comment suzzet

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 I NEED A POSITIVE COMMENT BASED IN THIS ARGUMENT..BETWEEN 100-120 WORDS

Dissemination of evidence-based practice (EBP) according to the Agency for Healthcare and Research Quality (AHRQ), is important, and they developed a tool to help do so. The dissemination plan should have several elements, six they have named:

Research findings and products—What is going to be disseminated?

End users—Who will apply it in practice?

Dissemination partners—Individuals, organizations or networks through whom you can reach end users?

Communication—How you convey the research outcomes?

Evaluation—How you determine what worked?

Dissemination work plan—Where you start? (Agency for Healthcare and Research Quality, 2014, para. 2).

So, who would be the end user of your proposal? End users are individuals, health care professionals, or delivery organizations that could benefit from and use your research finding or product. These end users are the ultimate target for your dissemination efforts. Specifying your target audience and their needs will provide a focus for your dissemination plan and will help you tailor your offering to their needs (AHRQ, 2014, para 4).

The author would use the American Academy of Pediatrics journal, Pediatrics because it is solely based on the care of Pediatrics. My proposal is based on the care of late preterm infants, and it is a journal that has advances in the care of pediatrics, and the author believes this would be the best organization to bring the proposal to.

Next, the author would present the proposal to a conference of multidisciplinary members of the hospital  specifically one that is centered around neonates because they all would have part in the dissemination of the project from lab,, neonatologist, pharmacy, radiology, occupational therapy, administration, managers and neonate nurses.  Having a multidisciplinary approach would disseminate the information much easier and everyone is on the same page with treatment.

 

References

Advances in Patient SafetyDissemination Planning Tool: Exhibit A from Volume 4. (2014). Retrieved from https://www.ahrq.gov/professionals/quality-patient-safety/patient-safety-resources/resources/advances-in-patient-safety/vol4/planningtool.html

COMMENT ZOE

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I NEED A POSITIVE COMMENT BASED IN THIS ARGUMENT..BETWEEEN 100-120 WORDS

As a nurse, it is important to acknowledge strengths and weaknesses so that one can make improvements where it is necessary. When implementing an evidence based project it is just as important to recognize one’s strengths and weaknesses. Giomuso states, “The nursing profession has developed into a sophisticated mindset of inquiry as to what works, what does not work, and what is best for the patient” (Giomuso, 2014). One personal strength I believe I have regarding professional presentations is my ability to get my point across in a clear and concise manner where the audience understands what I am saying and feels that they can ask questions and inquire more information about the subject. A weakness I have is getting nervous presenting to a larger group of unfamiliar people, I can always hear my voice quiver and that makes me more nervous. Sawchuck (2017) states the following to help people with fear of public speaking overcome it:

Know your topic

Get organized

Practice, and then practice some more

Challenge specific worries

Visualize your success

Do some deep breathing

Focus on your material, not on your audience

Don’t fear a moment of silence

Recognize your support

Get support

I find these very helpful when preparing myself to give a presentation to a group of people I am unfamiliar with. The one I found to be most useful is practice. I practice for a lot of things and this triggers my memory when giving the actual presentation.  

 

Reference:

 

Giomuso, C. (2014). A Successful Approach to Implementing Evidence Based Practice. Continuing Nursing Education. Retrieved from: http://eds.a.ebscohost.com.lopes.idm.oclc.org/ehost/pdfviewer/pdfviewer?vid=1&sid=69f9dcad-6290-40a4-863e-2459149d5e39%40sessionmgr4009

 

Sawchuck, C. (2017). Fear of Public Speaking: How Can I Overcome It? Mayoclinic. Retrieved from: https://www.mayoclinic.org/diseases-conditions/specific-phobias/expert-answers/fear-of-public-speaking/faq-20058416  

comment zoe

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I need a positive comment based in this argument.. between 100-120 words

Etiologies, Trends, and Predictors of 30-Day Readmission in Patients with Heart Failure 

Summary: Heart failure is the most common discharge diagnosis across the United States, and these patients are particularly vulnerable to readmissions. A study of heart failure patients was completed with specific qualifiers.  Readmission causes were identified using International Classification of Diseases, Ninth Revision, codes in primary diagnosis filed. The primary outcome was 30-day readmission. The study showed readmission after a hospitalization for HF is common. Although it may be necessary to readmit some patients, the striking rate of readmission demands efforts to further clarify the determinants of readmission and develop strategies in terms of quality of care and care transitions to prevent this adverse outcome.

