master’s degree from Johns Hopkins University. He obtained his MBA and has ventured out in his own business. He has one full-time employee and a receptionist/data entry person who works hourly. He recently moved from a home office, which he shared with his wife, to a new office that has space for his employees. The office is large enough to be used as a meeting space for his clients. His list of clients has grown, yet the clients tend to pay later than Gary desires (60 days or more), and he often has to have his virtual accounting office prompt them for payment.

Gary has to have a good cash flow in order to pay his employees, pay off his bills, and meet his family obligations. Due to a pre-existing health condition (his wife has a chronic illness), his health care premium is enormous (over $1K per month for his family plan alone). This does not include the premium Gary must pay for his full-time employee. Gary’s wife paid the family health care premium on her own plan for over two years. It cost her $1,600 per month to carry the entire family (which she did with no complaints).

Gary took over the premium, as he felt that his wife had carried that nearly $2K per year burden alone while he built his company. She had also covered all the expenses he was not able to pay during that time. Gary has stated that he could not have embarked on his private venture without his wife’s support (financial and otherwise). He feels that this has put a strain on his marriage in these stressful economic times.

Gary and his wife have two children, ages 6 and 9. Both are healthy, smart, obedient, fun, and well-behaved, per his report. Gary has no concerns regarding the children at the time of his visit. His wife works very hard to support the family and take care of the children. While Gary works most days from 8 a.m. to any and all hours of the evening, his wife does “double duty,” making nearly 200K and acting as a stay-at-home mother.

Gary feels that his wife’s deteriorating health stems from her attempts to do it all and be there for the children and him. While his wife does not complain, he feels and understands that she must resent him for her 24/7 work schedule that has been set to accommodate his business. As the economy has declined, Gary has felt his overall physical, emotional, professional, and personal state in decline.

Gary comes to your office asking you to help him regain control of his situation and make a plan to turn this cycle of decline around. Your assignment is to analyze Gary’s case and give this client a preliminary diagnosis using the International Classification of Diseases, Tenth Revision (ICD-10 link)provide a diagnosis.

Then, you will discuss your rationale for each decision using the knowledge you have gained in your studies. You will include homework assignments for this client in order to anchor his commitment to treatment and help him attain results.

Your paper will be around 6 full pages.

Your directions for this case:

What is your diagnosis of Gary? This is your first session/intake, so your information is limited to the above. (20 points: rationale; proper use of diagnostic coding; one-page discussion)

What are the key symptoms that led you to your diagnosis or treatment concern? Explain and be specific. (15 points: rationale; one-page discussion)

What are your treatment goals for Gary? (20 points: rationale; one-page discussion)

What are Gary’s strengths as you see them (look for these to assist you in being a good helper for him)? (15 points: rationale; one-page discussion)

What are areas for improvement for Gary? (15 points: rationale; one-page discussion)

What two homework assignments will you give Gary to work on for his next appointment with you? (7.5 points: rationale; one-page discussion)

What are some areas you will explore next (e.g., Gary’s relationship with his wife; professional goals)? (7.5 points: rationale; one-page discussion of your reasons for wanting to find out this information)

Answer preview to understanding of the basic theories and techniques of abnormal psychology

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Discussion: Describe two different intervention the practitioner can do the make possible a successful care of this patient.

Discussion: Describe two different intervention the practitioner can do the make possible a successful care of this patient.

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1-Case Study: A 67 y/o Caucasian male arrives to the clinic complaining of nausea, headache, and diarrhea after a dinned he has at a restaurant the night before. The practitioner starts the assessment, but the patient is showing a hostile behavior and is not providing the necessary information for the practitioner to proceed with the assessment and conduct a useful physical exam. Please describe two different intervention the practitioner can do the make possible a successful care of this patient.

2-Case study: A 35 y/o Hispanic female arrives to the clinic complaining of hyperpolymenorrhea with lower abdominal pain, fatigue, and weakness. The nurse walks the patient to the practitioner, and she looked surprised when she saw a male practitioner. When asked if she was ok, the patient states she doesn’t feel comfortable been gynecologically examined by a man. Please describe two ways this issue can be resolved without affecting the care of the patient.

3-Case study: A Family Nurse Practitioner is called to evaluate a patient in the Behavioral Crisis Stabilization Unit who is complaining of headache. After assesses the patient the practitioner determines it is a HTN problem and prescribes the appropriate Tx. The nurse also asks if the practitioner can prescribe Haldol and Ativan for the same patient and complete the psych evaluation. What the FNP must do?

Answer preview to describe two different intervention the practitioner can do the make possible a successful care of this patient

 

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.

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Consider why treatments for stimulant-use disorders have been ineffective and how treatment might be improved in the future.

Consider why treatments for stimulant-use disorders have been ineffective and how treatment might be improved in the future.

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There is the lure of the positive effects of stimulants: elevation of mood, increased alertness, reduced fatigue, increased energy, and relief from boredom. But the feeling of reward that comes from increased dopaminergic neurotransmission that activates the reward system of the nucleus accumbens can quickly lead to obsessive use and dependency. With increased dosages, what were once pleasant effects turn into anxiety, insomnia, irritability, and the need for higher and higher dosages to achieve the desired effect. Successful treatment of stimulant-use disorders must include pharmacology, nonpharmacological treatment, training and reinforcement of behavior change, and supportive social systems.

For this Discussion, consider why treatments for stimulant-use disorders have been ineffective and how treatment might be improved in the future. As you prepare for the Discussion, also take into account the role of the placebo effect as it relates to the treatment of stimulant-use disorders (refer to the Looby and Earleywine article in the Learning Resources).

Write an explanation for why researchers have not found any efficacious treatments for stimulant-use disorders. Include in your explanation an analysis of why previously tested treatments have failed. Be sure to include sociocultural and economic issues and references to the placebo effect in your Discussion. Finally, generate strategies for improving treatment of stimulant-use disorders.

READINGS

Brown, E. S., Tirado, C., Minhajuddin, A., Hillhouse, M., Adinoff, B., Ling, W., . . . Thomas, C. (2010). Association of race and ethnicity with withdrawal symptoms, attrition, opioid use, and side-effects during buprenorphine therapy. Journal of Ethnicity in Substance Abuse, 9(2), 106–114.
Retrieved from the Walden Library databases.

Döpfner, M., Ose, C., Fischer, R., Ammer, R., & Scherag, A. (2011). Comparison of the efficacy of two different modified release methylphenidate preparations for children and adolescents with attention-deficit/hyperactivity disorder in a natural setting: Comparison of the efficacy of Medikinet® retard and Concerta®—a randomized, controlled, double-blind multicenter clinical crossover trial. Journal of Child and Adolescent Psychopharmacology, 21(5), 445–454.
Retrieved from the Walden Library databases.

Filip, M., Alenina, N., Bader, M., & Przegaliński, E. (2010). Behavioral evidence for the significance of serotoninergic (5-HT) receptors in cocaine addiction. Addiction Biology, 15(3), 227–249.
Retrieved from the Walden Library databases.

Advokat, C. D., & Comaty, J. E., & Julien, R. M. (2019). Julien’s primer of drug action: A comprehensive guide to the actions, uses, and side effects of psychoactive drugs (14th ed.). New York, NY: Worth Publishers/Macmillan.

Chapter 6, “Caffeine and Nicotine” (pp. 177-206)

Chapter 7, “Cocaine, the Amphetamines, and Other Psychostimulants” (pp. 217-248)

 

 

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