Nursing homework help

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Directions:

Consider the scenario below, then follow the instructions underneath it to complete the discussion. If appropriate, support your position with credible resources/examples/evidence and provide APA references.

Mr. B

Mr. B, a 70-year-old male client, presented to his primary care physician with complaints of blurred vision and headaches over the last two months. On several visits, Mr. B’s blood pressure was found to be elevated, so the physician started him on hydrochlorothiazide 25 mg by mouth daily. One month later, Mr. B began to have chest pains and shortness of breath, so his primary care provider referred Mr. B to a cardiologist for further evaluation.

The cardiologist ordered an echocardiogram and stress test which revealed heart enlargement and a reduced ejection fraction (volume of blood pumped out of the heart per minute). As a result, the cardiologist started Mr. B on a beta-blocker (metoprolol 25 mg by mouth daily). Nursing homework help

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A few days after taking the new medication (in addition to the hydrochlorothiazide ordered by the primary physician), Mr. B suffered a fall at home. Upon arrival at the emergency room, Mr. B’s blood pressure was 80/50. The emergency room physician suspected the cause of Mr. B’s fall was hypotension secondary to the medications he was taking. The ER physician recommended that Mr. B follow up with his primary care physician and cardiologist, but hold the medication until seen by them.

As recommended, Mr. B visits his primary care physician for a follow-up. During the visit, Mr. B’s blood pressure is found to be elevated (160/90), so his physician tells Mr. B to restart taking his blood pressure medication.

Imagine that you are the nurse attending to Mr. B and that he indicates that he’s afraid to restart the medication because of his recent fall.

  1. What considerations/actions should the nurse make regarding the client’s refusal to restart his blood pressure medication?
  2. What considerations/actions would have helped the healthcare team to prevent the client’s fall? Nursing homework help

Personal Philosophy of Nursing Essay

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Personal Philosophy of Nursing Essay

Personal Philosophy of Nursing Essay

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Use the questions from Box 3-2 on page 111 of your textbook as a guide as you write your personal philosophy of nursing. The essay is to be typewritten and double-spaced (1,000 words) and should include the following:

1. Introduction that includes who you are and where you practice nursing

a) Who are you.

b) Where do you practice nursing.

2. Definition of nursing

a) What is nursing.

b) Why does nursing exist.

c) Why do you practice nursing.

3. Assumptions or underlying beliefs

Nurses, patients, other health care providers, Communities.

4. Definitions and examples of the major domains of nursing and provide examples.

Person, Health, Environment.

5. Summary that includes answers to the following questions:

a. How are the domains connected?

b. What is your vision of nursing for the future?

c. What are the challenges that you will face as a nurse?

d. What are your goals for professional development?

 

Text and Materials: Masters, K. (2017). Role Development in Professional Nursing Practice (4th ed.) ISBN: 978-1-284-07832-9
Publication Manual American Psychological Association (APA) (6th ed.).

2009 ISBN: 978-1-4338-0561-5

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Career in Healthcare Leadership Assignment

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Career in Healthcare Leadership Assignment

For your assignment this week, you will reflect on where you are in your career by reviewing your current resume and determine where you want your career path in healthcare leadership to take you. To successfully complete this assignment, include the following:

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  1. Articulate your professional/career goals.
  2. Explain why you decided to pursue a degree in healthcare management and/or leadership.
  3. Describe at least 3 key leadership characteristics that a healthcare administrator should exhibit.
  4. Explain what you believe are the 3 main responsibilities of a healthcare administrator.
  5. Summarize your leadership potential based on your responses to the previous four prompts.
  6. Attach your current resume or curriculum vitae to your assignment as an appendix. Career in Healthcare Leadership Assignment

Length: 3-4 pages, not including title page, reference page(s), or any appendices

References: Include at least 3 peer-reviewed sources.

The completed assignment should address all of the assignment requirements, exhibit evidence of concept knowledge, and demonstrate thoughtful consideration of the content presented in the course. The writing should integrate scholarly resources, reflect academic expectations and current APA standards, and adhere to Northcentral University’s Academic Integrity Policy.

When applicable, conduct a Turnitin pre-check and then upload your completed assignment and click the Submit to Dropbox button. Career in Healthcare Leadership Assignment

 

GCU HLT-308V Risk Management Program Analysis Part Two Assignment

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GCU HLT-308V Risk Management Program Analysis Part Two Assignment

This assignment builds on the Risk Management Program Analysis Part One assignment you completed in Topic 1 of this course.

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Assume that the example risk management program you analyzed in Topic 1 was developed by and is now currently implemented by your health care employer/organization. Further assume that your supervisor has asked you to present a high-level summary brief of this new risk management program to a group of administrative personnel from a newly created community health organization in your state who has enlisted your organization’s assistance in developing their own risk management policies and procedures.

Compose a 1,250-1,500 word summary brief that expands upon the elements you addressed in the Risk Management Program Analysis Part One assignment. In addition, analyze the following:

Explain the Joint Commission’s role in the evaluation of an organization’s quality management processes.
Describe the roles that different levels of administrative personnel play in establishing or sustaining operational policies that are focused on employer-employee organizational risk management policies.
Explain the relationship of risk management programs and compliance with ethical standards.
In addition to your textbook, you are required to support your analysis with a minimum of three peer-reviewed references.

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

Aging Process And Psychosocial Issues Chapter 19 Discussion Help

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Aging Process And Psychosocial Issues Chapter 19 Discussion Help

Read chapter 19 of the class textbook and review the attached PowerPoint presentation. Once done, answer the following questions;

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1. Discuss the aging process.

2. Discuss the demographic characteristics of the elderly population in your community.

3. Describe and give 2 examples of psychosocial issues related to aging.

4. Describe and give 2 examples of physiological changes due to aging.

As stated in the syllabus present your assignment in an APA format word document, Arial 12 font attached to the forum in the discussion tab of the blackboard titled “Week 13 discussion questions” for grading and in the tab titled “Week 13 assignment” in Turnitin to verify originality. A minimum of 3 evidence-based references besides the class textbook must be used and one must be from a Geriatric Nursing magazine or journal. You must post two replies to any of your peers sustained with the proper references and make sure that the references that you use in your assignment are properly quoted in it. A minimum of 700 words is required.

Health Education in Maternal, Infant, and Child in Health Promotion

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Health Education in Maternal, Infant, and Child in Health Promotion

Mother, Infant, and Child: ‘Goal is to “Improve the health and well-being of women, infants, children, and families” (Healthy People 2020, 2014). African Americans at highest risk for mother and infant mortality and morbidity as well as infertility (Healthy People 2020, 2014).

3.Outline a proposal for health education that can be used in a family-centered health promotion to address the issue for the target population. Ensure your proposal is based on evidence-based practice.

Tags: nursing infant healthy people NRS429VN Health Education in Maternal Child in Health Promotion

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United State University : Primary Healthcare if Chronic Client/Families Across the Lifespan-Clinical Practinum

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United State University : Primary Healthcare if Chronic Client/Families Across the Lifespan-Clinical Practinum

  Soap Note on Chest pain

 

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Subjective

ID: Mr.

Client’s initials: G.H, Age: 65, Gender: Male, Race: Caucasian, Date of Birth: January 01, 1962. Patient presents as a reliable historian.

CC: “I am experiencing chest pains.”

HPI: Mr. G.H, 65 years old, Caucasian man with a health history of high blood pressure, came to the clinic complaining of having chest discomfort for a span of about 2 months. In his description, the chest pain felt like an excruciating burning pain in the center of his chest. Mr. G.H described the rate of his pain as 5/10. Patient noted that the pain occurred slowly over a few minutes before going away. Most frequently while performing physically demanding tasks, such as climbing stairways; nevertheless, it might occur while seated as well as while standing up. On the other hand, Mr. G.H claims he has never felt dizzy or fainted before. The patient denied experiencing any discomfort in his neck or jaw. He attempted treating his chest pain with over-the-counter Advil 200 mg 2 tablet every 6 hours for 3 days, but the medication did not help. He denies using any herbal medications.

Past Health General:  He was diagnosed with hypertension in 2017. He is currently on metoprolol 100 mg orally once daily for the treatment of high blood pressure. Patient stated that he is non compliant with his blood pressure medication. He has also had a history of the common flu in the past.  United State University : Primary Healthcare if Chronic Client/Families Across the Lifespan-Clinical Practinum

Social History: He has never smoked tobacco or any hard substances in his life. For numerous years he has abstained from the consumption of alcoholic beverages and strong drugs. He is a retired soldier. He is a married man with two grown sons. He is not a regular participant in physical activities. He acknowledged that a large portion of his diet consisted of fast food.