Strength: Discusses causes of readmissions of heart failure patients.

Weakness: The study needs further clarification of why heart failure patients are being readmitted.  

Arora, S., Patel, P., Lahewala, S., Patel, N., Patel, N. J., Thakore, K., & … Gopalan, R. (2017).      Heart Failure: Etiologies, Trends, and Predictors of 30-Day Readmission in Patients With        Heart Failure. The American Journal Of Cardiology, 119760-769.    doi:10.1016/j.amjcard.2016.11.022

 

Using Teach-Back Method to Prevent 30-Day Readmissions in Patients with Heart Failure: A Systematic Review

Summary: Heart failure is one of the most common readmission diagnoses. A review of the literate is presented to identify a role for teach-back patient education in reducing readmissions in patients with heart failure.

Strength: The study showed reduced readmission rates when using the teach back method of education.

Weakness: The study did not state the actual teaching methods to reduce readmission rate of heart failure patients.

Almkuist, K. D. (2017). Using Teach-Back Method to Prevent 30-Day Readmissions in Patients    with Heart Failure: A Systematic Review. MEDSURG Nursing, 26(5), 309-351.

Care of Patients with Cardiovascular Disorders: Improving quality of life and decreasing readmissions in heart failure patients in a multidisciplinary transition-to-care clinic

Summary: A pilot for a four-week transition-to-care program on heart failure patient’s due to the critical time in between discharge and readmissions. The study used a pre and post test to determine the quality of life related to hospital readmissions. The study showed improved quality of life and decreased readmission rates following the transition-to-care program.

Strength: Has significant results showing a positive effect of a transition-to-care clinic on reucing readmission rates of heart failure patients.

Weakness: the study size was quite small at 50 patients.    

Whitaker-Brown, C. D., Woods, S. J., Cornelius, J. B., Southard, E., & Gulati, S. K. (2017). Care             of Patients With Cardiovascular Disorders: Improving quality of life and decreasing         readmissions in heart failure patients in a multidisciplinary transition-to-care clinic. Heart     & Lung – The Journal Of Acute And Critical Care, 4679-84.     doi:10.1016/j.hrtlng.2016.11.003

Brief Report: Strategies for Reducing the Hospital Readmission Rates of Heart Failure Patients

Summary: The purpose of this article is to review current HF readmission prevention strategies for effectiveness.

Strength: discusses the costs associated with heart failure readmissions and makes good recommendations for action on how to reduce readmissions.

Weakness: focuses on the role of the nurse practitioner

McClintock, S., Mose, R., & Smith, L. F. (2014). Brief Report: Strategies for Reducing the            Hospital Readmission Rates of Heart Failure Patients. The Journal For Nurse          Practitioners, 10430-433. doi:10.1016/j.nurpra.2014.04.005

An evaluation of involving family caregivers in the self-care of heart failure patients on hospital readmission: Randomized controlled trial (the FAMILY study).

Summary: The aim of this study was to evaluate the effect of involving family caregivers in the self-care of patients with heart failure on the risk of hospital readmission.

Strength: the study showed a lower readmission rate when family centered self-care was implemented.

Weakness: the study was completed in Lebanon

Deek, H., Chang, S., Newton, P. J., Noureddine, S., Inglis, S. C., Arab, G. A., & … Davidson, P. M. (2017). An evaluation of involving family caregivers in the self-care of heart failure        patients on hospital readmission: Randomized controlled trial (the FAMILY study).             International Journal Of Nursing Studies, 75101-111. doi:10.1016/j.ijnurstu.2017.07.015

Repeat Hospitalizations Predict Mortality in Patients with Heart Failure

Summary: The goal of the study was to evaluate the impact of repeat heart failure hospitalizations on all-cause mortality and to determine risk variable related to patient mortality.

