Case Study: Discuss Fibromyalgia

A 25-year-old female patient is being prescribed milnacipran to treat fibromyalgia, and expresses concern regarding “how she will feel and look” from taking the medicine. Which statement correctly describes the side effects as a result of taking this medication?

Question 52

Mr. Ruby is a 33-year-old single father who is requesting pharmacological intervention to treat his fibromyalgia. The PMHNP sees in the medical chart that he has a recent diagnosis of arrhythmia and a BMI of 29. During his assessment, the PMHNP learns that Mr. Ruby works 40–50 hours a week as a contractor and “manages his stress” by smoking 3–4 cigarettes a day and having 8–10 drinks of alcohol each week. Why would duloxetine be contraindicated for Mr. Ruby?

Question 53

A patient is prescribed sertraline to treat panic disorder. Knowing that sertraline can initially cause anxiety or insomnia, what should the PMHNP do?

Question 54

A patient is prescribed 50 mg of desvenlafaxine to take every other day for major depressive disorder. What does the PMHNP understand about this patient?

Question 55

The PMHNP understands that which mechanism contributes to a worse tolerability profile for patients taking tricyclic antidepressants (TCAs)? Case Study: Discuss Fibromyalgia

Question 56

A patient who was prescribed an MAO inhibitor is learning about dietary modifications. Which statement made by the PMHNP demonstrates proper teaching of the food-drug interactions for MAO inhibitors?

Question 57

A patient who is prescribed MAO inhibitors asks about whether he can continue taking pseudoephedrine to relieve his congestion. Which response by the PMHNP indicates proper understanding of drug-drug interactions?

Question 58

Ms. Skidmore presents for a follow-up appointment after being prescribed phenelzine (Nardil), and reports “I take my 45 mg pill, three times a day, just like I’m supposed to.” What does the PMHNP understand about this patient?

Question 59

The PMHNP is caring for several patients who present with various symptoms and health issues. For which patient does the PMHNP prescribe pregabalin (Lyrica)?

Question 60

Mr. Gutier is 72 years old with anxiety and depressive symptoms. His PMHNP is prescribing lorazepam (Ativan). What does the PMHNP understand regarding this prescription?

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Question 61

A patient is being prescribed a sedating antidepressant, but is concerned about weight gain. Which medication is most likely to be prescribed to addresses the patient’s concerns?

Question 62

A patient who was diagnosed with bipolar disorder without mania, asks the PMHNP why he is being prescribed a mood stabilizer. What is the appropriate response? Case Study: Discuss Fibromyalgia

Question 63

The PMHNP is assessing a patient in the emergency room. The patient shares that he has been on lithium (Lithobid) for many years. What blood tests does the PMHMP order?

Question 64

A 39-year old female patient presently on lithium would like to try a new medication to treat her bipolar disorder. She has had concerns about side effects from lithium and wants to learn more about Lamotrigine (Lamictal) as a treatment option. The PMHNP conveys some of the unique aspects of this agent, including which of the following?

Question 65

A nursing student is seeking clarification on the use of anticonvulsants to treat depression and is unclear about most effective outcomes. Which of the following agents does the PMHNP convey as having uncertain outcomes?

Question 66

A 46-year old male patient mentions several alternative treatments to Carbamazepine (Tegretol) as a way to manage symptoms of his bipolar depression. Which of the following does the PMHNP indicate would not be an agent to treat bipolar depression?

Question 67

The PMHNP is meeting with a new mother who would like to begin taking medication again to treat her bipolar depression; she is breastfeeding her 2-month old daughter. The PMHNP recognizes that which of the following medications is contraindicated for this patient?

Question 68

The PMHNP assesses a 10-year old male child in the ER and suspects mania. Which of the following symptoms and recommendations for follow-up evaluation are appropriate?

