Three out of the five most popular health-related searches on cell phones have to do with sex

March 31, 2022/in /by developer

Internet searches and cell phones. Pew Internet and American Life Project asked a random sample of 2485 cell phone users whether they had used their cell phone to look up health or medical information. Of these, 422 said “Yes.”²¹

(a) Pew dialed cell phone telephone numbers at random in the continental United States in an attempt to contact a random sample of adults. Based on what you know about national sample surveys, what is likely to be the biggest weakness in the survey?

(b) Act as if the sample is an SRS. Give a large-sample 90% confidence interval for the proportion p of all cell phone users who have used their cell phone to look up health or medical information.

(c) Three out of the five most popular health-related searches on cell phones have to do with sex: “pregnancy,” “herpes,” and “STD” (sexually transmitted diseases). Sex-related queries don’t even show up on Google and Yahoo’s lists of the top five health searches on computers. What do you think explains the difference in the topics of health-related searches on cell phones versus computers? When drawing conclusions from a sample, you must always be careful to take into account the relevant population.View less »

MN 576 Quiz Assignment

March 31, 2022/in Nursing Homework Help /by Naomi Nas

MN 576 Quiz Submissions – Unit 5 Midterm

Submission View

Random Section 1

Question 1

2 / 2 points

Which HPV types are most often associated with cervical and anogenital cancer?

Question options:

1)	1, 2, and 3

2)

6 and 11

3)

16 and 18

4)

22 and 24

Question 2

2 / 2 points

During a breast exam you note all of the findings below as normal except:

Question options:

1)	asymetrical size

2)	a supernumerary nipple

3)	hyperpigmentation

4)	breasts that move up symmetrically with raising the arms

Question 3

2 / 2 points

A 30-year-old woman presents without symptoms but states that her male partner has dysuria without penile discharge MN 576 Quiz. Examination reveals a friable cervix covered with thick yellow discharge. This description is most consistent with an infection caused by: MN 576 Quiz Assignment

Question options:

1)	Chlamydia trachomatis.

2)	Neisseria gonorrhoeae.

3)	human papillomavirus (HPV).

4)	Trichomonas vaginalis.

Question 4

2 / 2 points

The vaccine Gardasil that is used to prevent some strains of HPV infection is recommended in both males and females.

Question options:

	1) True
	2) False
Question 5		2 / 2 points

Lesbians may experience which of the following barriers to health care?

Question options:

1)	Homophobia from the healthcare provider

2)	Incorrect knowledge about health care needs of lesbians by healthcare providers

3)	Lack of insurance and/or access under partner’s coverage MN 576 Quiz

4)	All of the above

Question 6

2 / 2 points

Which of the following best describes lesions associated with condyloma acuminatum?

Question options:

1)	verruciform

2)	plaque-like

3)	vesicular-form

4)

bullous

Question 7

2 / 2 points

Presumptive treatment for PID should be initiated in sexually active young women and other women at risk for STDs if they are experiencing pelvic or lower abdominal pain, if no cause for the illness other than PID can be identified, and if one or more of the following minimum clinical criteria are present on pelvic examination:

Question options:

1)	cervical motion tenderness

2)	uterine tenderness

3)	adnexal tenderness.

4)	All of the above

Question 8

2 / 2 points

How long after contact do clinical manifestations of syphilis typically occur?

Question options:

1)	less than 1 week

2)	1 to 3 weeks

3)	2 to 4 weeks

4)	4 to 6 weeks

Question 9

2 / 2 points

In assessing a woman with disabilities, which of the following terms should be avoided?

Question options:

1)

Crippled

2)	Handicapped

3)	Mentally retarded MN 576 Quiz

4)	All of the above

Question 10

2 / 2 points

The definition of menopause is

Question options:

1)	Frequently skipping period for one year

2)	One year without a period

3)	Onset of hot flashes and night sweats with irregular menstruation

4)	None of the above

Question 11

2 / 2 points

MN 576 Quiz Treatment options for bacterial vaginosis include all of the following except:

Question options:

1)	oral metronidazole.

2)	clindamycin cream.

3)	oral clindamycin.

4)	oral azithromycin.

Question 12

2 / 2 points

Physical examination of a 19-year-old woman with a 3-day history of vaginal itch reveals moderate perineal excoriation, vaginal erythema, and a white, clumping discharge. Expected microscopic examination findings include:

Question options:

1)	a pH greater than 6. 0.

2)	an increased number of lactobacilli.

3)

hyphae.

4)	an abundance of white blood cells.

Question 13

2 / 2 points

Which of the following is a contraindication to estrogen/progestin-containing methods (combined oral contraception [COC], patch [Ortho Evra], or ring [NuvaRing]) MN 576 Quiz?

Question options:

1)	mother with a history of breast cancer

2)	personal history of hepatitis A at age 10 years

3)	presence of factor V Leiden mutation

4)	cigarette smoking one pack per day in a 22-year-old

Question 14

2 / 2 points

Recommendations for adolescents with disabilities include a comprehensive sex education program that should be tailored to fit their specific needs.

Question options:

	1) True
	2) False
Question 15		0 / 2 points

In assessing a 13 year old female, you know that the presence of breast bud with elevation of breast and papilla; enlargement of areola indicate which Tanner Stage?

Question options:

1)

Stage1

2)

Stage 2

3)

Stage 3

4)

Stage 4

Question 16

2 / 2 points

The Pap test should not be considered a screening test for STDs.

Question options:

	1) True
	2) False
Question 17		2 / 2 points

Which of the following agents is most active against C. trachomatis?

Question options:

1)	amoxicillin

2)	metronidazole

3)	azithromycin

4)	ceftriaxone

Question 18

2 / 2 points

When performing a bimanual exam all of the following are noted as normal findings except:

Question options:

1)	retoverted uterus

2)	anteflexed uterus

3)	fixed immobile uterus

4)	smooth, firm ovary

Question 19

2 / 2 points

Routine screening for C. trachomatis on an annual basis is recommended for all sexually active females aged <25 years .

Question options:

	1) True
	2) False
Question 20		2 / 2 points

When performing a pelvic examination the first part of the external genitalia exam is

Question options: MN 576 Quiz

1)	speculum examination

2)

palpation

3)	inspection

4)	cervical sampling

Question 21

2 / 2 points

In women who have experienced a spinal cord injury, temporary cessation of menses is normal for up to one year following the injury.

Question options:

	1) True
	2) False
Question 22		2 / 2 points

When counseling a woman about COC use, you advise that:

Question options:

1)	long-term use of COC is discouraged because the body needs a “rest” from birth control pills from time to time.

2)	fertility is often delayed for many months after discontinuation of COC.

3)	there is an increase in the rate of breast cancer after protracted use of COC.

4)	premenstrual syndrome symptoms are often improved with use of COC.

Question 23

2 / 2 points

Which of the following terms describes the mechanism of action of imiquimod (Aldara)?

Question options:

1)	keratolytic

2)	immune modulator

3)

cryogenic

4)

cytolytic

Question 24

2 / 2 points

Treatment of vulvovaginitis caused by Candida albicans includes:

Question options:

1)	metronidazole gel.

2)	clotrimazole cream.

3)	hydrocortisone ointment.

4)	clindamycin cream.

Question 25

2 / 2 points

Screening for osteoporosis with DEXA scan should begin

Question options:

1)

age 50

2)	one year after menopause

3)

age 65

4)

age 60

Question 26

2 / 2 points

What is the approximate incubation period for Neisseria gonorrhoea?

Question options:

1)	1 to 5 days

2)	7 to 10 days

3)

18 days

4)

28 days

Question 27

2 / 2 points

What percentage of anogenital and cervical cancers can be attributed to HPV infection?

Question options:

1)	less than 30%

2)	at least 50%

3)	at least 70%

4)	95% or greater

Question 28

2 / 2 points

Universal screening for chlamydia and gonorrhea in women ≤35 years entering juvenile and adult correctional facilities has been a long-standing recommendation.

Question options:

	1) True
	2) False
Question 29		2 / 2 points

A 22-year-old woman taking a 35-mcg ethinyl estradiol COC calls after forgetting to take her pills for 2 consecutive days. She is 2 weeks into the pack. You advise her to:

Question options:

1)	take the last pill missed immediately, even if this means taking 2 pills today.

2)	discard two pills and take two pills today.

3)	discard the rest of the pack and start a new pack with the first day of her next menses.

4)	continue taking one pill daily for the rest of the cycle.

Question 30

2 / 2 points

HCV infection is the most common chronic bloodborne infection in the United States, with an estimated 2.7 million persons living with chronic infection

Question options:

	1) True
	2) False
Question 31		2 / 2 points

Adolescent girls are not candidates for IUD use for contraception

Question options:

	1) True
	2) False
Question 32		2 / 2 points

About ____ of patients with genital warts have spontaneous regression of the lesions? MN 576 Quiz

Question options:

1)

10%

2)

25%

3)

50%

4)

75%

Question 33

2 / 2 points

Complementary and alternative medicine (CAM) is defined as a group of therapies that are not considered part of Western culture and include all of the following except:

Question options:

1)	Congugated estrogen

2)	Aromatherapy

3)

Tai Chi

4)

Yoga

Question 34

2 / 2 points

Which HPV types are most likely to cause genital condyloma acuminatum?

Question options:

1)	1, 2, and 3

2)

6 and 11

3)

16 and 18

4)

22 and 24

Question 35

2 / 2 points

Which test is performed around the time of ovulation to diagnose the basis of infertility?

Question options:

1)	Hysterosalpingogram

2)	Ultrasonography

3)	Laparoscopy

4)	Follicle-stimulating hormone (FSH) level

Question 36

2 / 2 points

The NP is seeing a 30-year-old woman before her routine gynecologic examination, the NP questions that patient about her recent menstrual cycles. Which statement made by the patient should prompt further investigation?

Question options:

1)	“My flow is very heavy all the time.”

2)	“I have occasionally spot in between cycles”

3)	“My menstrual cycles varies from 25 to 30 days.”

4)	“I have cramping prior to my cycle starting”

Question 37

2 / 2 points

Women with bacterial vaginosis typically present with:

Question options:

1)

vulvitis.

2)

pruritus.

3)

dysuria.

4)	malodorous discharge.

Question 38

2 / 2 points

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Treatment options for patients with condyloma acuminatum include all of the following except:

Question options:

1)	topical acyclovir.

2)	cryotherapy.

3)	podofilox.

4)	trichloroacetic acid.

Question 39

0 / 2 points

The average onset of perimenopause is between the ages of:

Question options:

1)	35 to 40 years.

2)	40 to 45 years.

3)	45 to 50 years.

4)	50 to 55 years.

Question 40

2 / 2 points

Which of the following is not representative of the presentation of primary syphilis?

Question options:

1)	painless ulcer

2)	localized lymphadenopathy

3)	flu-like symptoms

4)	spontaneously healing lesion

Question 41

2 / 2 points

Noncontraceptive benefits of COC use include a decrease in all of the following except:

Question options:

1)	iron-deficiency anemia.

2)	pelvic inflammatory disease (PID).

3)	cervicitis.

4)	ovarian cancer.

Question 42

2 / 2 points

MN 576 Quiz In patients who are allergic to azithromycin, an alternative treatment to chlamydia is

Question options:

1)	Doxycycline 100mg twice daily for 7 days

2)	Macrobid 100mg twice daily for 5 days

3)	BactimDS 1 PO BID for 3 day

4)	All of the above

Question 43

2 / 2 points

Puberty consists of a series of predictable events, and the sequence of changes in secondary sexual characteristics has been categorized by several groups. The staging system utilized most frequently used to describe these events is Tanner staging.

Question options:

	1) True
	2) False
Question 44		2 / 2 points

Which of the following may be a useful tool in screening for Female Sexual Disorder (FSD)?

Question options:

1)	The Female Sexual Function Index

2)	The Female Sexual Distress Scale

3)	The Orgasmic Disorder Scale

4)

A and B

Question 45

2 / 2 points

Which of the following is found in tertiary syphilis?

Question options:

1)	arthralgia

2)	lymphadenopathy

3)	macular or papular lesions involving the palms and soles

4)

gumma

Question 46

2 / 2 points

A patient presents to you with a chief complaint of primary dysmenorrhea, which nonpharmacologic intervention might you recommend she try first?

Question options:

1)	participating in physical activity

2)	increase iron rich foods to replace blood that is lost

3)	use of a heating pad on the pelvis for cramping

4)	use of an NSAID

Question 47

2 / 2 points

Which of the following agents is active against N. gonorrhoeae?

Question options:

1)	ceftriaxone

2)	metronidazole

3)	ketoconazole

4)	amoxicillin

Question 48

0 / 2 points

A recommended treatment for rectal gonorrhea is:

Question options:

1)	oral amoxicillin.

2)	oral azithromycin.

3)	oral ciprofloxacin.

4)	ceftriaxone injection.

Question 49

2 / 2 points

When charting on a patient whom you have noted a breast lump it is important to document

Question options:

1)	tenderness

2)

size

3)

location

4)

mobility

5)	all of the above MN 576 Quiz

Question 50

2 / 2 points

A 24-year-old woman presents with a 1-week history of thin, green-yellow vaginal discharge with perivaginal irritation. Physical examination findings include vaginal erythema with petechial hemorrhages on the cervix, numerous white blood cells, and motile organisms on microscopic examination. These findings most likely represent:

Question options:

1)	motile sperm with irritative vaginitis.

2)	trichomoniasis.

3)	bacterial vaginosis.

4)	condyloma acuminatum.

Describe examples of effective polices, services, or programs that apply to your selected problem

March 31, 2022/in /by developer

Week 5 Written Assignment -Essential Public Health Services

Week 5 Written Assignment – Essential Public Health Services

Instructions:

Make sure all of these instructions are followed carefully and exactly.

Select a population health problem you are interested in and about which you feel passionately (please use the Affordable Care Act). Discuss how each of the 10 Essential Public Health Services listed here: (http://www.cdc.gov/nphpsp/essentialservices.htmlcan) contribute to solving your selected significant public health problem.