Strength: the study showed that repeat admissions were a strong predictor of mortality.

Weakness: the study did not offer suggestions to help reduce the mortality of heart failure patients following readmissions.

Lin, A. H., Chin, J. C., Sicignano, N. M., & Evans, A. M. (2017). Repeat Hospitalizations Predict Mortality in Patients With Heart Failure. Military Medicine, 182(9), e1932-e      1937. doi:10.7205/MILMED-D-17-00017

discussion 3 response

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Please, post a response to the following discussion in APA format without cover page, one paragraph, using one reference from peer-reviewed Nursing Journal not older than 5 years.

 

     Abdominal Assessment

Performing a thorough assessment is an essential skill. The treatment for any client is based on the diagnosis, and that diagnosis relies entirely on the assessment. To assess a 78-year-old male with a chief complaint of abdominal pain, bloody diarrhea, fever, and weight loss; there are many important factors to take into consideration. First, it is crucial to assess more in-depth the chief complaint, known as a history of current illness. These will include an assessment of the abdominal pain following the pqrst. Also, an assessment of his bowel movement (diarrhea), when did it started, what causes it, what makes it subsides; did he took anything to stop it, did he had any changes in his eating habits, ask him to describe his bowel movements, and did any nausea or vomiting accompany it. Next, an assessment of the fever to find out when did start it, what was his highest temperature reading, what causes the fever to subside, was he exposed to any diseases like Clostridium difficile or food poisoning and is it accompanied by chills. Additionally, an assessment of his weight loss to see how much weight did he lost and in how long, was the weight loss intentionally, what type of diet does he follows, is there any cultural or belief factors that affect his diet.  

After the history of the current illness is obtained, the assessment continues into the risk factors. These will include a list of medications, and if the client is taking any NSAIDs or blood thinners; food, drugs, and environmental allergies; use of tobacco, alcohol and recreational drugs; history of vaccinations and traveling out of the country; past medical history (PMH), past surgical history (PSH), family history, previous hospitalizations, history of previous gastrointestinal (GI) problems like GERD, peptic ulcers, inflammatory bowel disease (IBD), anemia, and celiac disease, history of previous diagnostics GI tests and results like endoscopies and lab work. Also, assessment of living conditions, whom does he lives with, who prepares his meals, does he has access to drinking water and electricity. Even though certain diseases are not common in the US, the healthcare provider should never exclude them from the assessment. Assessing for parasitic diseases is a critical component for patients with GI symptoms and fever. Even though is more common in developing countries, it should not be ignored in the US. Commonly caused by ingestion of contaminated food or water, parasitic diseases are often misdiagnosed for tumors. The common symptoms are abdominal pain, diarrhea, bloody stool, fever, and weight loss (Çiftci, Bulut, Özdaş & Yıldırım. 2018). Amebomas are variable in sizes and on assessment are found as a palpable mass that causes obstructive symptoms and mimics many other diseases.

The next step is the physical examination. These start with the inspection, looking for the color, contour, size, shape,  pulsations, and lessions (Jensen, 2015). Then, the assessment continues with the auscultation of the bowel sounds over the four quadrants and the vascular sounds. The next step is percussion of the four abdominal quadrants assessing for the size of the organs and looking for tympanic sounds over the hollow areas and dullness over the organs, masses, fluids or obstructions (Jensen, 2015). The palpation is performed at the end, beginning with light palpation and assessing for pain, then follow by deep palpation to check for organs, masses, or tenderness (Jensen, 2015).

The documentation of the assessment findings is done using the SOAP format. All subjective data is documented under S, and all objective data is documented under O.  The assessment or diagnosis is written under A., And the plan of treatment is documented under P.