Question 69

A patient was diagnosed with GAD 4 weeks ago and was placed on Clonazepam (klonopin) twice a day and citalopram (citalopram (celexa)) once daily. When he asks the PMHNP why it is necessary to wean him off of the Clonazepam (klonopin) the best response is:

Question 70

During assessment a patient states “Why are you asking me about my heart, I am here for my head”, the PMHNP’s best response is:

Question 71

The PMHNP understands that the potential of alcohol abuse in the anxious patient is higher for the following reason:

Question 72

After ordering flumazenil (Rumazicon) the PMHNP cautions the staff to monitor for which possible effect?

Question 73

A patient is prescribed escitalopram (Lexapro) for his anxiety. When he asks why he was given an antidepressant the PMHNP’s best response is:

Question 74

The PMHNP evaluates the patient for “fear conditioning” when he asks:

Question 75

A patient diagnosed with PTSD is prescribed propranolol (Inderal) and the PMHNP understands that he was prescribed this medication for what purpose:

Question 76

When completing this exam, did you comply with Walden University’s Code of Conduct including the expectations for academic integrity? Case Study: Discuss Fibromyalgia

Discuss: Care Coordination Presentation

Develop a 20-minute presentation for nursing colleagues highlighting the fundamental principles of care coordination. Create a detailed narrative script for your presentation, approximately 4–5 pages in length, and record a video of your presentation.

Nurses have a powerful role in the coordination and continuum of care. All nurses must be cognizant of the care coordination process and how safety, ethics, policy, physiological, and cultural needs affect care and patient outcomes. As a nurse, care coordination is something that should always be considered. Nurses must be aware of factors that impact care coordination and of a continuum of care that utilizes community resources effectively and is part of an ethical framework that represents the professionalism of nurses. Understanding policy elements helps nurses coordinate care effectively.

This assessment provides an opportunity for you to educate your peers on the care coordination process. The assessment also requires you to address change management issues. You are encouraged to complete the Managing Change activity.

Completing course activities before submitting your first attempt has been shown to make the difference between basic and proficient assessment. Discuss: Care Coordination Presentation

Demonstration of Proficiency
By successfully completing this assessment, you will demonstrate your proficiency in the course competencies through the following assessment scoring guide criteria:

Competency 2: Collaborate with patients and family to achieve desired outcomes.
Outline effective strategies for collaborating with patients and their families to achieve desired health outcomes.
Competency 3: Create a satisfying patient experience.
Identify the aspects of change management that directly affect elements of the patient experience essential to the provision of high-quality, patient-centered care.
Competency 4: Defend decisions based on the code of ethics for nursing.
Explain the rationale for coordinated care plans based on ethical decision making.
Competency 5: Explain how health care policies affect patient-centered care.
Identify the potential impact of specific health care policy provisions on outcomes and patient experiences.
Competency 6: Apply professional, scholarly communication strategies to lead patient-centered care.
Raise awareness of the nurse’s vital role in the coordination and continuum of care in a video-recorded presentation. Script and reference list are not submitted.

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Preparation
Your nurse manager has been observing your effectiveness as a care coordinator and recognizes the importance of educating other staff nurses in care coordination. Consequently, she has asked you to develop a presentation for your colleagues on care coordination basics. By providing them with basic information about the care coordination process, you will assist them in taking on an expanded role in helping to manage the care coordination process and improve patient outcomes in your community care center.

To prepare for this assessment, identify key factors nurses must consider to effectively participate in the care coordination process.

You may also wish to:

Review the assessment instructions and scoring guide to ensure you understand the work you will be asked to complete.
Allow plenty of time to rehearse your presentation.
Note: Remember that you can submit all, or a portion of, your draft presentation to Smarthinking Tutoring for feedback, before you submit the final version for this assessment. If you plan on using this free service, be mindful of the turnaround time of 24–48 hours for receiving feedback.

Recording Equipment Setup and Testing
Check that your recording equipment and software are working properly and that you know how to record and upload your presentation. You may use Kaltura (recommended) or similar software for your audio recording. A reference page is required. However, no PowerPoint presentation is required for this assessment.

