Locate at least one scholarly journal article that discusses your subtopic (I have attached the required articles for this week you can choose from as well)-Identify your subtopic (Genetically competent care for those with chronic illness)and provide a brief summary of your journal article on how this topic relates to nursing practice.-What is the nurse’s role in providing care in relation to your subtopic and the overarching theme of advocacy?-What ethical implications should be considered with regard to genetics and genomics for nursing practice? Why?A 3-paragraph (at least 350 words)Be sure to use evidence from the readings and include in-text citations.Utilize essay-level writing practice and skills, including the use of transitional material and organizational frames.Avoid quotes; paraphrase to incorporate evidence into your own writing.A reference list is required. Use the most current evidence (usually ≤ 5 years old).

Decision Point OneSavella  12.5 mg once daily on day 1; followed by 12.5 mg BID on day 2 and 3;  followed by 25 mg BID on days 4-7; followed by 50 mg BID thereafterRESULTS OF DECISION POINT ONEClient returns to clinic in four weeksClient comes into the office to without crutches but is limping a  bit. The client states that the pain is “more manageable since I started  taking that drug. I have been able to get around more on my own. The  pain is bad in the morning though and gets better throughout the day”.  On a pain scale of 1-10; the client states that his pain is currently a  4. When asked what pain level would be tolerable on a daily basis, the  client states, “I would rather have no pain but don’t think that is  possible. I could live with a pain level of 3.”. When questioned  further, the PMHNP asks what makes the pain on a scale of 1-10 different  when comparing a level of 9 to his current level of 4?”. The client  states that since using this drug, I can get to a point on most days  where I do not need the crutches. ” The client is also asked what would  need to happen to get his pain from a current level of 4 to an  acceptable level of 3. He states, “If I could get to the point everyday  where I do not need the crutches for most of my day, I would be happy.”Client states that he has noticed that he frequently (over the  past 2 weeks) gets bouts of sweating for no apparent reason. He also  states that his sleep has “not been so good as of lately.” He does  complain of nausea todayClient’s blood pressure and pulse are recorded as 147/92 and 110  respectively. He also admits to experiencing butterflies in his chest.   The client denies suicidal/homicidal ideation and is still future  orientedDecision Point TwoContinue with current medication but lower dose to 25 mg twice a dayRESULTS OF DECISION POINT TWOClient returns to clinic in four weeksClient comes to office today with use  of crutches. He states that his current pain is a 7 out of 10. “I do not  feel as good as I did last month.”Client states that he is sleeping at night but woken frequently from pain down his right leg and into his footClient’s blood pressure and heart rate recorded today are 124/85 and 87 respectively. He denies any heart palpitations todayClient denies suicidal/homicidal ideation but he is discouraged about the recent slip in his pain management and looks sadDecision Point ThreeChange Savella to 25 mg orally in the MORNING and 50 mg orally at BEDTIMEGuidance to StudentThe client has a complex neuropathic  pain syndrome that may never respond to pain medication. Once that is  understood, the next task is to explain to the client that pain level  expectations need to realistic in nature and understand that he will  always have some level of pain on a daily basis. The key is to manage it  in a manner that allows him to continue his activities of daily living  with as little discomfort as possible. Next, it is important to explain  that medications are never the final answer but a part of a complex  regimen that includes physical therapy, possible chiropractic care, heat  and massage therapy, and medications. Savella is a SNRI that also  possesses NMDA antagonist activity which helps in producing analgesia at  the site of nerve endings. It is specifically marketed for fibromyalgia  and has a place in therapy for this gentleman. Tramadol is never a good  option along with other opioid type analgesics. Agonists at the Mu  receptors does not provide adequate pain control in these types of  neuropathic pain syndromes and therefore is never a good idea. It also  has addictive properties which can lead to secondary drug abuse.  Reductions in Savella can help control side effects but at a cost of  uncontrolled pain. It is always a good idea to start with dose  reductions during parts of the day that pain is most under control. The  addition of Celexa with Savella needs to be done cautiously. Both  medications inhibit the reuptake of serotonin and can, therefore, lead  to serotonin toxicity or serotonin syndrome.