Please response with a Positive post 150Words With references due tomorrow at 10 am est

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Adolescent suicide becomes a serious health concern. According to the American Academy of Child and Adolescent Psychiatry (AACAP, 2017), suicide is the second leading cause of death and the majority of suicide attempts are often impulsive as this might be associated with sadness, confusion, anger, and the saddest part, adolescents view suicide as a solution to their problems.

There are several risk factors that contribution to suicide in adolescents. According to AACAP (2017): the major risk factors of teens suicide include: family history of suicide attempts, exposure to violence, aggressive behavior, access to firearms, bullying, feeling of hopelessness, and acute loss or rejection. According to an article, “Teen Suicide is Preventable,” by the American Psychology Association (2017), some possible warning signs of teen suicide might be: talking about dying; recent loss of the loved one; change in personality, behavior, sleep patterns, or eating habits; fear of losing control; low self-esteem; and no hope for future .It is important to parents and family to early recognized warning signs of suicide; so that it could be prevented.

The primary methods in suicidal prevention would be to increase and awareness about adolescent suicide in the community. National suicide prevention such as school education programs, media guidelines, and limit firearm access are some of the examples (APA, 2017). The secondary prevention method such as suicidal screening could be very beneficial for identifying adolescents who are at risk. The tertiary methods could be appropriate referral and treatment to improve mental health and quality of life of the adolescents.

The community resources to prevent suicide in my community, the Burlington County, is the Legacy Treatment Service, which offer screening center, providing face-to-face crisis service within one hour of notification, and the mobile service is available 24 hours a day (State of New Jersey, 2017). For state resource, the State of New Jersey provides New Jersey Hopeline to provide peer support and specialists in suicidal prevention over the phone; this service also available 24 hours a day (NJ Hopeline, 2013).

The nursing interventions that could use to assist depressed adolescent is to first assess the teen whether he or she thinking about self-harm and whether he or she has a plan, to initiate safety precaution. After that, I would provide safe environment for the adolescent, ensure privacy, use calming approach and offer present. When the adolescent is ready to talk, I then would assess the risks factors and emotional status to creating the individual care plan. As the care process, I would evaluate the effectiveness of the care plan and adjust it as needed.

NJ Hopeline. New Jersey’s 24/7 Peer support & suicide prevention hotline. Retrieved October 17, 2017 from http://www.njhopeline.com/

State of new Jersey. 2017. Department of Human Services. Primary screening service in each county. Retrieved October 17, 2017 from http://www.state.nj.us/humanservices/dmhas/home/hotlines/MH_Screening_Centers.pdf

The American Academy of Child and Adolescent Psychiatry (AACAP). 2017. Suicide in children and teens. Retrieved October 17, 2017 from http://www.aacap.org/aacap/families_and_youth/facts_for_families/FFF-Guide/Teen-Suicide-010.aspx

The American Psychology Association. 2017. Teen suicide is preventable. Retrieved October 17, 2017 from http://www.apa.org/research/action/suicide.aspx

comment IJEOMA

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I NEED A POSITIVE COMMENT BASED IN THIS ARGUMENT..BETWEEN 100-120 WORDS

Discuss current research that links patient safety outcomes to ADN and BSN nurses. Based on some real-life experiences, do you agree or disagree with this research?

A study done in 2011 by Aiken and colleagues revealed that increasing the number of the registered nurses in hospitals is not only the solution to reducing patients’ mortality rate, but rather increasing number of nurses who have a higher educational, and a positive work environment, positively decrease the mortality rate in the hospitals (Cherry & Jacob, 2017). It interesting to know that every 10% increase in number of BSN nurses, decreases the mortality rate to 4% (Cherry & Jacob, 2017) even though 4% seems small, but it is still a great impact to life-saving effort.

     There is no doubt that knowledge is the key, just like we all are getting our bachelors in nursing, there is a huge difference in the knowledge acquired. I personally have grown in confidence and knowledge through the course of this study and I am excited to be a better nurse clinically and in the community.