Describe examples of effective polices, services, or programs that apply to your selected problem.

Provide a summary of how all 10 Essential Public Health Services working together form a comprehensive approach to solving the problem. One place to look for significant population health problems is the CDC Winnable Battles campaign.

My personal views are AGAINST the ACA and paper should be written as such.

***Cite at least 10 scholarly references. APA format!

1,000-1,500 words 6-7 pages minimum.Double-space, 12 pt font. Cite references in APA Style</pstyle=”margin-bottom:>

General Grading Rubric for Written Assignments (for assignments without a specific rubric)

Each written assignment will be evaluated in the following manner:

10% for proper use of grammar and spelling. Students should aim for having perfect spelling and grammar.
30% for organization. The paper should have a logical organization for the concepts and arguments presented. There should be a thesis statement or several statements outlining the goals of the paper and the achievement of these goals should be apparent throughout the final text.
10% for APA format. Please use this format for the title page, citations and reference lists. Contact the Benedictine University’s Student Success Center for writing assistance.
50% for content and clarity. The content of the paper should be clear and it should be apparent to the reader that the questions posed or the defined task has been undertaken as described by the original instructions. It should also be clear that students utilized the information referenced from the sources cited and the textbook readings. Vague and generalized statements should be avoided.

https://www.apha.org/topics-and-issues/health-reform</pstyle=”margin-bottom:>View less »

Public Health Care issues Raised in our text HealthCare

March 31, 2022/in /by developer

Public Health Care issues Raised in our text HealthCare Delivery in the US Identify a current public health care issue raised in our text that affects you or someone you know. Public health care issues can be, for example, related to: clean air and water, vaccinations, communicable diseases, traffic safety, healthy food, gun use, birth control, birth defects, smoking, school lunches, and recreation opportunities, such as sufficient parks and bike paths. Define the public health issue you choose and the public policy about this concern. Describe how this issue is addressed, whether federally, by states, locally, or by private groups, or by some combination of these. If this particular issue is relevant to only certain locations or handled differently in different areas, explain this variance. How are various entities responsible for and address (or don’t) the problem and the difficulties involved? Conclude with your analysis on the importance of the issue, and, propose how the issue might be better addressed. Include at least 3 sources to support your analysis and recommendations. 3 pages, 3 APA 20.70 Health disparities refer to the differences in the quality of the healthcare services across the different populations. Health disparity results due to difference in several factors, which are beyond the rich of human influence. Disparity refers to some kind of social injustice that happens with respect to the health services amongst the different individuals in the given society (Kawachi, Subramanian,& Almeida-Filho, 2002). Some section of the society will have access to all the types of healthcare services, and other section of the society will have access to only limited types of healthcare services. As a result, people with limited access will suffer, and their life will be endangered more in comparison with those who have access to all the types of healthcare services. And, disparity is not only limited to access to healthcare services, but it is also related to the difference in the health outcomes and difference in the way people approach for several healthcare services. Such disparities are observed amongst different race, sexual orientation, ethnicity, socioeconomic status, and others.

Attachments:

Describe and explain how key aspects of your discussions/analysis

March 31, 2022/in /by developer

Social Support and Psychosocial Health

For this assignment your task is to a) select a theory or model of social support ( The stress buffering model) and create a brief description of it; b) acquire and discuss empirical studies of the effects of social support on psychosocial health; c) discuss the theory/model and critically analyse its capacity to characterise and explain/predict, the effects of social support on psychosocial health; d) apply aspects of the discussion/analysis for b) and/or c), to practice.

Word count: 1,800 words. The assignment is to be submitted via the Assignment 3 submission link in the assessment section of the Learning Management System (LMS) subject homepage.
Sections/subsections for the Report on the Assignment Introduction:

Provide a brief outline of the topic, and the contents, of the report. Identify and briefly describe the selected theory or model of social support.

Body: 1. Discuss the findings of empirical studies of the effects of social support on psychosocial health. 2. Provide a critically-oriented discussion of the selected theory/model. In so doing, you are to explicate the key concepts of the theory/model and explore the ways in which, and the extent to which, the theory/model characterises and explains/predicts, the effects of social support on psychosocial health.

Conclusion: Describe and explain how key aspects of your discussions/analysis, for 1 and/or 2 (as above), could be applied to health practice. Provide a summary/synthesis of the key insights elucidated in the report.

The sub-section of the introduction that briefly describes the theory/model, both of the sub-sections of the body section, and the sub-section of the conclusion that describes/explains application to practice, need to draw upon and be supported by references. All in-text citations of references and the reference list should be consistent with APA6 format.

Assessment Breakdown In assessing the assignment, the following marks will be allocated for the quality of each component:5 marks Introduction30 marks Body
15 marks: Discussion of the findings of empirical studies of the effects of social support on psychosocial health.
15 marks: Discussion of the capacity of the theory/model to capture and conceptualise the effects of social support on psychosocial health.
5 marks Conclusion
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Leadership And Management Assignment Paper

March 31, 2022/in Nursing Homework Help /by Naomi Nas

Leadership And Management Assignment Paper

Module 3 – SLP

LEADERSHIP AND MANAGEMENT

Read the following article:

Abdulaziz, A. (2013). Leadership of healthcare professionals: Where do we stand? Oman Medical Journal, 28(4), 285-287. doi: 10.5001/omj.2013.79

For this assignment, you will identify an area of health care (i.e., long-term care, facility operations, finance, health care insurance, etc.) you find particularly interesting. Locate a health care leader (supervisor, manager, director, etc.) that is currently working in your selected area of health care. You are to conduct an interview with your chosen leader. Your interview can either be by phone or an in-person interview. You are to compose a list of 8-10 questions to ask the interviewee. Your questions should be directly related to this module’s readings and should not be closed-end questions (requiring more than a yes or no response). See example questions below:

What is your leadership style and how do you apply it in your everyday activities?
What are some leadership qualities that are needed in today’s health care environment?
How do you balance power and authority as a leader? Leadership And Management Assignment Paper

You are to complete a voice-recorded, narrated 12- to 15-slide PowerPoint (PPT) presentation covering the following:

Name of leader interviewed, years in the health care industry, education, and management experience.
Provide a brief discussion of his/her role and a brief description of the health care program/department managed, and the organization itself.
Summary of questions asked and responses.
Identify both leadership and management characteristics of your interviewee.
Explain how you will apply what you learned in your interview in your career as a health care leader.
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(Note: One resource that you can use to find a health care professional to interview is LinkedIn.com. For assistance with creating a PPT with a voiceover see the following two (2) sources: (1) https://www.youtube.com/watch?v=3uk4CU7uobM (2) https://support.office.com/en-us/article/Record-a-slide-show-with-narration-and-slide-timings-0b9502c6-5f6c-40ae-b1e7-e47d8741161c) Leadership And Management Assignment Paper

SLP Assignment Expectations

Conduct additional research to gather sufficient information to justify/support the importance to questions asked and information presented in PPT.
Support your SLP with peer-reviewed articles, using at least 2 references. Use the following source for additional information on how to recognize peer-reviewed journals: http://www.angelo.edu/services/library/handouts/peerrev.php.
You may use the following source to assist in formatting your assignment: https://owl.english.purdue.edu/owl/resource/560/01/.

LEADERSHIP AND MANAGEMENT ASSIGNMENT

MOD 3 CASE

LEADERSHIP AND MANAGEMENT

Assignment Overview

Most of us are familiar with the role of a manager and that of a leader. We also know the functions each is expected to perform. However, there is a trend in the UK that puts managers in a different role. This trend is manager as coach (MAC) and will be the focus of this assignment. Before beginning the tasks, please read the following article: Leadership And Management Assignment Paper

Ladyshewsky, R. K. (2010). The manager as coach as a driver of organizational development. Leadership & Organization Development Journal, 31(4), 292-306. doi: 10.1108/01437731011043320

Case Assignment

In a 3-page paper, answer the following questions:

What is meant by the term manager as coach (MAC)?
Is this role more appropriate for a leader or manager?
What are the advantages and disadvantages regarding MAC?
How does it fit with the other roles of a manager and leader?
Would this be an effective tool in a health care setting as a leader? Why or why not?

Assignment Expectations

Conduct additional research to gather sufficient information to justify/support your responses to each question.
Support your case with peer-reviewed articles, using at least 3 references. Use the following source for additional information on how to recognize peer-reviewed journals: http://www.angelo.edu/services/library/handouts/peerrev.php.
You may use the following source to assist in formatting your assignment: https://owl.english.purdue.edu/owl/resource/560/01/ Leadership And Management Assignment Paper

LEADERSHIP AND MANAGEMENT ASSIGNMENT

Write clearly and concisely about social environmental health management using proper writing mechanics

March 31, 2022/in /by developer

August 1, 2018 admin No Comments Uncategorized

Using the scenario in Assignment 1, you are continuing to prepare for your presentation at the global conference on environmental health issues.

Write a five to six (5-6) page paper in which you:

1. Select a specific method of energy production. Determine the most significant health risk associated with the production of this energy source, and recommend a process improvement that could significantly reduce the level of risk associated with the current method of production. Support your recommendation.

2. Examine the major global health issues related to climate change. Propose a model that governments of developed countries could build upon to mitigate the negative effects of climate change on health and the environment. Provide a rationale recommendation.

3. Evaluate the health risks associated with the waste produced during the manufacturing of products. Determine two (2) ethical concerns related to these practices, and propose a strategy to modify the current practices to resolve these issues.

4. Provide a detailed outline of three (3) key government regulations created to protect the population and the environment from the effects of hazardous waste produced from manufacturing.

5. Use at least three (3) quality academic resources in this assignment. Note: Wikipedia does not qualify as an academic resource.

6.Format your assignment according to the following formatting requirements:

a. Typed, double spaced, using Times New Roman font (size 12), with one-inch margins on all sides.

b. Include a cover page containing the title of the assignment, the student’s name, the professor’s name, the course title, and the date. The cover page is not included in the required page length.

c. Include a reference page. Citations and references must follow APA format. The reference page is not included in the required page length.

The specific course learning outcomes associated with this assignment are:

*Assess the role of ethics in environmental health administration.

*Evaluate the role of government agencies in production of goods and offer a private sector solution.

*Evaluate the role of government agencies in the production of energy and offer a private sector solution.

*Use technology and information resources to research issue in environmental health management.

*Write clearly and concisely about social environmental health management using proper writing mechanics.

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Foundational Neuroscience Discussion Paper

March 31, 2022/in Nursing Homework Help /by Naomi Nas

Foundational Neuroscience Discussion Paper

As a psychiatric mental health nurse practitioner, it is essential for you to have a strong background in foundational neuroscience. In order to diagnose and treat clients, you must not only understand the pathophysiology of psychiatric disorders, but also how medications for these disorders impact the central nervous system. These concepts of foundational neuroscience can be challenging to understand. Therefore, this Discussion is designed to encourage you to think through these concepts, develop a rationale for your thinking, and deepen your understanding by interacting with your colleagues. Foundational Neuroscience Discussion Paper

Learning Objectives

Students will:

· Analyze the agonist-to-antagonist spectrum of action of psychopharmacologic agents

· Compare the actions of g couple proteins to ion gated channels

· Analyze the role of epigenetics in pharmacologic action

· Analyze the impact of foundational neuroscience on the prescription of medications

Learning Resources

Note: To access this week’s required library resources, please click on the link to the Course Readings List, found in the Course Materials section of your Syllabus. Foundational Neuroscience Discussion.

Required Readings

Post a response to each of the following: Include sub headings please.

1. Explain the agonist-to-antagonist spectrum of action of psychopharmacologic agents.

2. Compare and contrast the actions of g couple proteins and ion gated channels.

3. Explain the role of epigenetics in pharmacologic action.

4. Explain how this information may impact the way you prescribe medications to clients. Include a specific example of a situation or case with a client in which the psychiatric mental health nurse practitioner must be aware of the medication’s action. Foundational Neuroscience Discussion.

Points to follow when writing a paper:

· Please all bullets points, bold, red and highlighted area must be attended to.

· A clear purpose statement (The purpose of this paper is to…) is required in the introduction of all writings.

· Please review all rubrics.

· Check APA format/setting.

· Your final paragraph should be a summary of the key points of your paper.

· Foundational Neuroscience Discussion. Please personalized where necessary.

Refrain from direct quote

Class Rules

Avoid public facing sites like university web pages or foundation pages (such as the American Cancer Society or the Alzheimer’s Association) and medical sites designed for consumption by the general public (such as Mayo Clinic or WebMD).

you are required to cite scholarly resources including peer-review journals and current practice guidelines.

May use https://www.ahrq.gov/professionals/clinicians-providers/guidelines-recommendations/index.html

Writer must be familiar with nursing pharmacology Foundational Neuroscience Discussion

NUR 6630 Week 1 Discussion: Foundational Neuroscience

Explain the agonist-to-antagonist spectrum of action of psychopharmacologic agents.

Full agonists allow a receptor site to open up an ion channel to the maximum amount and frequency which is allowed by that particular binding site which causes the maximum amount of downstream signal transduction possible to be utilized at the binding site. The ion channel can open more frequently than with a full agonist alone but requires the help of a second receptor site. An antagonist causes a stabilization in the receptor sites in resting phases which is the same mechanism of action at the receptor site when an agonist is not present. Because there are no changes whether an antagonist is present or not, it is said to be neutral or silent.

