Comorbidity

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    As reported in 2015, the United States statistics reported that approximately 14% of the American population has chronic kidney disease, 661,000 have kidney failure, 468,000 individuals are on dialysis, and approximately 193,000 live with a functioning kidney transplant. (NIDDK, 2016) Kidney disease is an ever rising epidemic and this author has an interest in pursuing a future career as a Nephrology Nurse Practitioner. In 2004, CMS created changes to the nephrology billing “bundling” allowing…

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    Issues Pertaining to Diagnosis There are various views on how Selective Mutism should be classified. Some individuals believe that SM should be classified under social anxiety but others disagree. Some studies show that children with SM score lower than children who have a social phobia on the Social Phobia and Anxiety Inventory (SPAIK), so social anxiety may not be the cause of SM in many cases (Wong, 2010). Other professionals believe that SM should be classified under social phobia because…

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    those questions. All of these “symptoms” are side effects of many sleeping medications. He would also be meeting the criteria for a depression of diagnosis despite not actually having depression. Practitioners need to be able to recognize the comorbidities and medications that can mimic mental illness and be able to correctly identify patients who are in need of actual help. They also need the knowledge and resources to make the appropriate referrals if they are needed. Trossman (2013),…

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    Daffern and Gilbert discussion of the General Aggression Model (GAM) is an attempt to thoroughly explain the elaborate relationship that exist between violence and personality disorders along with providing a structured systematic method that clinicians can utilize to treat and further investigate the link between the two. The article discusses the history of evidence revolving around individuals with personality disorders (prisoners, psychiatric patients, and etc.) and their relationship with…

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    Affordable Health Care

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    In United States of America, there has been a change in health policy after the lawmakers came together to rectify the flaws in our limited healthcare. With the Affordable Care Act (ACA), the national health focus has been shifted towards disease prevention and health promotion. The affordable care act provides the largest coverage of behavioral health in history. Under the Affordable Care Act, health plans must cover preventive care which in previous years was not catered without copayment and…

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    Introduction Facility Demographic Information Hospitals are required to attempt meeting high quality standards as described in Prevention of Hospital-Acquired Infections, WHO recognizes that older facilities and facilities in developing countries may not be able to achieve these standards, however the underlying principles should be kept in mind when local planning and changes or revisions are made. (WHO, 2002) The facility assessed is Riverside Hospital, specifically, Orthopedic unit. This is…

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    been classified into different groups in order to make the payments for the services. The MS-DRG assigns code such as 190 stands for chronic obstructive pulmonary disease with MCC. The codes are distributed on the basis of major complication or comorbidity [MCC] and without MCC. There have been studies which have suggested that the cost of certain procedures for the MS-DRG are going to increase exponentially as the demand for such procedures will rise.[1] With a view to bring a control on the…

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    It is very common to come across an older patient and for them to be on 5 or more medications. However, just because this is a common occurrence does not mean that it is acceptable. To put it in perspective an average “adult age 65 and older compose 13% of the population in the United States, yet this cohort accounts for more than one-third of overall outpatient spending on prescription medications”, which comes to show that older adults are consistently prescribed numerous medications of which…

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    The patient is an 84-year-old female who was brought to the ED referred from her doctor's office brought by her daughter because of profound weakness, not eating well and having persistent diarrhea. The patient is known to have some dementia, non-insulin-dependent diabetes mellitus, hypertension, aortic insufficiency and increased lipids. Her history is that she had a recent fracture of her right hip. She underwent an inter cephalo-medullary pinning on the 30th and was discharged to the…

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    Research 3: Patients in two groups did not have any major difference on demographic or clinical variables at baseline. According to (Telch, Schmidt, Jaimez, Jacquin, Harrington, 1995), “Examination of overall SDS scores at baseline revealed that 69% of all participants rated the panic disorder symptoms as creating moderate-to-serve impairment in work functioning, 80% rated the symptoms as creating moderate-to-severe impairment in social functioning, and 62% rated the symptoms as creating…

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