Recently, hospital position openings are BSN preferred, based on the reports like that of Institute of Medicine which support that nurses who are BSN possess the skills and knowledge needed to produce a better or positive patient outcome (Sherman, 2012). Last year, I attended a job-fair organized my Methodist hospital, and it was an instant offer for the positions available, everyone was qualified except me because I didn’t have a BSN, so that was my instant driving force to enroll in BSN program.

Based on my experience, I have worked with nurses who have years of work experiences without BSN and Nurses who have BSN but no experience. I personally think that having years’ experience is a big plus in terms of practical nursing. For example, an LPNs/LVNs took me on floor orientation in Nursing home after I was hired, even though she is an LVN, there are things she taught me that I didn’t know as an RN, obviously because she has years of experience, but not a higher education. I strongly believe also that having a higher education in nursing, prepares nurses to assume leadership roles, and exposes nurses to skills and knowledge needed to deliver a high-quality nursing care.

I agree with the aspect of BSN being prepared to assume leadership roles, but I do not believe that ADN nurses contribute to higher mortality role, because all nurses are exposed to the same clinical training in the hospitals. I believe that having a positive work environment, increasing the number of nurses, and a better communication with other health care teams improve a better patient outcome.

 If I am in a hiring position, I would refer to hire a registered nurse with ADN who have years of experience over a BSN nurse who has no experience based on the type of position available, leadership positions would go for BSN, while floor position goes to ADN with a higher years of work experience.                                  

                                                                 References

Cherry, B. & Jacob. S. (2017) Contemporary nursing, issues, trends, & management. St. Louis: Elsevier. Six editions. Retrieved from https://pageburstls.elsevier.com/#/books/978-0-323-101097/cfi/6/8!/4/2/14/4@0:10

Sherman. R (2012) An 80% BSN Prepared Nursing Workforce by 2020? Emerging RN Leader. Retrieved on September 18th. From http://www.emergingrnleader.com/80bsnworkforce2020/

nursing leadership dis/wk 4/ reor

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PART1/an

With a society that is so diverse in its own nature, issues pertaining to cultural diversity are bound to occur in the process of team management and leadership. Using the South University Online Library or the Internet, research about cultural diversity. Based on your research and understanding, answer the following questions:

· How does having members of different cultures on a team affect the team’s performance?

· How would you incorporate a person from a culture of your choice into your team, keeping in mind communication differences within your and the chosen culture?

Part 2

Understanding cultural diversity is extremely important specially leaving in Florida. According to a research “As the United States population becomes more diverse and camps employ more international staff, the issue of communicating and interacting effectively with people from other cultures becomes more important” (American Camp Association, 2017). Nurses get to work with many different cultures so it is extremely important that we get learn about different cultures types so we can provide the best care possible.

· How does having members of different cultures on a team affect the team’s performance?

Nurses also get to work with people from other cultures backgrounds which can definitely make a big impact on team performance. The biggest problem in this case will be language barrier which can definitely reduce the effectiveness of communication between team members. I will like to add to the discussion that I am from a different cultural background and do I agree that language barrier can make a big impact on team performance. Several times during my career I had to experience how some team members encounter a hard time trying to understand what I said because of my hard accent. I know this is something that I must work on and I tried to do better every day in order to not to compromise my work or the safety of my patients.

· How would you incorporate a person from a culture of your choice into your team, keeping in mind communication differences within your and the chosen culture?

The biggest thing about incorporating someone from a different culture to the team is that we must understand that they must be treated the same, we must respect the choices and we must take the time to learn more about their cultures and we can positively make them feel welcome in their new environment.

Week14_Disc_Suze

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Please respond to the discussion below with a minimum of two paragraphs with two references, APA Style and no plagiarism. 

-Nsaids are a commonly used drug that can be bought over the counter without a prescription. NSAIDS are used for patients that have chronic pain, stroke, atherosclerosis and postoperatively this medication is used very commonly. Like all medications Nsaids have risks and benefits. One major risk is bleeding. It is important for patients who are going for surgery to stop this medication the morning of surgery to prevent the risk of bleeding during surgery.  NSAIDS are also contraindicated when taking lithium. NSAIDs are known to increase the effects of lithium can can lead to lithium toxicity when taken together. NSAIDs when combined with certain medications can be very dangerous. Nsaids are commonly taken by most people not only geriatrics but also younger population take nsaids for migraine and for menstrual cramps. 