Compare and contrast the actions of g couple proteins and ion gated channels.Partial agonists cause changes in receptors so that ion channels open to a greater extent and with more frequency that at a resting state but less than when a full agonist is present. Antagonists reverse partial antagonists just as it reverses full agonists and result in the receptor site returning to its state of rest. Partial agonists produce ion flow and downstream signal transduction which is more than at a resting state but less than that of a full agonist. When there are unstable neurotransmissions within the brain, a balance must be found to stabilize the receptor output so that there is not too much or too little downstream action occurring. Partial agonists are also referred to as stabilizers since they are typically able to cause an even reaction between extremes of too much or too little action potential (Stahl, 2013). Foundational Neuroscience Discussion Paper

A class of receptors linked to G proteins are a major target of psychotropic drugs. The G couple proteins have the structure of seven transmembrane regions, spanning the membrane seven times. Each region of the membrane is arranged around a central core which contains a binding site for a neurotransmitter. Drugs can interact at a particular neurotransmitter binding site or at other sites, also called allosteric sites within a receptor. This binding can lead to various modifications of receptor actions by either partially or fully mimicking or blocking any neurotransmitter function which would normally occur at a specific receptor site. Downstream molecular processes can be changed by drug actions as when phosphoproteins are activated or inactivated which results in a difference in which enzymes, receptors, or ion channels are modified by the neurotransmission. These drug actions can also lead to changes in which genes are expressed, altering which proteins are synthesized and which functions are amplified, from synaptogenesis, to receptor and enzyme synthesis, to communication with downstream neurons innervated by the neuron with the G-protein-linked receptor. As a result, drug-induced alterations at the G-protein-linked receptor site can cause actions on psychiatric disorders or symptoms (Stahl, 2013). Foundational Neuroscience Discussion.

Like G proteins, ligand-gated ion channels are a type of receptor which also forms an ion channel. For this reason, they are both ligand-gated ion channel and also ionotropic receptors or ion-channel-linked receptors. They have dual functions, hence the two names. Ligand-gated ion channels consist of long strings of amino acids which are gathered as subunits around an ion channel. There are many binding sites around these subunits for neurotransmitters, ions and drugs. Complex proteins have sites where ions can pass through a channel or bind to the channel, or where a neurotransmitter can act as a binding site and where natural substances or drugs can bind to a site different than where the neurotransmitter binds resulting in an increase or decrease to the sensitivity of a channel opening. In psychopharmacology, the ion channels that are the most important are those that control sodium, calcium, chloride, and potassium. Full agonists will directly change the receptor site to open the ion channel. Antagonists will cause a steady state at the receptor in its resting state which is similar to how a receptor responds when there is no agonist present. Alternatively, drug-induced modifications which occur with ionotropic receptors cause immediate effects by changing the flow of ions resulting in an immediate clinical onset as when medications such as anxiolytics and hypnotics are used. Some drugs that act at the G-protein-linked receptor sites may have a delayed response caused by an instigation in cellular functions that become activated by the signal transduction cascade (Stahl, 2013).

Explain the role of epigenetics in pharmacologic action.

In genetics, there is a DNA code which transcribes specific types of RNA or proteins within cells. While there are greater than 20,000 genes within the human genome, not every gene is expressed, even within the brain. Epigenetics goes a step further than genetics in that there is a determination whether a given gene is made into specific RNA and protein or instead it is just simply ignored or silenced. Further definition states that if a genome is a glossary of all “words” related to protein, than the epigenome is the “story” of all of those “words” into something that is cohesive. The genomic makeup of potential proteins is the same within every single neuron and cell in the body. What causes a normal neuron to malfunction, as in psychiatric diagnoses, or how a neuron winds up a neuron rather than a liver cell is all the result of whether or not specific genes are expressed or silenced. Neurons that are functioning improperly are often impacted by genes with abnormal sequences and if these genes are expressed rather than silenced, mental disorders can ensue. Brain development is not only dependent on inherited genes, but whether or not abnormal genes are expressed, and/or normal genes are silenced. There are many factors which regulate whether or not genes are expressed or silenced and include neurotransmission, the gene makeup, drugs and environment. All of these factors help decide whether or not the brain is one full of learning and memories or drug abuse, stress and psychiatric disorders and whether or not there can be improvement with medications and therapy (Stahl, 2013). Foundational Neuroscience Discussion Paper

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Explain how this information may impact the way you prescribe medications to clients. Include a specific example of a situation or case with a client in which the psychiatric mental health nurse practitioner must be aware of the medication’s action.

In depth knowledge regarding medications, pharmacokinetics and pharmacodynamics are important prior to prescribing. In addition to this, one must understand genetics and factors regarding medication uptake and absorption. Farmer (2014) discusses psychopharmacological treatment from a social work perspective and states that a new way of thinking about mental illness is evolving. The National Institute of Mental Health has worked on a project (the Research Domain Criteria RDoC) to change the thought process behind mental illness diagnoses. The RDoC utilizes data regarding pathophysiology, especially related to genomics and neuroscience when it comes to understanding mental illness. Investigation of the biological underlying of mental disorders is being focused on and a new understanding of different dimensions of functioning related to positive and negative valence systems, cognitive systems, systems for social processes, and arousal/modulatory systems are being included and studied as well as the analysis of genes, molecules, cells, neural circuits, physiology. Client behaviors and self-reports are also considered. The idea is to link neurobiology with mental illness diagnoses and find better medications to treat specific mental disorders. We must understand that psychotropic medications work in the brain and CNS to affect the level of a neurotransmitter. Human behavior is the result of neural activity where an axon sends chemical and electrical messages to receiving neurons and a synapse is a communication point between neurons and where an action potential takes place. As PMHNPs, we must understand the mechanism of action in how a medication works, whether it is an agonist or antagonist, and how the major neurotransmitters (acetyl-choline, norepinephrine, dopamine, serotonin, gamma aminobutyric acid, glutamate) are affected by specific medications. Medications have different effects based on factors such as client age, gender, race and ethnicity. More studies are needed how race and ethnicity may affect medications as pharmacokinetics and pharmacodynamics, as are influenced by genetic factors as well as the environment which includes lifestyle, behavioral patterns, and social interactions. One person’s response to a medication will be determined by gene–environment interaction (Farmer, 2014). Foundational Neuroscience Discussion.

Understanding that psychiatric disorders such as major depressive disorder, drug addiction, and schizophrenia can have multiple gene involvements rather than “one gene/one disease” relation can assist with finding the right medications and treatments for clients. Understanding epigenetic modifications (histone acetylation and deacetylation, DNA methylation) and how these can result in changes in gene expression is looking to be the future of treating psychiatric disorders (Mahgoub & Monteggia, 2013).

PMHNPs must be aware at this time, when prescribing medications such as an SSRI or SNRI, these medications take time to reach therapeutic effect. Patients must be well educated that they will not feel “better” instantly and must be counseled to stay the course with medication compliance and therapies to achieve maximum benefit.

References

Farmer, R. L. (2014). Interface between psychotropic medications, neurobiology, and mental illnesses. Smith College Studies in Social Work, 84(2-3), 255-272.

Mahgoub, M., & Monteggia, L. M. (2013). Epigenetics and psychiatry. Neurotherapeutics, 10, 734-741.

Stahl, S. M. (2013). Stahl’s essential psychopharmacology: Neuroscientific basis and practical applications (4th ed.). New York, NY: Cambridge University Press.

NUR 6630 Week 1 Discussion: Foundational Neuroscience

To prepare for this Discussion:

Review this week’s Learning Resources.
Reflect on concepts of foundational neuroscience.

Note: For this Discussion, you are required to complete your initial post before you will be able to view and respond to your colleagues’ postings. Begin by clicking on the “Post to Discussion Question” link and then select “Create Thread” to complete your initial post. Remember, once you click on Submit, you cannot delete or edit your own posts, and you cannot post anonymously. Please check your post carefully before clicking on Submit!

By Day 3

Post a response to each of the following:

Explain the agonist-to-antagonist spectrum of action of psychopharmacologic agents.
Compare and contrast the actions of g couple proteins and ion gated channels.
Explain the role of epigenetics in pharmacologic action.
Explain how this information may impact the way you prescribe medications to clients. Include a specific example of a situation or case with a client in which the psychiatric mental health nurse practitioner must be aware of the medication’s action.

Read a selection of your colleagues’ responses.

By Day 6

Respond to two colleagues in one of the following ways:

If your colleagues’ posts influenced your understanding of these concepts, be sure to share how and why. Include additional insights you gained.
If you think your colleagues might have misunderstood these concepts, offer your alternative perspective and be sure to provide an explanation for them. Include resources to support your perspective.

Week 1 discussion

Discussion: Foundational Neuroscience

As a psychiatric mental health nurse practitioner, it is essential for you to have a strong background in foundational neuroscience. In order to diagnose and treat clients, you must not only understand the pathophysiology of psychiatric disorders, but also how medications for these disorders impact the central nervous system. These concepts of foundational neuroscience can be challenging to understand. Therefore, this Discussion is designed to encourage you to think through these concepts, develop a rationale for your thinking, and deepen your understanding by interacting with your colleagues. Foundational Neuroscience Discussion Paper

Learning Objectives

Students will:

Analyze the agonist-to-antagonist spectrum of action of psychopharmacologic agents

Compare the actions of g couple proteins to ion gated channels

Analyze the role of epigenetics in pharmacologic action

Analyze the impact of foundational neuroscience on the prescription of medications

Learning Resources

Note: To access this week’s required library resources, please click on the link to the Course Readings List, found in the Course Materials section of your Syllabus.

Required Readings

Note: All Stahl resources can be accessed through the Walden Library using this link. This link will take you to a log-in page for the Walden Library. Once you log into the library, the Stahl website will appear.

Stahl, S. M. (2013). Stahl’s essential psychopharmacology: Neuroscientific basis and practical applications (4th ed.). New York, NY: Cambridge University Press *Preface, pp. ix–x

Note: To access the following chapters, click on the Essential Psychopharmacology, 4th ed tab on the Stahl Online website and select the appropriate chapter. Be sure to read all sections on the left navigation bar for each chapter.

Chapter 1, “Chemical Neurotransmission”

Chapter 2, “Transporters, Receptors, and Enzymes as Targets of Psychopharmacologic Drug Action”

Chapter 3, “Ion Channels as Targets of Psychopharmacologic Drug Action”

Document: Midterm Exam Study Guide (PDF)

Document: Final Exam Study Guide (PDF)

Required Media

Laureate Education (Producer). (2016i). Introduction to psychopharmacology [Video file]. Baltimore, MD: Author.

Note: The approximate length of this media piece is 3 minutes. Foundational Neuroscience Discussion.

Accessible player

Optional Resources

Laureate Education (Producer). (2009). Pathopharmacology: Disorders of the nervous system: Exploring the human brain [Video file]. Baltimore, MD: Author.

Note: The approximate length of this media piece is 15 minutes.

Dr. Myslinski reviews the structure and function of the human brain. Using human brains, he examines and illustrates the development of the brain and areas impacted by disorders associated with the brain. Foundational Neuroscience Discussion Paper

Accessible player

Laureate Education (Producer). (2012). Introduction to advanced pharmacology [Video file]. Baltimore, MD: Author.

Note: The approximate length of this media piece is 8 minutes.

In this media presentation, Dr. Terry Buttaro, associate professor of practice at Simmons School of Nursing and Health Sciences, discusses the importance of pharmacology for the advanced practice nurse.

Accessible player

To prepare for this Discussion:

Review this week’s Learning Resources.

Reflect on concepts of foundational neuroscience.

Week 1 Discussion

Discussion: Foundational Neuroscience

As a psychiatric mental health nurse practitioner, it is essential for you to have a strong background in foundational neuroscience. In order to diagnose and treat clients, you must not only understand the pathophysiology of psychiatric disorders, but also how medications for these disorders impact the central nervous system. These concepts of foundational neuroscience can be challenging to understand. Therefore, this Discussion is designed to encourage you to think through these concepts, develop a rationale for your thinking, and deepen your understanding by interacting with your colleagues.

NURS 6630 – Psychopharmacologic Approaches to Treatment of Psychopathology Essay Assignment Week 1 Discussion: Foundational Neuroscience

Required Readings

Note: All Stahl resources can be accessed through the Walden Library using this link. This link will take you to a log-in page for the Walden Library. Once you log into the library, the Stahl website will appear.

Stahl, S. M. (2013). Stahl’s essential psychopharmacology: Neuroscientific basis and practical applications (4th ed.). New York, NY: Cambridge University Press *Preface, pp. ix–x

Note: To access the following chapters, click on the Essential Psychopharmacology, 4th ed tab on the Stahl Online website and select the appropriate chapter. Be sure to read all sections on the left navigation bar for each chapter Foundational Neuroscience Discussion.

Chapter 1, “Chemical Neurotransmission”

Chapter 2, “Transporters, Receptors, and Enzymes as Targets of Psychopharmacologic Drug Action”

Chapter 3, “Ion Channels as Targets of Psychopharmacologic Drug Action”

Document: Midterm Exam Study Guide (PDF)

Document: Final Exam Study Guide (PDF)

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Required Media

Laureate Education (Producer). (2016i). Introduction to psychopharmacology [Video file]. Baltimore, MD: Author.

NURS 6630 – Psychopharmacologic Approaches to Treatment of Psychopathology Essay Week 1 Discussion: Foundational Neuroscience

Note: The approximate length of this media piece is 3 minutes.

Accessible player

Discussion: Foundational Neuroscience Optional Resources

Laureate Education (Producer). (2009). Pathopharmacology: Disorders of the nervous system: Exploring the human brain [Video file]. Baltimore, MD: Author.NURS 6630 – Psychopharmacologic Approaches to Treatment of Psychopathology Essay Assignment

Note: The approximate length of this media piece is 15 minutes.

Dr. Myslinski reviews the structure and function of the human brain. Using human brains, he examines and illustrates the development of the brain and areas impacted by disorders associated with the brain.

Discussion: Foundational Neuroscience Accessible player

Laureate Education (Producer). (2012). Introduction to advanced pharmacology [Video file]. Baltimore, MD: Author.NURS 6630 – Psychopharmacologic Approaches to Treatment of Psychopathology Essay Assignment

Note: The approximate length of this media piece is 8 minutes.

In this media presentation, Dr. Terry Buttaro, associate professor of practice at Simmons School of Nursing and Health Sciences, discusses the importance of pharmacology for the advanced practice nurse. Foundational Neuroscience Discussion Paper

Accessible player

To prepare for this Discussion:

Review this week’s Learning Resources.