If using Kaltura, refer to the Using Kaltura tutorial for directions on recording and uploading your video in the courseroom. Discuss: Care Coordination Presentation
Note: If you require the use of assistive technology or alternative communication methods to participate in this activity, please contact DisabilityServices@capella.edu to request accommodations.

Instructions
Complete the following:

Develop a presentation for nursing colleagues highlighting the fundamental principles of care coordination. Include community resources, ethical issues, and policy issues that affect the coordination of care. To prepare, develop a detailed narrative script. The script will be submitted along with the video.
Record a video of your presentation.
Note: For this assessment, develop your audio script, then record your presentation. You are not required to deliver your presentation to an actual audience but you certainly could.

Presentation Format and Length
Create a detailed narrative script for your presentation, approximately 4–5 pages in length. Include a reference list at the end of the script.

Assignment: Care Coordination Presentation

Assignment: Care Coordination Presentation

Supporting Evidence
Cite 3–5 credible sources from peer-reviewed journals or professional industry publications to support your presentation. Include your source citations on a references page appended to your narrative script. Watch the example video in your course room to hear how citations are referenced.

Grading Requirements
The requirements outlined below correspond to the grading criteria in the Care Coordination Presentation to Colleagues Scoring Guide, so be sure to address each point. Read the performance-level descriptions for each criterion to see how your work will be assessed.

Outline effective strategies for collaborating with patients and their families to achieve desired health outcomes.
Provide, for example, drug-specific educational interventions, cultural competence strategies.
Include evidence that you have to support your selected strategies.
Identify the aspects of change management that directly affect elements of the patient experience essential to the provision of high-quality, patient-centered care.
Explain the rationale for coordinated care plans based on ethical decision making.
Consider the reasonable implications and consequences of an ethical approach to care and any underlying assumptions that may influence decision making.
Identify the potential impact of specific health care policy provisions on outcomes and patient experiences.
What are the logical implications and consequences of relevant policy provisions?
What evidence do you have to support your conclusions?
Raise awareness of the nurse’s vital role in the coordination and continuum of care in a video-recorded presentation. Script and reference list are not submitted.
Fine tune the presentation to your audience.
Stay focused on key issues of import with respect to the effects of resources, ethics, and policy on the provision of high-quality, patient-centered care. Discuss: Care Coordination Presentation
Adhere to presentation best practices.
Additional Requirements
Submit both your presentation video and script. The script should include a reference page. See Using Kaltura for more information about uploading multimedia files. You may submit the assessment only once, so be sure that both assessment deliverables are included.

Grading Rubric:

1. Outline effective strategies for collaborating with patients and their families to achieve desired health outcomes.

Passing Grade: Outlines effective, evidence-based, and culturally sensitive strategies for collaborating with patients and their families to achieve desired health outcomes. Ensures the strategies are well-supported by credible evidence.

2. Identify the aspects of change management that directly affect elements of the patient experience essential to the provision of high-quality, patient-centered care.

Passing Grade: Identifies the aspects of change management that directly affect elements of the patient experience essential to the provision of high-quality, patient-centered care. Focuses on aspects of care highly valued by patients, and distinguishes between patient experience and patient satisfaction.

3. Explain the rationale for coordinated care plans based on ethical decision making.

Passing Grade: Explains the rationale for coordinated care plans based on ethical decision making. Identifies the logical implications and consequences of an ethical approach to care, and articulates underlying assumptions that guide decision making.

4. Identify the potential impact of specific health care policy provisions on outcomes and patient experiences.

Passing Grade: Identifies the potential impact of specific health care policy provisions on outcomes and patient experiences. Draws logical, evidence-based conclusions from an insightful interpretation of relevant and significant policy provisions.

5. Raise awareness of the nurse’s vital role in the coordination and continuum of care in a video-recorded presentation.

Passing Grade: Raises awareness of the nurse’s vital role in the coordination and continuum of care. Clearly establishes the importance and relevance of the nurse’s role in an engaging, and memorable presentation appropriate for the audience and well-supported by error-free slides that enhance key points and adhere to visual design best practices. Assignment: Care Coordination Presentation

Assignment: Legal And Ethical

Assignment: Legal And Ethical

Create your Assignment submission and be sure to cite your sources, use APA style as required, check your spelling.

