Epidemiology Assignment Paper

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Epidemiology Assignment Paper

Epidemiology Paper | APA Style

Write on either HIV or Tuberculosis

Write a paper (2,000-2,500 words) in which you apply the concepts of epidemiology and nursing research to a communicable disease. Refer to “Communicable Disease Chain,” “Chain of Infection,” and the CDC website for assistance when completing this assignment.

Communicable Disease Selection

Epidemiology Paper Requirements

Describe the chosen communicable disease, including causes, symptoms, mode of transmission, complications, treatment, and the demographic of interest (mortality, morbidity, incidence, and prevalence). Is this a reportable disease? If so, provide details about reporting time, whom to report to, etc.

Describe the social determinants of health and explain how those factors contribute to the development of this disease.

Discuss the epidemiologic triangle as it relates to the communicable disease you have selected. Include the host factors, agent factors (presence or absence), and environmental factors. Are there any special considerations or notifications for the community, schools, or general population?

Explain the role of the community health nurse (case finding, reporting, data collection, data analysis, and follow-up) and why demographic data are necessary to the health of the community. Epidemiology Assignment Paper
Identify at least one national agency or organization that addresses the communicable disease chosen and describe how the organizations contribute to resolving or reducing the impact of disease.

Discuss a global implication of the disease. How is this addressed in other countries or cultures? Is this disease endemic to a particular area? Provide an example.

A minimum of three peer-reviewed or professional references is required.

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

You are required to submit this assignment to LopesWrite. A link to the LopesWrite technical support articles is located in Course Materials if you need assistance. Epidemiology Assignment Paper

NRS 433V All Assignments

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NRS 433V All Assignments

NRS 433V Week 1 Literature Search: Prevention of Surgical Site Infection

Details:

Conduct a literature search to locate research articles focused on a practice problem of interest. This literature search should include both quantitative and qualitative peer research articles to support your practice problem or issue of interest in 350-750 words.

Identify six peer research articles which will be utilized through the next 5 weeks as reference sources. Create a reference list in which the six articles are listed. Beneath each reference include the article’s abstract. The completed assignment should have a title page and a reference list with abstracts.

Suggestions for locating qualitative and quantitative research articles from credible sources:

Use a library database such as CINAHL Complete for your search. NRS 433V All Assignments

Using the advanced search page check the box beside “Research Article” in the “Limit Your Results” section.

When setting up the search you can type your topic in the top box, then add quantitative or qualitative as a search term in one of the lower boxes. Research articles often are described as qualitative or quantitative.

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To narrow/broaden your search, remove the words qualitative and quantitative and include words that narrow or broaden your main topic. For example: Diabetes and pediatric and dialysis. To determine that research design was used, review the abstract and the methods section of the article. The author will provide a description of data collection using qualitative or quantitative methods.

Prepare this assignment according to the APA guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion. NRS 433V All Assignments  

NRS 433V Week 2 Research Summary and Ethical Considerations

Select either the qualitative or quantitative study method for this assignment. In an essay of 750-1,000 words, summarize the study, explain the ways in which the findings might be used in nursing practice, and address any ethical considerations associated with the conduct of the study.

Refer to Resource Research Summary and Ethical Considerations Guidelines for suggested headings for your paper. Prepare this assignment according to the APA guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

NRS 433V Week 3 Assignment Critical Analysis of Qualitative Study (Part 1)

Introduction to Nursing Research    Theory, Design, and Sampling

Prepare a critical analysis of a qualitative study focusing on the problem statement, study purpose, research question, literature review, and theoretical framework. This can be one of the selected articles from your previous literature review or a new peer-reviewed article.

The completed analysis should be 1,000-1,250 words and should connect to your identified practice problem of interest.

Refer to “Research Critique Part 1.” Questions under each heading should be addressed as a narrative, in the structure of a formal paper.

Prepare this assignment according to the APA guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

 

NRS 433V Week 4 Benchmark Research Critique (Part 2)

Prepare a critical analysis of a quantitative study focusing on protection of human participants, data collection, data management and analysis, problem statement, and interpretation of findings. The quantitative research article can be from your previous literature review or a new peer-reviewed article.

Each study analysis will be 1,000-1,250 words and submitted in one document. As with the assignments in Topics 1-3, this should connect to your identified practice problem of interest.

Refer to the resource entitled “Research Critique Part 2.” Questions under each heading should be addressed as a narrative, in the structure of a formal paper. You are also required to include an Introduction and Conclusion.

Prepare this assignment according to the APA guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

You are required to submit this assignment to Turnitin.

Submit the assignment along with an electronic version of the article used for the analysis. If an electronic version is not available, submit a clean unmarked copy of the article.

 

NRS 433V Week 5 Evidence-Based Practice Presentation Healthcare Associated Infections

NRS 433V Week 5 – Evidence-Based Practice Presentation – Healthcare Associated Infections [12 Slides + Speaker Notes]

This is a CLC assignment.

Choose a nursing problem from your current practice setting, and identify a possible solution to that problem.

Conduct a search of the literature related to this problem.

