I want this assignment asap -PLAGIARISM MUST BE LESS THAN 10%sychosis and schizophrenia greatly impact the brain’s normal processes, which interferes with the ability to think clearly. When symptoms of these disorders are uncontrolled, clients may struggle to function in daily life. However, clients often thrive when properly diagnosed and treated under the close supervision of a psychiatric mental health practitioner. 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 psychosis and schizophrenia.Learning ObjectivesStudents will:Assess client factors and history to develop personalized plans of antipsychotic therapy for clientsAnalyze factors that influence pharmacokinetic and pharmacodynamic processes in clients requiring antipsychotic therapyEvaluate efficacy of treatment plansAnalyze ethical and legal implications related to prescribing antipsychotic therapy to clients across the lifespanTo prepare for this Assignment:Review this week’s Learning Resources. Consider how to assess and treat clients requiring anxiolytic therapy.The AssignmentExamine Case Study: Pakistani Woman with Delusional Thought Processes. You will be asked to make three decisions concerning the medication to prescribe to this client. Be sure to consider factors that might impact the client’s pharmacokinetic and pharmacodynamic processes.At each decision point stop to complete the following:Decision #1Which 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 #2Why 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 #3Why 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?SAMPLE  ONLYNURS 6630WEEK SEVENCase 2: Volume 2, Case #11: The figment of a man who looked upon the ladyIntroductionBriefly, this is a scenario of a 42 year- old woman with a complex psychiatric history extending from depression, posttraumatic stress disorder, insomnia, visual hallucinations (little man)and impaired behavior with aggression. In the course of more than 36 months, the client was treated with Paroxetine (SSRI), Bupropion ( NDRI), Tiagabine, Ramelteon and , but finally a combination of Lexapro, Bupropion and quetiapine was able to decrease her symptoms . The client’s medical history includes diabetes, hypertension, CAD, hyperlipidemia, COPD, OSA, GERD, Glaucoma, overweight and a remote history of substance abuse.Related Professional QuestionsCertain medications or supplements can cause symptoms of mental illness and also due to her extensive medical history and usage of multiple medications I would ask the following questions:1. Do you take any over -the – counter, herbal supplements or remedies and I would check for interactions with current medication regimen?2. When and how often do you use your albuterol inhaler ? Some of the side effects of albuterol include anxiety, nervousness, and insomnia ( Cunha, 2016)Sleep Hygiene: Do you keep regular sleep schedule ? Do you drink caffeine beverages close to bedtime?Patient HistoryThe patient may not be a reliable source of information, particularly that she has a significant mental illness that affects her functioning, hence verifying her responses with her direct family members, and mental social workers to get clues to the underlying or precipitating causes of mental crisis. Also checking facility records from previous encounters, or any psychiatric hospitalizations would be useful.Diagnostics Testing1. Thyroid Stimulating Hormone (TSH). Based on recent evidence, the prevalence of depressive symptoms in hypothyroidism was nearly 50%, and clinical depression occurs in more than 40% of people suffering from hypothyroidism ( Bhagwat, 2017)2. Electrocardiogram (ECG) The client has cardiovascular diseases ( HTN, CAD), with risks of cardio complications. In the setting of taking antidepressants and antipsychotics, baseline ECG and possibly every three to six months would be appropriate.  