Assignment:

Professional Development Exercises :

Read the case study presented at the end of Chapter 11 (Guido, p. 222)
A nurse had been working in a critical care unit for more than 25 years, gaining respect for her competence and dedication before suspicions began to gather that she was diverting narcotics for her
own use. The acute care hospital had recently installed a “computerized medicine cabinet” for enhanced distribution and better monitoring of narcotics. The cabinet recorded the nurse’s per
222 Part 4 • Impact of the Law on the Professional Practice of Nursing
nurses testified that they often deviated from the physician’s order for an IM injection, electing to give the medication by an IV route. Finally, there was testimony that the hospital had no formal policy for which nurse was to document narcotics in the paper record when two nurses, such as a preceptor and a mentee, both had responsibility for the patient. The nurse who was suspended testified that she, too, frequently entered data into the paper record long after she had administered the medication and, in some rare instances, entered the data on the following day.
QUESTIONS 1. D id the facility have sufficient evidence to suspend the nurse from their employee? 2. How should the testimony of the other nurses in the unit affect the outcome of this case? 3. What additional questions should the institution address before the court rules in this case? 4. How would you have ruled in this case?
sonal keypad code and the patient’s data before it could be unlocked and narcotics dispensed. The nurses were also required to document the narcotic usage by handwriting the patient’s name, medication, time, route, and dosage on a more traditional paper medication administration record (MAR). D iscrepancies were noted between this nurse’s patients’ electronic data for narcotic administration and the handwritten notations made on the paper record. The nurse was first questioned by her supervisors and then she was suspended, as they did not find her explanations credible. Her grievance was upheld by the arbitrator assigned to the case and the hospital appealed. A t trial, other nurses from the same unit testified that they frequently completed their paper record documentation during their breaks or at the end of the shift, often when they could not remember exactly what medications or dosages they had administered to patients. There was additional information that the nurses would electronically sign for narcotics, prepare IV drip bags in advance of when they were needed, and then discard these same IV bags when they were no longer required or the physicians had changed the medication orders. Additionally, these
Did the facility have sufficient evidence to suspend the nurse? Assignment: Legal And Ethical
How should the testimony of the other nurses in the unit affect the outcome of this case?
What additional questions should the institution address before the court rules in this case?
How would you have ruled in this case?
Read the case study presented at the end of Chapter 12 (Guido, p. 238)
preschool teacher called child protective services about a child who appeared to have a vaginal infection and the child protective services worker instructed the mother to take her child to the emergency center at the local acute care facility. In the emergency center, the child was examined by an ANP who found a vaginal tear, which the ANP felt could have been caused by digital penetration. The child would not talk about the injury with the ANP. T he ANP then discussed the child’s case with the child protective services worker, and the child was admitted to the facility. The parents were subsequently questioned regarding potential abuse of the child. Charges of child abuse were filed against the father, who is now a registered sex offender in the state. The parents filed suit against the preschool teacher, the case worker and the ANP. A t trial, evidence was presented that the ANP did not share her findings or impressions of possible child abuse with the mother, the child’s primary pediatrician, or other emergency center physicians. She also did not recommend that the mother contact the
child’s pediatrician for an evaluation and a second opinion. The ANP also admitted that it was possible that the child had scratched herself as a result of the infection and that the child herself had caused the vaginal tear.

