MSN5700 Advanced Practice in Primary Care
Signature Assignment
Understanding disease conditions specific to advanced primary care is vital to ensure proper and timely diagnosis and treatment to improve healthcare outcomes for the patient. The purpose of this assignment is to evaluate one disease condition in the adult population and explore current evidence-based guidelines and treatments to determine a proper plan of care.
This assignment will focus on the following course student learning outcomes (CSLO):
1. Evaluate the role of the advanced practice nurse (APN) and the Family Nurse Practitioner (FNP) in particular, as it relates to obtaining a health history, performing a health assessment on adolescents, adults, and elderly from diverse cultural groups presenting with chronic and some acute physical and emotional concerns to an ambulatory, acute and/or managed health care delivery system (EOPSLO # 1, 2, 3, 4, 9).
2. Examine the principles and theories applicable to risk assessment and primary, secondary, and tertiary prevention for the promotion of optimum health of clients experiencing chronic or multisystem health problems (EOPSLO# 3 and 8).
3. Compare and contrast the possible interrelationships and impact of demographic characteristics, health beliefs, values, family situations, environment and community resources on the incidence and management outcome of chronic and some acute conditions of adult clients (EOPSLO # 2, 6, 7, and 9)
4. Incorporate epidemiological, social, and environmental research data in the assessment, holistic planning and outcome evaluation of interventions aimed at the diagnosis and management of the adult client’s health/illness status, with emphasis on common chronic illnesses of adult individuals of diverse ethnic and cultural groups (EOPSLO # 6, 7, and 9).
5. Examine the interrelationships and influences of genetics, age, gender, race/ethnicity, socioeconomic status, mental health, lifestyle, family situation, culture or subculture, health beliefs and values on the differential diagnosis and selection of screening and therapeutic agents for the management of selected chronic and multisystem illnesses of adult clients, families, and groups (EOPSLO# 3, 8 and 9).
6. Synthesize the following concepts in the advanced nursing care of the client experiencing chronic multisystem illness: the advanced nurse-client relationship, client teaching-coaching function, professional role enactment, client empowerment, mutual participation in health care decision-making, ethics, client education and counseling, change theory and process, and collaboration in health care delivery (i.e., interdisciplinary, multidisciplinary, multicultural teams and global nursing) (EOPSLO # 2, 3, 4, 7, and 9).
7. Compare and contrast pharmacological and non-pharmacological/alternative therapeutic measures for the client experiencing chronic and/or multisystem diseases taking into
SCHOOL OF NURSING GRADUATE STUDIES
MASTER OF SCIENCE IN NURSING – FNP
consideration pharmacotherapeutics prescriptive legal requirements for APNs and issues of polypharmacy (EOPSLO# 6, 7, and 9).
10. Utilize computer technology in synthesizing scientific and research-based knowledge regarding health care issues and problems of multicultural, multiethnic adults and populations at risk for health disparities (EOPSLO# 5, 8, and 9).
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Requirements:
Talk about a disease that we will see in our daily live.
Disease, epidemiology, etiology, pathofisiology, clinical presentation, how support the diagnosis, differential diagnosis, treatment and management, if is a sexual transmission explain how to inform the authorities and the protocol.
No more than 5 pages, excluding tittle and references.
APA rules
Instructions: Please choose one adult health condition learned in the course. Once the health condition is chosen, you are to write a three-to-five-page paper in APA format 7th edition with the following sections and level 2 headings:
Introduction
-Brief overview of adult health
-Introduce the disease condition chosen
-Importance of understanding the condition
Presentation of Condition
-Describe the condition chosen and its pathophysiology.
-What signs/symptoms are identified in the patient that can be found?
-Identify if there can be presentation variations based on culture, race, ethnicity, age, etc.
Diagnosis of Condition
-Diagnostic testing (include imaging, labs, and other necessary evaluations based on condition)
-Clinical evaluation via medical history and physical examination
Treatment of Condition
-Medications
-Treatments
-Managing symptoms (if needed)
-Non-pharmacological treatments (if applicable)
Potential Health Risks if Left Untreated
-Physical and mental health risks
Recent Evidence-Based Advancements in Condition
-Choose one evidence-based treatment that has shown to improve condition within the last 5 years.
-Briefly summarize the treatment and results.
Conclusion
-Recap points discussed in paper
-Importance of management and early diagnosis (if applicable)
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### Title: Comprehensive Management of Type 2 Diabetes Mellitus in Adult Patients
**Introduction**
**Brief Overview of Adult Health**
Adult health encompasses a broad range of conditions and diseases that impact individuals from various backgrounds and lifestyles. Effective management of these conditions requires a thorough understanding of each disease’s pathophysiology, presentation, diagnosis, and treatment. Advanced practice nurses (APNs) and family nurse practitioners (FNPs) play a critical role in providing comprehensive care and promoting optimal health outcomes for adults with chronic conditions.
**Introduce the Disease Condition Chosen**
Type 2 Diabetes Mellitus (T2DM) is a prevalent chronic condition characterized by insulin resistance and impaired glucose metabolism. It affects millions of adults worldwide and is associated with significant morbidity and mortality. Understanding T2DM is essential for managing its complex interplay of risk factors, clinical manifestations, and complications.