Some benefits of Nsaids is that it is easily accessible OYTC and that is very affordable for most people. NSAIDS are very effective for mild to moderate pain. Possible negative side effects include liver and kidney damage, nausea, vomiting and neuropathy. NSAIDs have also been used in combination with chemotherapy drugs in treatment of some cancer. This is now being dispelled and scientists are finding that NSAIDs don’t have any ant cancer causing properties and have now been contraindicated for patients on chemotherapy, the benefits don’t outweigh the cons of taking this drug. Stronger opioids are preferred when treating cancer pain.  One benefit of taking an NSAID is that is is not habit forming and there is very low risk of becoming addicted to this medication in comparison to opioids/ narcotics which are extremely addictive and have higher risk of overdose. 

Reference

Cosmo, G. D., & Congedo, E. (2015). The Use of NSAIDs in the Postoperative Period: Advantage and Disadvantages. J Anesth Crit Care Open Access, 3(4), 00107.

Discussion_L-D

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Please answer to this discussion post with a minimum of two hundred words. APA style 6th edition and no plagiarism. 

________________________________________________________

Even though the benefits of vaccines and vaccination have been well communicated to the people, controversies have still been detected. Apparently, this is out of the high number of people who still die because of an outbreak of vaccinated diseases. The controversies arise as many vaccines have been found to cause other health-related problems and are thus not welcomed by a majority of people.

Mercury was found in vaccines, especially, in multi-dose vaccines which are being preserved by methyl mercury. The effect of mercury in the nervous system is hazardous as the liquid metal causes illnesses to human beings. Consequently, many people avoided the vaccines as they considered them harmful to their health. The DPT vaccine also has some conspiracies as some children suffered neurological conditions just after being vaccinated. As a result, the potential risk of the vaccine was escaped by avoiding immunization (Dube, Vivion & MacDonald, 2015).

Various incidences, especially, when the Cutter Laboratories manufactured a number of drugs to aid in the prevention of polio, led to controversies. The doses were found to contain some virus which caused the number of polio infection, death, and even paralysis. The epidemic led to an increase in the number of people who reject the issue of vaccination. Seemingly, the controversies are caused by doubt of effectiveness and safety (Verger et al, 2015).  

Assuredly, in reference to the previous cases, many people still find it difficult to believe that the vaccines are effective and cannot cause harm. The perceptions are being based on how the vaccines affected people before and this makes people run away from vaccination. As a result, disease outbreaks wipe a lot of people who still find it difficult to change their perceptions. I feel that vaccines are essential and that they shouldn’t be all considered unsafe due to a few cases. 

References

Dube, E., Vivion, M., & MacDonald, N. E. (2015). Vaccine hesitancy, vaccine refusal, and the anti-vaccine movement: influence, impact, and implications. Expert review of vaccines, 14(1), 99-117.

Verger, P., Fressard, L., Collange, F., Gautier, A., Jestin, C., Launay, O., … & Peretti-Watel, P. (2015). Vaccine hesitancy among general practitioners and its determinants during controversies: a national cross-sectional survey in France. EBioMedicine, 2(8), 891-897.

Discussion: Assessment Tools and Diagnostic Tests in Adults and Children

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I need 1 comment per each post in APA with citation and 2 references per comment not older that 2013.

Post 1

For this week’s discussion, I chose the 5-year old girl with normal weight with obese parents.  Unfortunately, this topic hits close to home as our youngest daughter is 4 ½ and both my husband and I have gained significant weight over the past few years and are in the obese category.  Most children are able to self-regulate diet and balance what they eat with the amount of energy that they are expending. Parental influence at a young age can have a significant effect on the child’s ability to regulate on their own.  Obesity places adults and children alike at a higher risk for hypertension and diabetes than those of normal weight.  A child who has obese parents is at a higher risk of becoming obese due to unhealthy eating habits that are learned at home.  Obesity is defined in the course text as BMI > 95th percentile for age and gender in children ages 2-18 (Ball, Dains, Flynn, Solomon and Stewart, 2015). 