Family History: Father died at the age of 83 due to complications from ischemic heart disease. Mother, who is 84 years old, is in good health except for a vision problem and tinnitus, which are both common side effects of old age. His sister has hypertension and diabetes. He has two adult children who do not have any medical issues. His wife has had UTIs and stomach ulcers in the past.

Surgical History: No surgeries.

Allergies: He has no food or drug allergies.

Review of System

General: Patient has steadily gained weight over the previous ten years. In fact, he denied experiencing weariness, fevers, memory abnormalities, discomfort, or even suicidal thoughts.

Skin: No rashes, blisters, irritation, dryness, or discoloration. There were no wounds or bruises, as well as there was no extreme sweating; also, he does not experience high and low-temperature hypersensitivity. No hair loss and no nail alterations.

Head: Patient claims that he has no headache, dizziness, or a concussion.

Eyes: There are no adverse effects, such as blurred vision or excessive tearing, that need the use of corrective lenses.

Ears: Patient claims to experience no ringing in the ears, no infection, and no other form of ear discharge to be found.

Nose: No rhinitis, sneezing, a runny nose, or epistaxis were experienced.

Mouth: Patient has no bleeding gums, oral ulcer, as well as no cracked lips. A dental exam has not taken place in four months.

Throat: There was no painful throat or swelling in the throat.

Neck: Goiter, lymphoma, and other malignancies of the neck, as well as any other enlarged glands, are not present.

Neuro: No syncope or tremors are present in this patient. There are no aberrant movements in this patient’s extremities either.

Cardiac: In the two months prior, the patient had been experiencing pressure, and burning chest pain. In the midst of his chest, the agony felt like a scorching and tingling. He gave it a score of five out of ten, describing his discomfort. United State University : Primary Healthcare if Chronic Client/Families Across the Lifespan-Clinical Practinum

Musculoskeletal: No muscle or joint discomfort or stiffness.

Gastrointestinal: He did not have any alterations in appetite, severe thirst or food desire, no swallowing problems, no heartburn, no stomach pains, and no changes in bowel patterns.

Genitourinary: No urgency or increased urination; no hesitancy or decreased stream; no incontinence; as well as no blood in urine, no renal pain, or cramping in the genitals were reported.

Objective

Vital Signs

Temperature: 37.5°F, His height: 5’5” ft, His weight: 199 lbs., BMI: 33.11, Blood Pressure: 154/88, RR: 19, SpO2: 98%

Physical Examination

Constitutional: He has a decent physique; however, he is a touch overweight.

HEENT: Head: Normocephalic, as well as no palpable masses. Eye: Extensive extraocular movements, large visual ranges to confrontation, and clean conjunctivae are present in both eyes. Icterus does not exist, pupil size and shape are equal, light sensitivity and correction are present, and the eyes have a chance of developing cataracts. Ears: His hearing accuracy is quite poor on both sides of the ears. The tympanic membrane’s markers were plainly visible on the slide. Nose: No abnormal discharge, obstruction, or deviation of the septum can be found in the nose. Mouth: A complete set of dentures, upper and lower. The pharynx has no exudates since nothing has been injected into it. The uvula, which is located in the center of the body, moves upward. Gag reflexes are quite natural. United State University : Primary Healthcare if Chronic Client/Families Across the Lifespan-Clinical Practinum

Neck: No lumps. No thyroids, and the pressure in the jugular veins is 8 cm. No masses.

Lymph nodes: There are no enlarged lymph nodes.

Chest: It appears that the breasts have no lumps or discharges. Lung sound is reduced, but there is no reduction in percussion. The diaphragm’s breathing is effortless. No rhonchi, rubs, or wheezes.

Heart: The PMI is positioned at the sixth ICS one centimeter laterally to the MCL. This film fails to excite or excite the audience. The tempo is steady, with the exception of a few extra beats. Carotid upstrokes, which characterize normal S1 and S2 splits, are prominent in pulses. A positive carotid, brachial, and femoral pulse round out the electrocardiogram.

Abdomen: There is normal bowel sound in all four quadrant of the abdomen.. Palpation reveals that it is not sensitive in the least. Neither the liver, and spleen could be felt on the surface. The liver grows by 7cm when percussion is applied.

Rectal: There is a noticeable external hemorrhoid, but no masses are seen. The stool is darkish and contains no blood.

Skin: There are visible changes in leg vein stasis despite the skin being generally healthy. A grade of 1+ knee edema is present; however, it is non-pitting. Cyanosis and clubbing are not present.

Neurologic: Has complete awareness. The cranial nerves are intact. Patient moves all extremities without being tested for strength. The cerebellum exhibits neither tremor nor dysmetria. The reflexes are symmetric 2+ throughout, and there is no Babinski sign.

Labs: A portable chest x-ray shows moderate Premature Ventricular Contractions, which are consistent with the presence of cardiomegaly. Other test to consider are resting EKG, cardiac enzymes echocardiogram, CMP, Complete Blood Count , Lipid profile, and HbA1c (Cash et al., 2017).

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Diagnostic Plan

Differential Diagnoses

Stable Angina (I20. 9): When under physical exercise or are under stress, you may experience stable angina, which is chest discomfort that does not go away. A blockage in the blood vessels, which may result in less blood flow to the heart, is the underlying cause of angina (Lanza, 2019). Primarily as a result of the client’s medical assessment and the similarities between his complaints and the symptoms of stable angina, therefore, diagnosis of stable angina was confirmed. Also, an exercise stress echocardiogram is needed to assess the ability of the heart to resist physical exercise.

GERD (K21.9) – Epigastric or retrosternal pain radiating to the throat or chest is a common symptom of esophageal reflux (Chen & Brady, 2019). This condition might be a possible differential diagnosis; therefore, some tests should be assessed to rule out.

Costochondritis (M94. 0) – Costochondritis is inflammatory in the muscle tissue that lies between the rib bone and the sternum, or breastbone. This inflammatory can be very painful. Costochondritis is a condition that can be caused by physical activity or joint illnesses such as osteoarthritis (Schumann et al., 2019). Chest pain can result from this inflammation.

Final  Differetial: Stable Angina (I20.9)- The signs and symptoms the patient is presenting most correlate to stable angina. Stable angina discomfort usually starts slowly and worsens over a few minutes before disappearing (Lanza, 2019).

Diagnostic Plan

Exercise Stress Echocardiogram–

The ability of the heart to resist physical exercise should be evaluated. Investigates the functioning of the heart’s valves and other internal organs. This will assist you in determining whether or not you have a substantial chance of acquiring heart disease in the future (Lanza, 2019). As a result, it will be possible to examine the outcomes of the existing cardiac therapy plan. Upon evaluation, the EKG revealed changes in the Q-waves, which suggested the presence of stable angina.

Bravo reflux testing

The pH acidity of the esophagus is measured by the Bravo reflux testing instrument, which uses unique capsule technology. Additionally, this test measures how PPIs affect blood pH and how severe reflux symptoms are. Individuals can continue their daily activities and normally eat while the doctor does a more exact diagnosis of Bravo Reflux (Chen & Brady, 2019). This procedure is also preferred by the majority of patients over catheter-based examinations.

Costochondritis test

There is no specific test that may be used to diagnose costochondritis. In order to effectively rule out more serious heart or costochondritis that might be causing chest pain, doctors frequently perform a chest X-ray and an echocardiogram (ECG). Whether the discomfort is in the rib cartilage, which is normally placed between the 4th and 6th ribs, will be discernible by the doctor during the examination (Schumann et al., 2019).

Treatment Plan

Among the therapeutic objectives for stable angina patients is the reduction in cardiovascular-related mortality and prevention of angina complications such as unstable angina and heart attack, among other things. Anginal symptoms can be completely eliminated by maintaining an active lifestyle and a positive outlook on life.

Pharmacotherapy

The use of aspirin for an indefinite period of time is suggested for patients, but if low-dose aspirin medication causes an adverse reaction, clopidogrel is a suitable substitute (Valgimigli et al., 2018). Therefore, Mr. G.H is instructed to start taking Aspirin 75 mg orally once daily  or clopidogrel 75 mg orally once daily for six months. Atrovastastin 20 mg orally daily. Metoprolol 100 mg orally once daily, this will help to treat his high blood pressure and angina (Cash et al., 2017).