Several atypical antipsychotics including quetiapine (Seroquel) are known to cause prolongation of the QT interval, hypothesized to occur via direct inhibition of the cardiac delayed potassium rectifier channel, which extends the ventricular repolarization process (Zhai et al., 2017)Differential Diagnoses1. Posttraumatic Stress Disorder ( PTSD)_2. Major Depressive Disorder  (MDD)3. Insomnia Disorder.Pharmacotherapy Options for Sleep/ Wake cycle1. Zolpidem (Ambien) 5mg oral at bedtime for Seven days.Zolpidem is nonbenzodiazepine hypnotic, it works by enhancing GABA inhibitory actions that provide sedative hypnotic effects more selectively than other actions of GABA (Stahl, 2017). With its side effects of sedation,  low dose prescribed as the client has respiratory problems (sleep apnea OSA)).  Studies have shown that Zolpidem did not significantly worsen OSA as measured by the numbers and duration of pauses in breathing during sleep, but in one trial, it significantly lowered minimum oxygen levels during the night when compared with placebo ( Mason & Smith, 2015).2. Trazadone 25 mg oral at bedtime for Thirty days.Trazadone is a serotonin 2 antagonist/reuptake inhibitor, used in management of depression and insomnia. It is absorbed well, metabolized by CYP 450 3A4 with average half life of 6hrs. It has less side sedative effects compared to zolpidem (Stahl, 2017)The best choice for the client would be Trazadone as there is no reliable evidence of dependence or withdraws and it can also work for the client’s depression.ConclusionThe case was a perfect example how it is sometimes difficult to find effective pharmacological treatments of psychiatric illnesses. In the course of four years, the client was prescribed 5-6 medications targeting different neurotransmitters to improve the symptoms. Client’s polypharmacy increased risks of drug-drug interactions, and her medical comorbidities increased risks of adverse reactions. Lesson learned from this study was  that treatment  should be optimally initiated after diagnosis, and augment or switching to a new agent must be carefully  done in consideration of possible  side effects and better outcomes.ReferencesBhagwat, N., Tayde, P., Sharma, P., Sharma, B., Dalwadi, P., Sonawane, A., … Varthakavi, P. (2017). Hypothyroidism and depression: Are cytokines the link? Indian Journal of Endocrinology and Metabolism, 21(6), 886. Retrieved from https://web-b-ebscohost-com.ezp.waldenulibrary.org/ehost/pdfviewer/pdfviewer?vid=7&sid=aeb79c1d-68dc-40a4-bd10-f956796bc9e8%40sessionmgr101Cunha, J. (2016). Common Side Effects of Ventolin HFA (Albuterol Sulfate Inhalation Aerosol) Drug Center – RxList. Retrieved from https://www.rxlist.com/ventolin-hfa-side-effects-drug-center.htmMason, M., & Smith, I. (2015). Effects of opioid, hypnotic and sedating medications on obstructive sleep apnoea (OSA) in adults with known OSA | Cochrane. Retrieved from http://www.cochrane.org/CD011090/AIRWAYS_effects-opioid-hypnotic-and-sedating-medications-obstructive-sleep-apnoea-osa-adults-known-osaZhai, D., Lang, Y., Dong, G., Liu, Y., Wang, X., Zhou, D., … Zhang, R. (2017). QTc interval lengthening in first-episode schizophrenia (FES) patients in the earliest stages of antipsychotic treatment. Schizophrenia Research, 179, 70-74. Retrieved from https://resolver-ebscohost-com.ezp.waldenulibrary.org/openurl?ID=pmid%3a27727006&genre=article&atitle=QTc+interval+lengthening+in+first-episode+schizophrenia+(FES)+patien

Congratulations! Because you are distinguishing yourself as a skilled healthcare manager, your boss has asked you to consult with a local physicians group. Review the mini case study on page 150 of the textbook then create a journal assignment in which you provide one or more recommendations for ways the physician owners can improve profitability without raising rates. Your recommendations should apply the principles in Exhibit 6.5 on page 149 and Exhibit 6.6 on page 150.