**Importance of Understanding the Condition**
Understanding T2DM is crucial for the prevention and management of its associated complications. With early diagnosis and appropriate management, healthcare providers can significantly improve patient outcomes and reduce the burden of this disease on individuals and the healthcare system.
**Presentation of Condition**
**Describe the Condition Chosen and Its Pathophysiology**
Type 2 Diabetes Mellitus is characterized by chronic hyperglycemia due to insulin resistance and eventual pancreatic beta-cell dysfunction. The pathophysiology involves:
– **Insulin Resistance:** The body’s cells become less responsive to insulin, leading to elevated blood glucose levels.
– **Beta-Cell Dysfunction:** Over time, pancreatic beta cells fail to produce adequate insulin to meet the body’s needs.
– **Increased Gluconeogenesis:** The liver produces excess glucose, exacerbating hyperglycemia.
**Signs/Symptoms Identified in the Patient**
Common symptoms of T2DM include:
– **Polydipsia:** Increased thirst
– **Polyuria:** Frequent urination
– **Polyphagia:** Increased hunger
– **Fatigue:** General tiredness
– **Blurred Vision:** Impaired vision due to fluctuating blood sugar levels
– **Wounds:** Slow healing of cuts and bruises
**Presentation Variations Based on Culture, Race, Ethnicity, Age, etc.**
– **Cultural Variations:** Dietary habits and lifestyle can affect the prevalence and management of T2DM. For example, high-carbohydrate diets prevalent in certain cultures can increase risk.
– **Ethnicity:** Certain ethnic groups, such as African Americans, Hispanics, and Native Americans, are at higher risk for T2DM.
– **Age:** Older adults may experience T2DM with atypical symptoms or complications such as frailty or cognitive decline.
**Diagnosis of Condition**
**Diagnostic Testing**
– **Fasting Blood Glucose:** Elevated levels (>126 mg/dL) suggest diabetes.
– **Oral Glucose Tolerance Test (OGTT):** Blood glucose levels >200 mg/dL two hours after glucose intake confirm diabetes.
– **Hemoglobin A1c (HbA1c):** Levels ≥6.5% indicate poor long-term glucose control.
– **Imaging:** While not typically used for diagnosis, imaging can help identify complications like diabetic retinopathy or neuropathy.
**Clinical Evaluation**
– **Medical History:** Includes assessment of risk factors such as family history, obesity, sedentary lifestyle, and dietary habits.
– **Physical Examination:** Focuses on detecting signs of complications, including foot ulcers, neuropathy, and retinopathy.
**Treatment of Condition**
**Medications**
– **Metformin:** First-line treatment to improve insulin sensitivity.
– **Sulfonylureas:** Stimulate insulin release from beta cells.
– **GLP-1 Receptor Agonists:** Enhance insulin secretion and suppress glucagon release.
– **SGLT2 Inhibitors:** Promote glucose excretion via urine.
**Treatments**
– **Lifestyle Modifications:** Emphasis on diet, exercise, and weight management.
– **Blood Glucose Monitoring:** Regular checks to manage and adjust treatment.
**Managing Symptoms**
– **Hypertension and Dyslipidemia:** Address co-morbid conditions with appropriate medications (e.g., ACE inhibitors, statins).
**Non-Pharmacological Treatments**
– **Dietary Changes:** Low-carbohydrate, high-fiber diet.
– **Physical Activity:** Regular exercise to improve insulin sensitivity.
**Potential Health Risks if Left Untreated**
– **Physical Health Risks:** Increased risk of cardiovascular disease, nephropathy, neuropathy, and retinopathy.
– **Mental Health Risks:** Depression and anxiety are common among individuals with chronic conditions.
**Recent Evidence-Based Advancements in Condition**
**Evidence-Based Treatment**
– **SGLT2 Inhibitors:** Recent studies have demonstrated that SGLT2 inhibitors, such as empagliflozin, not only improve glycemic control but also reduce cardiovascular events and renal deterioration in patients with T2DM. For instance, the EMPA-REG OUTCOME trial showed significant reductions in cardiovascular mortality and hospitalization for heart failure among patients treated with empagliflozin.
**Summary of Treatment and Results**
The EMPA-REG OUTCOME trial provided strong evidence supporting the use of SGLT2 inhibitors in reducing cardiovascular risk and renal complications, which are critical concerns in T2DM management. The findings underscore the importance of incorporating these medications into treatment regimens for improved patient outcomes.
**Conclusion**
**Recap Points Discussed in Paper**
This paper highlighted the importance of understanding Type 2 Diabetes Mellitus, its pathophysiology, clinical presentation, and the diagnostic and treatment approaches. Effective management requires a comprehensive approach, including pharmacological and non-pharmacological treatments.
**Importance of Management and Early Diagnosis**
Early diagnosis and effective management of T2DM are crucial for preventing complications and improving patient quality of life. The integration of evidence-based treatments, such as SGLT2 inhibitors, demonstrates the advancements in managing this chronic condition and emphasizes the role of advanced practice nurses in providing high-quality care.
**References**
(Include references in APA 7th edition format, citing relevant literature and evidence-based guidelines used in the paper.)
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This format provides a structured approach to evaluating Type 2 Diabetes Mellitus, focusing on its management and the role of advanced practice nurses in improving patient outcomes.
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