Reflect on concepts of foundational neuroscience.

Assignment: Assessing and Treating Clients With Dementia

The Alzheimer’s Association defines dementia as “a general term for a decline in mental ability severe enough to interfere with daily life” (Alzheimer’s Association, 2016). This term encompasses dozens of cognitive disorders of impaired memory formation, recall, and communication. The care and treatment of clients with dementia is dependent on multiple factors, including the stage of dementia, comorbidities, family support, and even the care setting. In your role, as the psychiatric mental health nurse practitioner, you must be prepared to not only treat clients with these various cognitive disorders, but also the multiple behavioral issues that often accompany them. For this Assignment, as you examine the client case study in this week’s Learning Resources, consider how you might assess and treat clients presenting with dementia Foundational Neuroscience Discussion.

Reference: Alzheimer’s Association. (2016). What is dementia? Retrieved from http://www.alz.org/what-is-dementia.asp

To prepare for this Assignment:

· Review this week’s Learning Resources. Consider how to assess and treat clients requiring therapy for dementia.

The Assignment

Examine Case Study: An Elderly Iranian Man With Alzheimer’s Disease. 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 pharmacodynamic processes. At each decision point stop to complete the following:

Introduction regarding disease state

High-level summary of patient case

Purpose of the essay statement

Decision #1

What options were listed?

Which decision did you select?

Why did you select this decision? Support your response with evidence and references to the Learning Resources Foundational Neuroscience Discussion.

Why didn’t you select the other two options?

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 #1 and the results of the decision. Why were they different?

Decision #2

What options were listed?

What option did you choose?

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

Why didn’t you select the other two options?

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 #2 and the results of the decision. Why were they different? Foundational Neuroscience Discussion

Decision #3

What options were listed?

What option did you choose?

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

Why didn’t you select the other two options?

What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources. Foundational Neuroscience Discussion Paper

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.

Note : Support your rationale with a minimum of three academic resources. While you may use the course text to support your rationale, it will not count toward the resource requirement.

Note: To access this week’s required library resources, please click on the link to the Course Readings List, found in the Course Materials section of your Syllabus.

References

Stahl, S. M. (2013). Stahl’s essential psychopharmacology: Neuroscientific basis and practical applications (4th ed.). New York, NY: Cambridge University Press.

To access the following chapter, click on the Essential Psychopharmacology, 4th ed tab on the Stahl Online website and select the appropriate chapter. Be sure to read all sections on the left navigation bar for each chapter.

· Chapter 13, “Dementia and Its Treatment”

Stahl, S. M. (2014b). The prescriber’s guide (5th ed.). New York, NY: Cambridge University Press.

To access information on the following medications, click on The Prescriber’s Guide, 5th ed tab on the Stahl Online website and select the appropriate medication.

Review the following medications:

For insomnia

· donepezil

· galantamine

· memantine

· rivastigmine

Bui, Q. (2012). Antidepressants for agitation and psychosis in patients with dementia. American Family Physician, 85(1), 20–22. Retrieved from http://www.aafp.org/journals/afp.html

Note: Retrieved from from the Walden Library databases.

Meltzer, H. Y., Mills, R., Revell, S., Williams, H., Johnson, A., Bahr, D., & Friedman, J. H. (2010). Pimavanserin, a serotonin receptor inverse agonist for the treatment of Parkinson’s disease psychosis. Neuropsychopharmacology, 35, 881–891. Retrieved from http://www.nature.com/npp/journal/v35/n4/pdf/npp2009176a.pdf

Required Media

Laureate Education. (2016h). Case study: An elderly Iranian man with Alzheimer’s disease [Interactive media file]. Baltimore, MD: Author.

BACKGROUND

Mr. Akkad is a 76 year old Iranian male who is brought to your office by his eldest son for “strange behavior.” Mr. Akkad was seen by his family physician who ruled out any organic basis for Mr. Akkad’s behavior. All laboratory and diagnostic imaging tests (including CT-scan of the head) were normal.

According to his son, he has been demonstrating some strange thoughts and behaviors for the past two years, but things seem to be getting worse. Per the client’s son, the family noticed that Mr. Akkad’s personality began to change a few years ago. He began to lose interest in religious activities with the family and became more “critical” of everyone. They also noticed that things he used to take seriously had become a source of “amusement” and “ridicule.”

Over the course of the past two years, the family has noticed that Mr. Akkad has been forgetting things. His son also reports that sometimes he has difficult “finding the right words” in a conversation and then will shift to an entirely different line of conversation.

SUBJECTIVE

During the clinical interview, Mr. Akkad is pleasant, cooperative and seems to enjoy speaking with you. You notice some confabulation during various aspects of memory testing, so the PMHNP performs a Mini-Mental State Exam. Mr. Akkad scores 18 out of 30 with primary deficits in orientation, registration, attention & calculation, and recall. The score suggests moderate dementia.

MENTAL STATUS EXAM

Mr. Akkad is 76 year old Iranian male who is cooperative with today’s clinical interview. His eye contact is poor. Speech is clear, coherent, but tangential at times. He makes no unusual motor movements and demonstrates no tic. Self-reported mood is euthymic. Affect however is restricted. He denies visual or auditory hallucinations. No delusional or paranoid thought processes noted. He is alert and oriented to person, partially oriented to place, but is disoriented to time and event [he reports that he thought he was coming to lunch but “wound up here”- referring to your office, at which point he begins to laugh]. Insight and judgment are impaired. Impulse control is also impaired as evidenced by Mr. Akkad’s standing up during the clinical interview and walking towards the door. When the PMHNP asked where he was going, he stated that he did not know. Mr. Akkad denies suicidal or homicidal ideation.

Diagnosis: Major neurocognitive disorder due to Alzheimer’s disease (presumptive)

RESOURCES

§ Folstein, M. F., Folstein, S. E., & McHugh, P. R. (2002). Mini-Mental State Examination (MMSE). Lutz, FL: Psychological Assessment Resources.

Decision Point One

Select what the PMHNP should do:

https://mym.cdn.laureate-media.com/2dett4d/Walden/NURS/6630/10/mm/alzheimers_disease/img/pill-red.pngBegin Exelon (rivastigmine) 1.5 mg orally BID with an increase to 3 mg orally BID in 2 weeks

https://mym.cdn.laureate-media.com/2dett4d/Walden/NURS/6630/10/mm/alzheimers_disease/img/pill-blue.png Begin Aricept (donepezil) 5 mg orally at BEDTIME

https://mym.cdn.laureate-media.com/2dett4d/Walden/NURS/6630/10/mm/alzheimers_disease/img/pill-yellow.pngBegin Razadyne (galantamine) 4 mg orally BID

Decision Point One

https://mym.cdn.laureate-media.com/2dett4d/Walden/NURS/6630/10/mm/alzheimers_disease/img/pill-blue.pngBegin Aricept (donepezil) 5 mg orally at BEDTIME Foundational Neuroscience Discussion

RESULTS OF DECISION POINT ONE

· Client returns to clinic in four weeks

· The client is accompanied by his son who reports that his father is “no better” from this medication

· He reports that his father is still disinterested in attending religious services/activities, and continues to exhibit disinhibited behaviors

· You continue to note confabulation and decide to administer the MMSE again. Mr. Akkad again scores 18 out of 30 with primary deficits in orientation, registration, attention & calculation, and recall

Decision Point Two

Select what the PMHNP should do next:

https://mym.cdn.laureate-media.com/2dett4d/Walden/NURS/6630/10/mm/alzheimers_disease/img/pill-red.pngIncrease Aricept to 10 mg orally at BEDTIME

https://mym.cdn.laureate-media.com/2dett4d/Walden/NURS/6630/10/mm/alzheimers_disease/img/pill-blue.pngDiscontinue Aricept and begin Razadyne (galantamine) extended release 24 mg orally daily

https://mym.cdn.laureate-media.com/2dett4d/Walden/NURS/6630/10/mm/alzheimers_disease/img/pill-yellow.pngDiscontinue Aricept and begin Namenda (memantine) extended release, 28 mg orally dailyFoundational Neuroscience Discussion Paper

Decision Point Two https://mym.cdn.laureate-media.com/2dett4d/Walden/NURS/6630/10/mm/alzheimers_disease/img/pill-red.pngIncrease Aricept to 10 mg orally at BEDTIME

RESULTS OF DECISION POINT TWO

· Client returns to clinic in four weeks

· Client’s son reports that the client is tolerating the medication well, but is still concerned that his father is no better

· He states that his father is attending religious services with the family, which the son and the rest of the family is happy about. He reports that his father is still easily amused by things he once found serious

Decision Point Three

Select what the PMHNP should do next:

https://mym.cdn.laureate-media.com/2dett4d/Walden/NURS/6630/10/mm/alzheimers_disease/img/pill-red.pngContinue Aricept 10 mg orally at BEDTIME Foundational Neuroscience Discussion

https://mym.cdn.laureate-media.com/2dett4d/Walden/NURS/6630/10/mm/alzheimers_disease/img/pill-blue.pngIncrease Aricept to 15 mg orally at BEDTIME x 6 weeks, then increase to 20 mg orally at BEDTIME

https://mym.cdn.laureate-media.com/2dett4d/Walden/NURS/6630/10/mm/alzheimers_disease/img/pill-yellow.pngDiscontinue Aricept and begin Namenda 5 mg orally daily

Decision Point Three

https://mym.cdn.laureate-media.com/2dett4d/Walden/NURS/6630/10/mm/alzheimers_disease/img/pill-red.pngContinue Aricept 10 mg orally at BEDTIME

Guidance to Student

At this point, it would be prudent for the PMHNP to continue Aricept at 10 mg orally at bedtime. Recall that this medication can take several months before stabilization of deterioration is noted. At this point, the client is attending religious services with the family, which has made the family happy. Disinhibition may improve in a few weeks, or it may not improve at all. This is a counseling point that the PMHNP should review with the son.

There is no evidence that Aricept given at doses greater than 10 mg per day has any therapeutic benefit. It can, however, cause side effects. Increasing to 15 and 20 mg per day would not be appropriate.

There is nothing in the clinical presentation to suggest that the Aricept should be discontinued. Whereas it may be appropriate to add Namenda to the current drug profile, there is no need to discontinue Aricept. In fact, NMDA receptor antagonist therapy is often used with cholinesterase inhibitors in combination therapy to treat Alzheimer’s disease. The key to using both medications is slow titration upward toward therapeutic doses to minimize negative side effects.

Finally, it is important to note that changes in the MMSE should be evaluated over the course of months, not weeks. The absence of change in the MMSE after 4 weeks of treatment should not be a source of concern Foundational Neuroscience Discussion Paper

actionable recommendations to help improve health for your specific population and issue.

March 31, 2022/in /by developer

A local government official, who happens to be up for reelection, has hired you to analyze the data from the Behavioral Risk Factor Surveillance System (BRFSS) surveys and develop a public health intervention plan based on the information.

The BRFSS is an ongoing telephone health survey system. It has been tracking health conditions and risk behaviors in the United States yearly since 1984. Data are collected monthly in all fifty states, the District of Columbia, Puerto Rico, the US Virgin Islands, and Guam. For this assignment, you need to do the following:

Part 1: Analyze the Data

1. View this link: http://www.cdc.gov/brfss/state_info/coordinators.htm

2. Select your criteria for any state statistical areas, for any year 2002 to 2011, and pick a category.

3. Click a subcategory (if offered) to retrieve the necessary data.

4. In a detailed report, analyze the data by completing the following:

o Summarize what data was collected, the method of collection, and the basic findings from the data.

o Evaluate the data’s validity, quality, and reliability.

o Identify and discuss strengths and weaknesses within the data.

o Based on the data, develop a hypothesis about a public health problem that could be tested with a study.

o Recommend one other form of data that should be collected in order to enhance the study.

o Develop a study design to best collect your recommended data.

o Identify the resources you would need to collect the data, including the people you would need to work with.

o Identify and justify an appropriate method to display the findings.

Part 2: Public Health Intervention Plan

Based on your analysis of the provided data, create a public health intervention plan by completing the following:

· Describe your chosen population and the health issue you are addressing.

· Provide 2–3 specific, actionable recommendations to help improve health for your specific population and issue.

· To whom would you present the results to achieve the desired outcomes?

Write an 8-page paper in Word format. Apply APA standards to citation of sources.

Grading Criteria

Grading Rubric

This assignment is worth 300 points and will be graded using a rubric. Click here to download and read the rubric to understand the expectations.View less »

Assignment 1 Practicum Decision Tree

March 31, 2022/in Nursing Homework Help /by Naomi Nas

For this Assignment, as you examine the client case study in this week’s Learning Resources, consider how you might assess and treat pediatric clients presenting symptoms of a mental health disorder.
Learning Objectives
Students will:

Evaluate clients for treatment of mental health disorders
Analyze decisions made throughout diagnosis and treatment of clients with mental health disorders

The Assignment:
Examine Case 2: You will be asked to make three decisions concerning the diagnosis and treatment for this client. Be sure to consider co-morbid physical as well as mental factors that might impact the client’s diagnosis and treatment. Practicum: Decision Tree.
At each Decision Point, stop to complete the following:

Decision #1: Differential Diagnosis

Which Decision did you select?
Why did you select this Decision? Support your response with evidence and references to the Learning Resources.
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 #1 and the results of the Decision. Why were they different?

Decision #2: Treatment Plan for Psychotherapy

Why did you select this Decision? Support your response with evidence and references to the Learning Resources.
What were you hoping to achieve by making this Decision? Support your response with evidence and references to the Learning Resources. Practicum: Decision Tree.
Explain any difference between what you expected to achieve with Decision #2 and the results of the Decision. Why were they different? Assignment 1 Practicum Decision Tree

Decision #3: Treatment Plan for Psychopharmacology

Why did you select this Decision? Support your response with evidence and references to the Learning Resources.
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? Practicum: Decision Tree.

Also include how ethical considerations might impact your treatment plan and communication with clients and their families.