Education

Education and regular checkups are critical parts of the therapy process, as are offering recommendations to patients on how they might improve their health. In order to aid in his recovery, the medical professional will urge that he get enough rest and sleep (Meeder et al., 2021). The patient’s weight can be managed by avoiding fast foods and engaging in modest physical activity. He should consume a healthy diet rich in fresh produce such as vegetables, fruits, whole grains, and legumes. He should eat fish, chicken meat, and beans are all excellent sources of lean protein. He should avoid foods with high salt content, and also, he should consume low-fat products like yogurt or skim milk, or no-fat dairy (Evans, 2018). Stop using asprin and call your PCP if have ringing in your ears, confusion , hallucination, stomach pian, blood or tarry stool. Advice patient that non-compliant with his blood pressure medication could leaf to health consequences.

Follow Up

In two week’s time,  Mr. G.H is requested to come back to the clinic, to assess the efficacy of his drugs, and to monitor his lab results. United State University : Primary Healthcare if Chronic Client/Families Across the Lifespan-Clinical Practinum

 

References

Cash, J., & Glass, C (2017). Family practice quideline (4th ed.). Springer Publishing Company, LLC.

Chen, J., & Brady, P. (2019). Gastroesophageal reflux disease: Pathophysiology, diagnosis, and treatment. Gastroenterology Nursing: The Official Journal of the Society of Gastroenterology Nurses and Associates, 42(1), 20–28. https://doi.org/10.1097/sga.0000000000000359

Evans, M. (2018). Blood Pressure: Solution-The Ultimate Guide To Naturally Lowering High Blood Pressure And Reducing Hypertension (Vol. 1). Alakai Publishing LLC.

Lanza, G. A. (2019). Diagnostic approach to patients with stable angina and no obstructive coronary arteries. European Cardiology, 14(2), 97–102. https://doi.org/10.15420/ecr.2019.22.2

Meeder, J. G., Hartzema-Meijer, M. J., Jansen, T. P. J., Konst, R. E., Damman, P., & Elias-Smale, S. E. (2021). Outpatient management of patients with angina with No Obstructive Coronary Arteries: How to come to a proper diagnosis and therapy. Frontiers in Cardiovascular Medicine, 8, 716319. https://doi.org/10.3389/fcvm.2021.716319

Schumann, J. A., Sood, T., & Parente, J. J. (2018). Costochondritis. https://europepmc.org/article/NBK/nbk532931

Valgimigli, M., Bueno, H., Byrne, R. A., Collet, J. P., Costa, F., Jeppsson, A., … & Levine, G. N. (2018). 2017 ESC focused update on dual antiplatelet therapy in coronary artery disease developed in collaboration with EACTS. European journal of cardio-thoracic surgery, 53(1), 34-78. https://doi.org/10.1093/ejcts/ezx334

 

Nursing homework help

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Discussion post 1

Based on the case study, the patient is taking two drugs that are treating two different conditions, and I believe she does not have enough information about their side effects and other interactions that both the physician and the cardiologist were supposed to provide this led to a fall and make the patient afraid of taking the medication.

What considerations/actions should the nurse make regarding the client’s refusal to restart his blood pressure medication?

As nurses, we have different roles in our patients,s and the first action I will have done was to ask the patient questions regarding history, if she takes over-the-counter medications, supplements, smoking, or drinking alcohol, how often does she takes this blood pressure medication, I should teach her about the importance of both metoprolol and hydrochlorothiazide and their side effects which can lead to dizziness, hypotension that leads to a fall, and I will advocate his concerns to the physician. Nursing homework help

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What considerations/actions would have helped the healthcare team to prevent the client’s fall?

Team members should have coordinated care of this patient through communication. The physician, cardiologist, and nurses were involved to determine a better patient outcome( Pamela Baxter,2022). To ensure safety nurses were to educate them about the side effects of these medications such as dizziness and lightheadedness, unusual tiredness or weakness, and let him know that he should change positions slowly and have periods of rest (Mayo Clinic, 2022). Other things include removing rugs on the floor, ensuring adequate lighting, use of non-slip socks at home, and using assistive devices when needed.

Discussion post 2

  1. What considerations/actions should the nurse make regarding the client’s refusal to restart his blood pressure medication?  The nurse would want to listen to Mr. B’s reason for not wanting to restart the medication and respect the patients decision for refusing medications. “A serious fall can result in decreased functional independence and quality of life.”(Jin, 2018). Although the nurse would also want to evaluate the patients ability in understanding the risks involved with not taking the medications. The nurse should evaluate the patients ability to read the medication label. Counsel the patient on the importance of taking the medication as prescribed by the Dr. Encourage the patient to consider getting a revised dose or following up with another Dr. to get second opinion. The nurse should recognize that the two medication where prescribed by two different physicians leading to polypharmacy. which resulted in a low BP that caused dizziness that contributed to the patient falling. “Health care providers can educate patients to promote medication adherence by adequately explaining how to take a medicine, by raising and discussing with patients any reluctance to take medicines, and by discussing with patients their beliefs and knowledge about their health and associated treatments.”(Costa et al., 2015).  Nursing homework help

2, What considerations/actions would have helped the healthcare team to prevent the client’s fall? Teaching the patient about the affects that are expected with taking medications that affect heart rate and BP. For instance teaching the patient to take their time while getting out of bed or a chair. And if they feel dizzy to go back to a sitting or lying position. Teach Mr. B the importance of being well hydrated while taking the BP medications. Consider the patients diet, OTC meds, and prescription medications that may have and adverse affect while taking the metoprolol and Hydrochlorothiazide. Have the patient disclose all medications taken to his provider so they could catch adverse drug interactions. Given the patients age they could help him recognize contributing factors to fall risks, such as environment, throw rugs, dim lighting, staircases or physical factors feeling weak, dizzy and lightheaded. Nursing homework help

Cardiovascular Case Study Assignment

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Cardiovascular Case Study Assignment

Description

As professional nurses, it is our responsibility to gather data for the health care team. It is often our role to present the data in an organized manner for the analysis and interpretation. Diagnostic reasoning is “the process of analyzing health data and drawing conclusions to identify diagnoses.” While it is not our role to determine medical diagnoses, it is our role to determine “the human response to actual or potential health problems and life processes” (Defining the knowledge of nursing and NANDA).

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Often we are called to quickly cluster like data which leads to the identification of clinical problems and helps to focus on accurate solutions. It is through our assessment of patterns of signs and symptoms that we can prioritize our interventions and promote health in our patients.

Upon successful completion of this discussion, you will be able to:

Integrate nursing knowledge and evidence-based practice by the analysis of a clinical case study.
Implement effective communication with health team members. Cardiovascular Case Study Assignment
Resources
Textbook: Physical Examination & Health Assessment
External Tools
The Heart and Vascular System Assessment
File: Case Study Template
Background Information

Review the case study below. Organize the data utilizing the Case Study Template.

Jane is a 69-year-old African American female presenting to her primary physician office. Jane complains of a “racing heart” and shortness of breath. Jane has a history of anxiety attacks, hypertension and hypercholesterolemia, gout and 4 ½ years ago had a two-vessel coronary bypass after suffering an anterior wall MI. She had a double mastectomy 2 years ago for breast cancer, stage 2 and completed radiation 1½ years ago. She states she has been having problems sleeping through the night for the past month and has been sleeping with 3 pillows; she has also been experiencing fatigue and weakness throughout the day and believes she may be gaining weight since her shoes and pants are getting tight. She says she will not go to the hospital since she is still paying from her last surgery.

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The nurse notes her Temp is 98.6 F, Pulse is 94 (irregular), Resp 20, Denies pain. BP 125/80. Weight is 215 lbs (up 9 pounds since her last visit one month ago). She appears to be anxious and slightly diaphoretic. She is alert and oriented answering the phone throughout her assessment, asking her family and friends to pray for her as she is sure she is dying. Current medications: Allopurinol, Atorvastatin, Baby ASA, and clopidogrel. She states she stopped smoking when she had her “heart attack,” although when she gets anxious she may “sneak 1 or 2 cigarettes” but “no more than a pack a week.”

