Nurse become sensitive to the complexities of caring 

This assignment is intended to help the future nurse become sensitive to the complexities of caring for diverse ethnic groups during their practice. Students will be required to explore the social and healthcare beliefs…

Nurse become sensitive to the complexities of caring

This assignment intention is to help the future nurse become sensitive to the complexities of caring for diverse ethnic groups during their practice.  Students requirement is to explore the social and healthcare beliefs and traditions of 4 ethnic groups to include one from the United States, one Hispanic, one Middle Eastern, and one Asian.  You should include your cultural group in whichever of these is appropriate.  Students will be expect ed to examine each group in some detail, compare similarities and differences between the groups, and compare one group to the student’s own ethnic background. There is a rubric for this assignment to guide you.

The paper MUST be in APA style; spelling, punctuation, and grammar will also be graded.  The paper  submission will be through Turnitin and cannot have more than 25% shared content with other sources.

More details;

How do you provide culturally competent care to diverse client groups?
Here are 5 ways to help you provide culturally competent nursing care.

Firstly, Perform a cultural competence self-assessment.

Secondly, Obtain a certificate in cultural competence.

Thirdly, Improve communication and language barriers.

Fourthly, Directly engage in cross-cultural interactions with patients.

Further, Participate in online chats and networks.

How does culture influence health beliefs?
The influence of culture on health is vast. It affects perceptions of health, illness and death, beliefs about causes of disease, approaches to health promotion, how illness and pain are experience and express ed, where patients seek help, and the types of treatment patients prefer.

How does diversity affect nursing?

Diversity in the Nursing field is essential because it provides opportunities to administer quality care to patients. … Every healthcare experience provides an opportunity to have a positive effect on a patient’s health. Healthcare providers can maximize this potential by learning more about patients’ cultures.

Assessing the abdomen A woman with abdominal cramping

This is an assignment that focuses on assessing the abdomen A woman with abdominal cramping. The paper also requires reviewing the episodic note case study.

Assessing the abdomen A woman with abdominal cramping

A‌‌‍‌‌‍‍‍‌‍‍‌‍‍‍‌‌‌‍ssignment 1:
Lab Assignment: Assessing the Abdomen A woman went to the emergency room for severe abdominal cramping. She was diagnosed with diverticulitis; however, as a precaution, the doctor ordered a CT scan. The CT scan revealed a growth on the pancreas, which turned out to be pancreatic cancer—the real cause of the cramping. Because of a high potential for misdiagnosis, determining the precise cause of abdominal pain can be time consuming and challenging. By analyzing case studies of abnormal abdominal findings, nurses can prepare themselves to better diagnose conditions in the abdomen.

In this Lab Assignment, you will firstly analyze an Episodic note case study that describes abnormal findings in patients seen in a clinical setting. Secondly, you will consider what history collection should be from the patients as well as which physical exams and diagnostic tests to conduct. You will also formulate a differential diagnosis with several possible conditions.

Assignment

To Prepare Review the Episodic note case study your instructor provides you for this week’s Assignment. Please see the “Course Announcements” section of the classroom for your Episodic note case study. With regard to the Episodic note c‌‌‍‌‌‍‍‍‌‍‍‌‍‍‍‌‌‌‍ase study provided: Review this week’s Learning Resources, and consider the insights they provide about the case study. Consider what history would be necessary to collect from the patient in the case study. Additionally, consider what physical exams and diagnostic tests would be appropriate to gather more information about the patient’s condition. Identify at least five possible conditions that may be in a differential diagnosis for the patient.

The Assignment Analyze the subjective portion of the note. List additional information that should be in the documentation. Also analyze the objective portion of the note. List additional information that should be in the documentation. Why or why not? What diagnostic tests would be appropriate for this case, and how would the results  to make a diagnosis? Would you reject/accept the current diagnosis? Why or why not? Identify three possible conditions to consider as a differential diagnosis for this patient. Explain your reasoning using at least three different references from current evidence-base‌‌‍‌‌‍‍‍‌‍‍‌‍‍‍‌‌‌‍ literature.

HPI ROS and physical exam-Physical Exam of the Adult Patient

For the purpose of this assignment, include: complete HPI, ROS, and physical exam comprehensive Physical Exam of the Adult Patient. Elicit and document a patient history, including: Chief Complaint, History of Present Illness, Past Medical and Surgical History, Family History and Personal Social History.