BACKGROUND

Tyrel is an 8-year-old black male who is brought in by his mother for a variety of psychiatric complaints. Shaquana, Tyrel’s mother, reports that Tyrel has been exhibiting a lot of worry and “nervousness” over the past 2 months. She states that she notices that he has been quite “keyed up” and spends a great deal of time worrying about “germs.” She states that he is constantly washing his hands because he feels as though he is going to get sick like he did a few weeks ago, which kept him both out of school and off the playground. He was also not able to see his father for two weekends because of being sick. Shaquana explains that although she and her ex-husband Desmond divorced about 2 years ago, their divorce was amicable and they both endeavor to see that Tyrel is well caredfor.
Shaquana reports that Tyrel is irritable at times and has also had some sleep disturbances (which she reports as “trouble staying asleep”). She reports that he has been more and more difficult to get to school as he has become nervous around his classmates. He has missed about 8 days over the course of the last 3 weeks. He has also stopped playing with his best friend from across the street. Assignment 1 Practicum Decision Tree
His mother reports that she feels “responsible” for his current symptoms. She explains that after he was sick with strep throat a few weeks ago, she encouraged him to be more careful about washing his hands after playing with other children, handling things that did not belong to him, and especially before eating. She continues by saying “maybe if I didn’t make such a big deal about it, he would not be obsessed with germs.” Practicum: Decision Tree.
Per Shaquana, her pregnancy with Tyrel was uncomplicated, and Tyrel has met all developmental milestones on time. He has had an uneventful medical history and is current on all immunizations.

OBJECTIVE
During your assessment of Tyrel, he seems cautious being around you. He warms a bit as you discuss school, his friends at school, and what he likes to do. He admits that he has been feeling “nervous” lately, but when you question him as to why, he simply shrugs his shoulders.
When you discuss his handwashing with him, he tells you that “handwashing is the best way to keep from getting sick.” When you question him how many times a day he washes his hands, he again shrugs his shoulders. You can see that his bilateral hands are dry. Throughout your assessment, Tyrel reveals that he has been thinking of how dirty his hands are; and no matter how hard he tries to stop thinking about his “dirty” hands, he is unable to do so. He reports that he gets “really nervous” and “scared” that he will get sick, and that the only way to make himself feel better is to wash his hands. He reports that it does work for a while and that he feels “better” after he washes his hands, but then a little while later, he will begin thinking “did I wash my hands well enough? What if I missed an area?” He reports that he can feel himself getting more and more “scared” until he washes his hands again.

MENTAL STATUS EXAM
Tyrel is alert and oriented to all spheres. Eye contact varies throughout the clinical interview. He reports his mood as “good,” admits to anxiety. Affect consistent to self-reported mood. He denies visual/auditory hallucinations. No overt delusional or paranoid thought processes were apparent. He denies suicidal ideation.
Lab studies obtained from Tyrel’s pediatric nurse practitioner were all within normal parameters. An antistreptolysin O antibody titer was obtained for reasons you are unclear of, and this titer was shown to be above normal parameters. Practicum: Decision Tree.
Decision Point One
BASED ON THE INFORMATION PROVIDED IN THE SCENARIO ABOVE, WHICH OF THE FOLLOWING DIAGNOSES WOULD THE PMHNP GIVE TO TYREL?
In your write-up of this case, be certain to link specific symptoms presented in the case to DSM–5 criteria to support your diagnosis. Practicum: Decision Tree.

Decision Point One
Obsessive Compulsive Disorder
Decision Point Two
Begin Fluvoxamine immediate release 25 mg orally at bedtime

RESULTS OF DECISION POINT TWO

Client returns to clinic in four weeks
Upon return to the clinic, Tyrel’s mother reported that he has had some decrease in his symptoms. She states that the frequency of the handwashing has decreased, and Tyrel seems a bit more “relaxed” overall.
She also reports that Tyrel has not fully embraced returning to school, but that his attendance has improved. She reported that over this past weekend, Tyrel went outside to play with his friend from across the street, which he has not done in a while. Practicum: Decision Tree.

Decision Point Three
Increase Fluvoxamine to 50 mg orally at bedtime

Guidance to Student
In terms of an actual diagnosis, the child’s main symptoms are most consistent with obsessive-compulsive disorder. There may also be an element of social phobia developing, but at this point, the PMHNP has not assessed the nature of the school avoidance—that is, why is the child avoiding school. Notice that nothing in the scenario tells us that the PMHNP has assessed this.
Fluvoxamine immediate release is FDA-approved for the treatment of OCD in children aged 8 years and older. Fluvoxamine’s sigma-1 antagonist properties may cause sedation and as such, it should be dosed in the evening/bedtime.
At this point, it would be appropriate to consider increasing the bedtime dose, especially since the child is responding to the medication and there are no negative side effects.
Atypical antipsychotics are typically not used in the treatment of OCD. There is also nothing to tell us that an atypical antipsychotic would be necessary (e.g., no psychotic symptoms). Additionally, the child seems to be responding to the medication, so there is no rationale as to why an atypical antipsychotic would be added to the current regimen.
Cognitive behavioral therapy is the psychotherapy of choice for treating OCD. The PMHNP should augment medication therapy with CBT. If further assessment determines that Tyrel has social anxiety disorder, CBT is effective in treating this condition as well. Assignment 1 Practicum Decision Tree
P(5.u)

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Can I Push Back Time? A Realistic Approach to Reducing Ageing Effects

Can I Push Back Time? A Realistic Approach to Reducing Ageing Effects

No one likes to grow old, especially when it means that your appearance will change, sometimes drastically. Although ageing is a natural process and we should accept it and grow old gracefully, it is difficult. Some people age quicker than others and some people are blessed with great genes, and then there are those who go to great lengths to slow down the ageing process. This module teaches you what happens to your skin as it ages and what physical signs to expect as you grow older. You will also get a better insight on how you can prevent through a careful skincare regime. This module includes the following items: Practicum: Decision Tree.

7.1. What Happens when your Skin ages?

7.2. How your Skin Changes with Each Birthday

7.3. Ethnicity and Ageing

7.4. Ingredients to Look for in Anti-Ageing Products

7.5. Botox versus Facelift

7.1. What Happens when your Skin ages?

As a person gets older, their body produces less collagen and elastin, thus leading to the appearance of fine lines and wrinkles. If you add gravity and sun exposure to that equation, the result will be saggy skin that appears leathery and old.

As you grow older, your skin continues to change. It becomes thinner, much drier, and even more fragile as the dermis of the skin begins to thin out. The fatty areas in your chin, cheeks, and nose begin to disappear, again making the skin sag more. More facial hair is evident in women as their bodies go through a number of different hormonal changes, sometimes making the skin more prone to acne and blackhead breakouts. Practicum: Decision Tree.

People, who suffer from oilier skin, will continue to have breakouts; however, there is a positive side to this – the oilier the skin is, the longer it will remain moist and smooth.

Using a good moisturiser over the years is one way that a person can lessen the impact of wrinkles and premature ageing.

Also with age, your body’s ability to attack free radicals that damage your cells and collagen slows down.

Consciously consuming foods with more antioxidants will protect your skin against free radicals and also improve its appearance, which is why vitamins A, C and E are often found in anti-ageing supplements.

7.2. How your Skin changes with each Birthday

Your 30s

Between the ages of 30-35 is the most common time when women give birth to children. Pregnancy is good for a woman’s skin because there is a normal healthy production of the hormonesoestrogen and progesterone. Some women break out in spots due to the overgrowth of blood vessels caused by too much oestrogen. It is also common for the texture of a woman’s skin to become tougher and drier while she is pregnant because the baby takes up so many of its mother’s nutrients. Practicum: Decision Tree.

Some other common features of a woman’s skin in their 30s include:

Drier and duller in colour due to the slowing down of the production of a person’s skin cells.
Visible fine lines appear around eyes and mouth.
Smile lines do not disappear.
Collagen and elastin start to become weaker.
Smoking accentuates fine lines.
May begin to lose part of your skin tone due to the weakening of the lymph glands that are responsible for flushing out all of the body’s toxins.
Skin’s appearance is less bright.
Tendency to put on more weight with more visible cellulite due to hormonal changes.
Stretch marks are more evident through pregnancy or slimming. Assignment 1 Practicum Decision Tree

Your 40s

When a person is in their 40s their lymphatic system begins to steadily slow down resulting in puffiness in and around the eye and cheek areas. This is a period when a person, especially a woman will notice visible physical differences in their appearance due to their age.

People in their 40s will notice:

More susceptible to the environment around them, such as smoky or polluted places due to the skin’s waxy protective coating being weaker. It is weaker due to the body’s lower sebum production.
Oestrogen production slows down resulting in duller skin.
Evidence of sagging and wrinkles around the neck and chest areas.
Increased cellulite and fat deposits around the hip and thigh areas.
Practicum: Decision Tree

50 +

More visible signs of ageing can be seen on other parts of the body other than the face in a person’s 50s. Pigmentation patches on the skin are common as are age spots. Excesses over the years, such as drinking, smoking, and sun worshipping will begin to show in damaged skin like spider veins caused by damaged blood vessels caused by the sun.

People in their 50s will notice:

Increased pore size.
Flakier skin.
Wrinkles become more apparent due to dehydration of the skin caused by weaker skin cells.
Eyelids may become hooded and wrinkled.
Break down of skin’s elasticity.
Menopause begins in women and the decreased oestrogen levels slow down the production of sebum resulting in drier skin.
Facial hair in women is not uncommon due to hormone imbalances brought on by menopause.
Skin is more likely to dry out and crack.
Loss of muscle tone and definition.

7.3. Ethnicity and Ageing

A lot of how you age is related to the colour of your skin and your ethnicity.

White Skin/Caucasian

The paler or fairer you are, the more you will have to do to protect it from ageing prematurely externally. Naturally, your melanin levels are lower, which means that the harmful UVA/UVB rays can penetrate much deeper into your skin thus causing photo-ageing and contributing to your skin’s break down of elastin and collagen.

For white complexions, the most important anti-ageing weapon would be a broad spectrum SPF 30 sun cream which has both UVA and UVB protection. Apply this daily, even when it is cloudy to every bit of your skin that is exposed, especially your face and neck.

Keep your skin nice and soft with its natural oils intact by using a gentle cleanser. After cleansing, apply your broad-spectrum cream and then your make-up.

Fairer skin tones have less collagen bundles than darker skin tones, which results in getting fine lines earlier than other ethnicities.

Use night creams that contain retinoids to boost the skin-cell turnover and thicken your thinning skin to make it feel and appear smoother. Look out for products that contain antioxidants such as soy, vitamins C and E to help nourish the skin and repair it.

When fairer skin is damaged by the sun, it causes the skin to develop an uneven skin tone. To overcome this, replace your harsher facial and body scrubs with natural enzyme-based scrubs and exfoliants. If you find that retinol creams are toosevere for your face, try peptides instead as they act as a great collagen booster.

Olive Skin

Because you have a warmer skin tone, it is likely you will show signs of ageing with fine lines and wrinkles later than people that have fairer skin. Assignment 1 Practicum Decision Tree

Your skin haslower melanin content than those people with darker skin, but more than people with lighter skin. Your risk of sun damage compared to the fairer skinned person is significantly lower, but there is still a risk, which is why it is important to still always wear a broad-spectrum sun cream.

Generally, olive skin tans well, but at the same time it is more susceptible to melasma, which are darker brown patches of skin on the forehead, upper lip, cheeks, and chin areas. It is possible to fade these darker patches using certain creams and lotions that contain hydroquinone, azelaic acid or kojic acid. The combination of antioxidants in the above ingredients will help protect the skin from further damage; it will also help even out the skin tone, and strengthen the skin’s outer layer to help it retain its moisture. Continue wearing a high SPF sun cream that has zinc oxide or titanium dioxide.

Olive skin tones are prone to hypigmentation as they grow older. To help combat this, use a gentle foaming cleanser to get rid of the excess oil and then follow up by applying a serum which is rich in vitamin C.

People with olive skin are also more prone to an under-the-eye hollowness as they get older. To firm up the sagging skin in these areas use a night cream that contains peptides.

Middle Eastern and Asian Skin

Middle Eastern and Asian ethnicities do not begin to show signs of ageing until their mid-forties. However, although wrinkles tend to come later, these ethnicities are more prone to getting an uneven skin tone and darker patchy areas due to hormones, irritation and too much sun exposure.

Because of the excess pigment in the skin, Asians and those from the Middle East are prone to darker circles under the eyes. These bags under the eyes are often accentuated by the loss of volume under this area as a person ages. These ethnicities also suffer from more water retention when their hormones change, which again worsens the appearance under the eyes.

To try and reduce any signs of ageing underneath the eyes, you need to apply an eye cream that has cucumber extract, caffeine, or vitamin E to make the skin plumper and fresher looking.

Cleanse your skin gently with a face cloth and lukewarm water. After cleansing, use a serum that contains kokic acid to help fade the darker areas of the skin caused by hyperpigmentation and sun damage.

The moisturiser you use should be nourishing and rich. It should also contain salicylic acid, which will prevent your pores from getting too clogged.

Black / Dark Skin

Due to the high melanin levels in darker skin, they will not see any signs of ageing until their late 40’s or even 50’s. However, over time, darker skin loses its density and could result in sagging. To fight the sagging, opt for creams containing peptides as they help the body produce more collagen.

Darker skin tones also tend to suffer from uneven skin tones. You cannot scrub this away, so to reduce the severity of this, use a gentle cleanser together with an electric brush and glycolic toner to help stimulate your skin’s collagen and fade the darker patchy areas while regulating the skin’s oil production at the same time.

Moisturise in the morning with a cream that is rich in vitamin C. This will help brighten your skin and even out the patchier areas. In the evening, use creams that contain retinol, peptides and ceramides to hydrate the skin and prevent sagging.

Some people with darker skin benefit from semi-regular microdermabrasion treatments. This treatment is done by licensed professionals and gently buffs the skin, getting rid of all the dead skin cells to help even out and soften the skin with reduced pores.