Analyze and critically appraise evidence-based literature to support the solution to the identified problem. A minimum of (5) articles must be identified. This may include guidelines from the National Guideline Clearinghouse, Joanna Briggs Institute, or a review from the Cochrane Database of Systematic Review. NRS 433V All Assignments

Prepare a 10-minute (8-10 slides; no larger than 5 MB) PowerPoint presentation related to the problem, evidence appraisal, and practice implications.

Include the following components into the presentation:

  1. Present the nursing practice problem with the PICOT question.
  2. Discuss your appraisal of the literature that addresses the problem.
  3. Present the proposed practice changes from an integration of the findings.

While APA format is not required for the body of this assignment, solid academic writing is expected and in-text citations and references should be presented using APA documentation guidelines, which can be found in the APA Style Guide, located in the Student Success Center.

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NRS 433V Week 5 Assignment – PICOT Statement

You are to write a PICO question in a word document, individually and submit for week 5.

The PICO statement will provide a framework for your Capstone Project (The project you must complete during your final course in the RN-BSN program of study). You can review the PICO article “Evidence-Based Practice, Step by Step: Asking the Clinical Question” (2010) for help with this.

 

The PICO question should be written to address the following:

P-Patient population (what are the characteristics of the patient or population or what disease are you interested in)?

I- Intervention (What do you want to do with this patient population-treat/observe/diagnose)?

C- Comparison (What are the alternatives to the intervention placebo, different drug, different nursing intervention)?

O- Outcome (What is the desired effect of the intervention to the patient population)?

T- Timeframe (By when do you want to see results?) NRS 433V All Assignments

Legal and Ethical Nursing Assignment

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Legal and Ethical Nursing Assignment

Assignment Description:
For this assignment, create a PowerPoint presentation based on any three of the following four case studies.

Read the case study You be the Judge presented at the end of Chapter 18 which begins, “The older adult male patient was admitted…” (Guido, p. 363) and answer the following questions:

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The older adult male patient was admitted to the hospital emergency center with major blunt abdominal trauma following a car crash. In the emergency center, the nurse carried out the physician’s order for a dose of morphine for the patient’s pain, which he said was an 8 on a scale from 1 to 10. After being given the morphine, the patient’s blood pressure dropped significantly, and the patient went into cardiac and respiratory arrest after lapsing into unconsciousness. Legal and Ethical Nursing Assignment

The nurse alerted the physician, who immediately intubated the patient and sent him to the operating room to be resuscitated and then for exploratory surgery to determine the extent and cause of the abdominal bleeding. The patient was never revived, and he died the next day in the facility’s intensive care unit.

The family has brought a wrongful death lawsuit, alleging that the morphine was the cause of the patient’s demise. In the lawsuit, there were no allegations of excessive dose, improper administration of the medication, or inattentive monitoring by the nurses in the emergency center.

• Was the nurse negligent for not questioning the use of morphine for a patient with blunt abdominal pain before administering the dose of morphine?
• Would knowing that the patient’s blood pressure was 148/94 when the morphine was administered impact the finding of the trial court?
• What evidence would you argue in the nurse’s defense regarding the care of this patient?
• How would you decide this case? Legal and Ethical Nursing Assignment

 

Read the case study You be the Judge presented at the end of Chapter 19 that begins, “An 82-year-old patient…” (Guido, p. 394) and answer the following questions:
An 82-year-old patient who was herself a retired physician was admitted to a rehabilitation facility after surgery to repair a broken hip. During her stay at the rehabilitation facility, she woke one morning feeling nauseous and began vomiting blood. The rehabilitation physician believed that the patient had an upper gastrointestinal bleed for which she needed to be hospitalized.
She was immediately taken to the emergency department at the acute care hospital located on the same campus as the rehabilitation facility. She was evaluated and monitored in the hospital emergency department for two hours and then moved to the hospital’s intensive care area for continuous monitoring and treatment.

Complications caused her death in the early hours of the subsequent morning. Her estate subsequently filed a lawsuit for an EMTALA violation, alleging that the patient was not stabilized as mandated by the Act.

• What initial care should the patient have received in the emergency center?
• Did the emergency department staff meet the standards of care for a patient with these presenting signs and symptoms?
• Was the admission to the intensive care area a violation of the EMTALA law?
• How would you decide this case and what provisions of the EMTALA law would you anticipate the court enumerated in its holding?

Read the case study You be the Judge presented at the end of Chapter 20 (Guido, p. 415) beginning with, “The patient was a detainee,…” and answer the following questions:

The patient was a detainee, not yet proven guilty, who was being held in the county jail pending trial on felony charges of dealing controlled substances and creating a public nuisance. The patient suffers from a blood clotting disorder that causes him chronic pain. He was prescribed OxyContin for this pain by his current physician. The patient was seen and evaluated as part of his booking into the county jail. Instead of prescribing the OxyContin
for him, the jail physician-prescribed Vistaril, clonidine, and Donnatal to manage his narcotic withdrawal, started ibuprofen and Tylenol for his pain management, and continued the metroprolol, Coumadin, and Nexium that he had been taking. The jail nurses administered these medications per the physician’s orders.
The patient continued to suffer chronic and debilitating pain while in the county jail and, on his transfer to the state prison system, he brought a lawsuit against the county jail physician and nurses for violation of his Constitutional rights. Legal and Ethical Nursing Assignment

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• Should the nurses have followed the physician’s orders and continued the ordered medications, which varied significantly from his pre-jail medications, specifically his medications for pain?
• Was it deliberate indifference to the patient’s medical needs to change his pain medications in the belief that he needed to withdraw from narcotics?
• What more could the nurse have done to prevent a lawsuit from being filed for an Eighth Amendment violation?
• How would you expect the court decided this case?