HPI, ROS, and physical exam-Physical Exam of the Adult Patient

For the purpose of this assignment, include: complete HPI, ROS, and physical exam Comprehensive Physical Exam of the Adult Patient.
Firstly, Elicit and document a patient history, including: Chief Complaint, History of Present Illness, Past Medical and Surgical History, Family History and Personal Social History.

Secondly, Accurately document Subjective Abnormal Data.

Thirdly,  Elicit a complete Review of Systems (ROS).

Fourthly, Demonstrate understanding the meaning of Pertinent Positives and Negatives.

Furthermore, Demonstrate the components of symptom analysis using the “Seven Attributes of a Symptom.”

Also,  Begin the practice of sequencing and coordinating the Comprehensive Physical Exam of the Adult Patient.

Additionally,  Identify anatomical landmarks of the human body pertaining to the systems listed below.

Lastly, Correlate examination techniques of the following body systems using the correct sequence and anatomical landmarks in an adult patient:

A. General Survey, Vital Signs, Pain g. Female Genitalia*

b. Behavior and Mental Status h. Anus Rectum and Prostate
c. Skin, Hair, and Nails i. Musculoskeletal System
d. Lymphatic System j. Nervous
e. Head and Neck
f. Thorax and Lungs
b. Cardiovascular
c. Breasts and Axilla
d. Abdomen
e. Peripheral Vascular
f. Male Genitalia

8. Use correct terminology to record objective components of the physical examination findings.
Hogan-Quigley, Palm, and Bickley: Bates’ Nursing Guide to Physical Examination and History Taking, Second Edition

• Chapters 1, 2, & 3. Review, “Seven Attributes of a Symptom” found on page 70-71.

Please focus your reading for this unit on the sections of each chapter that detail system anatomical landmarks and general examination techniques. For the most part, this reading assignment, while extensive, is a review of material previously mastered at the undergraduate level. There is a tremendous amount of useful and important information in these chapters, which will become more useful as you gain skills and increase expertise in performing the physical exam. The goal of this course is to gain proficiency in the exam itself, and to be able to document your findings. As you read, keep this in mind.

The only way to become comfortable and proficient in physical exam skills is to practice them. We strongly suggest that you practice your assessment skills for each system at least 10 times on different classmates.

Chapter 1:

Firstly, Introduction to Health assessment

Chapter 4:

Secondly, The Health History

Chapter 6:

Thirdly, Physical examination

Chapter 7

Fourthly, Beginning the Physical Examination: General Survey, Vital Signs, Pain

Chapter: 8

Further, Nutrition

Chapter 9:

Also, The Skin, Hair and Nails

Chapter 10:

Additionally, The Head and Neck Page 7 of 25

Chapter 11:

Moreover, The EYES

Chapter 12:

Besides, Ears, Nose, Mouth and Throat

Chapter 13:

Apparently, The Thorax and Lungs

Chapter 14:

Also, The Cardiovascular System

Chapter 10:

Further, The Breasts and Axillae

Chapter 11:

Also, The Abdomen

Chapter 15:

Furthermore, The Peripheral Vascular System

Chapter 16:

Also, The Gastrointestinal and renal System

Male Genitalia and Hernia

Chapter 14:

Moreover, Female Genitalia

Chapter 15:

The Anus, Rectum, and Prostate

Chapter 16:

Lastly, The Musculoskeletal System

Chapter 17:

Finally, The Nervous System

 

ASSESSMENTS

1. Using the guidelines presented in the “Components of the Health History” chapters 1& 4 from Hogan-Quigley, Palm, and Bickley: Bates’ Nursing Guide to Physical Examination and History Taking, Second Edition text, obtain and document a complete ROS for a patient. Document Pertinent Positives and Negatives while taking this ROS, using the Components of the Health History in the Hogan-Quigley, Palm, and Bickley: Bates’ Nursing Guide to Physical Examination and History Taking, Second Edition text, found under “Present Illness.” Include a thorough description of each positive finding on the elicited ROS.

2. Complete a separate one-page document and choose one of the Subjective Abnormal Findings mentioned by your patient in the CC, History of Present Illness, or Review of Systems. Document your understanding of how to use the “Seven Attributes” for symptom analysis found in the Hogan-Quigley, Palm, and Bickley: Bates’ Nursing Guide to Physical Examination and History Taking, Second Edition text.