Instructions
Review the rubric to make sure you understand the criteria for earning your grade.
In your textbook, Physical Examination & Health Assessment, read:
Chapter 20: Heart and Neck Vessels
Chapter 21: Peripheral Vascular and Lymphatic System
Chapter 11: Pain Assessment
Use the Case Study Template and prepare to discuss the following prompts:
What focused assessments would you perform on Jane? What cues are you looking for and why? (Utilize at least one scholarly reference for rationale.) Cardiovascular Case Study Assignment
What problems would you deduce? What do you believe is happening to Jane? How severe is the problem? (Prioritize according to labels on page 5 of the text.)
Utilizing NANDA diagnostic labels, identify 3 nursing diagnoses.
Based on the data, develop 3 goals. (Goals must be SMART.)
What recommendations do you have? What are some probable interventions you would recommend based upon the assessment data and goals? Define the assessment data and evidence-based prior knowledge upon which you are basing your recommendations. (You must have at least 3 recommendations and use at least 2 scholarly references.)
Research and select at least two current scholarly sources to support your explanations and insights. Wikipedia is not permitted, as it is not a peer-reviewed, scholarly source.
Whether written or spoken, interactions are expected to:
clearly and thoroughly address the prompt with meaningful information that shows critical thinking. Cardiovascular Case Study Assignment

NURS 6630 Week 1 Discussion Discussion: Foundational Neuroscience

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NURS 6630 Week 1 Discussion Discussion: Foundational Neuroscience

Explain the agonist-to-antagonist spectrum of action of psychopharmacologic agents.
The spectrum of agonists to antagonists describes how substances, either occurring naturally (ligand) or synthetically such as psychopharmacologic agent, effect receptor sites (Stahl, 2008). The agonists are agents can increase an action on the receptor by mimicking a naturally occurring agent (Strange, 2008). An antagonist acts by blocking the receptor site to decrease the action of agents (Strange, 2008). Substances can also be partial agonists, which is an action that ranges between full agonist and full antagonist. Instead of increasing an action to the maximum level or blocking the action completely, it is an action that is somewhere in between the two levels (Strange, 2008). Many psychopharmacologic agents work by acting on G-protein-linked systems and ion-channel systems because these are triggered by neurotransmitters (Stahl, 2008).Nurs 6630 week (1-11) Discussion and Assignments.

 

Compare and contrast the actions of g couple proteins and ion gated channels.
G protein-coupled and ion-gated channels are both triggered by neurotransmitters (Stahl, 2008). G protein-coupled receptors (GPCRs) have seven transmembrane alpha helices (Strange, 2008). G proteins have three subunits (alpha, beta, and gamma). Ion-gated channels can be activated by electrical signals and neurotransmitters (Stahl, 2008). Ion-gated channels change the flow of ions, causing an almost-immediate effect and GPCRs take longer to work because they may make changes to cellular function over time (Stahl, 2008).

Explain the role of epigenetics in pharmacologic action.
Epigenetics is the study of gene expression, or which genes are turn off or on (Stahl, 2008). Pharmacologic actions can turn genes on or off to gain a desired effect. Epigenetic regulation of brain functions is important in the etiology of psychiatric disorders (Boks, et al., 2012). Epigenetic mechanisms, such as DNA methylation and histone acetylation, are affected by many pharmaceuticals, including psychiatric drugs (Boks, et al., 2012).

 

Explain how this information may impact the way you prescribe medications to clients. Include a specific example of a situation or case with a client in which the psychiatric mental health nurse practitioner must be aware of the medication’s action.
Thorough knowledge of how medications work will allow the nurse practitioner to prescribe the best medication for the client. For example, knowing that many anxiolytics work on inotropic receptors and will work very quickly to calm a client in an acute situation rather than prescribing an antidepressant that works on GPCRs and will take much longer to help with an acute episode. NURS 6630 Week 1 Discussion Discussion: Foundational Neuroscience

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

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

Note: All Stahl resources can be accessed through the Walden Library using this link. This link will take you to a log-in page for the Walden Library. Once you log into the library, the Stahl website will appear. NURS 6630 Week 1 Discussion Discussion: Foundational Neuroscience

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

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

Chapter 1, “Chemical Neurotransmission”

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

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

Document: Midterm Exam Study Guide (PDF)

Document: Final Exam Study Guide (PDF)

Required Media

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

 

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

Note: The approximate length of this media piece is 3 minutes.Nurs 6630 week (1-11) Discussion and Assignments.

Accessible player

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Discussion: Foundational Neuroscience Optional Resources
Laureate Education (Producer). (2009). Pathopharmacology: Disorders of the nervous system: Exploring the human brain [Video file].

Essay Assignment NURS 6630 – Psychopharmacologic Approaches to Treatment of Psychopathology

Baltimore, MD: Author.NURS 6630 – Psychopharmacologic Approaches to Treatment of Psychopathology Essay Assignment

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

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

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

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

In this media presentation, Dr. Terry Buttaro, associate professor of practice at Simmons School of Nursing and Health Sciences, discusses the importance of pharmacology for the advanced practice nurse.Nurs 6630 week (1-11) Discussion and Assignments.

Accessible player

To prepare for this Discussion:

Review this week’s Learning Resources.

Reflect on concepts of foundational neuroscience.

Assignment: Assessing and Treating Clients With Dementia
The Alzheimer’s Association defines dementia as “a general term for a decline in mental ability severe enough to interfere with daily life” (Alzheimer’s Association, 2016). This term encompasses dozens of cognitive disorders of impaired memory formation, recall, and communication. The care and treatment of clients with dementia is dependent on multiple factors, including the stage of dementia, comorbidities, family support, and even the care setting. In your role, as the psychiatric mental health nurse practitioner, you must be prepared to not only treat clients with these various cognitive disorders, but also the multiple behavioral issues that often accompany them. For this Assignment, as you examine the client case study in this week’s Learning Resources, consider how you might assess and treat clients presenting with dementia.Nurs 6630 week (1-11) Discussion and Assignments.

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

To prepare for this Assignment:

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

The Assignment

Examine Case Study: An Elderly Iranian Man With Alzheimer’s Disease. You will be asked to make three decisions concerning the medication to prescribe to this client. Be sure to consider factors that might impact the client’s pharmacokinetic and pharmacodynamic processes. At each decision point stop to complete the following:

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Introduction regarding disease state

High-level summary of patient case

Purpose of the essay statement

Decision #1

What options were listed?
Which decision did you select?
Why did you select this decision? Support your response with evidence and references to the Learning Resources.
Why didn’t you select the other two options?
What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.Nurs 6630 week (1-11) Discussion and Assignments.
Explain any difference between what you expected to achieve with Decision #1 and the results of the decision. Why were they different?

Decision #2

What options were listed?
What option did you choose?
Why did you select this decision? Support your response with evidence and references to the Learning Resources.
Why didn’t you select the other two options?
What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.
Explain any difference between what you expected to achieve with Decision #2 and the results of the decision. Why were they different?Nurs 6630 week (1-11) Discussion and Assignments.

Decision #3

What options were listed?
What option did you choose?
Why did you select this decision? Support your response with evidence and references to the Learning Resources.
Why didn’t you select the other two options?
What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.
Explain any difference between what you expected to achieve with Decision #3 and the results of the decision. Why were they different?
Also include how ethical considerations might impact your treatment plan and communication with clients.

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

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

References

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

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

· Chapter 13, “Dementia and Its Treatment”

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

To access information on the following medications, click on The Prescriber’s Guide, 5th ed tab on the Stahl Online website and select the appropriate medication.  NURS 6630 Week 1 Discussion Discussion: Foundational Neuroscience

Review the following medications:

For insomnia

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

Note: Retrieved from from the Walden Library databases.

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

Required Media

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

BACKGROUND

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

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

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

SUBJECTIVE

During the clinical interview, Mr. Akkad is pleasant, cooperative and seems to enjoy speaking with you. You notice some confabulation during various aspects of memory testing, so the PMHNP performs a Mini-Mental State Exam. Mr. Akkad scores 18 out of 30 with primary deficits in orientation, registration, attention & calculation, and recall. The score suggests moderate dementia.Nurs 6630 week (1-11) Discussion and Assignments.

MENTAL STATUS EXAM

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

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

 

NURS 6630 Week 2 Assignment
Assessing and Treating Pediatric Clients With Mood Disorders
Therapy for Pediatric Clients With Mood Disorders
Case Study: An African American Child Suffering From Depression

Mood disorders can impact every facet of a child’s life, making the most basic activities difficult for clients and their families. This was the case for 13-year-old Kara, who was struggling at home and at school. For more than 8 years, Kara suffered from temper tantrums, impulsiveness, inappropriate behavior, difficulty in judgment, and sleep issues. As a psychiatric mental health nurse practitioner working with pediatric clients, you must be able to assess whether these symptoms are caused by psychological, social, or underlying growth and development issues. You must then be able recommend appropriate therapies.Nurs 6630 week (1-11) Discussion and Assignments.

This week, as you examine antidepressant therapies, you explore the assessment and treatment of pediatric clients with mood disorders. You also consider ethical and legal implications of these therapies.Nurs 6630 week (1-11) Discussion and Assignments.