7.4. Ingredients to Look for in Anti-Ageing Products

Retinol

Retinol comes from vitamin A. Although it may take a few weeks to start seeing results, it is the most effective anti-ageing ingredient bought over the counter. It helps smooth out the face’s wrinkles and unclogs the pores. Additionally, it helps improve the skin’s texture and lightens superficial dark spots. Retinol is quite potent, which results in some people suffering from skin irritation, especially when they come into contact with direct sunlight. Use retinol-based anti-ageing products at nighttime on dry skin and make sure you apply an SPF moisturiser in the morning.

Niacinamide

If you suffer from darker uneven spots that have been caused by acne scars, old age, or sun damage, you can use a product that contains niacinamade, which comes from vitamin B3 to lighten them and prevent melanin from rising to the skin’s surface. As a result your skin’s moisture and collagen production will improve and slowly over time reverse the damage from the sun.

Hyaluronic Acid

Hyaluronic acid is a form of humectants, which means that it draws water from both the air and dermis. Lotions with hyaluronic acid have excellent hydrating qualities and sometimes help improve collagen production to firm up sagging skin.

Alpha Hydroxyl Acid

Alpha hydroxyl acids (AHAs) work as exfoliators. They help remove dead skin cells and encourage new cell turnover revealing more youthful skin. When you exfoliate your skin, you will also allow serums, moisturisers, and other skin treatments to absorb and penetrate the skin more effectively. Look for a product that has 8% or less AHAs – when there are high concentrations of AHAs, you will help reduce and fade brown marks, spots and fine lines, but it will also make you more vulnerable and sensitive to the sun. Assignment 1 Practicum Decision Tree

L-ascorbic Acid

L-ascorbic acid is another word for vitamin C. It helps build your skin’s collagen, helps to reduce any inflammation, and at the same time it plumps up the skin and promotes elasticity.

Avobenzone

This is a common chemical ingredient found in sun creams and sun blocks. Usually, this is found in combination with oxybenzone or benzophenone-3 to help block UVB rays. Use this before applying your regularmoisturiser or serum.

Antioxidants

Antioxidants help to prevent more damage happening and they also help repair your body’stissue and cell damage. They neutralise the free radicals and promote cell grown. Popular antioxidants found in anti-ageing products include vitamins C and E, green tea, berry extracts, and pomegranate.

7.5. Botox versus Facelift

While Botox and facelifts are more extreme measures for looking young, they are not uncommon and it is becoming increasingly common for people, especially in the 40s and 50s, to go under the knife whereas the popularity of Botox is waning slightly.

When a person’s age begins to show from their many years of excessive sun exposure, pollutants, daily life stress, and smoking, they begin to suffer from wrinkles, some of which are deeper creases than others. It is also common for a person to suffer from sagging skin around the jaw line and neck area, which often makes them appear older than they really are.

No person really enjoys the idea of having an invasive facelift, otherwise known as rhytidectomysurgergy and the long hard recovery process that follows, but it does not stop people, especially in the US where 13 million people undergo surgery for anti-ageing purposes alone each year.

Can you explain the difference between Botox and facelifts?

A facelift is an invasive surgical procedure while Botox are injections and are non-surgical.

Some people opt for Botox because it is non-surgical; however, it really depends on the specific problems you have to know which anti-ageing beauty procedure is the right one for you. The important thing to remember is that facelifts and Botox are completely different and they are used for completely different purposes – they do complement each other, but it is essential to remember that they do not produce the same results.

Facelift

People have facelifts usually to reshape their deep facial structures. Additionally, they are used to try and remove extra skin tissue which results in a more youthful appearance; these saggy skin tissues are usually located in the lower region of the face, neck, and jowls. If a person has a lot of sagging skin, there is nothing that can be done to reduce it significantly. To reduce the skin, it needs to be removed, repositioned, and repaired. Some facelift surgeries might involve eyelid surgery, a neck lift, or a forehead lift to improve the appearance and age of a person.

Facelift surgery helps correct the following problems:

Deep under-the-eye creases and wrinkles
Deep forehead wrinkles and creases
Droopy eyebrows
Lowered cheek pads
Deep creases, folds or wrinkles along the nose
Saggy jowls
Double chin

Botox

Botox is a form of botulinum toxin. It is directed at a person’s overactive muscles to help alleviate expression lines, wrinkles, and crows’ feet. Usually Botox is used mostly in the upper parts of a person’s face,in the corners of a person’s eyes, forehead creases, and lines and wrinkles that form between the eyebrows. The muscles absorb the Botox and help them relax more. Botox injections do not really have any impact on the skin and Botox is often referred to as a “non-surgical facelift.” However, it cannot really be called a facelift because it does not involve any kind of skin removal or lifting. However, the Botox injections can help the skin’s appearance look smoother, softer, and more youthful.

Botox helps correct the following problems:

Fine facial lines and wrinkles
Expression lines e.g. laughter lines
Crows’ feet
Furrows between the eyebrows
Fine forehead lines and wrinkles
Neck bands

Scenario for Week 7 Case: You are a PMHNP

Scenario for Week 7 Case:

You are a PMHNP working in a large intercity hospital. You receive a call from the answering service informing you that a “stat” consult has been ordered by one of the hospitalists in the ICU. Upon arriving in the ICU, you learn that your consult is a 14 year old male who overdosed on approximately 50 Benadryl (diphenhydramine hydrochloride) tablets in an apparent suicide attempt. At the scene, a suicide note was found indicating that he wanted to die because his girlfriend’s parents felt that their daughter was too young to be “dating.” The client stated in the suicide note that he could not “live without her” and decided to take his own life. Although he has been medically stabilized and admitted to the ICU, he has been refusing to talk with the doctors or nurses. The hospital staff was finally able to get in touch with the clients parents (using contact information retrieved from the 14 year old’s cell phone). Unbeknown to the hospital staff, the parents are divorced, and both showed up at the hospital at approximately the same time, each offering their own perspectives on what ought to be done. The client’s father is demanding that the client be hospitalized because of the suicide, but his mother points out that he does not have “physical custody” of the child. The client’s mother demands that the client be discharged to home with her stating that her son’s actions were nothing more than a “stunt” and “an attempt at manipulating the situation that he didn’t like.” The client’s mother then becomes “nasty” and informs you that she works as a member of the clerical staff for the state board of nursing, and if you fail to discharge her child “right now” she will make you “sorry.” How would you proceed?

The Assignment (2–3 pages):
Based on the scenario, would you recommend that the client be voluntarily committed? Why or why not?
Based on the laws in your state, would the client be eligible for involuntary commitment? Explain why or why not.
Did understanding the state laws confirm or challenge your initial recommendation regarding involuntarily committing the client? Explain.
If the client were not eligible for involuntary commitment, explain what actions you may be able to take to support the parents for or against voluntary commitment.
If the client were not eligible for involuntary commitment, explain what initial actions you may be able to take to begin treating the client.

Scenario for Week 7 Case: You are a PMHNP

Scenario for Week 7 Case:

You are a PMHNP working in a large intercity hospital. You receive a call from the answering service informing you that a “stat” consult has been ordered by one of the hospitalists in the ICU. Upon arriving in the ICU, you learn that your consult is a 14 year old male who overdosed on approximately 50 Benadryl (diphenhydramine hydrochloride) tablets in an apparent suicide attempt. At the scene, a suicide note was found indicating that he wanted to die because his girlfriend’s parents felt that their daughter was too young to be “dating.” The client stated in the suicide note that he could not “live without her” and decided to take his own life. Although he has been medically stabilized and admitted to the ICU, he has been refusing to talk with the doctors or nurses. The hospital staff was finally able to get in touch with the clients parents (using contact information retrieved from the 14 year old’s cell phone). Unbeknown to the hospital staff, the parents are divorced, and both showed up at the hospital at approximately the same time, each offering their own perspectives on what ought to be done. The client’s father is demanding that the client be hospitalized because of the suicide, but his mother points out that he does not have “physical custody” of the child. The client’s mother demands that the client be discharged to home with her stating that her son’s actions were nothing more than a “stunt” and “an attempt at manipulating the situation that he didn’t like.” The client’s mother then becomes “nasty” and informs you that she works as a member of the clerical staff for the state board of nursing, and if you fail to discharge her child “right now” she will make you “sorry.” How would you proceed? Assignment 1 Practicum Decision Tree

The Assignment (2–3 pages):
Based on the scenario, would you recommend that the client be voluntarily committed? Why or why not?
Based on the laws in your state, would the client be eligible for involuntary commitment? Explain why or why not.
Did understanding the state laws confirm or challenge your initial recommendation regarding involuntarily committing the client? Explain.
If the client were not eligible for involuntary commitment, explain what actions you may be able to take to support the parents for or against voluntary commitment.
If the client were not eligible for involuntary commitment, explain what initial actions you may be able to take to begin treating the client.

Assignment 1: Practicum: Decision Tree

For this Assignment, as you examine the client case study in this week’s Learning Resources, consider how you might assess and treat pediatric clients presenting symptoms of a mental health disorder.

Learning Objectives

Students will:

· Evaluate clients for treatment of mental health disorders
· Analyze decisions made throughout diagnosis and treatment of clients with mental health disorders

The Assignment:

Examine Case 2: You will be asked to make three decisions concerning the diagnosis and treatment for this client. Be sure to consider co-morbid physical as well as mental factors that might impact the client’s diagnosis and treatment.

At each Decision Point, stop to complete the following:

· Decision #1: Differential Diagnosis

· Which Decision did you select?

· Why did you select this Decision? Support your response with evidence and references to the Learning Resources.

· 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 #1 and the results of the Decision. Why were they different?

· Decision #2: Treatment Plan for Psychotherapy

· Why did you select this Decision? Support your response with evidence and references to the Learning Resources.

· 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 #2 and the results of the Decision. Why were they different?

· Decision #3: Treatment Plan for Psychopharmacology

· Why did you select this Decision? Support your response with evidence and references to the Learning Resources.

· 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 and their families.

BACKGROUND

Tyrel is an 8-year-old black male who is brought in by his mother for a variety of psychiatric complaints. Shaquana, Tyrel’s mother, reports that Tyrel has been exhibiting a lot of worry and “nervousness” over the past 2 months. She states that she notices that he has been quite “keyed up” and spends a great deal of time worrying about “germs.” She states that he is constantly washing his hands because he feels as though he is going to get sick like he did a few weeks ago, which kept him both out of school and off the playground. He was also not able to see his father for two weekends because of being sick. Shaquana explains that although she and her ex-husband Desmond divorced about 2 years ago, their divorce was amicable and they both endeavor to see that Tyrel is well cared for.

Shaquana reports that Tyrel is irritable at times and has also had some sleep disturbances (which she reports as “trouble staying asleep”). She reports that he has been more and more difficult to get to school as he has become nervous around his classmates. He has missed about 8 days over the course of the last 3 weeks. He has also stopped playing with his best friend from across the street.

His mother reports that she feels “responsible” for his current symptoms. She explains that after he was sick with strep throat a few weeks ago, she encouraged him to be more careful about washing his hands after playing with other children, handling things that did not belong to him, and especially before eating. She continues by saying “maybe if I didn’t make such a big deal about it, he would not be obsessed with germs.”

Per Shaquana, her pregnancy with Tyrel was uncomplicated, and Tyrel has met all developmental milestones on time. He has had an uneventful medical history and is current on all immunizations.

OBJECTIVE

During your assessment of Tyrel, he seems cautious being around you. He warms a bit as you discuss school, his friends at school, and what he likes to do. He admits that he has been feeling “nervous” lately, but when you question him as to why, he simply shrugs his shoulders.

When you discuss his handwashing with him, he tells you that “handwashing is the best way to keep from getting sick.” When you question him how many times a day he washes his hands, he again shrugs his shoulders. You can see that his bilateral hands are dry. Throughout your assessment, Tyrel reveals that he has been thinking of how dirty his hands are; and no matter how hard he tries to stop thinking about his “dirty” hands, he is unable to do so. He reports that he gets “really nervous” and “scared” that he will get sick, and that the only way to make himself feel better is to wash his hands. He reports that it does work for a while and that he feels “better” after he washes his hands, but then a little while later, he will begin thinking “did I wash my hands well enough? What if I missed an area?” He reports that he can feel himself getting more and more “scared” until he washes his hands again.

MENTAL STATUS EXAM

Tyrel is alert and oriented to all spheres. Eye contact varies throughout the clinical interview. He reports his mood as “good,” admits to anxiety. Affect consistent to self-reported mood. He denies visual/auditory hallucinations. No overt delusional or paranoid thought processes were apparent. He denies suicidal ideation.

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Lab studies obtained from Tyrel’s pediatric nurse practitioner were all within normal parameters. An antistreptolysin O antibody titer was obtained for reasons you are unclear of, and this titer was shown to be above normal parameters.

Decision Point One

BASED ON THE INFORMATION PROVIDED IN THE SCENARIO ABOVE, WHICH OF THE FOLLOWING DIAGNOSES WOULD THE PMHNP GIVE TO TYREL?

In your write-up of this case, be certain to link specific symptoms presented in the case to DSM–5 criteria to support your diagnosis.

Decision Point One

Obsessive Compulsive Disorder

Decision Point Two

https://mym.cdn.laureate-media.com/2dett4d/Walden/NURS/6660/05/mm/decision_tree/img/pill-blue.pngBegin Fluvoxamine immediate release 25 mg orally at bedtime

RESULTS OF DECISION POINT TWO

· Client returns to clinic in four weeks

· Upon return to the clinic, Tyrel’s mother reported that he has had some decrease in his symptoms. She states that the frequency of the handwashing has decreased, and Tyrel seems a bit more “relaxed” overall.

· She also reports that Tyrel has not fully embraced returning to school, but that his attendance has improved. She reported that over this past weekend, Tyrel went outside to play with his friend from across the street, which he has not done in a while.