IT IS IMPORTANT TO COVER THE COMPETENCIES !!!Write a 3–5 page executive summary that examines an organization’s diversity policies and practices.Becoming a nursing leader requires a good deal of thought, consideration, and evaluation of the qualities you believe are essential for a nurse to effectively lead in the delivery of health care.By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and assessment criteria:· Competency 2: Apply systems theory and systems thinking to facilitate health care delivery and patient outcomes.(IMPORTANT) –Analyze the impact of a diverse nursing workforce on patient outcomes.· Competency 3: Analyze the role of multiculturalism and diversity in organizational and systems structure and leadership.(IMPORTANT)-Analyze how a health care organization integrates diversity and multiculturalism into its practices.(IMPORTANT)-Analyze current recruitment and retention policies to identify gaps between best practices and current policies.· Competency 4: Evaluate how power relates to health care organizational structure, behavior, and leadership.(IMPORTANT) -Recommend evidence-based changes to the organizational structure and systems leadership that empower a diverse workforce.· Competency 5: Communicate in a manner that is consistent with the expectations of a nursing professional.(IMPORTANT) -Write content clearly and logically, with correct use of grammar, punctuation, mechanics, and current APA style.Assessment InstructionsPreparationTo prepare for this assessment, use the Capella library and the Internet to study the impact of health system’s power structure on nursing, leadership, diversity related to empowerment in nursing and patient outcomes, and recruitment of a diverse workforce. You may also wish to look for examples of an executive summary on the Internet.· Identify a type of health care facility and examine the Web site and available public information to review the organization of the nursing department, nursing recruitment, and any information about the diversity of the system’s workforce and leadership.o You may use the health care setting in which you currently work or have worked in the past.o Describe the type of organization and region. Example: a major Midwestern teaching hospital or a rehabilitation hospital on the East Coast.o Do not report the name of the facility.Deliverable: Executive Summary of Organizational DiversityRead the following scenario:Scenario:The city in which you work has undergone a significant population shift within the last 10 years, due to increased employment, education opportunities, and an influx of immigrants and refugees. To put the population shift in perspective, the local school district enrollment report states that nearly 100 languages are spoken in the schools, up from 32 languages in the last census. Senior leadership has asked you to examine all types of multiculturalism and diversity within your health care organization.To do this, you will need to use a systems perspective to examine the relationship between a diverse workforce and patient outcomes; identify gaps between best practices and the organization’s diversity policies, and make a recommendation for organizational change.In the executive summary:· Analyze the impact of a diverse workforce on patient outcomes.o In what ways or situations might multiculturalism and diversity impact health care delivery or patient outcomes?o How is diversity defined in the organization?· Analyze how the health care system integrates diversity and multiculturalism into its practices.o Is the makeup of the organization’s leadership representative of the patient and employee populations? Is this important? What would you change?o Explain how multiculturalism and diversity can impact health care delivery or patient outcomes.· Analyze current recruitment and retention policies to identify gaps between best practices and current policies.· Assess the level of integration and importance of multiculturalism and diversity in a health care organization.o Are all types of diversity recognized and included?o Provide support for your position by including 2 or 3 examples of the integration of multiculturalism and diversity into the organization.· Recommend evidence-based changes to the organizational structure and systems leadership that empower a diverse workforce.o What changes would you champion as a health care leader to make the system more responsive to patients and the organization’s workforce?Make your document easy to scan for readers by:· Using subheadings to organize content.· Using bullet points and phrases for main points, in addition to short, succinct paragraphs.· Including a visual, such as a graph, table, or chart.Additional Requirements· Written communication: Written communication should be free of errors that distract from the overall message.· APA formatting: Resources and in-text citations should be formatted according to current APA style and formatting.· Font and font size: Times New Roman, 12 point, double-spaced.· Length: Summary report should be 3–5 pages.· Number of resources: Use a minimum of three peer-reviewed resources.