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Case Study: An African American Child Suffering From Depression
When pediatric clients 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 clients with the same disorders, but they also metabolize medications much differently. As a result, psychiatric mental health nurse practitioners must exercise caution when prescribing psychotropic medications to these clients. For this Assignment, as you examine the client case study in this week’s Learning Resources, consider how you might assess and treat pediatric clients presenting with mood disorders.NURS 6630 – Psychopharmacologic Approaches to Treatment of Psychopathology Essay Assignment

Note: This Case Study: An African American Child Suffering From Depression Assignment is the first of 10 assignments that are based on interactive client case studies. For these assignments, you will be required to make decisions about how to assess and treat clients. Each of your decisions will have a consequence. Some consequences will be insignificant, and others may be life altering. You are not expected to make the “right” decision every time; in fact, some scenarios may not have a “right” decision. You are, however, expected to learn from each decision you make and demonstrate the ability to weigh risks versus benefits to prescribe appropriate treatments for clients. NURS 6630 Week 1 Discussion Discussion: Foundational Neuroscience

NURS 6630 – Psychopharmacologic Approaches to Treatment of Psychopathology Essay Assignment

Case Study: An African American Child Suffering From Depression Required Readings
Note: All Stahl resources can be accessed through the Walden Library using this link. This link will take you to a log-in page for the Walden Library. Once you log into the library, the Stahl website will appear.

Stahl, S. M. (2013). Stahl’s essential psychopharmacology: Neuroscientific basis and practical applications (4th ed.). New York, NY: Cambridge University Press.Nurs 6630 week (1-11) Discussion and Assignments.

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

Chapter 6, “Mood Disorders”

Chapter 7, “Antidepressants”

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

Note: To access the following medications, click on the The Prescriber’s Guide, 5th ed tab on the Stahl Online website and select the appropriate chapter. Be sure to read all sections on the left navigation bar for each chapter.

Review the following medications:

amitriptyline
bupropion
amitriptyline
bupropioncital
opramclomipramine
desipramine
desvenlafaxine
doxepin
dulox
etine escitalopram
fluoxetine
fluvoxamine
imipramine
ketamine
mirtazapine
nortriptyline
paroxetine
selegiline
sertraline
trazodone
venlafaxine
vilazodone
vortioxetine
citalopram
clomipramine
Case Study: An African American Child Suffering From Depression
Magellan Health, Inc. (2013). Appropriate use of psychotropic drugs in children and adolescents: A clinical monograph. Retrieved from http://www.magellanhealth.com/media/445492/magellan-psychotropicdrugs-0203141.pdf

Rao, U. (2013). Biomarkers in pediatric depression. Depression & Anxiety, 30(9), 787–791. doi:10.1002/da.22171

Note: Retrieved from Walden Library databases. NURS 6630 Week 1 Discussion Discussion: Foundational Neuroscience

Vitiello, B. (2012). Principles in using psychotropic medication in children and adolescents. In J. M. Rey (Ed.), IACAPAP e-Textbook of Child and Adolescent Mental Health. Geneva: International Association for Child and Adolescent Psychiatry and Allied Professions. Retrieved from http://iacapap.org/wp-content/uploads/A.7-PSYCHOPHARMACOLOGY-072012.pdf

Poznanski, E., & Mokros, H. (1996). Child Depression Rating Scale–Revised. Los Angeles, CA: Western Psychological Services.

Note: Retrieved from Walden Library databases.

Case Study: An African American Child Suffering From Depression Required Media
Laureate Education (2016e). Case study: An African American child suffering from depression [Interactive media file]. Baltimore, MD: Author.

Note: This case study will serve as the foundation for this week’s Assignment.

Case Study: An African American Child Suffering From Depression Optional Resources
El Marroun, H., White, T., Verhulst, F., & Tiemeier, H. (2014). Maternal use of antidepressant or anxiolytic medication during pregnancy and childhood neurodevelopmental outcomes: A systematic review. European Child & Adolescent Psychiatry, 23(10), 973–992. doi:10.1007/s00787-014-0558-3

Gordon, M. S., & Melvin, G. A. (2014). Do antidepressants make children and adolescents suicidal? Journal of Pediatrics and Child Health, 50(11), 847–854. doi:10.1111/jpc.12655

Seedat, S. (2014)NURS 6630 – Psychopharmacologic Approaches to Treatment of Psychopathology Essay Assignment . Controversies in the use of antidepressants in children and adolescents: A decade since the storm and where do we stand now? Journal of Child & Adolescent Mental Health, 26(2), iii–v. doi:10.2989/17280583.2014.938497

To prepare for this Case Study: An African American Child Suffering From Depression Assignment:

Review this week’s Learning Resources. Consider how to assess and treat pediatric clients requiring antidepressant therapy.

The Case Study: An African American Child Suffering From Depression Assignment
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 client. Be sure to consider factors that might impact the client’s pharmacokinetic and pharmacodynamic processes.

At each decision point stop to complete the following:

Decision #1

Which decision did you select?
Why did you select this decision? Support your response with evidence and references to the Learning Resources.
What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.
Explain any difference between what you expected to achieve with Decision #1 and the results of the decision. Why were they different?
Decision #2
NURS 6630 – Psychopharmacologic Approaches to Treatment of Psychopathology Essay Assignment

Why did you select this decision? Support your response with evidence and references to the Learning Resources.
What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.
Explain any difference between what you expected to achieve with Decision #2 and the results of the decision. Why were they different?
Decision #3
Why did you select this decision? Support your response with evidence and references to the Learning Resources.
What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.
Explain any difference between what you expected to achieve with Decision #3 and the results of the decision. Why were they different?
Also include how ethical considerations might impact your treatment plan and communication with clients.
BACKGROUND INFORMATION
The client is an 8-year-old African American male who arrives at the ER with his mother. He is exhibiting signs of depression.

Client complained of feeling “sad”
Mother reports that teacher said child is withdrawn from peers in class
Mother notes decreased appetite and occasional periods of irritation
Client reached all developmental landmarks at appropriate ages
Physical exam unremarkable
Laboratory studies WNL
Child referred to psychiatry for evaluation
Client seen by Psychiatric Nurse Practitioner
MENTAL STATUS EXAM

Alert & oriented X 3, speech clear, coherent, goal directed, spontaneous. Self-reported mood is “sad”. Affect somewhat blunted, but child smiled appropriately at various points throughout the clinical interview. He denies visual or auditory hallucinations. No delusional or paranoid thought processes noted. Judgment and insight appear to be age-appropriate. He is not endorsing active suicidal ideation, but does admit that he often thinks about himself being dead and what it would be like to be dead.

The PMHNP administers the Children’s Depression Rating Scale, obtaining a score of 30 (indicating significant depression)

Case Study: An African American Child Suffering From Depression RESOURCES

§ Poznanski, E., & Mokros, H. (1996). Child Depression Rating Scale–Revised. Los Angeles, CA: Western Psychological Services.

Decision Point One
Select what the PMHNP should do:

Begin Zoloft 25 mg orally daily
Begin Paxil 10 mg orally daily
Begin Wellbutrin 75 mg orally BID
Case Study of the above client

Decision Point One

I selected Zoloft 25 mg orally daily

RESULTS OF DECISION POINT ONE

Client returns to clinic in four weeks

No change in depressive symptoms at all

Decision Point Two
Increase dose to 50 mg orally daily
RESULTS OF DECISION POINT TWO

Client returns to clinic in four weeks

Depressive symptoms decrease by 50%. Cleint tolerating well

Decision Point Three
Maintain current dose

Guidance to Student

At this point, sufficient symptom reduction has been achieved. This is considered a “response” to therapy. Can continue with current dose for additional 4 week to see if any further reductions in depressive symptoms are noted. An increase in dose may be warranted since this is not “full” remission- Discuss pros/cons of increasing drug dose with client at this time and empower the client to be part of the decision. There is no indication that the drug therapy should be changed to an SNRI at this point as the client is clearly responding to this therapy.Nurs 6630 week (1-11) Discussion and Assignments.

SAMPLE DECISION TREE ASSIGNMENT
An Elderly Iranian Man with Alzheimer’s

Alzheimer’s condition is a neurodegenerative disease that begins slowly and worsens over a long period of time. The condition has been associated with almost 70% of all dementia cases in the world. The most prevalent early symptoms entail the absence of memory concerning recent events. As the condition progresses, other symptoms such as language difficulties, mood swings, disorientation, behavioral issues, lack of self-care management, and disorientation may occur (Houmani et al., 2018). In a gradual manner, all the bodily functions will be lost resulting in eventual death. As much as the disease’s life expectancy varies, the typical expectancy does not go beyond nine years after diagnosis. Importantly, the disease does not have a cure but it could be managed to ensure that the quality of life of patients suffering from it is improved.Nurs 6630 week (1-11) Discussion and Assignments.