Decision Point Three

https://mym.cdn.laureate-media.com/2dett4d/Walden/NURS/6660/05/mm/decision_tree/img/pill-red.pngIncrease Fluvoxamine to 50 mg orally at bedtime Practicum: Decision Tree.

Guidance to Student

In terms of an actual diagnosis, the child’s main symptoms are most consistent with obsessive-compulsive disorder. There may also be an element of social phobia developing, but at this point, the PMHNP has not assessed the nature of the school avoidance—that is, why is the child avoiding school. Notice that nothing in the scenario tells us that the PMHNP has assessed this. Practicum: Decision Tree.

Fluvoxamine immediate release is FDA-approved for the treatment of OCD in children aged 8 years and older. Fluvoxamine’s sigma-1 antagonist properties may cause sedation and as such, it should be dosed in the evening/bedtime.

At this point, it would be appropriate to consider increasing the bedtime dose, especially since the child is responding to the medication and there are no negative side effects. Practicum: Decision Tree.

Atypical antipsychotics are typically not used in the treatment of OCD. There is also nothing to tell us that an atypical antipsychotic would be necessary (e.g., no psychotic symptoms). Additionally, the child seems to be responding to the medication, so there is no rationale as to why an atypical antipsychotic would be added to the current regimen.

Cognitive behavioral therapy is the psychotherapy of choice for treating OCD. The PMHNP should augment medication therapy with CBT. If further assessment determines that Tyrel has social anxiety disorder, CBT is effective in treating this condition as well. Assignment 1 Practicum Decision Tree

NURS 660 Week 4: Trauma and Stressor-Related Disorders in Childhood

“He was drunk again, so I should have known better. I should have stayed away from the house, but that would have made him madder. He has done this before, but not nearly this bad. He broke my wrist as I was protecting my mom. The neighbor heard the screaming and called the cops. They hauled him away, but I know he will be back. She always lets him come back.”

Avery, age 14

In August of 2005, thousands of children lost their homes in Hurricane Katrina. On December 14, 2012, the students at Sandy Hook Elementary School experienced the death of 20 of their classmates and six of their teachers. Every day, children experience physical and sexual abuse and neglect by their parents or caregivers. These types of trauma have a lifelong impact on the children involved and those witnessing the events. As much as we try to prevent unwanted childhood trauma and stressors, the phenomena are present in our culture. Practicum: Decision Tree. Childhood trauma is a significant contributor to both physical and mental health problems in children and adults.

This week, you examine several cases of child abuse and neglect, and you recommend strategies for assessing for abuse. You analyze influences of media and social media on mental health and evaluate the need for mandatory reporting of abuse. You also submit your Practicum Journal and Assignments. Practicum: Decision Tree.

Photo Credit: StaffordStudios / Getty Images

Learning Resources

Required Readings

Sadock, B. J., Sadock, V. A., & Ruiz, P. (2014). Kaplan & Sadock’s synopsis of psychiatry: Behavioral sciences/clinical psychiatry (11th ed.). Philadelphia, PA: Wolters Kluwer.

· Chapter 31, “Child Psychiatry” (pp. 1216–1226)

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.

· “Trauma- and Stressor-related Disorders”

Note: You will access this book from the Walden Library databases.

Pfefferbaum, B., & Shaw, J. A. (2013). Practice parameter on disaster preparedness. Journal of the American Academy of Child & Adolescent Psychiatry, 52(11), 1224–1238. Retrieved from http://www.jaacap.com/article/S0890-8567(13)00550-9/pdf Practicum: Decision Tree

American Psychiatric Nurses Association. (2017). Childhood and adolescent trauma. Retrieved from http://www.apna.org/i4a/pages/index.cfm?pageID=4545

Stahl, S. M. (2014). Prescriber’s Guide: Stahl’s Essential Psychopharmacology (5th ed.). New York, NY: Cambridge University Press.

Optional Resources

Thapar, A., Pine, D. S., Leckman, J. F., Scott, S., Snowling, M. J., & Taylor, E. A. (2015). Rutter’s child and adolescent psychiatry (6th ed.). Hoboken, NJ: Wiley Blackwell.

· Chapter 50, “Provision of Intensive Treatment: Intensive Outreach, Day Units, and In-Patient Units” (pp. 648–664)

· Chapter 58, “Disorders of Attachment and Social Engagement Related to Deprivation” (pp. 795–805)

· Chapter 59, “Post Traumatic Stress Disorder” (pp. 806–821)

· Chapter 64, “Suicidal Behavior and Self-Harm” (pp. 893–912)

Discussion: Treating Childhood Abuse

In 2012, statistics in the United States indicated that state CPS agencies received 3.4 million referrals for child abuse and neglect. Of these, nearly 700,000 children were found to be victims of maltreatment: 18% were victims of physical abuse and 78% were victims of neglect (CDC, 2014). Child sexual abuse makes up roughly 10% of child maltreatment cases in the United States (CDC, 2014). The CDC considers sexual abuse at any age a form of violence. Child abuse of any kind can lead to an increased state of inflammatory markers in adulthood, as well as multiple physical illnesses and high-risk behavior such as alcoholism and drug abuse. If a PMHNP identifies child abuse, there may be a need to report the abuse to authorities. Practicum: Decision Tree. Once able to provide treatment, the PMHNP can be instrumental in reducing the long-term effects of child abuse.

In this Discussion, you recommend strategies for assessing for abuse and analyze influences of media and social media on mental health. You also evaluate the need for mandatory reporting of abuse.

Learning Objectives

Students will:

· Recommend strategies for assessing for abuse

· Analyze influences of media and social media on mental health

· Evaluate the need for mandatory reporting of abuse

To Prepare for this Discussion:

· Read the Learning Resources concerning treating childhood abuse.

· Read the Child Abuse Case Study in the Learning Resources. See Child Abuse Case Study

Assignment Question to be addressed Practicum: Decision Tree

· What strategies would you employ to assess the patient for abuse? Explain why you selected these strategies.

· How might exposure to the media and/or social media affect the patient?

· What type of mandatory reporting (if any) is required in this case? Why?

Child Abuse Case Study

NURS 6660: Psychiatric Mental Health Nurse Practitioner Role I: Child

and Adolescent

Child Abuse Case Study
NURS 6660: Psychiatric Mental Health Nurse Practitioner Role I: Child and Adolescent
Morgan, a 19-year-old male comes to your office to discuss his current mood and symptoms. This is his first visit to a mental health clinic. “I’ve had 26 jobs in the last 2years; I finally have a job that I like and I want to make it work.” As you begin to get to know him, he tells you that his mood is down and that he also has times where he has “more energy and motivation”: “That’s when I am able to get a new job.” Practicum: Decision Tree. He says that he has difficulty interacting with coworkers. “I feel like I can’t talk to them.” If it wasn’t for his supportive girlfriend, he wouldn’t be able to function. “She understands me and accepts me; she knows what I have been through.”
As the PMHNP listens to the client and explores what he means by some of his statements, you try to put together his story. He mentions that he has been having nightmares and is not sleeping well. He says he startles easily. He becomes withdrawn when he begins to talk about the reason for the nightmares.“This all started a few weeks ago when a cousin of mine got out of jail.” He haltingly tells the story of his parents’ mental illness and how he had to live with various relatives. “One cousin who I stayed with a lot took advantage of me. He molested me.” They found out he also molested other children and he went to jail. “It gives me the creeps that he is out of jail. I have to face what he did to me.” Morgan asks about his diagnosis. The PMHNP tells him that he has some symptoms that sound like depression and anxiety, and that when a child has a traumatic experience, it can reoccur and stay with a person for many years. He acknowledges that he thought about PTSD but wasn’t sure what the symptoms look like.
As you think about Morgan’s story, consider the following questions: Where did he fall between the cracks? Are there agencies who advocate for children like him? There are thousands of children like Morgan. They were in a vulnerable family situation and the “responsible” adult was not able to care for the child. Sometimes it takes yearsfor clients to remember and disclose the abuse. Practicum: Decision Tree

Week 4: Trauma and Stressor-Related Disorders in Childhood

“He was drunk again, so I should have known better. I should have stayed away from the house, but that would have made him madder. He has done this before, but not nearly this bad. He broke my wrist as I was protecting my mom. The neighbor heard the screaming and called the cops. Practicum: Decision Tree. They hauled him away, but I know he will be back. She always lets him come back.”

Avery, age 14

In August of 2005, thousands of children lost their homes in Hurricane Katrina. On December 14, 2012, the students at Sandy Hook Elementary School experienced the death of 20 of their classmates and six of their teachers. Every day, children experience physical and sexual abuse and neglect by their parents or caregivers. These types of trauma have a lifelong impact on the children involved and those witnessing the events. Practicum: Decision Tree. As much as we try to prevent unwanted childhood trauma and stressors, the phenomena are present in our culture. Childhood trauma is a significant contributor to both physical and mental health problems in children and adults.

This week, you examine several cases of child abuse and neglect, and you recommend strategies for assessing for abuse. You analyze influences of media and social media on mental health and evaluate the need for mandatory reporting of abuse. You also submit your Practicum Journal and Assignments. Assignment 1 Practicum Decision Tree

Note: To access this week’s required library resources, please click on the link to the Course Readings List, found in the Course Materials section of your Syllabus. Practicum: Decision Tree.

Required Readings

Sadock, B. J., Sadock, V. A., & Ruiz, P. (2014). Kaplan & Sadock’s synopsis of psychiatry: Behavioral sciences/clinical psychiatry (11th ed.). Philadelphia, PA: Wolters Kluwer.

Chapter 31, “Child Psychiatry” (pp. 1216–1226)

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.

“Trauma- and Stressor-related Disorders”

Note: You will access this book from the Walden Library databases.

Pfefferbaum, B., & Shaw, J. A. (2013). Practice parameter on disaster preparedness. Journal of the American Academy of Child & Adolescent Psychiatry, 52(11), 1224–1238. Retrieved from http://www.jaacap.com/article/S0890-8567(13)00550-9/pdf Practicum: Decision Tree.

American Psychiatric Nurses Association. (2017). Childhood and adolescent trauma. Retrieved from http://www.apna.org/i4a/pages/index.cfm?pageID=4545

Document: Childhood Abuse Case Study (PDF)

Stahl, S. M. (2014). Prescriber’s Guide: Stahl’s Essential Psychopharmacology (5th ed.). New York, NY: Cambridge University Press.

Note: All Stahl resources can be accessed through the Walden Library using the link. This link will take you to a login page for the Walden Library. Once you log in to the library, the Stahl website will appear. Practicum: Decision Tree.

To access information on the following medications, click on The Prescriber’s Guide, 5th Ed. tab on the Stahl Online website and select the appropriate medication.

Review the following medications:

Posttraumatic stress disorder
citalopram clonidine desvenlafaxine escitalopram fluoxetine fluvoxamine mirtazapine nefazodone paroxetine prazosin (nightmares) propranolol (prophylactic) sertraline venlafaxine

Note: Many of these medications are FDA approved for adults only. Some are FDA approved for disorders in children and adolescents. Many are used “off label” for the disorders examined in this week. As you read the Stahl drug monographs, focus your attention on FDA approvals for children/adolescents (including “ages” for which the medication is approved, if applicable) and further note which drugs are “off label.” Practicum: Decision Tree.

Optional Resources

Thapar, A., Pine, D. S., Leckman, J. F., Scott, S., Snowling, M. J., & Taylor, E. A. (2015). Rutter’s child and adolescent psychiatry (6th ed.). Hoboken, NJ: Wiley Blackwell.

Chapter 50, “Provision of Intensive Treatment: Intensive Outreach, Day Units, and In-Patient Units” (pp. 648–664)

Chapter 58, “Disorders of Attachment and Social Engagement Related to Deprivation” (pp. 795–805)

Chapter 59, “Post Traumatic Stress Disorder” (pp. 806–821)

Chapter 64, “Suicidal Behavior and Self-Harm” (pp. 893–912)

Discussion: Treating Childhood Abuse

In 2012, statistics in the United States indicated that state CPS agencies received 3.4 million referrals for child abuse and neglect. Of these, nearly 700,000 children were found to be victims of maltreatment: 18% were victims of physical abuse and 78% were victims of neglect (CDC, 2014). Child sexual abuse makes up roughly 10% of child maltreatment cases in the United States (CDC, 2014). Practicum: Decision Tree. The CDC considers sexual abuse at any age a form of violence. Child abuse of any kind can lead to an increased state of inflammatory markers in adulthood, as well as multiple physical illnesses and high-risk behavior such as alcoholism and drug abuse. If a PMHNP identifies child abuse, there may be a need to report the abuse to authorities. Once able to provide treatment, the PMHNP can be instrumental in reducing the long-term effects of child abuse.

In this Discussion, you recommend strategies for assessing for abuse and analyze influences of media and social media on mental health. You also evaluate the need for mandatory reporting of abuse. Practicum: Decision Tree.

Learning Objectives

Students will:

Recommend strategies for assessing for abuse
Analyze influences of media and social media on mental health
Evaluate the need for mandatory reporting of abuse

To Prepare for this Discussion:

Read the Learning Resources concerning treating childhood abuse.
Read the Child Abuse Case Study in the Learning Resources.

Note: For this Discussion, you are required to complete your initial post before you will be able to view and respond to your colleagues’ postings. Begin by clicking on the “Post to Discussion Question” link and then select “Create Thread” to complete your initial post. Remember, once you click submit, you cannot delete or edit your own posts and cannot post anonymously Practicum: Decision Tree. Please check your post carefully before clicking Submit!

By Day 3

Post:

What strategies would you employ to assess the patient for abuse? Explain why you selected these strategies.
How might exposure to the media and/or social media affect the patient?
What type of mandatory reporting (if any) is required in this case? Why? Assignment 1 Practicum Decision Tree

By Day 6

Respond to at least two of your colleagues by providing at least two ways that their strategies may be expanded or improved.