Read the case study You be the Judge presented at the end of Chapter 21 (Guido, p. 440-441) beginning with, “An elderly woman was admitted to the hospital…” and answer the following questions:

An elderly woman was admitted to the hospital from home, then admitted to a skilled nursing facility for rehabilitation, and then to an assisted living facility. She had chronic
kidney failure that required dialysis. Sometimes her mental status deteriorated into confusion, usually just before her dialysis appointments. At some point, she also suffered a
stroke, which seemed to affect her cognitive status.
Over the course of a few weeks, she spoke with an attorney several times on the phone, discussing with him how to write her last will and testament. She had had a lifelong rift with one of her siblings and chose not to give anything in her will to the now deceased sibling’s children. She also wanted to give substantial amounts to charity rather than to her other two siblings and their children.
The attorney mailed her will to her at the assisted living facility. The social worker and a second individual from the facility’s staff witnessed her signature on the document in her
room at the assisted living facility. When she died, the children of her estranged sibling contested the will and sued in court to have the will vacated.

• What types of questions should be asked of the social worker and the other individual who witnessed her signature on the will?
• What other evidence should be requested of the nursing staff to best ascertain her cognitive ability at the time she dictated how she wanted the will drafted and at the time she signed the document?
• Does the fact that she had been estranged for many years from the sibling whose children are now suing factor into the final decision of the court?
• How would you decide this case? Legal and Ethical Nursing Assignment

Focused SOAP Note and Patient Case Presentation Paper

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Focused SOAP Note and Patient Case Presentation Paper

  • Present the full complex case study. Include chief complaint; history of present illness; any pertinent past psychiatric, substance use, medical, social, family history; most recent mental status exam; current psychiatric diagnosis including differentials that were ruled out; and plan for treatment and management.
  • Report normal diagnostic results as the name of the test and “normal” (rather than specific value). Abnormal results should be reported as a specific value Focused SOAP Note and Patient Case Presentation Paper.
  • Be succinct in your presentation, and do not exceed 8 minutes. Specifically address the following for the patient, using your SOAP note as a guide:
    • Subjective: What details did the patient provide regarding their chief complaint and symptomology to derive your differential diagnosis? What is the duration and severity of their symptoms? How are their symptoms impacting their functioning in life?

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    • Objective: What observations did you make during the psychiatric assessment?

    • Assessment:Discuss their mental status examination results. What were your differential diagnoses? Provide a minimum of three possible diagnoses and why you chose them. List them from highest priority to lowest priority. What was your primary diagnosis, and why? Describe how your primary diagnosis aligns with DSM-5 diagnostic criteria and supported by the patient’s symptoms.
    • Plan:In your video, describe your treatment plan using clinical practice guidelines supported by evidence-based practice. Include a discussion on your chosen FDA-approved psychopharmacologic agents and include alternative treatments available and supported by valid research. All treatment choices must have a discussion of your rationale for the choice supported by valid research. What were your follow-up plan and parameters? What referrals would you make or recommend as a result of this treatment session?
    • In your written plan include all the above as well as include one social determinant of health according to the HealthyPeople 2030 (you will need to research) as applied to this case in the realm of psychiatry and mental health. As a future advanced provider, what are one health promotion activity and one patient education consideration for this patient for improving health disparities and inequities in the realm of psychiatry and mental health? Demonstrate your critical thinking.
    • Reflection notes:What would you do differently with this patient if you could conduct the session over? If you are able to follow up with your patient, explain whether these interventions were successful and why or why not. If you were not able to conduct a follow up, discuss what your next intervention would be Focused SOAP Note and Patient Case Presentation Paper.

CASE STUDY

Chief Complaint: Patient stated “ I came in because I was depressed and having suicidal thoughts.”

 

HISTORY OF PRESENT ILLNESS:

Y.R is a 18-year old African American female who came to ED due to severe depression, suicidal ideations, non compliance with medications, severe anxiety, racing thoughts, and mood swings, marijuana use, commanding auditory hallucinations, and difficulty sleeping at night. During interview patient started “I feel depressed, anxious, I have trouble sleeping at night, I stopped taking my medication in over a year because it was making me feel worse. I used to take Zoloft and ability. I hear voices telling me bad and negative things like give up and hurt myself. I have thoughts of wanting to hurt myself.” Patient denies homicidal ideations. The patient at this time is danger to self and others. The plan is to start medications, encourage patient to attend groups, and social service to follow up with placement and appointments (including PHP and drug rehab referral.)

PAST PSYCHIATRIC HISTORY

Patient denies and past inpatient psychiatric hospitalizations, reports seeing psychiatrist Dr. H., outpatient clinic at Howard Brown. Last visit was in May 2021. Patient in the past was prescribed Zoloft and Ability but claims that both medications made her symptoms worse and stopped taking both medications. She has been noncompliant with medications over year. Patient wishes to try different psychotropic medications. Patients received prescriptions for Abilify 2mg on 4/7/2022 as per medication reconciliation external profile but never took the medication Focused SOAP Note and Patient Case Presentation Paper.