3. Nursing Care plan Peripheral artery disease

This assignment should be submitted to APD in Week 13.
Review the Grading Rubric below which will guide you as you prepare to demonstrate proficiency in your documentation of the Review of Systems and the Seven Attributes of symptom analysis.

What is lymphedema how is it diagnosed and how do you classify 

What is lymphedema, how is it diagnosed and how do you classify the clinical stages of lymphedema? Secondly, What are the key management strategies related to the clinical issues associated with lymphedema?

What is lymphedema, how is it diagnosed and how do you classify

Question .1
1. Firstly, The Diagnosis and Treatment of Peripheral Lymphedema: 2016 Consensus Document of the International Society of Lymphology. Lymphology. 2016 Dec; 49(4):170-84.

1.  Secondly, Penzer R. Lymphoedema. Nurs Stand. 2003; 17(35):14-20.

Question:1(i) Firstly, What is lymphedema, how is it diagnose d and how do you classify the clinical stages of lymphedema?

Question: 1(ii) Secondly, What are the key management strategies related to the clinical issues associated with lymphedema?

 Question .2

2.   Firstly, Stocks ME, Freeman MC, Addiss DG. The Effect of Hygiene- Based Lymphedema Management in Lymphatic Filariasis-Endemic Areas: A Systematic Review and Meta-analysis. PLoS Negl Trop Dis. 2015 Oct 23;9(10):e0004171. doi: 10.1371/journal.pntd.0004171. eCollection 2015 Oct.

2. Secondly, Coulibaly YI, Dembele B, Diallo AA, et al. A randomized trial of doxycycline for   mansonella perstans infection. N Engl J Med. 2009; 361(15):1448-58.

Question: 2(i) Firstly, What is the role of hygiene and doxycycline in the management of filarial related lymphedema?

Question: 2(ii) Secondly, How can hygiene and doxycycline be extrapolated to the management of other forms of lymphedema?

 Question 3

3. Firstly, Hadamitzky C, Pabst R, Gordon K, Vogt PM. Surgical procedures in lymphedema         management.J Vasc Surg Venous Lymphat Disord. 2014 Oct;2(4):461-8. doi: 10.1016/j.jvsv.2014.02.001. Epub 2014 Mar 22.

3. Secondly, Sharkey AR, King SW, Ramsden AJ, Furniss D. Do surgical interventions for limb lymphoedema reduce cellulitis attack frequency? Microsurgery. 2017 May;37(4):348-353. doi: 10.1002/micr.30115. Epub 2016 Sep 23.

Question: 3 (i) Firstly, What is the role of surgical interventions for lymphedema?

Question: 3 (ii) Secondly, What are the complications and long-term consequences of these surgical procedures?

Question 4

13.4 Firstly, Rabe E et al. Indications for medical compression stockings in venous and lymphatic disorders: An evidence-based consensus statement. Phlebology. 2018 Apr;33(3):163-184. doi: 10.1177/0268355516689631. Epub 2017 Feb 22.

13.4 Secondly, Scheer R. Clinical innovation: compression garments for managing lymphoedema. Also, Wounds International 2017;8(2): 34–8

Question: 13.4 (i) Firstly, Describe the principles of lymphedema bandaging.

Question: 13.4 (ii) Secondly, How would you assist the patient with financial constraints to pay for bandages or stockings?

Question 5
Firstly, Utilize all the readings (refrences) provided above to answer this question.

Question: 5

Firstly, Discuss a brief scenario of a patient who suffers from lymphedema in your practice or a practice you are familiar with, including:
Firstly, Special patient centered concerns.
Secondly,  Physical exam or description of the lymphedema.
Thirdly, Diagnostic testing or procedures that have been carried out planned or would be part of the ideal management.
Fourthly, Treatment to date planned and treatment that would be part of ideal care if resources were available.

 

Choose one member of the family from the module

Choose one member of the family from the module. This person has come to A&E following a scald to their left arm. You need to discuss the appropriate communication and assessment skills required to facilitate person centred care for this family member.

Choose one member of the family from the module

Firstly, choose one member of the family from the module. Secondly, this person has come to A&E following a scald to their left arm.
You need to discuss the appropriate communication and assessment skills required to facilitate person centred care for this family member.