The case study for the present assignment entails the examination and treatment of an elderly Iranian man who displays strange behaviors according to his son. Mr. Akan has lost interest in things that erstwhile interested him. Further, the client has been forgetting things and his subjective test revealed confabulation during mental health testing process. Mr. Akad also has restricted affect and impaired impulse and judgment. A mini-mental state examination reveals that Mr. Akad suffers from major neurocognitive disorder caused by presumptive Alzheimer’s disease. This paper describes the assessment outcomes and treatment options for an elderly Iranian man, who has been diagnosed with Alzheimer’s. The condition can be treated with pharmacological interventions, which are dependent on among other factors dosage, proper selection of drug, and time of use, and administration route.

NURS 6630 Week 3 Assignment: Assessing and Treating Adult and Geriatric Clients With Mood Disorders
Case Study: An Elderly Hispanic Man With Major Depressive Disorder

Needs to be 6-8 pages, & total references, but 3 need to be Academic References. Apa Format. Please Read the case study and choose one of the medications below and answer the questions below. The instructor states its ok if we don’t choose the best medication for the patient just as long as we answer the questions and state why we chose the medication and why we did not choose the others.Nurs 6630 week (1-11) Discussion and Assignments.

Assignment: Assessing and Treating Adult and Geriatric Clients With Mood Disorders
Advances in genetics and epigenetics have changed the traditional understanding of mood disorders, resulting in new evidence-based practices. In your role as a psychiatric mental health nurse practitioner, it is essential for you to continually educate yourself on new findings and best practices in the field. For this Assignment, you consider best practices for assessing and treating adult and geriatric clients presenting with mood disorders.

Case Study: An Elderly Hispanic Man With Major Depressive Disorder Required Readings
Note: All Stahl resources can be accessed through the Walden Library using this link. This link will take you to a log-in page for the Walden Library. Once you log into the library, the Stahl website will appear.NURS 6630 – Psychopharmacologic Approaches to Treatment of Psychopathology Essay Assignment

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

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

Chapter 6, “Mood Disorders”

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

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

ORDER NURS 6630 Weekly Discussions and Assignments Today !

 

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

Note: Retrieved from Walden Library databases.

Montgomery, S. A., & Asberg, M. (1979). A new depression scale designed to be sensitive to change. British Journal of Psychiatry, 134, 382-389. Retrieved from https://www.researchgate.net/profile/Marie_Asberg/publication/22697065_A_New_Depression_Scale_Designed_to_be_Sensitive_to_Change/links/09e41513f85c708fee000000.pdf

Case Study: An Elderly Hispanic Man With Major Depressive Disorder Required Media

Laureate Education. (2016g). Case study: An elderly Hispanic man with major depressive disorder [Interactive media file]. Baltimore, MD: Author.

Note: This case study will serve as the foundation for this week’s Assignment. NURS 6630 Week 1 Discussion Discussion: Foundational Neuroscience

To prepare for this Assignment

Review this week’s Learning Resources. Consider how to assess and treat adult and geriatric clients requiring antidepressant therapy.

The Case Study: An Elderly Hispanic Man With Major Depressive Disorder Assignment
Examine Case Study: An Elderly Hispanic Man With Major Depressive Disorder. You will be asked to make three decisions concerning the medication to prescribe to this client. Be sure to consider factors that might impact the client’s pharmacokinetic and pharmacodynamic processes.

At each decision point stop to complete the following:

At each decision point stop to complete the following:

Decision #1
Which decision did you select?
Why did you select this decision? Support your response with evidence and references to the Learning Resources.
What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.
Explain any difference between what you expected to achieve with Decision #1 and the results of the decision. Why were they different?
Decision #2
Why did you select this decision? Support your response with evidence and references to the Learning Resources.
What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.
Explain any difference between what you expected to achieve with Decision #2 and the results of the decision. Why were they different?
Decision #3
Why did you select this decision? Support your response with evidence and references to the Learning Resources
What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources
Explain any difference between what you expected to achieve with Decision #3 and the results of the decision. Why were they different?Nurs 6630 week (1-11) Discussion and Assignments
Also include how ethical considerations might impact your treatment plan and communication with clients.
Case Study: An Elderly Hispanic Man With Major Depressive Disorder
BACKGROUND INFORMATION

The client is a 32-year-old Hispanic American male who came to the United States when he was in high school with his father. His mother died back in Mexico when he was in school. He presents today to the PMHNPs office for an initial appointment for complaints of depression. The client was referred by his PCP after “routine” medical work-up to rule out an organic basis for his depression. He has no other health issues with the exception of some occasional back pain and “stiff” shoulders which he attributes to his current work as a laborer in a warehouse.

SUBJECTIVE

During today’s clinical interview, client reports that he always felt like an outsider as he was “teased” a lot for being “black” in high school. States that he had few friends, and basically kept to himself. He describes his home life as “good.” Stating “Dad did what he could for us, there were 8 of us.” He also reports a remarkably diminished interest in engaging in usual activities, states that he has gained 15 pounds in the last 2 months. He is also troubled with insomnia which began about 6 months ago, but have been progressively getting worse. He does report poor concentration which he reports is getting in “trouble” at work.

MENTAL STATUS EXAM

The client is alert, oriented to person, place, time, and event. He is casually dressed. Speech is clear, but soft. He does not readily make eye contact, but when he does, it is only for a few moments. He is endorsing feelings of depression. Affect is somewhat constricted, but improves as the clinical interview progresses. He denies visual or auditory hallucinations, no overt delusional or paranoid thought processes readily apparent. Judgment and insight appear grossly intact. He is currently denying suicidal or homicidal ideation. The PMHNP administers the “Montgomery- Asberg Depression Rating Scale (MADRS)” and obtained a score of 51 (indicating severe depression).

RESOURCES

Montgomery, S. A., & Asberg, M. (1979). A new depression scale designed to be sensitive to change. British Journal of Psychiatry, 134, 382-389.
Decision Point One

Select what the PMHNP should do:

Begin zoloft 25 mg orally daily

Begin Effexor XR 37.5 mg orally daily

Begin Phenelzine 15 mg orally TID

Which decision did you select?
Why did you select this decision? Support your response with evidence and references to the Learning Resources.
What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.
Explain any difference between what you expected to achieve with Decision #1 and the results of the decision. Why were they different?
Also include how ethical considerations might impact your treatment plan and communication with clients.
Support your rationale with a minimum of three academic resources but need 7 in total.. While you may use the course text to support your rationale, it will not count toward the resource requirement. NURS 6630 Week 1 Discussion Discussion: Foundational Neuroscience

Stahl, S. M. (2013). Stahl’s essential psychopharmacology: Neuroscientific basis and practical applications (4th ed.). New York, NY: Cambridge University Press.
Note: To access the following chapters, click on the Essential Psychopharmacology, 4th ed tab on the Stahl Online website and select the appropriate chapter. Be sure to read all sections on the left navigation bar for each chapter.

Chapter 6, “Mood Disorders”
Stahl, S. M. (2014b). The prescriber’s guide (5th ed.). New York, NY: Cambridge University Press.
Note: To access the following medications, click on the The Prescriber’s Guide, 5th ed tab on the Stahl Online website and select the appropriate medication.

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.
Note: Retrieved from Walden Library databases.

Montgomery, S. A., & Asberg, M. (1979). A new depression scale designed to be sensitive to change. British Journal of Psychiatry, 134, 382-389. Retrieved from https://www.researchgate.net/profile/Marie_Asberg/…

Required Media
Laureate Education. (2016g). Case study: An elderly Hispanic man with major depressive disorder [Interactive media file]. Baltimore, MD: Author.
Note: This case study will serve as the foundation for this week’s Assignment.