 

Patient reports past suicidal attempt, twice in her lifetime, first attempt was when patient was 13 years old via biting her self in her arm and lip. She also attempted this same behavior again at 16 years old. (2ndattempt). Patient denies any past homicidal attempts.

 

Patient reports being diagnosed as major depression, ADHD, and PTSD. Patient reports being sexually abused when she was a teenager.

 

PAST MEDICAL HISTORY:

Patient reports obesity only.

 

FAMILY HISTORY:

Patient reports her mother has bipolar disorder. Also, her grandmother has bipolar disorder, major depression and OCD.

 

PERSONAL/SOCIAL HISTORY:

SOCIAL HISTORY: Patient reports living with her partner, one daughter who is two months old and living with partner. Currently unemployed and denies receiving any monthly financial benefits. She is positive for marijuana use as per UDS. HCG negative. Denies any past legal history. Denies owning any firearms.

LABS:

Positive Marijuana

Negative HCG

Glucose 143

Sodium 135

TREATMENT/PLAN

  1. Based on the patient’s presenting symptoms and past history, the diagnosis will be bipolar disordered Mixed Episode with psychotic features. The patient noted to be disorganized, hypomanic, responding to internal stimuli, guarded, anxious, isolative, and withdrawn to self. The patient reports severe depression, difficulty sleeping at night, severe mood swings, racing thoughts, and anxiety during the day, marijuana use, noncompliance with medications in over a year, commanding auditory hallucinations, and suicidal ideations. The patient is a danger to self and others. Requires inpatient psychiatrist hospitalization.

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  1. Based on the past hospitalizations and the symptoms presented by the patient, the plan is to start Trileptal 300 mg PO BID and Seroquel 100 mg PO at bedtime. Medication education provided to the patient including side effects and adverse drug reactions. After education, patient agreed to start these medications. Substance abuse education provided as well Focused SOAP Note and Patient Case Presentation Paper.
  1. The patient was encouraged to attend group therapy to improve insight, judgment, and compliance.

 

  1. Social service to follow up with appropriate placement and appointments (including PHP and drug rehab referral).

3 DIAGNOSIS (NOTE: USE DSM-5 TO WRITE ABOUT THE BELOW DIAGOSIS AND RELATE IT TO PATIENT’S PROBLEM BASED ON HER HISTORY.

  • Bipolar Disorder Mixed Episode with Psychotic Features
  • Personality Development Disorder
  • Substance Abuse Focused SOAP Note and Patient Case Presentation Paper

Advanced Health Assessment Paper

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Advanced Health Assessment Paper

Respond tooth’s peer posts. Response posts can include one or more of the following, insight on a solution to an identified peer challenge, pose questions relating to the peer post, and providing resources that may be helpful related to your peer’s post. PLEASE PLEASE PLEASE do not just “SUMMARIZE”. the post. New, insightful information is warranted and it is against rubric. Thank you!

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REPLY TO RAMANDEEP’s post :

The purpose of this discussion is to discuss the various challenges which are encountered when performing a HEENT examination. Parts of the examination this week include but are not limited to the shape, symmetry, lesions, trauma for the head and face. The visualization and palpation of the external and internal ear as well as performing tests like Rinne and Weber for detecting hearing loss in the ears. The examination of the external eyes for symmetry, discharge, eyelids, eyelashes, as well as internal eyes with the help of an ophthalmoscope. The visualization and palpation of the external and internal nose for discharge, color, masses, septal deviation for the nose. The inspection of the mouth and throat, including dental hygiene, the pharynx, tongue, gums, teeth, buccal mucosa. Inspection and palpation of the neck to assess for any lumps or masses, assess lymph nodes and detect swelling or tracheal deviation. Advanced Health Assessment Paper

To begin, COVID-19 has made it difficult for providers as well as patients to feel fully comfortable participating in this examination. A major reason for this is because, you are in contact with the persons mouth, nose and eyes, which are the primary source of transmission of the virus. In addition to this, it is difficult to even get access to HEENT specialists in areas where cases of COVID-19 are high. Many immunocompromised and elderly people rely on telemedicine to meet with their doctors, yet proper examination of the HEENT system through a digital platform is next to impossible, imposing a major challenge for providers as well as patients. Telemedicine devices show poor agreement in comparison to the in-person physical examination in terms of tonsil size measurement but exhibit moderate agreement on the coloration of the palate and cervical lymphadenopathy (Akhtar et. al., 2018).

In addition to this, another challenge is performing this examination on children. This is difficult because the tools and instrument’s may be scary for the little kids, and they may be scared when the provider approaches them. Ways to overcome this challenge include ensuring the parent is in the room, or even holding the child depending on the age. In addition to this, there is also a challenge of examining children with medical complexities, that is showing medical fragility and having complex chronic conditions (Huth et. al., 2018). There is evidence showing the lack of medical professionals who are adequately trained to comfortably handle this patient population, and not everyone who is a provider can examine these children (Huth et. al., 2018).