Did the ANP have a duty to consult with the child’s physician or another emergency center physician regarding the possibility of child abuse before she reported her findings to the case worker?
What questions would you anticipate might be asked regarding the injury itself and the possibility that the child had caused her own injury?
Did the ANP have a duty to report the injury, even though the diagnosis was not absolutely conclusive at the point that the child was initially examined? Assignment: Legal And Ethical

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Assignment: Legal And Ethical

Assignment: Legal And Ethical
How would you determine liability in this case, assuming that the trial court found liability against any of the three defendants?
Read the case study presented at the end of Chapter 16 (Guido, p. 329)
licensed practical nurse (LPN) employed by a nursing personnel agency worked one evening shift at the Veterans Administration Hospital in a major city. She cared for a patient who had recently undergone hip replacement surgery. Since his surgery, the patient had consistently spiked significant temperatures, and his temperature generally responded well to oral Tylenol, 500 mg, 2 tablets, every 4 hours as needed. The change nurse explained to the LPN that the patient was to continue on vital signs every 4 hours, including temperatures, and that he was to be medicated if his fever increased, even if only at low-grade levels. During the evening that she worked, the LPN obtained the patient’s temperature at 4 p.m. and again at 8 p.m. He had a lowgrade fever at the 4 p.m. hour and his temperature had risen to 102 degrees orally at 8 p.m. At both intervals, the LPN administered Tylenol as ordered. The charge nurse did not assess the patient during the evening, nor did she inquire about the patient’s condition. The nurse caring for the patient at midnight noted that his temperature was still elevated (102.4 orally). When notified, the attending physician ordered blood cultures, additional treatment for his ever-increasing fever, and a change in antibiotic therapy.
D espite this aggressive therapy, the patient developed a fatal septicemia and the patient’s family sued for wrongful death. At trial, the court determined that the charge nurse had been derelict in her duty to supervise this patient and assessed partial liability against the LPN and the charge nurse
Did the nurse manager have a responsibility to supervise the care of the patient?
Was the care of this patient appropriately assigned to the LPN by the charge nurse, or could the charge nurse have delegated this patient’s care more appropriately?
If the charge nurse assigned the care of the patient to the LPN, did she retain any supervisory responsibility that would result in her liability in this case?
How do the principles associated with delegation and supervision figure into this case?
How would you decide this case?
You are not required to adhere to the 500-1000 word count for each of the responses, but please be thorough in your responses so that you adequately address all aspects of each question.
Please combine all of these responses into a single Microsoft Word document for submission

Please submit only complete assignments (not partial or “draft” assignments). Submit only the assignments corresponding to the module in this section. Assignment: Legal And Ethical

Understanding Mental Health Assignment

Understanding Mental Health Assignment

Unit 20: understanding mental health assignment C and D Distinction achieved overall. P4 Explain the impact of mental ill health on a selected individual. P5 Explain how mental ill health affects a selected individual’s relationships with others. P6 Explain strategies that can be applied to promote the mental wellbeing and mental health of a selected individual diagnosed with a mental ill-health condition. M3 Analyse the impact of mental ill health on a selected individual’s relationships within their social networks with reference to factors that may have caused it. M4 Justify strategies that can be applied to promote the mental wellbeing and mental health of a selected individual diagnosed with a mental ill-health condition, making reference to relevant legislation, policies and codes of practice. D2 Evaluate the importance of promoting, protecting and restoring the mental wellbeing and mental health of a selected individual diagnosed with a mental ill-heath D3 Evaluate how accurate diagnosis of mental ill-health conditions leads to correct treatment. Understanding Mental Health Assignment

Learning outcome:

LO8:

Name:

Instructions and guidelines (Read carefully)
Instructions

Insert your name and surname in the space provided above, as well as in the file name. Save the file as: First name Surname Assignment 4 – e.g. Lilly Smith Assignment 4. NB: Please ensure that you use the name that appears in your student profile on the Online Campus.
2     Write all your answers in this document. There is an instruction that says, “Start writing here” under each question. Please type your answer there.

3     Submit your assignment in Microsoft Word only. No other file types will be accepted.

4     Do not delete the plagiarism declaration or the assignment instructions and guidelines. They must remain on your assignment when you submit.

PLEASE NOTE: Plagiarism cases will be penalised according to the Head Tutor’s and GetSmarter’s discretion.

IMPORTANT NOTICE: Please ensure that you have checked your course calendar for the due date for this assignment.

Guidelines

1     There are eight pages and one question in this assignment.

2     Make sure that you have carefully read and fully understood the questions before answering them. Answer the questions fully but concisely and as directly as possible. Follow all specific instructions for individual questions (e. g. “list”, “in point form”).