Then, post a draft of Part 1 of your Academic Success and Professional Development Plan Template indicating at least two academic and at least two  professional individuals or teams that you would like to collaborate  with to be successful in your MSN program and as a practicing nurse  along with an explanation for your selections.My MSN programme is psychiatry mental health nursing nurse oractitioner

Discussion: Patient Preferences and Decision MakingChanges in culture and technology have resulted in patient populations that are often well informed and educated, even before consulting or considering a healthcare need delivered by a health professional. Fueled by this, health professionals are increasingly involving patients in treatment decisions. However, this often comes with challenges, as illnesses and treatments can become complex.What has your experience been with patient involvement in treatment or healthcare decisions?In this Discussion, you will share your experiences and consider the impact of patient involvement (or lack of involvement). You will also consider the use of a patient decision aid to inform best practices for patient care and healthcare decision making.To Prepare:· Review the Resources and reflect on a time when you experienced a patient being brought into (or not being brought into) a decision regarding their treatment plan.· Review the Ottawa Hospital Research Institute’s Decision Aids Inventory at https://decisionaid.ohri.ca/.o Choose “For Specific Conditions,” then Browse an alphabetical listing of decision aids by health topic.NOTE: To ensure compliance with HIPAA rules, please DO NOT use the patient’s real name or any information that might identify the patient or organization/practice.By Day 3 of Week 8Post a brief description of the situation you experienced and explain how incorporating or not incorporating patient preferences and values impacted the outcome of their treatment plan. Be specific and provide examples. Then, explain how including patient preferences and values might impact the trajectory of the situation and how these were reflected in the treatment plan. Finally, explain the value of the patient decision aid you selected and how it might contribute to effective decision making, both in general and in the experience you described. Describe how you might use this decision aid inventory in your professional practice or personal life.Assignment: Evidence-Based Project, Part 5: Recommending an Evidence-Based Practice ChangeThe collection of evidence is an activity that occurs with an endgame in mind. For example, law enforcement professionals collect evidence to support a decision to charge those accused of criminal activity. Similarly, evidence-based healthcare practitioners collect evidence to support decisions in pursuit of specific healthcare outcomes.In this Assignment, you will identify an issue or opportunity for change within your healthcare organization and propose an idea for a change in practice supported by an EBP approach.To Prepare:· Reflect on the four peer-reviewed articles you critically appraised in Module 4.· Reflect on your current healthcare organization and think about potential opportunities for evidence-based change.The Assignment: (Evidence-Based Project)Part 5: Recommending an Evidence-Based Practice ChangeCreate an 8- to 9-slide PowerPoint presentation in which you do the following:· Briefly describe your healthcare organization, including its culture and readiness for change. (You may opt to keep various elements of this anonymous, such as your company name.)· Describe the current problem or opportunity for change. Include in this description the circumstances surrounding the need for change, the scope of the issue, the stakeholders involved, and the risks associated with change implementation in general.· Propose an evidence-based idea for a change in practice using an EBP approach to decision making. Note that you may find further research needs to be conducted if sufficient evidence is not discovered.· Describe your plan for knowledge transfer of this change, including knowledge creation, dissemination, and organizational adoption and implementation.· Describe the measurable outcomes you hope to achieve with the implementation of this evidence-based change.· Be sure to provide APA citations of the supporting evidence-based peer reviewed articles you selected to support your thinking.· Add a lessons learned section that includes the following:o A summary of the critical appraisal of the peer-reviewed articles you previously submittedo An explanation about what you learned from completing the evaluation table (1 slide)o An explanation about what you learned from completing the levels of evidence table (1 slide)o An explanation about what you learned from completing the outcomes synthesis table (1 slide)Required ReadingsMelnyk, B. M., & Fineout-Overholt, E. (2018). Evidence-based practice in nursing & healthcare: A guide to best practice (4th ed.). Philadelphia, PA: Wolters Kluwer.Chapter 7, “Patient Concerns, Choices and      Clinical Judgement in Evidence-Based Practice” (pp. 219–232)Hoffman, T. C., Montori, V. M., & Del Mar, C. (2014). The connection between evidence-based medicine and shared decision making. Journal of the American Medical Association, 312(13), 1295–1296. doi:10.1001/jama.2014.10186. Retrieved from https://jamanetwork.com/journals/jama/article-abstract/1910118Note: You will access this article from the Walden Library databases.Kon, A. A., Davidson, J. E., Morrison, W., Danis, M., & White, D. B. (2016). Shared decision making in intensive care units: An American College of Critical Care Medicine and American Thoracic Society policy statement. Critical Care Medicine, 44(1), 188–201. doi:10.1097/CCM.0000000000001396. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4788386/Note: You will access this article from the Walden Library databases.Opperman, C., Liebig, D., Bowling, J., & Johnson, C. S., & Harper, M. (2016). Measuring return on investment for professional development activities: Implications for practice. Journal for Nurses in Professional Development, 32(4), 176–184. doi:10.1097/NND.0000000000000483Note: You will access this article from the Walden Library databases.Schroy, P. C., Mylvaganam, S., & Davidson, P. (2014). Provider perspectives on the utility of a colorectal cancer screening decision aid for facilitating shared decision making. Health Expectations, 17(1), 27–35. doi:10.1111/j.1369-7625.2011.00730.xNote: You will access this article from the Walden Library databases.