Other challenges when performing the HEENT examination include visualization of the body part, as it plays major role in detection of discrepancies and diagnosis of disease. It is essential for the provider to ensure there is adequate light, the patient is at level with the eyes, in the correct position as well as following commands and instructions. On the other hand, there are certain examinations which should be performed in the dark, where adequate light can in fact pose a challenge. This includes examining the eyes with an ophthalmoscope, and ensuring proper visualization of the red reflex, optic disk, retinal vessels, and other structures to rule out glaucoma and papilledema, amongst other issues (Bickley, Szilagyi & Hoffman, 2017). These things may become a challenge when the patient has language barriers, intellectual deficits, psychiatric issues, or simply does not have good rapport with the provider. Language barriers can lead to poor patient assessment, misdiagnosis, delayed treatment, and incomplete understanding of the patient condition and prescribed treatment (Moissac & Bowen, 2018).

References

Akhtar, M., Van Heukelom, P. G., Ahmed, A., Tranter, R. D., White, E., Shekem, N., … Mohr, N. M. (2018, October 1). Telemedicine Physical Examination Utilizing a Consumer Device Demonstrates Poor Concordance with In-Person Physical Examination in Emergency Department Patients with Sore Throat: A Prospective Blinded Study. Telemedicine journal and e-health : the official journal of the American Telemedicine Association. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6205037/. Advanced Health Assessment Paper

Bickley, L. S., Szilagyi, P. G., & Hoffman, R. M. (2017). Bates’ guide to physical examination and history taking (12th ed.). Wolters Kluwer.

Huth, K., Long-Gagne, S., Mader, J., & Sbrocchi, A. M. (2018, October 19). Approach to Clinical Assessment of Children With Medical Complexity. MedEdPORTAL : the journal of teaching and learning resources. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6342381/.

Moissac, D. de, & Bowen, S. (2018, April 18). Impact of Language Barriers on Quality of Care and Patient Safety for Official Language Minority Francophones in Canada – Danielle de Moissac, Sarah Bowen, 2019. SAGE Journals. https://journals.sagepub.com/doi/full/10.1177/2374373518769008. Advanced Health Assessment Paper

Healthcare Plan Analysis Essay Paper

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Healthcare Plan Analysis Essay Paper

In 400 to 500 words, address the following:

• Select a managed care plan such as an HMO, PPO, POS, or EPO and discuss its advantages and disadvantages.

• Explain the main features of a consumer-directed health plan (CDHP).

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• Examine one real-life example of a CDHP plan (e.g., Cigna 1500) and another for the selected managed care plan (e.g., Aetna Open Choice PPO) in terms of covered benefits, choice of providers, and level of cost sharing and then determine which one would be the optimal choice for your family.

Support your response with at least two scholarly sources published in APA Style within the last five years.

Healthcare Plan Analysis Essay Paper

NURS 6630 Week 4: Therapy for Patients with Major Depressive Disorder (MDD)

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NURS 6630 Week 4: Therapy for Patients with Major Depressive Disorder (MDD)

Assignment: Assessing and Treating Pediatric Patients with Mood Disorders.

 

When pediatric patients present with mood disorders, the process of assessing, diagnosing, and treating them can be quite complex. Children not only present with different signs and symptoms than adult patients with the same disorders, they also metabolize medications much differently. Yet, there may be times when the same psychopharmacologic treatments may be used in both pediatric and adult cases with major depressive disorders. As a result, psychiatric nurse practitioners must exercise caution when prescribing psychotropic medications to these patients. For this Assignment, as you examine the patient case study in this week’s Learning Resources, consider how you might assess and treat pediatric patients presenting with mood disorders. NURS 6630 Week 4: Therapy for Patients with Major Depressive Disorder (MDD)

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To prepare for this Assignment:

  • Review this week’s Learning Resources, including the Medication Resources indicated for this week.
  • Reflect on the psychopharmacologic treatments you might recommend for the assessment and treatment of pediatric patients requiring antidepressant therapy.

The Assignment: 5 pages

Examine Case Study: An African American Child Suffering From Depression. You will be asked to make three decisions concerning the medication to prescribe to this patient. Be sure to consider factors that might impact the patient’s pharmacokinetic and pharmacodynamic processes.

 

At each decision point, you should evaluate all options before selecting your decision and moving throughout the exercise. Before you make your decision, make sure that you have researched each option and that you evaluate the decision that you will select. Be sure to research each option using the primary literature.

Introduction to the case (1 page)
  • Briefly explain and summarize the case for this Assignment. Be sure to include the specific patient factors that may impact your decision making when prescribing medication for this patient.
Decision #1 (1 page)
  • Which decision did you select?
  • Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
  • Why did you not select the other two options provided in the exercise? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
  • What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources (including the primary literature).
  • Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples. NURS 6630 Week 4: Therapy for Patients with Major Depressive Disorder (MDD)
Decision #2 (1 page)
  • Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
  • Why did you not select the other two options provided in the exercise? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
  • What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources (including the primary literature).
  • Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples.
Decision #3 (1 page)
  • Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
  • Why did you not select the other two options provided in the exercise? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
  • What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources (including the primary literature).
  • Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples. NURS 6630 Week 4: Therapy for Patients with Major Depressive Disorder (MDD)