Submission and Grading Information

Grading Criteria

To access your rubric:

Week 4 Discussion Rubric

Post by Day 3 and Respond by Day 6

To participate in this Discussion:

Week 4 Discussion

Assignment 1: Practicum: Week 1 Practicum Journal

By Day 7

Submit your Assignment. Refer to Week 1 for additional guidance.

Submission and Grading Information NURS 6660 Trauma and Stressor-Related Disorders

To submit your completed Assignment for review and grading, do the following:

Please save your Assignment using the naming convention “WK4Assgn1+last name+first initial.(extension)” as the name. NURS 6660 Trauma and Stressor-Related Disorders
Click the Week 4 Assignment 1 Rubric to review the Grading Criteria for the Assignment.
Click the Week 4 Assignment 1 link. You will also be able to “View Rubric” for grading criteria from this area.
Next, from the Attach File area, click on the Browse My Computer button. Find the document you saved as “WK4Assgn1+last name+first initial.(extension)” and click Open.
If applicable: From the Plagiarism Tools area, click the checkbox for I agree to submit my paper(s) to the Global Reference Database. Practicum: Decision Tree.
Click on the Submit button to complete your submission.

Grading Criteria

To access your rubric:

Week 4 Assignment 1 Rubric NURS 6660 Trauma and Stressor-Related Disorders

Check Your Assignment Draft for Authenticity

To check your Assignment draft for authenticity:

Submit your Week 4 Assignment 1 draft and review the originality report.

Submit Your Assignment by Day 7

To submit your Assignment:

Week 4 Assignment 1

Assignment 2: Practicum: Week 3 Decision Tree

By Day 7 NURS 6660 Trauma and Stressor-Related Disorders

Submit your Assignment. Refer to Week 3 for additional guidance.

Submission and Grading Information

To submit your completed Assignment for review and grading, do the following:

Please save your Assignment using the naming convention “WK4Assgn2+last name+first initial.(extension)” as the name.
Click the Week 4 Assignment 2 Rubric to review the Grading Criteria for the Assignment.
Click the Week 4 Assignment 2 link. You will also be able to “View Rubric” for grading criteria from this area. Practicum: Decision Tree.
Next, from the Attach File area, click on the Browse My Computer button. Find the document you saved as “WK4Assgn2+last name+first initial.(extension)” and click Open.
If applicable: From the Plagiarism Tools area, click the checkbox for I agree to submit my paper(s) to the Global Reference Database.
Click on the Submit button to complete your submission.

Grading Criteria

To access your rubric: NURS 6660 Trauma and Stressor-Related Disorders

Week 4 Assignment 2 Rubric

Check Your Assignment Draft for Authenticity

To check your Assignment draft for authenticity:

Submit your Week 4 Assignment 2 draft and review the originality report.

Submit Your Assignment by Day 7

To submit your Assignment:

Week 4 Assignment 2 NURS 6660 Trauma and Stressor-Related Disorders

Assignment 3: Board Vitals

This week you will be responding to twenty Board Vitals questions that cover a broad review of your Nurse Practitioner program courses up to this point.

These review questions will provide practice that is critical in your preparation for the national certification exam that’s required to certify you to practice as a nurse practitioner. These customized test questions are designed to help you prepare for your Nurse Practitioner certification exam. It is in your best interest to take your time, do your best, and answer each question to the best of your ability. NURS 6660 Trauma and Stressor-Related Disorders

ORDER A PLAGIARISM FREE PAPER NOW

You can access Board Vitals through the link sent to you in email or by following the link below:

By Day 7 NURS 6660 Trauma and Stressor-Related Disorders

Complete the Board Vitals questions.

Practicum Reminder

Time Logs

You are required to keep a log of the time you spend related to your practicum experience and enter every patient you see each day. You can access your time log from the Welcome Page in your Meditrek account. You track time individually for each patient you work with. Please make sure to continuously input your hours throughout the term.

Making Connections

This week, you examined several cases of child abuse and neglect and recommended strategies for assessing for abuse. You analyzed influences of media and social media on mental health and evaluated the need for mandatory reporting of abuse. You also submitted your Practicum Journal and Assignments. Practicum: Decision Tree.

Next week, you analyze case studies to determine the diagnosis and treatment of anxiety disorders.

NURS 6660 Midterm and Final Exam Study Guide Questions and Answers

Working from a lifespan approach, this course introduces child and adolescent psychiatry. Emphasis is placed on the psychiatric and/or mental health disorders that begin in childhood and adolescence. Topics include psychiatric assessment; differential diagnosis; and application of diagnostic criteria, appropriate diagnostic testing, and diagnostic formulation. The learner will select a combination of psychotherapeutic modalities coupled with psychopharmacologic approaches to treat common psychiatric mental health conditions of children and adolescents. The focus of the practicum experience is on application of didactic concepts to actual patient care situations. Legal and ethical considerations for working with children and adolescents will be addressed. NURS 6660 Midterm and Final Exam Study Guide Questions and Answers Practicum: Decision Tree

BUY NURS 6600 EXAM HERE

Assignments and Projects

An Assignment or Project often is a writing assignment submitted to the Instructor for evaluation. Complete Assignment or Project directions are in the Assignments or Projects areas, including how and where to submit the Assignment or Project and the due date. Please note that you should keep copies of your Assignments and Projects on your computer in case of any technical difficulties. NURS 6660 Midterm and Final Exam Study Guide Questions and Answers

Information on scholarly writing may be found in the APA manual and at the Walden Writing Center website.

Please refer to the APA Guide or visit the Walden University Online Writing Center at http://writingcenter.waldenu.edu/.

Walden University expects you to act with integrity and honesty in your academic courses. Refer to the Guidelines and Policies and Academic Integrity areas for more details.

Check the Course Information area for any rubrics relating to the Assignments and Projects.

All assignments must be completed to pass the course. NURS 6660 Midterm and Final Exam Study Guide Questions and Answers Practicum: Decision Tree

Practicum Activities

The practicum experience in this course will assist your transition from the role of learner to that of scholar-practitioner. To achieve this transition, you will engage in a relationship with a clinical instructor and preceptor, focusing on roles and role functions and the achievement of individualized learning objectives. The primary objective of your practicum is to provide you with the basic skills necessary to serve as a mid-level provider of primary care to selected populations and prepare you to take the appropriate national certification exam. NURS 6660 Midterm and Final Exam Study Guide Questions and Answers . Assignment 1 Practicum Decision Tree

The practicum component of the course will be graded as Satisfactory or Unsatisfactory. In order to pass the course, you must earn a grade of Satisfactory on all required practicum activities including journal entries and time logs.

At the end of the course, you must also ensure that your practicum preceptor submits an online evaluation of your performance. You will also complete an online evaluation of your practicum experience at the end of the course. These evaluations will not only provide information about the progress of individual students, but also help program leadership to continuously work on the course review and improvements. You will receive an Incomplete (I) as a grade if any of the above evaluations are not received by the posted deadlines. NURS 6660 Midterm and Final Exam Study Guide Questions and Answers Practicum: Decision Tree

Time Logs: Students are required to keep a log of the time spent related to their practicum experience and enter every patient they see each day. Students can access their time log from the Welcome Page in their Meditrek account. Students will track time individually for each patient they work with. Students are required to continuously input their hours throughout the term. Logs are reviewed by instructors in Weeks 4, 7, and 10. Please print and keep your completed Meditrek Log at the end of your clinical experiences for future use as a component of your portfolio. NURS 6660 Midterm and Final Exam Study Guide Questions and Answers

Week 1	Comprehensive Integrated Psychiatric Assessment
	Learning Resources	Required Readings Required Media Optional Resources
	Discussion	Comprehensive Integrated Psychiatric Assessment
	Assignment	Practicum Journal Entry: Analyzing an Ethical Decision
	Making Connections
	Looking Ahead	Didactic Assignments Practicum Assignments
Week 2	Assessment in Child and Adolescent Psychiatry Practicum: Decision Tree
	Learning Resources	Required Readings Optional Resources
	Discussion	Working With Children and Adolescents Versus Adults
	Assignment 1	Practicum: Cover Letter, Resume, and Portfolio
	Assignment 2	Board Vitals
	Making Connections
	Looking Ahead
Week 3	Autism Spectrum Disorder, ADHD, ODD, and ICD
	Learning Resources	Required Readings Required Media Optional Resources
	Discussion	Parent Guide
	Assignment 1	Practicum: Decision Tree
	Assignment 2	Board Vitals
	Making Connections
Week 4	Trauma and Stressor-Related Disorders in Childhood
	Learning Resources	Required Readings Optional Resources
	Discussion	Treating Childhood Abuse
	Assignment 1	Practicum: Week 1 Practicum Journal
	Assignment 2	Practicum: Week 3 Decision Tree
	Assignment 3	Board Vitals
	Practicum Reminder	Practicum: Decision Tree
	Making Connections
Week 5	Anxiety Disorders in Childhood and Adolescence
	Learning Resources	Required Readings Required Media Optional Resources
	Discussion	Clinical Supervision
	Assignment 1	Practicum: Decision Tree
	Assignment 2	Board Vitals
	Making Connections
	Looking Ahead
Week 6	Emergency Psychiatric Care in Childhood and Adolescence
	Learning Resources	Required Readings Optional Resources
	Discussion	Treatment of Psychiatric Emergencies in Children Versus Adults
	Assignment 1	Midterm Exam
	Assignment 2	Board Vitals
	Making Connections	NURS 6660 Midterm and Final Exam Study Guide Questions and Answers
	Looking Ahead
Week 7	Learning and Motor Disorders in Childhood
	Learning Resources	Required Readings Optional Resources
	Discussion	Parent Guide
	Assignment 1	Practicum Journal: Voluntary and Involuntary Commitment
	Assignment 2	Practicum: Week 5 Decision Tree
	Assignment 3	Board Vitals
	Practicum Reminder	Time Logs
	Making Connections	NURS 6660 Midterm and Final Exam Study Guide Questions and Answers
Week 8	Mood Disorders Practicum: Decision Tree
	Learning Resources	Required Readings Optional Resources
	Discussion	Pediatric Bipolar Depression Disorder Debate
	Assignment	Board Vitals
	Making Connections
	Looking Ahead	NURS 6660 Midterm and Final Exam Study Guide Questions and Answers
Week 9	Early-Onset Schizophrenia
	Learning Resources	Required Readings Required Media Optional Resources
	Assignment 1	Early Onset Schizophrenia
	Assignment 2	Practicum: Decision Tree
	Assignment 3	Board Vitals
	Making Connections
Week 10	Feeding, Eating, and Elimination Disorders in Childhood
	Learning Resources	Required Readings Optional Resources
	Discussion	Parent Guide
	Assignment 1	Practicum: Week 2 Cover Letter, Resume, and Portfolio
	Assignment 2	Practicum: Week 9 Decision Tree
	Assignment 3	Board Vitals
	Practicum Reminder	Time Logs
	Making Connections
Week 11	Special Topics in Child and Adolescent Psychiatry
	Learning Resources	Required Readings Optional Resources
	Discussion	Special Topics in Child and Adolescent Psychiatry
	Assignment 1	Final Exam
	Assignment 2 NURS 6660 Midterm and Final Exam Study Guide Questions and Answers

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.

Giles, L. L., & Martini, D. R. (2016). Challenges and promises of pediatric psychopharmacology. Academic Pediatrics, 16(6), 508-518.

Hargrave, T. M., & Arthur, M. E. (2015). Teaching child psychiatric assessment skills: Using pediatric mental health screening tools. International Journal of Psychiatry in Medicine, 50(1), 60-72.

Kaltiala-Heino, R. (2010). Involuntary commitment and detainment in adolescent psychiatric inpatient care. Social Psychiatry Epidemiology, 45, 785-793. doi: 10.1007/s00127-009-0116-3.

Lindsey, M. A., Joe, S., Muroff, J., & Ford, B. E. (2010). Social and clinical factors associated with psychiatric emergency service use and civil commitment among African-American youth. General Hospital Psychiatry, 32, 300-309. doi:10.1016/j.genhosppsych.2010.01.007

McClelland, M., Crombez, M., Crombez, C., Wenz, C., Lisius, M., Mattia, A., & Marku, S. (2015). Implications for advanced practice nurses when pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections (PANDAS) is suspected: A qualitative study. Journal of Pediatric Healthcare, 29(5), 442-452. doi:10.1016/j.pedhc.2015.03.005

McGavey, E. L., Leon-Verdin, M., Wancheck, T. N., & Bonnie, R. J. (2013). Decisions to initiate involuntary commitment: The role of intensive community services and other factors. Psychiatric Services, 64(2), 120-126.

Practicum: Decision Tree

NUR 6630 Week 1 Discussion: Foundational Neuroscience

NUR 6630 Week 1 Discussion: Foundational Neuroscience

Week 1 Discussion

NURS 6630 – Psychopharmacologic Approaches to Treatment of Psychopathology Essay Assignment Week 1 Discussion: Foundational Neuroscience

Discussion: Foundational Neuroscience Optional Resources

Discussion: Foundational Neuroscience Accessible player

Assignment: Assessing and Treating Clients With Dementia

7.1. What Happens when your Skin ages?

7.2. How your Skin changes with each Birthday

7.3. Ethnicity and Ageing

7.4. Ingredients to Look for in Anti-Ageing Products

7.5. Botox versus Facelift

The Assignment:

Child Abuse Case Study

Week 4: Trauma and Stressor-Related Disorders in Childhood

Required Readings

Optional Resources

Discussion: Treating Childhood Abuse

Learning Objectives

By Day 3

By Day 6

Submission and Grading Information

Grading Criteria

Post by Day 3 and Respond by Day 6

Assignment 1: Practicum: Week 1 Practicum Journal

Grading Criteria

Check Your Assignment Draft for Authenticity

Submit Your Assignment by Day 7

Assignment 2: Practicum: Week 3 Decision Tree

Grading Criteria

Check Your Assignment Draft for Authenticity

Submit Your Assignment by Day 7

NURS 6660 Midterm and Final Exam Study Guide Questions and Answers

Assignments and Projects

Practicum Activities

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