3     Answer all questions in your own words. Do not copy any text from the notes, readings or other sources. The assignment must be your own work only.

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Plagiarism Declaration:
1. I know that plagiarism is wrong. Plagiarism is to use another’s work and pretend that it is one’s own.

2. This assignment is my own work. Understanding Mental Health Assignment

3. I have not allowed, and will not allow, anyone to copy my work with the intention of passing it off as his or her own work.

4. I acknowledge that copying someone else’s assignment (or part of it) is wrong, and declare that my assignments are my own work.
2. Mark allocation
Each question receives a mark allocation. However, you will only receive a final percentage mark and will not be given individual marks for each question. The mark allocation is there to show you the weighting and length of each question.

TOTAL                                                                                                          50

Assignment instructions
Complete Question 1 in this document. Make sure you have read Modules 3 and 4 before completing this assignment.

Note:

Make sure that you show all your workings within the assignment when calculations are required. Understanding Mental Health Assignment

Assignment: Clinical Nutrition Assistant

Assignment: Clinical Nutrition Assistant

Imagine that you are a clinical nutrition assistant working at a local hospital under the supervision of a Registered Dietitian (RD). Overnight, a 74-year-old male patient was admitted to the hospital and needs to be fully assessed for any nutritional risks (in accordance with hospital/medical nutrition care laws). The hospitals initial nutritional screening protocol identified that the patient may be at nutrition risk, due to a high risk admitting diagnosis. The admitting physician suspects that the patient has suffered a heart attack; however the full cardiac consult results are not yet showing in the computer. Furthermore, the patient has recently moved here to the U.S. from a foreign country within the past year so that his daughter can help care for him due to his declining health. The entire family speaks very little English. The patients cultural background is significant because the culture may not place much influence on western-style healthcare practices. The patients expression of his culture needs to be examined further. The nurses notes reveal that the daughter does not know how much her father weighs, but she suspects that he has gained weight since her mother passed away a year ago. Your assignment from the supervising RD is to examine the patients complete cultural, social, medical, and nutritional background so that the next steps of the Nutrition Care Process can be instituted. Upon your initial investigation within the hospitals electronic medical records system, you notice that there is no height or weight listed for the patient. The diet order reads: NPO (nothing by mouth) and they are awaiting more lab results for various tests related to hydration and kidney function. His cardiac enzyme lab work indicates that he suffered a Myocardial Infarction (MI). The MD notes confirm a heart attack diagnosis and the MD also noted that the patient appears to be morbidly obese. Assignment: Clinical Nutrition Assistant

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Assignment: Clinical Nutrition Assistant

Assignment: Clinical Nutrition Assistant

His medications include: a blood pressure medication, a diuretic, and a cholesterol-lowering drug.
1.Imagine that you have to complete this demographic/cultural background patient research for your supervisor within the next couple of hours. Record and describe this fictional patients cultural background information by listing the answers to certain questions (translator may be requested in hospitals). Record observations, human expressions, and any other unique characteristics about the patients culture or background that may impact his ability to adhere to any type of medical nutrition therapy, nutrition education, or dietary restrictions. (You may use information created in the Unit 6 Discussion Board here).
2.The patient and daughter are unaware of the patients current height and weight. His hospital bed unfortunately does not have a built-in weight scale. The patient is unable to stand upright due to his medical condition. Therefore, list and describe one alternative way to estimate height (stature) and one alternative way to estimate a persons weight that is covered in Chapter 7 of the textbook. (Refer to page 254 for general ideas and Tables 7.1, 7.3, and 7.4.)
3.Based on your knowledge of the patients cultural background as well as your evaluation and observations of your current interactions with the patient and daughter, do you believe the patient will comply with the MD suggesting a strict, very low calorie (10001200 calories), low fat, low cholesterol, and low salt diet, due to the heart attack/cardiac consultation results and morbidly obese appearance? Assignment: Clinical Nutrition Assistant