During the child’s health assessment the provider needs to be watchful for any signs of malnutrition as well as over-nutrition.  In addition to standard screening using height, weight and BMI, additional nutritional screening should be performed. Below are three specific questions that could be utilized to further assess nutrition and risk for obesity.  

  1. Can you describe to me all of the foods that the child has eaten in the past 24-48 hours? How many sugary drinks such as soda and juice, does the child drink each day? 
  2. How many minutes/hours of screen time does your child have per day? 
  3. Do you have a standard bedtime? How many hours of sleep does the child typically get per night? 

Describing the foods that the child has eaten over 24-48 hours will provide a more accurate account of overall nutrition.  Specifically asking about sugary drinks such as soda and juice can provide opportunity to discuss the health risks that can be associated with too much sugar intake. Specific questions related to amounts of fruits and vegetables are important as well.  Determining if the child is receiving adequate nutrients from the food that they are eating is important.  If there is concern that the child may not be receiving enough vitamins and minerals from food, it may be necessary to recommend a multi-vitamin to supplement what the child is missing from diet.   

There are multiple studies that have shown that an increased amount of screen time can have devastating effects on children’s health.  High volume of screen time whether that is from television, video games, computers or other hand-held devices can lead to increased risk of obesity as well as behavioral problems.  Asking questions related to screen time also provides the opportunity to determine where the child eats most of their meals.  Does the family eat together at the table? Do they eat while watching television? How often do they eat in the car or on the go due to busy schedules?  These factors can be used to determine the risk of the normal weight child at age 5 becoming overweight or obese as they get older.  These questions also provide an opportunity to educate parents on healthy eating habits that they can utilize as well to improve the overall health of the family.   

Another important factor to determine overall health of the child is determining if the child is getting enough sleep each night.  Children are in a period of rapid growth in early childhood and the body needs time to rest so that it can develop appropriately.  Asking if the child has a standard bedtime and how many hours of sleep the child gets each night can help determine if the child is getting adequate sleep.  In relation to screen time it is important to discuss bedtime habits that the child and parents may have as well.  Does the child have their own bedroom?  Or do they share with an older sibling or parent?  Is there a television in the room? Video games in the room?  There are many children whose parents will tell providers that their children are in bed by 8 pm each evening and while that may be a true statement, the child may not actually be going to sleep until much later due to television or other distractions present in the room. This again provides the opportunity to educate family members on the importance of a good night sleep for overall family health.  

Strategies to encourage parents to be proactive about child’s health 

In addition to the above strategies, maintaining a food dairy can be an excellent tool to determine over time whether there is adequate nutrition for both the child and parents.  There are many tools that can be utilized to keep a food diary.  A simple notebook and pen works well and with all of the technology available, there are multiple apps such as My Fitness Pal that can be used to track more than the type of food.  They can help track calories, fat, cholesterol, sugar as well as exercise.  These apps are only as good as the information that the user puts in them. “Parents influence a child’s weight through interactions that shape the development of child eating behaviors.” (Pietrobelli and Agosti, 2017).  Parents can be educated on modeling good habits of eating such as eating at the table versus in the care or while watching television. Avoid using food as a reward that can lead to child becoming an emotional eater when they are older. (Pietrobelli and Agosti, 2017). Providing good habits that can be passed on to children can also decrease their risk of depression and eating disorders such as anorexia and bulimia.  

Reference 

Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2015). Seidel’s guide to physical examination (8th ed.). St. Louis, MO: Elsevier Mosby. 