Case Study: An Elderly Hispanic Man With Major Depressive Disorder
SAMPLE APPROACH
Geriatric Depression Therapy

Mood disorders, such as depression, are prevalent in geriatric population and older adults. According to studies, conditions such as depression may have debilitating impacts on the family, the patient and their social constructs. Further, studies have revealed that there exist particularities in the etiology, management and clinical presentation of mood disorders in the elderly and older adults (Flint, 2012). Thus, taking cognizance of these particularities and their clinical importance are significant for their effective management in the geriatric population. However, before the management, comprehensive diagnostic undertakings including using the Geriatric Depression Scale (American Psychiatric Association, 2013) are necessary so as to identify the kind of condition that a PMHNP nurse will be addressing. After the identification of the significant variables, and the administration of effective drugs to arrest the condition is recommended. The formulation of the treatment regimen for depression depends on the safety and efficacy of a drug. Other medications and psychotherapeutic interventions are encouraged if the first intervention proves unsuccessful. In the current paper, a 31-year old Hispanic has been diagnosed with severe depression based on score of 51 that was obtained from the Montgomery- Asberg Depression Rating Scale (MADRS) (Montgomery & Asberg, 1979) by the PMHNP. The diagnosis, medication choice, and alterations made in the present analysis will facilitate a greater comprehension of how PMHNP nurses can therapeutically address depression in an elderly patient.Nurs 6630 week (1-11) Discussion and Assignments.

NURS 6630 Week 4 Assignment
Assignment: Assessing and Treating Clients with With Bipolar Disorder
Case Study: An Asian American Woman With Bipolar Disorder

Bipolar disorder is a unique disorder that causes shifts in mood and energy, which results in depression and mania for clients. Proper diagnosis of this disorder is often a challenge for two reasons: 1) clients 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 client case study in this week’s Learning Resources, consider how you might assess and treat clients presenting with bipolar disorder. NURS 6630 Week 1 Discussion Discussion: Foundational Neuroscience

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NURS 6630 – Psychopharmacologic Approaches to Treatment of Psychopathology Essay Assignment: Case Study: An Asian American Woman With Bipolar Disorder

Required Readings

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

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

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

Chapter 6, “Mood Disorders”

Chapter 8, “Mood Stabilizers”

Stahl, S. M., & Ball, S. (2009b). Stahl’s illustrated mood stabilizers. New York, NY: Cambridge University Press.

To access the following chapters, click on the Illustrated Guides tab and then the Mood Stabilizers tab.

Chapter 4, “Lithium and Various Anticonvulsants as Mood Stabilizers for Bipolar Disorder”

Chapter 5, “Atypical Antipsychotics as Mood Stabilizers for Bipolar Disorder”

Vitiello, B. (2013). How effective are the current treatments for children diagnosed with manic/mixed bipolar disorder? CNS Drugs, 27(5), 331-333. doi:10.1007/s40263-013-0060-3

Note: Retrieved from Walden Library databases.Nurs 6630 week (1-11) Discussion and Assignments.

Chen, R., Wang, H., Shi, J., Shen, K., & Hu, P. (2015). Cytochrome P450 2D6 genotype affects the pharmacokinetics of controlled-release paroxetine in healthy Chinese subjects: comparison of traditional phenotype and activity score systems. European Journal of Clinical Pharmacology, 71(7), 835-841. doi:10.1007/s00228-015-1855-6

Note: Retrieved from Walden Library databases.

Case Study: An Asian American Woman With Bipolar Disorder Required Media
Laureate Education. (2016f). Case study: An Asian American woman with bipolar disorder [Interactive media file]. Baltimore, MD: Author

Note: This case study will serve as the foundation for this week’s Assignment.

Case Study: An Asian American Woman With Bipolar Disorder Optional Resources
Mostafavi, A., Solhi, M., Mohammadi, M., Hamedi, M., Keshavarzi, M., & Akhondzadeh, S. (2014). Melatonin decreases olanzapine induced metabolic side-effects in adolescents with bipolar disorder: a randomized double-blind placebo-controlled trial. Acta Medica Iranica, 52(10), 734-739.NURS 6630 – Psychopharmacologic Approaches to Treatment of Psychopathology Essay Assignment

Retrieved from http://acta.tums.ac.ir/index.php/acta

Analyze ethical and legal implications related to prescribing bipolar therapy to clients across the lifespan ..

Learning Objectives
Students will:

Assess client factors and history to develop personalized plans of bipolar therapy for clients
Analyze factors that influence pharmacokinetic and pharmacodynamic processes in clients requiring bipolar therapy
Evaluate efficacy of treatment plans
To prepare for this Assignment:

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

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

At each decision point stop to complete the following:

Decision #1
Which decision did you select?
Why did you select this decision? Support your response with evidence and references to the Learning Resources.
What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.
Explain any difference between what you expected to achieve with Decision #1 and the results of the decision. Why were they different?
Decision #2
Why did you select this decision? Support your response with evidence and references to the Learning Resources.
What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.
Explain any difference between what you expected to achieve with Decision #2 and the results of the decision. Why were they different?
Decision #3
NURS 6630 – Psychopharmacologic Approaches to Treatment of Psychopathology Essay Assignment

Why did you select this decision? Support your response with evidence and references to the Learning Resources.
What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.
Explain any difference between what you expected to achieve with Decision #3 and the results of the decision. Why were they different?
Also include how ethical considerations might impact your treatment plan and communication with clients.

SAMPLE APPROACHES

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Assessing and Treatment for Bipolar Disorder Patient
IntroductionBipolar disorder is not an uncommon illness. It is a very chronic and severe mental disorder, affecting approximately 1-2% of the adult population. The signs and symptoms of bipolar disorder are different depending on the type of episode (i.e., manic or depressive). Each episode marks a critical change from the way a person usually acts and their typical mood, and can be characterized by a sudden change in the general attitude of the patient, the way the patient thinks and the behavior. 1 The changes will be sudden that it will be noticed by people around (Robert et al., 2017). This dangerous demonstrative unpredictability mood disorder can be found in all area of life, that is, from the poor to the rich, this disorder affects millions of people in all facets of life (Robert et al., 2017). Bipolar disorder can be seen mostly in the age starting at 25years or older, but it is not totally absent in the teenage age. It shows that about 2.6 percent of the population are diagnosed as bipolar. 3 (National Alliance on Mental Illness, 2017).Nurs 6630 week (1-11) Discussion and Assignments.

If not well treated ,Bipolar disorder can be critical; 1 early identification of symptoms with an appropriate treatment plan may include psychotherapy, medications, a healthy lifestyle and a regular schedule will keep the patient healthy (National Alliance on Mental Illness. (2017). 1 The NP should have a good understand of this disorder to be able to take care of this the patient because of its long-term management and how it affects the health in totality (National Alliance on Mental Illness. (2017). 1 My focus of this paper will look into an Asian American Woman with a bipolar disorder, symptoms management, diagnosing the symptom, and the complete treatment. The paper will consider the most safe and appropriate options of treatment and the outcome as the treatment, and care.

NURS 6630 Week 5 Assignment
Assignment: Assessing and Treating Clients With Anxiety Disorders

Common symptoms of anxiety disorders include chest pains, shortness of breath, and other physical symptoms that may be mistaken for a heart attack or other physical ailment. These manifestations often prompt clients to seek care from their primary care providers or emergency departments. Once it is determined that there is no organic basis for these symptoms, clients are typically referred to a psychiatric mental health practitioner for anxiolytic therapy. For this Assignment, as you examine the client case study in this week’s Learning Resources, consider how you might assess and treat clients presenting with anxiety disorders.

Assignment: Assessing and Treating Clients With Anxiety Disorders – NURS 6630 – Psychopharmacologic Approaches to Treatment of Psychopathology Essay Assignment.

Assignment: Assessing and Treating Clients With Anxiety Disorders Required Readings
Note: All Stahl resources can be accessed through the Walden Library using this link. This link will take you to a log-in page for the Walden Library. Once you log into the library, the Stahl website will appear.

Stahl, S. M. (2013). Stahl’s essential psychopharmacology: Neuroscientific basis and practical applications (4th ed.). New York, NY: Cambridge University Press. NURS 6630 Week 1 Discussion Discussion: Foundational Neuroscience

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

Chapter 9, “Anxiety Disorder and Anxiolytics”

Stahl, S. M., & Grady, M. (2010). Stahl’s illustrated anxiety, stress, and PTSD. New York, NY: Cambridge University Press.NURS 6630 – Psychopharmacologic Approaches to Treatment of Psychopathology Essay Assignment

To access the following chapters, click on the Illustrated Guides tab and then the Anxiety, Stress, and PTSD tab.

Chapter 4, “First-Line Medications for PTSD”

Chapter 5, “Second-Line, Adjunct, and Investigational Medications for PTSD”

Strawn, J. R., Wehry, A. M., DelBello, M. P., Rynn, M. A., & Strakowski, S. (2012). Establishing the neurobiologic basis of treatment in children and adolescents with generalized anxiety disorder. Depression and Anxiety, 29(4), 328–-339. doi:10.1002/da.21913

Note: Retrieved from Walden Library databases.

