Case Study Of Assessing Health Risks Discussion Paper
Please give a response to those 2-discussion post with their reference separately .
Note : I add the initial post so you can have a idea for what they post those response.
CASE STUDY BK is a 16-year-old Caucasian female who comes in with her grandmother for an annual exam. The grandmother reports BK has been â€œacting strange, staying in her room all the time and refusing to do all the things she used to enjoy like singing in the youth choirâ€. Grandmother shares that BKâ€™s mother is a drug addict is currently incarcerated so she is worried BK is using drugs and wants her tested for drugs. BK is not on any medications. She is obese and does not make eye contact when you enter the room. Case Study Of Assessing Health Risks Discussion Paper
Post an explanation of the specific socioeconomic, spiritual, lifestyle, and other cultural factors associated with the patient you were assigned. Explain the issues that you would need to be sensitive to when interacting with the patient, and why. Provide at least five targeted questions you would ask the patient to build his or her health history and to assess his or her health risks.
My patient is a 16-year-old Caucasian female, who present for an annual exam with grandmother. Grandmother reports patient is not acting like herself. Grandmother states patientâ€™s mother is incarcerated and a drug addict. Grandmother is concerned patient is using drugs due to her recent behavior changes. Grandmother is requesting drug testing for the patient.
This patient is a hormonal teenage girl, who is obviously being taken care of by her grandmother since her mother is incarcerated and a drug addict. It is not stated whether the patient is attending school or whether they are in a lower socioeconomic class. The patient is obese and does not make eye contact, which could be a sign of poor self-esteem or drug use. The patient may come from a cultural background where the provider needs to speak to the grandmother instead of the patient, which the provider would need to be mindful and integrate within this visit. The provider would need to be culturally aware and ask permission from the caregiver to address the teenage patient (Coleman, 2019).
This patient may be sensitive about her weight, which could be the reason for poor eye contact or possible drug use. Another topic that would need to be addressed in a sensitive manner is the motherâ€™s addiction and incarceration. The provider would need to do a deeper assessment on whether the change in behavior is due to depression, bullying, drug use, or another reason. The patientâ€™s lack of eye contact could be a sign of her reluctance on discussing the topics with the provider, therefore it needs to be addressed delicately to build trust with the teenage patient. It is important for the provider to integrate their previous cultural competency or lifestyle knowledge so they can adapt it into their everyday practice (Centers, 2020). It is important for the provider to understand their patientâ€™s values, beliefs, and the learned behaviors that could be passed down amongst generations, which could be happening with this particular patient (Young, 2016)Case Study Of Assessing Health Risks Discussion Paper.
Has anyone every expressed their concerns about the changes in your behavior?
Do you ever feel guilty or ashamed about the circumstances with your mother?
Do you feel pressure or bullied to try drugs or alcohol by your peers?
Do you feel that you have lost pleasure in previous activities that you once enjoyed or feel sad often?
Tell me about the stress you feel at home and school?
Young, S., & Guo, K. L. (2016). Cultural diversity trainingLinks to an external site.Links to an external site.. The Health Care Manager, 35(2), 94â€“102. https://doi.org/10.1097/hcm.0000000000000100
Centers for Disease Control and Prevention. (2020, October 21). Cultural competence in health and human servicesLinks to an external site.Links to an external site.. Retrieved from https://npin.cdc.gov/pages/cultural-competenceLinks to an external site.
Coleman, D. E. (2019). Evidence based nursing practice: The challenges of health care and cultural diversityLinks to an external site.Links to an external site.. Journal of Hospital Librarianship, 19(4), 330â€“338. https://doi.org/10.1080/15323269.2019.1661734
Post a response to each of the following:
1. Explain the agonist-to-antagonist spectrum of action of psychopharmacologic agents, including how partial and inverse agonist functionality may impact the efficacy of psychopharmacologic treatments.
2. Compare and contrast the actions of g couple proteins and ion gated channels.
3. Explain how the role of epigenetics may contribute to pharmacologic action.
4. Explain how this information may impact the way you prescribe medications to patients. Include a specific example of a situation or case with a patient in which the psychiatric mental health nurse practitioner must be aware of the medicationâ€™s action. Case Study Of Assessing Health Risks Discussion Paper
An agonist is a chemical that binds to a receptor to cause a reaction. Antagonist does the opposite by blocking a response. The agonist to antagonist spectrum of action of psychopharmacologic agents are drug actions that can activate or block receptors in the brain. Partial agonist doesnâ€™t activate the receptor to its full extent. These agonists can also act as antagonists by blocking full agonists.
Inverse agonist are drugs that bind to the same receptors as agonist but produces an opposite effect than the agonist. They reduce activity. Partial agonists have a lower efficacy than full agonist which intern leads to a reduced response. The drug only has a percent of its power. You will not see the full effect of the drug.
G protein coupled receptors (GPCRs) mediate our sense of vision, smell, taste, and pain. Ion gated channels are responsible for quick changes in membrane potential that occurs during neuronal signaling. GPCRs mediate slower, while Ion gated channels move rapidly. GPCRs can be activated by a variety of structurally related ligands, which are ions or molecules. Ion gated channels are specific and only respond to a specific ion. They both are involved in transferring signals across the cell membrane.
Epigenetics is the study of changes in cell function, which do not alter the DNA sequence. The changes affect the regulation of the gene expression that persists through cellular division. Epigenetics can determine the efficacy and toxicity of some drugs. This can alter gene expression and affect the drugs therapeutic effect. Epigenetic modifications may also increase or decrease a patientâ€™s sensitivity to a drug in different patients. It basically alters the way a drug works in the body.
When prescribing medications, it is important to know the different effects a drug may or may not have on an individual. Everyone is different and may be affected in a different way by the drug. With this information I would make sure I understand the medication, and its expected effects on the patientâ€™s symptoms. I would make sure I understood the interactions, and potential adverse reactions. The PMHNP must be aware if their client has another condition other than the psychiatric one. If for instance my client has depression, and diabetes, I would make sure that the antidepressants I prescribe donâ€™t interact with the anti-diabetic medications. If my client has depression and cardiac condition, I will make sure the antidepressant doesnâ€™t interfere with the cardiac meds. I would adjust the medications if needed.
McCance, K. L., Huether, S. E., Brashers, V. L., Rote, N. S., & McCance, K. L. (2019a). Pathophysiology: The biologic basis for disease in adults and children. Elsevier.
Rosenthal, L. D., Burchum, J. R., & Rosenthal, L. D. (2021). Lehneâ€™s pharmacotherapeutics for advanced practice nurses and physician assistants. Elsevier.
Stahl, S. M., Grady, M. M., & Muntner, N. (2021). Stahlâ€™s essential psychopharmacology: Neuroscientific basis and practical applications (5th ed.). Cambridge University Press.
Yekehtaz, H., Farokhnia, M., & Akhondzadeh, S. (2013, October 28). Cardiovascular considerations in antidepressant therapy: An evidence-based review. The journal of Tehran Heart Center. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4434967/ Case Study Of Assessing Health Risks Discussion Paper