 

Conclusion (1 page)

Summarize your recommendations on the treatment options you selected for this patient. Be sure to justify your recommendations and support your response with clinically relevant and patient-specific resources, including the primary literature.
Note: Support your rationale with a minimum of five academic resources. While you may use the course text to support your rationale, it will not count toward the resource requirement. You should be utilizing the primary and secondary literature. NURS 6630 Week 4: Therapy for Patients with Major Depressive Disorder (MDD)

NURS 6630 Walden University Psychopharmacological Approaches to Treat Psychopathology

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NURS 6630 Walden University Psychopharmacological Approaches to Treat Psychopathology

Description

Assignment 1: Short Answer Assessment

As a psychiatric nurse practitioner, you will likely encounter patients who suffer from various mental health disorders. Not surprisingly, ensuring that your patients have the appropriate psychopharmacologic treatments will be essential for their overall health and well-being. The psychopharmacologic treatments you might recommend for patients may have potential impacts on other mental health conditions and, therefore, require additional consideration for positive patient outcomes. For this Assignment, you will review and apply your understanding of psychopharmacologic treatments for patients with multiple mental health disorders.

Photo Credit: Getty Images/Collection Mix: Sub

TO PREPARE

  • Review the Learning Resources for this week.
  • Reflect on the psychopharmacologic treatments that you have covered up to this point that may be available to treat patients with mental health disorders.
  • Consider the potential effects these psychopharmacologic treatments may have on co-existing mental health conditions and/or their potential effects on your patient’s overall health. NURS 6630 Walden University Psychopharmacological Approaches to Treat Psychopathology

TO COMPLETE:

Address the following Short Answer prompts for your Assignment. Be sure to include references to the Learning Resources for this week.

  1. In 3 or 4 sentences, explain the appropriate drug therapy for a patient who presents with MDD and a history of alcohol abuse. Which drugs are contraindicated, if any, and why? Be specific. What is the timeframe that the patient should see resolution of symptoms?
  2. List 4 predictors of late onset generalized anxiety disorder.
  3. List 4 potential neurobiology causes of psychotic major depression.
  4. An episode of major depression is defined as a period of time lasting at least 2 weeks. List at least 5 symptoms required for the episode to occur. Be specific.
  5. List 3 classes of drugs, with a corresponding example for each class, that precipitate insomnia. Be specific.

Assignment 2: Assessing and Treating Patients With Sleep/Wake Disorders

Sleep disorders are conditions that result in changes in an individual’s pattern of sleep (Mayo Clinic, 2020). Not surprisingly, a sleep disorder can affect an individual’s overall health, safety, and quality of life. Psychiatric nurse practitioners can treat sleep disorders with psychopharmacologic treatments, however, many of these drugs can have negative effects on other aspects of a patient’s health and well-being. Additionally, while psychopharmacologic treatments may be able to address issues with sleep, they can also exert potential challenges with waking patterns. Thus, it is important for the psychiatric nurse practitioner to carefully evaluate the best psychopharmacologic treatments for patients that present with sleep/wake disorders. NURS 6630 Walden University Psychopharmacological Approaches to Treat Psychopathology

Reference: Mayo Clinic. (2020). Sleep disorders. https://www.mayoclinic.org/diseases-conditions/sle…

TO PREPARE FOR THIS ASSIGNMENT:

  • Review this week’s Learning Resources, including the Medication Resources indicated for this week.
  • Reflect on the psychopharmacologic treatments you might recommend for the assessment and treatment of patients with sleep/wake disorders.

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THE ASSIGNMENT: 5 PAGES

Examine Case Study: Pharmacologic Approaches to the Treatment of Insomnia in a Younger Adult. You will be asked to make three decisions concerning the medication to prescribe to this patient. Be sure to consider factors that might impact the patient’s pharmacokinetic and pharmacodynamic processes.

At each decision point, you should evaluate all options before selecting your decision and moving throughout the exercise. Before you make your decision, make sure that you have researched each option and that you evaluate the decision that you will select. Be sure to research each option using the primary literature.

Introduction to the case (1 page)

  • Briefly explain and summarize the case for this Assignment. Be sure to include the specific patient factors that may impact your decision making when prescribing medication for this patient.

Decision #1 (1 page)

  • Which decision did you select?
  • Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
  • Why did you not select the other two options provided in the exercise? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
  • What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources (including the primary literature).
  • Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples. NURS 6630 Walden University Psychopharmacological Approaches to Treat Psychopathology

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Decision #2 (1 page)

  • Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
  • Why did you not select the other two options provided in the exercise? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
  • What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources (including the primary literature).
  • Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples.

Decision #3 (1 page)

  • Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
  • Why did you not select the other two options provided in the exercise? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
  • What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources (including the primary literature).
  • Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples.

Conclusion (1 page)

  • Summarize your recommendations on the treatment options you selected for this patient. Be sure to justify your recommendations and support your response with clinically relevant and patient-specific resources, including the primary literature.

Note: Support your rationale with a minimum of five academic resources. While you may use the course text to support your rationale, it will not count toward the resource requirement. You should be utilizing the primary and secondary literature.

