Please Reply to the following TWO Discussion posts:
Requirement
APA format with intext citation
Word count minimum of 150 words per post, not including references
References at least one high-level scholarly reference per post within the last 5 years in APA format.
Plagiarism free.
Turn it in receipt.
DISCUSSION POST # 1Reply to Claire
This patient needs immediate assistance establishing her thought pattern and further explaining the meaning of “feeling like she can’t go on.” Jumping to conclusions could very well cause more harm than good. Discontinuing her medication three weeks ago appears to be the biggest issue due to her inability to afford them. It would be prudent to ask her specific questions about self-harm or harm to others. Spottswood et al. (2022) state:
Suicide prevention implementation in primary care is needed due to the increasing rate of suicide in the past few decades, particularly for young and marginalized people. Primary care is the most likely point of contact for suicidal patients in the healthcare system. The United States Preventive Service Taskforce (USPSTF) recommends universal depression screening for adults in primary care when paired with resources for diagnostic accuracy, treatment, and follow-up. Data suggest that depression screening and treatment prevent suicide. Because the PHQ-9 is already used in many health care systems for depression screening and contains question #9 (“thoughts that you would be better off dead, or thoughts of hurting yourself in some way”), many studies use question #9 to detect suicidal thoughts. Another suicide screening tool with a broad evidence base is the Columbia-Suicide Severity Rating Scale (C-SSRS), validated for patients ages 12+ (55). It has been used extensively in research studies and can also be used by laypeople in healthcare settings and other community settings.
Treatment should be planned with the responses to the assessment tool, which categorizes the risk of the patient completing the act of suicide. Secondly, prescription assistance was voiced by the patient as to discontinuation of medication to manage symptoms. Providers should have resources available for patients to assist them with medical and drug coverage. RxResouce.org (n.d.) states:
Florida has a prescription assistance program entitled the Florida Rx Card. Florida Rx Card is the free statewide prescription assistance program available to all Florida residents. The program was launched in August 2007 to help uninsured and underinsured Florida residents with their prescription medication costs. Florida residents with insurance can also utilize the program for their non-covered medications. The website for access is floridarxcard.com.
As nurse practitioners, we will carry more responsibility in assisting our patient population. Therefore, it is prudent to remain current in clinical practice guidelines and resources to help patients receive what they need to manage their healthcare goals.
DISCUSSION POST #2 Reply to Minu
The following are the differential diagnoses for a patient complaining of jaw discomfort after a normal dental exam:
- Trigeminal Neuralgia
Trigeminal neuralgia is characterized by pain at the trigeminal nerve, which begins at the top of the ear and divides into three branches: toward the eye, toward the cheek, and toward the jaw. There are two trigeminal nerves, one on each side of the face, but only one side normally hurts, and patients usually seek treatment from a dentist first. Trigeminal neuralgia symptoms include acute, stabbing pain in the jaw and check, which is exacerbated by touching the face or eating (Gambetta et al., 2020).
Because the pain is in her jaw and radiates to her ear, my first thought is trigeminal neuralgia (TN). When a doctor examines a patient with face discomfort and suspects trigeminal neuralgia, he or she should refer the patient to a neurologist. A neurologist, neurosurgeon, dentist, nurses, and pharmacist may be part of the inter professional team, and all team members should interact and communicate openly to improve patient treatment and outcomes (Gambetta et al., 2020). Because there is no specific test to diagnose trigeminal neuralgia, a thorough history of the pain is required to rule out other issues such as nerve injury, temporal arthritis, tumors, and migraines. If a blood artery is compressing the trigeminal nerve, an MRI may be required. MRI of the brain is recommended over CT because it allows for the evaluation of minor nearby lesions. After the diagnosis is made, patients must be educated about the treatment plan. Pharmacologic therapy is the first-line treatment for people with classic TN and idiopathic TN. The anticonvulsant medicine carbamazepine is the most widely utilized treatment. Other medications include oxcarbazepine, baclofen, lamotrigine, phenytoin, gabapentin, clonazepam, and valproic acid. If the pain is an ongoing issue, a pain management program may be beneficial to patients in order to help them cope with discomfort and uncertainty. Patients who have failed medical treatment may be candidates for surgery. Microvascular decompression is commonly regarded as the gold standard surgical treatment for this illness (Di Stefano et al., 2019).