Martha:
Firstly, she lives alone – refuses to move from home.

Secondly, husband died 8 months ago.

Thirdly, diagnosed with vascular dementia.

Fourthly, suffers from COPD – diagnosed 8 years ago.

Further, since the death of her husband has become more confused.

Also, has recurrent falls.
Vascular Dementia – one type of dementia that is progressive in nature and characterised by progressive decline in ability to maintain activities of daily living.

Effect on Martha – problems with planning or organising, making decisions or solving problems, difficulties following a series of steps (eg cooking a meal), slower speed of thought, problems concentrating, including short periods of sudden confusion, problems recalling recent events, speech becoming less fluent, problems perceiving objects in three dimensions.

Effect on family – Stress; frustration; strain on family relationships; wellbeing of family members; financial implications; anxiety.

COPD – Chronic Obstructive Pulmonary Disease. Characterised by chronic obstruction of lung airflow that is not fully reversible.

Effect on Martha – Prone to chest infections; limitation of mobility; reduced ability to maintain activities of daily living.

Effect on family- increased input into caring for Martha; anxiety; financial implications; escorting Martha to appointments.

Learning outcomes:

Explain and apply best-practice approach to assess the mental and physical health and well-being of all people across the life span.

Demonstrate knowledge of and apply the core skills of communication essential to the development of relationship with adult and children, at different stages of development across a range of care settings, recognising the potential barriers to communicating with all people across the lifespan.

Explain and apply the platforms for accountability and recognise professional responsibility to fulfil those platforms through reflection and continued professional development.

Students will approach five patient beds within the simulation lab

Students will approach five patient beds within the simulation lab. Each patient’s name is clearly designated at the head of the bed. There are orders, armbands, Kardexes, hand-off report sheets, and an explanation of each scenario at each patient bedside.

Students will approach five patient beds within the simulation lab

Process:
Students will approach five patient beds within the simulation lab. Each patient’s name is clearly
designated at the head of the bed. There are orders, armbands, Kardexes, hand-off report sheets,
and an explanation of each scenario at each patient bedside. Students are to review each scenario
as a clinical group, collaborate with clinical group, and after review of each patient, determine
priorities and/or delegations of care, documenting their decisions on the form provided. Students will be informed of the correct priorities at debriefing.

1. Patient: Susan Right
Age: 23; DOB 11/4/1995

Scenario:

You are the nurse. The health care provider has completed an assessment of the patient.
You cared for her yesterday after delivery. She appears more confused than when you
cared for her previously. The newborn is in the crib in the corner, sucking on her fist.
Vital Signs are: Temp 100.9, HR 116, RR 32, BP 80/60, SPO2 85% on Room Air
On your assessment, you note a boggy fundus, large clots, fundus remains boggy on
massage. Saline lock is in Right hand.
What will you do next?

2. Patient: Emma Right
Age: 1 day; DOB 11/13/XX

Scenario:

You are the nurse. The newborn is in the crib in the corner of the mom’s room.
Vital Signs are: Temp 37.2 C., HR 140, RR 34, BP 70/55, SPO2 95%
Weight: 7lb 2oz. Admit Apgar 8 at 1 minute and 9 at 5 minutes
On assessment, you note the vital signs are the same as what was given to you in the handoff report. The baby is sucking on her fist and moving around. You attempt to obtain a
feeding schedule from the mom, but she has a flat effect, not looking at the baby, and not
responding to the question.
What will you do next?

3. Patient: Elizabeth Will you
Age: 24; DOB 3/24/1994

Scenario:

You are the nurse.
Vital signs are: Temp 98.6, HR 80, RR 16, BP 116/80.
On assessment the fundus is boggy with clots; the fundus firms with massage.
Hgb is 8 from 11 on yesterday
Hct is 28 from 32 yesterday
You received from hand-off report that the patient is receiving a unit of PRBCs. Upon
entering the room, the patient was having respiratory distress.
What will you do next?
4. Patient: JoAnna Train
Age: 27; DOB 04/19/1991

Scenario:

You are the nurse for the patient who is 39 weeks gestation, Gravida 2 Para 2.
Vital Signs are: Temp 99.1, HR 88, BP 122/60.
Her underpad is wet. You place the external fetal monitor and interpret the reading as
contractions 8 minutes apart, irregular, FHR is 120-130, moderate variability.
What will you do next?