NURS 6630: Psychopharmalogical Approaches To Treat Psychopathology Assignment: Assessing And Treating Patients With Bipolar Disorder

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NURS 6630: Psychopharmalogical Approaches To Treat Psychopathology Assignment: Assessing And Treating Patients With Bipolar Disorder

Bipolar disorder is a unique disorder that causes shifts in mood and energy, which results in depression and mania for patients. Proper diagnosis of this disorder is often a challenge for two reasons: 1) patients often present as depressive or manic but may have both; and 2) many symptoms of bipolar disorder are similar to other disorders. Misdiagnosis is common, making it essential for you to have a deep understanding of the disorder’s pathophysiology. For this Assignment, as you examine the patient case study in this week’s Learning Resources, consider how you might assess and treat patients presenting with bipolar disorder. NURS 6630: Psychopharmalogical Approaches To Treat Psychopathology Assignment: Assessing And Treating Patients With Bipolar Disorder

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To prepare for this Assignment:

  • Review this week’s Learning Resources, including the Medication Resources indicated for this week.

https://psychiatryonline.org/pb/assets/raw/sitewide/practice_guidelines/guidelines/bipolar.pdf

https://psychiatryonline.org/pb/assets/raw/sitewide/practice_guidelines/guidelines/bipolar-watch.pdf

To access the following medications, use the Drugs@FDA resource. Type the name of each medication in the keyword search bar. Select the hyperlink related to the medication name you searched. Review the supplements provided and select the package label resource file associated with the medication you searched. If a label is not available, you may need to conduct a general search outside of this resource provided. Be sure to review the label information for each medication as this information will be helpful for your review in preparation for your Assignments.

https://www.accessdata.fda.gov/scripts/cder/daf/index.cfm

Review the following medications:

  • amitriptyline
  • bupropion
  • citalopram
  • clomipramine
  • desipramine
  • desvenlafaxine
  • doxepin
  • duloxetine
  • escitalopram
  • fluoxetine
  • fluvoxamine
  • imipramine
  • ketamine
  • mirtazapine
  • nortriptyline
  • paroxetine
  • selegiline
  • sertraline
  • trazodone
  • venlafaxine
  • vilazodone
  • vortioxetine

 

  • Reflect on the psychopharmacologic treatments you might recommend for the assessment and treatment of patients requiring bipolar therapy.
  • Utilize at least 5 scholarly, peer reviewed sources.
  • Utilize SafeAssign Drafts for originality report before final submission.

The Assignment: 5 pages

Examine Case Study: An Asian American Woman. Diagnosis-Bipolar Disorder. You will be asked to make three decisions concerning the medication to prescribe to this patient. Be sure to consider factors that might impact the patient’s pharmacokinetic and pharmacodynamic processes.

At each decision point, you should evaluate all options before selecting your decision and moving throughout the exercise. Before you make your decision, make sure that you have researched each option and that you evaluate the decision that you will select. Be sure to research each option using the primary literature. NURS 6630: Psychopharmalogical Approaches To Treat Psychopathology Assignment: Assessing And Treating Patients With Bipolar Disorder

Introduction to the case (1 page)
  • Briefly explain and summarize the case for this Assignment. Be sure to include the specific patient factors that may impact your decision making when prescribing medication for this patient.
Decision #1 (1 page)
  • Which decision did you select?
  • Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
  • Why did you not select the other two options provided in the exercise? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
  • What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources (including the primary literature).
  • Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples.

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Decision #2 (1 page)

  • Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
  • Why did you not select the other two options provided in the exercise? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
  • What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources (including the primary literature).
  • Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples. NURS 6630: Psychopharmalogical Approaches To Treat Psychopathology Assignment: Assessing And Treating Patients With Bipolar Disorder
Decision #3 (1 page)
  • Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
  • Why did you not select the other two options provided in the exercise? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
  • What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources (including the primary literature).
  • Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples.
Conclusion (1 page)
  • Summarize your recommendations on the treatment options you selected for this patient. Be sure to justify your recommendations and support your response with clinically relevant and patient-specific resources, including the primary literature.

Note: Support your rationale with a minimum of five academic resources. While you may use the course text to support your rationale, it will not count toward the resource requirement. You should be utilizing the primary and secondary literature. NURS 6630: Psychopharmalogical Approaches To Treat Psychopathology Assignment: Assessing And Treating Patients With Bipolar Disorder

 

Advanced Pharmacology Nurs 6521 N Week 6 Alzheimer’s Disease

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Advanced Pharmacology Nurs 6521 N Week 6 Alzheimer’s Disease

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.” Advanced Pharmacology Nurs 6521 N Week 6 Alzheimer’s Disease

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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 you perform 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 you asked where he was going, he stated that he did not know. Mr. Akkad denies suicidal or homicidal ideation. Advanced Pharmacology Nurs 6521 N Week 6 Alzheimer’s Disease

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

Solution

Advanced pharmacology Nurs 6521 n week 6 Alzheimers disease

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 you perform 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 you 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) Advanced Pharmacology Nurs 6521 N Week 6 Alzheimer’s Disease

 

Solution

Advanced Pharmacology Nurs 6521

Introduction

The case study focuses on Mr. Akkad a 76-year-old Iranian man who was diagnosed with major neurocognitive disorder due to Alzheimer’s disease (presumptive). The MMSE score for the client was 18/30 indicating moderate dementia. This paper, therefore, aims to make three decisions on the mediations to prescribe to the client. In addition, the ethical considerations likely to affect communication and the treatment plan for the client will be discussed.