Pietrobelli, A., & Agosti, M. (2017). Nutrition in the First 1000 Days: Ten Practices to Minimize Obesity Emerging from Published Science. International Journal Of Environmental Research And Public Health, 14(12), doi:10.3390/ijerph14121491 

Rub, G., Marderfeld, L., Poraz, I., Hartman, C., Amsel, S., Rosenbaum, I., & … Shamir, R. (2016). Validation of a Nutritional Screening Tool for Ambulatory Use in Pediatrics. Journal Of Pediatric Gastroenterology And Nutrition, 62(5), 771-775. doi:10.1097/MPG.0000000000001046 

Watkins, F., & Jones, S. (2015). Reducing Adult Obesity in Childhood: Parental Influence on the Food Choices of Children. Health Education Journal, 74(4), 473-484 

Post 2

Diagnostic Tests: Mammography

  Mammography is an effective diagnostic test that can help practitioners identify breast cancer at an early stage (Jerome-D’Emilia & Chittams, 2015). Typically, a mammogram is a series of x-ray images capable of detecting tumors too small to be palpated as well as calcium microcalcifications that are associated with breast cancer growth (National Cancer Institute, 2016). Screening mammograms are performed routinely and diagnostic mammograms, specific targeted imaging, are used when changes are identified on screening exams or when visibility is compromised, for example with breast implants (National Cancer Institute, 2016).

     It is important to evaluate the validity and reliability of important screening tests like mammography to ensure proper screening and early diagnosis and treatment in affected patients. This early detection allows for a greater array of treatment options and an improved overall prognosis (Jerome-D’Emilia & Chittams, 2015). The reliability and validity of the mammogram increases when used in accordance to recommendations, for instance, in patients over the age of 30, as younger women have increased breast density that affects the diagnostic value (Dains, Baumann, & Scheibel, 2016). In addition, for best results, it is important to adhere to regularly scheduled mammograms, typically done annually for women over the age of 40 (National Cancer Institute, 2016). The National Health Service Breast Screening Programme has developed national guidelines to standardize image assessments and screening programs (Hill & Robinson, 2015). The Breast Imaging Reporting and Database System provides radiologists a uniform way to describe and report findings from mammograms, which helps physicians to appropriately coordinate necessary plans of care (National Cancer Institute, 2016).

     At times, mammogram imaging can lead to false-positive results, when radiologists identify abnormalities without the presence of cancer. This can result in over treatment with follow up diagnostic mammograms, ultrasounds, and biopsies to rule out findings (National Cancer Institute, 2016). Predictive values can change if screening is not done properly, and Taylor et al. describes breast positioning as being the most important factor in producing quality mammography images (2017). Ensuring that diagnostic tests provide valuable, accurate, and useful information is key to preventative health care services and early management and treatment of identified disease processes.

References

Jerome-D’Emilia, B., & Chittams, J. (2015). Validation of a cultural cancer screening scale for mammogram utilization in a sample of African American women. Cancer Nursing, 38(2), 83-88. Retrieved from

     https://ezp.waldenulibrary.org/login?url=https://search.ebscohost.com/login.aspx?direct=true&db=psyh&AN=2015-07872-002&site=eds-live&scope=site

National Cancer Institute. (2016). Mammograms. Retrieved from https://www.cancer.gov/types/breast/mammograms-fact-sheet

Dains, J. E., Baumann, L. C., & Scheibel, P. (2016). Advanced health assessment and clinical diagnosis in primary care  (5th ed.). St. Louis, MO: Elsevier Mosby. 

Hill, C., & Robinson, L. (2015). Mammography image assessment; validity and reliability of current scheme. Radiography, 21, 304-307. Retrieved from https://ezp.waldenulibrary.org/login

     url=https://search.ebscohost.com/login.aspx?direct=true&db=edselp&AN=S1078817415000899&site=eds-live&scope=site

Taylor, K., Parashar, D., Bouverat, G., Poulos, A., Gullien, R., Stewart, E., & … Wallis, M. (2017). Mammographic image quality in relation to positioning of the breast: A multicentre international evaluation of the

     assessment systems currently used, to provide an evidence base for establishing a standardised method of assessment. Radiography, 23(4), 343-349. Retrieved from https://ezp.waldenulibrary.org/login

     url=https://search.ebscohost.com/login.aspx?direct=true&db=mnh&AN=28965899&site=eds-live&scope=site