5. Patient: Rebecca Dowee
Age 24: DOB 4/23/1994

Scenario:

You are the nurse.
Vital signs are: Temp 98.6, HR 110, RR 28, BP 98/60.
On assessment the fundus is boggy; she is diaphoretic. The patient is Muslim. Her
husband is not present at the time of your assessment.
Hgb is 8 from 11 on yesterday
Hct is 28 from 32 yesterday
What will you do next, while being culturally sensitive?
Decision/Delegation/Prioritization Activity
“What Would You Do Walk-Through”

1. FIRSTLY, Which patient requires attention First and how might you accomplish this?
Please explain the rationale for your decision:

2. SECONDLY, Which patient will you see next, and how might you accomplish this BEST?
Please explain the rationale for your decision?

3. THIRDLY, Which patient will you see next?
Please explain the rationale for your decision?

4. FOURTHLY, Which patient will you see next?
Please explain the rationale for your decision?

5. FURTHER, Which patient will you see last?
Please explain the rationale for your decision?

6. ALSO, Place yourself in this situation, with this patient assignment. Reflect on what your BEST
course of action would be and how you might ensure patient-centered care.

Please Explain:
FIRSTLY, Rather than work as a group, you can work in pairs, share among the entire group and
come up with one document.
ALSO, Write a progress note individually on one of the patients with PIE
LASTLY, Using SBAR, individually write a communication message to the Charge Nurse

How we should we address diet with our patients-socio-economic forces

How we should we address diet with our patients (giving advice vs. a motivational interviewing approach vs. a combo vs. other? Your thoughts.) What are socio-economic forces, policies and health disparities related to diet and food access?

How we should we address diet with our patients-socio-economic forces

In the unit on Nutrition, Obesity, diet and Food Access, the various assigned materials approach the content from different angles. The following questions will be the basis of a short reflection essay.

1. How we should we address diet with our patients (giving advice vs. a motivational interviewing approach vs. a combo vs. other? Your thoughts.)

2. What are socio-economic forces, policies and health disparities related to diet and food access?
In a short paper (minimum of 3 paragraphs, but doesn’t need to be much longer than 3 paragraphs), comment on the above questions with something that struck you from the assigned materials. You can also relate it to your experience with patients or your experience as a patient. However, use the assigned materials and documentary as a basis for your discussion. Did something surprise you or was new information for you? Is there something you agree or disagree with?
Be sure to appropriately site any sources using APA. Finally,  I do not expect you to do research or include anything outside of the assigned readings.

Grading Criteria

Firstly, reflect on communication strategies with patients re diet 30 pts.
(MI vs. advice)

Secondly, Identify socio-economic factors, policies & health disparities related to diet and food access 40 pts.

Thirdly, Writing is clear 20 pts.

Fourthly, Utilizes at least 2 sources 10 pts.

More details;

Lastly, what is the role of a nurse in nutrition education?
Nurses have the expertise and responsibility to ensure that patients and clients’ nutritional needs are met. Providing nutrition screening and appropriate nutrition advice is essential to improve healthy eating and subsequent health outcomes. Non-communicable diseases are often associated with modifiable risk factors.

 

The patient analysis and teaching tool proposal analysis

This is a paper that focuses on the patient analysis and teaching tool proposal. The paper also focuses on the health promotion and risks in health.

The patient analysis and teaching tool proposal

In your patient analysis and teaching tool proposal, the following critical elements must be addressed:
I. Patient Analysis
A.    Analyze health risks uncovered during your assessment. In other words, what indicators of disease, illness, or unhealthy behaviors the patient engages in did you discover? If you feel there were none, be sure to explain your rationale.
B.     Analyze healthy behaviors the patient engages in that you discovered during your assessment. In other words, what opportunities exist for health promotion? If you feel there were none, be sure to explain your rationale.

II. Health Promotion Teaching Tool Proposal
A.    Describe a health risk or healthy behavior that you identified during your assessment that you will use as the basis for your health promotion teaching tool proposal and explain why you chose that topic.
B.     Identify the goals or objectives of your proposed teaching tool based on the health risk or healthy behavior you identified.
C.    Specify the critical information about your topic based on your assessment findings that you would include in your teaching tool.