Decision Point One

The first pharmacological agent that was selected for the client is to begin Exelon (rivastigmine) 1.5 mg orally BID with an increase to 3 mg orally BID in 2 weeks. The rationale for selecting rivastigmine is due to the medication’s efficacy in treating dementia and Alzheimer’s Disease. According to Su et al (2015), pathological changes associated with dementia of Alzheimer type include deficits in cholinergic neuronal pathways. Accordingly, the rivastigmine works by enhancing the cholinergic function by stopping the breakdown of acetylcholine. This improves the synaptic transmissions within the brain and thus improves memory as well as other cognitive functions (Kandiah et al, 2017). Because the client has dementia of Alzheimer type, he has low quantities of acetylcholine in the brain and thus rivastigmine will improve the symptoms the client is manifesting. Additionally, Birks et al (2015) explain that FDA recommended that the initial dose should be 1.5 mg BID and if the client does not experience significant side effects and tolerates the initial dose well after taking rivastigmine for two weeks, the dose should be increased to 3 mg BID.

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Selection of this decision expected that the cognitive performance, behavior, function, as well as the ability to conduct activities of daily living for the client,  would improve. This is because the efficacy of Exelon (rivastigmine) in treating has been demonstrated in several studies (Kandiah et al, 2017).

However, the expected outcome and the actual outcome of the first decision were different. This is because there was no symptom improvement as the son reported and also there was no change in the MMSE score. The lack of symptom improvement can be attributed to the low dose of rivastigmine prescribed to the client. The low dose of rivastigmine did not avail adequate levels of acetylcholine in the brain that could have led to symptom improvement (Kandiah et al, 2017).

Decision Point Two

The second decision that was selected is to have the rivastigmine dose increased to 4.5 mg orally BID. The reason for increasing the dose is because evidence indicates that an increased dose of rivastigmine has higher efficacy for people with Alzheimer’s Disease (Stahl, 2014). Evidence has shown that the efficacy of rivastigmine is dose-dependent when it comes to symptoms such as activities of daily living, cognitive functions, and global functioning. Therefore, it is expected that an increased dose will be more effective (Su et al, 2015).

The decision to increase the dose to 4.5 mg orally BID hoped that the cognitive function and other symptoms for this client would improve. It was also expected that the client would tolerate the higher dose well (Birks et al, 2016).

The actual outcome of the selected decision and the expected outcome were relatively similar. This is because the client manifested slight symptom improvement as evidenced by his attendance to religious service with the family. This shows that the increased dose of rivastigmine led to symptom improvement for the client, however slight (Kandiah et al, 2017). Moreover, as anticipated, the client tolerated the increased dose well as he did not report any side effect with the higher dose.

Decision Point Three

The last decision was to have the rivastigmine dose increased to 6 mg orally BID. As aforementioned, higher dose of rivastigmine increases the amount of acetylcholine within the brain and thus increases the efficacy of the medication (Sadowsky et al, 2015).

The decision to increase the dose to 6 mg orally BID hoped that there will be notable symptom improvement for the client, especially with the cognitive functioning and the capacity to carry out activities of the daily living. A study performed by Su et al (2015) showed that the administration of higher doses of rivastigmine to people with Alzheimer’s disease led to better symptom improvement especially symptoms such as cognitive functioning and the capacity to carry out activities of daily living. Since cholinesterase inhibitors like rivastigmine can only improve symptoms and not reverse the generative process, it will be important to educate the client and the son as well about how the medication works (Stahl, 2014).

Another expectation was that the client would still tolerate the increased dose of rivastigmine and thus will not experience significant side effects. Advanced Pharmacology Nurs 6521 N Week 6 Alzheimer’s Disease

Ethical Considerations

Ethical considerations applicable to this client involve capacity determination, the ability of the client to make treatment decisions, and informed consent as well. In regard to capacity determination and the ability to make treatment decisions, symptoms of Alzheimer’s disease and dementia such as impairment in the cognitive functioning may hamper the ability of the client to understand and make treatment decisions (Fields & Calvert, 2015). In addition, it will be important for the PMHNP to explain to the client and the son about all the available treatment choices in order to enable them to make an informed decision (Fields & Calvert, 2015).

Conclusion

The initial medication that was selected is Exelon (rivastigmine) 1.5 mg. This is because the medication works by improving the cholinergic function and thus improves symptoms like cognitive functioning. With this decision, the client did not report any symptom improvement. Therefore, the second decision was to increase the dose of rivastigmine to 4.5 mg and the client showed some symptom improvement as he started attending religious functions with the family. The last decision was also to increase the dose to 6 mg orally BID. The increased dose aimed to increase the efficacy of the medication because higher-doses of rivastigmine are associated with increased efficacy. The ethical considerations applicable to this client encompass capacity determination, the ability of the client to make treatment decisions, and the informed consent. Advanced Pharmacology Nurs 6521 N Week 6 Alzheimer’s Disease