When it comes to facilitating spiritual care for patients with worldviews different from your own, what are your strengths and weaknesses? If you were the patient

Throughout this course, you analyzed your current work environment to identify their acquiring, developing, and training practices. Employees are the biggest asset and contribute to the culture and overall performance of the organization. The final part of this project requires you to determine how to leverage on the human capital within your organization. Use the research you have complied throughout this course to determine how to appropriately develop and motivate your employees.Develop a final written proposal (1,250-1,500 words), discussing performance indicators, rewards and incentives, and a plan for motivating employees. Your proposal must include the following:1. An evaluation of the current employee status. Describe tasks and performance indicators that contribute to the overall performance on the job.2. Develop strategies to encourage employees. How will you reward them for their performance and support them during difficulty?3. Describe strategies to leverage on employee assets. How will you identify their strengths and use them to better the performance and skills of individual employees?4. Describe a vision for the overall culture you aspire to develop in your organization.5. How will you integrate rewards and incentives to remain competitive in your market and appeal to your employees?

Psychotherapeutic Approaches to Group Therapy with Children and AdolescentsGroup therapy may be beneficial for children and adolescents, because it often provides an environment that normalizes clients’ thoughts, feelings, and behaviors. However, as with any therapeutic approach, group therapy might not be appropriate for every client, every setting, or even every therapist. When selecting therapies, you must always consider the psychodynamics of the client and your own skill set.This week, as you assess and develop diagnoses for clients presenting for child and adolescent group psychotherapy, you examine the effectiveness of this therapeutic approach. You also consider legal and ethical implications of counseling children and adolescent clients with psychiatric disorders.Learning ObjectivesStudents will:· Assess clients presenting with disruptive behavior· Analyze group therapeutic approaches for treating clients presenting with disruptive behavior· Evaluate outcomes for clients presenting with disruptive behaviorTo prepare:· Review this week’s Learning Resources and reflect on the insights they provide.· Read the case study I am Feeling Like I’m Going Crazy below· For guidance on assessing the client, refer to pages 137-142 of the Wheeler text in this week’s Learning Resources.Post an explanation of the most likely DSM-5 diagnosis for the client in the case study. Be sure to link those behaviors to the criteria in the DSM-5. Then, explain group therapeutic approaches you might use with this client.  Explain expected outcomes for the client based on these therapeutic approaches. Finally consider legal and ethical implications of counseling children and adolescent clients with psychiatric disorders. Support your approach with evidence-based literature.Required Readings( Need 3 references)American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.McGillivray, J. A., & Evert, H. T. (2014). Group cognitive behavioural therapy program shows potential in reducing symptoms of depression and stress among young people with ASD. Journal of Autism and Developmental Disorders, 44(8), 2041-2051. doi:10.1007/s10803-014-2087-9Restek-Petrović, B., Bogović, A., Mihanović, M., Grah, M., Mayer, N., & Ivezić, E. (2014). Changes in aspects of cognitive functioning in young patients with schizophrenia during group psychodynamic psychotherapy: A preliminary study. Nordic Journal of Psychiatry, 68(5), 333-340. doi:10.3109/08039488.2013.839738Wheeler, K. (Ed.). (2014). Psychotherapy for the advanced practice psychiatric nurse: A how-to guide for evidence-based practice. New York, NY: Springer.Chapter 17, “Psychotherapy      with Children” (pp. 597–624)Chapter 20, “Termination and Outcome      Evaluation” (pp. 693–712)Document: I am Feeling Like I’m Going CrazyRequired MediaMicrotraining Associates (Producer). (2009). Leading groups with adolescents [Video file]. Alexandria, VA: Author.Psychotherapy.net (Producer). (2002). Adlerian parent consultation [Video file]. Mill Valley, CA: Author.The approximate length of this media pice is 117 minutes.Optional ResourcesPsychotherapy.net (Producer). (2012). Group counseling with adolescents: A multicultural approach [Video file]. Mill Valley, CA: Author.