D.    Recommend specific intervention(s) for your topic that will result in improved patient outcomes or will promote health maintenance. Be sure to support your recommendations with evidence-based research.
E.     Determine the medium (presentation, brochure, poster, or other format) that would be most appropriate for communicating information about your chosen topic. Be sure to explain your rationale.
F.     Discuss the health literacy best practices you would employ to ensure your teaching tool is appropriate for diverse populations. Be sure to support your claims with specific examples from evidence-based research.
G.    Describe your plan to ensure compliance of your teaching tool with Flesch-Kincaid readability guidelines. Be sure to explain your rationale.

14 years girl with eating disorder-she recently discharges

The patient is a 14 years girl with eating disorder. She recently discharges from hospital due to require NG tube feeding. She also has a 12 years old sister has same eating disorder. Both of her and her sister are rude to their mom. Pleas mention in the reflection and need for a therapy. Please concentrate on Plan part of this assessment.

14 years girl with eating disorder-she recently discharges

The patient is a 14 years girl with eating disorder. She recently discharges from hospital due to require NG tube feeding. She also has a 12 years old sister has same eating disorder. Both of her and her sister are rude to their mom. Pleas mention in the reflection and need for a therapy. Please concentrate on Plan part of this assessment.

ASSESSMENT:

List your priority diagnosis (es). For each priority diagnosis, list at least three differential diagnoses, each of which must be supported with evidence and guidelines. For holistic care, you need to include previous diagnoses and indicate whether these are controlled or not controlled. These should also be include d in your treatment plan.
Anorexia Nervosa 1st,
Bulimia Nervosa 2nd,
Binge eating disorder 3rd,

Please make up the s/s to fit the priority diagnosis (Anorexia Nervosa).

PLAN:

Include additional laboratory and diagnostic tests, consults, therapeutic modalities, health promotion patient education as well as disposition/follow up instructions as they pertain to your patients’ assessment.

Treatment Plan:

If applicable, include both pharmacological and non-pharmacological strategies, alternative therapies, follow-up recommendations, referrals, consultations, and any additional labs, x-ray, or other diagnostics. Support the treatment plan with evidence and guidelines.

Health Promotion:

Include exercise, diet, and safety recommendations, as well as any other health promotion strategies for the patient/family. Support the health promotion recommendations and strategies with evidence and guidelines.

Disease Prevention:

As appropriate for the patient’s age, include disease prevention recommendations and strategies such as fasting lipid profile, mammography, colonoscopy, immunizations, etc. Support the disease prevention recommendations and strategies with evidence and guidelines.

REFLECTION:

Document what you learned from this experience? Any ah-ha’s?

You are required to include at least three evidence based peer-reviewed journal articles or evidenced based guidelines which relates to this case to support your diagnostics and differentials diagnoses. Be sure to use correct APA 6th edition formatting.

Assessing and Treating Clients with Psychosis and Schizophrenia

Assessing and Treating Clients with Psychosis and Schizophrenia. Examine Case Study: Pakistani Woman with Delusional Thought Processes. You will be asked to make three decisions concerning the medication to prescribe to this client.

Assessing and Treating Clients with Psychosis and Schizophrenia

Examine Case Study: Pakistani Woman with Delusional Thought Processes. You will be asked to make three decisions concerning the medication to prescribe to this client. Be sure to consider factors that might impact the client’s pharmacokinetic and pharmacodynamics processes.

At each decision point stop to complete the following:

Decision #1
Firstly, Which decision did you select?

Secondly, Why did you select this decision? Support your response with evidence and references to the Learning
Resources.

Thirdly, What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.

Fourthly, Explain any difference between what you expected to achieve with Decision #1 and the results of the decision. Why were they different?

Decision #2
Firstly, Why did you select this decision? Support your response with evidence and references to the Learning
Resources.

Secondly, What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.

Thirdly, Explain any difference between what you expected to achieve with Decision #2 and the results of the decision. Why were they different?

Decision #3
Firstly, Why did you select this decision? Support your response with evidence and references to the Learning
Resources.
Secondly, What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.
Explain any difference between what you expected to achieve with Decision #3 and the results of the decision. Why were they different?
Also include how ethical considerations might impact your treatment plan and communication with clients.