Hamilton, M. (1959). Hamilton Anxiety Rating Scale. Psyctests, doi:10.1037/t02824-0

Note: Retrieved from Walden Library databases.

Assignment: Assessing and Treating Clients With Anxiety Disorders Required Media

Laureate Education. (2016b). Case study: A middle-aged Caucasian man with anxiety [Interactive media file]. Baltimore, MD: Author.

Note: This case study will serve as the foundation for this week’s Assignment.

Assignment: Assessing and Treating Clients With Anxiety Disorders Optional Resources

Lupi, M., Martinotti, G., Acciavatti, T., Pettorruso, M., Brunetti, M., Santacroce, R., & … Di Giannantonio, M. (2014). Pharmacological treatments in gambling disorder: A qualitative review. Biomed Research International, 2014. doi:10.1155/2014/537306

To prepare for this Assignment:NURS 6630 – Psychopharmacologic Approaches to Treatment of Psychopathology Essay Assignment

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

The Assignment: Assessing and Treating Clients With Anxiety Disorders Assignment

Examine Case Study: A Middle-Aged Caucasian Man With Anxiety. You will be asked to make three decisions concerning the medication to prescribe to this client. Be sure to consider factors that might impact the client’s pharmacokinetic and pharmacodynamic processes.Nurs 6630 week (1-11) Discussion and Assignments.

At each decision point stop to complete the following:

Decision #1 NURS 6630 – Psychopharmacologic Approaches to Treatment of Psychopathology Essay Assignment
Which decision did you select?
Why did you select this decision? Support your response with evidence and references to the Learning Resources.
What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.
Explain any difference between what you expected to achieve with Decision #1 and the results of the decision. Why were they different?
Decision #2

Why did you select this decision? Support your response with evidence and references to the Learning Resources.
What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.
Explain any difference between what you expected to achieve with Decision #2 and the results of the decision. Why were they different?
Decision #3

Why did you select this decision? Support your response with evidence and references to the Learning Resources.
What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.Nurs 6630 week (1-11) Discussion and Assignments.
Explain any difference between what you expected to achieve with Decision #3 and the results of the decision. Why were they different?
Also include how ethical considerations might impact your treatment plan and communication with clients.

A Middle-Aged Caucasian Man with Anxiety
The case study is about a 46-year old white male who works as a welder. His primary care physician refers the man to psychiatry after a trip to the emergency room where he showed symptoms of a heart attack. The patient indicated instances of chest tightness, shortness of breath, and a feeling of impending doom. He has light hypertension but manages it with low sodium diet; he is also a little overweight. The possibility of myocardial infarction was ruled out in the emergency room, and the electrocardiogram did not reveal significant results. The client admits that he occasionally consumes 3-4 beers to counter work-related stress. The patient takes care of his aging parents and encounters stress at the workplace. The mental health exam reveals that the client is alert and oriented; however, he does not have any suicidal or homicidal thoughts. The psychiatric-mental health practitioner (PMHNP) administered the Hamilton Anxiety Rating Scale (HAM-A) and revealed a score of 26. The PMHNP diagnosed the client with generalized anxiety disorder. The PMHNP made three treatment decisions for the patient; the first was to apply Zoloft 50 mg po daily, start Imipramine 25 mg po BID, and useBuspirone.

NURS 6630 Week 6 Assignment
Assignment: Assessing and Treating Clients With Psychosis and Schizophrenia

NURS 6630 Week 6: Antipsychotic Therapy

According to the National Alliance on Mental Illness, approximately 100,000 people experience psychosis in the United States each year (NAMI, 2016). In practice, clients may present with delusions, hallucinations, disorganized thinking, disorganized or abnormal motor behavior, as well as other negative symptoms that can be disabling for these individuals. Not only are these symptoms one of the most challenging symptom clusters you will encounter, many are associated with other disorders such as depression, bipolar disorder, and disorders on the schizophrenia spectrum. As a psychiatric mental health nurse practitioner, you must understand the underlying neurobiology of these symptoms to select appropriate therapies and improve outcomes for clients.Nurs 6630 week (1-11) Discussion and Assignments.

This week, as you examine antipsychotic therapies, you explore the assessment and treatment of clients with psychosis and schizophrenia. You also consider ethical and legal implications of these therapies.

Assignment: Assessing and Treating Clients With Psychosis and Schizophrenia
Psychosis and schizophrenia greatly impact the brain’s normal processes, which interferes with the ability to think clearly. When symptoms of these disorders are uncontrolled, clients may struggle to function in daily life. However, clients often thrive when properly diagnosed and treated under the close supervision of a psychiatric mental health practitioner. For this Assignment, as you examine the client case study in this week’s Learning Resources, consider how you might assess and treat clients presenting with psychosis and schizophrenia.Assignment: Assessing and Treating Clients With Psychosis and Schizophrenia – NURS 6630 – Psychopharmacologic Approaches to Treatment of Psychopathology Essay Assignment.Nurs 6630 week (1-11) Discussion and Assignments.

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Assignment: Assessing and Treating Clients With Psychosis and Schizophrenia Learning Resources

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

Assignment: Assessing and Treating Clients With Psychosis and Schizophrenia Required Readings

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

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

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

Chapter 4, “Psychosis and Schizophrenia”

Chapter 5, “Antipsychotic Agents”

Stahl, S. M. (2014b)NURS 6630 – Psychopharmacologic Approaches to Treatment of Psychopathology Essay Assignment . The prescriber’s guide (5th ed.). New York, NY: Cambridge University Press.

To access information on the following medications, click on The Prescriber’s Guide, 5th ed tab on the Stahl Online website and select the appropriate medication. NURS 6630 Week 1 Discussion Discussion: Foundational Neuroscience. Naber, D., & Lambert, M. (2009). The CATIE and CUtLASS studies in schizophrenia: Results and implications for clinicians. CNS Drugs, 23(8), 649-659. doi:10.2165/00023210-200923080-00002

Note: Retrieved from Walden Library databases.

Document: Midterm Exam Study Guide (PDF)

Kay, S. R., Fiszbein, A., & Opler, L. A. (1987). The Positive and Negative Syndrome Scale (PANSS) for schizophrenia. Schizophrenia Bulletin, 13(2), 261-276.NURS 6630 – Psychopharmacologic Approaches to Treatment of Psychopathology Essay Assignment

Note: Retrieved from Walden Library databases.

Clozapine REMS. (2015). Clozapine REMS: The single shared system for clozapine. Retrieved from https://www.clozapinerems.com/CpmgClozapineUI/rems/pdf/resources/Clozapine_REMS_A_Guide_for_Healthcare_Providers.pdf

Walden University. (2016). ASC success strategies: Studying for and taking a test. Retrieved from http://academicguides.waldenu.edu/ASCsuccess/ASCtesting

Assignment: Assessing and Treating Clients With Psychosis and Schizophrenia Required Media

Laureate Education. (2016j). Case study: Pakistani woman with delusional thought processes [Interactive media file]. Baltimore, MD: Author

Note: This case study will serve as the foundation for this week’s Assignment.

Assignment: Assessing and Treating Clients With Psychosis and Schizophrenia Optional Resources

Chakos, M., Patel, J. K., Rosenheck, R., Glick, I. D., Hammer, M. B., Tapp, A., & … Miller, D. (2011). Concomitant psychotropic medication use during treatment of schizophrenia patients: Longitudinal results from the CATIE study. Clinical Schizophrenia & Related Psychoses, 5(3), 124-134. doi:10.3371/CSRP.5.3.2

Fangfang, S., Stock, E. M., Copeland, L. A., Zeber, J. E., Ahmedani, B. K., & Morissette, S. B. (2014). Polypharmacy with antipsychotic drugs in patients with schizophrenia: Trends in multiple health care systems. American Journal of Health-System Pharmacy, 71(9), 728-738. doi:10.2146/ajhp130471NURS 6630 – Psychopharmacologic Approaches to Treatment of Psychopathology Essay Assignment

Lin, L. A., Rosenheck, R., Sugar, C., & Zbrozek, A. (2015). Comparing antipsychotic treatments for schizophrenia: A health state approach. The Psychiatric Quarterly, 86(1), 107-121. doi:10.1007/s11126-014-9326-2

To prepare for this Assignment: Assessing and Treating Clients With Psychosis and Schizophrenia Assignment:

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

The Assignment: Assessing and Treating Clients With Psychosis and Schizophrenia Assignment
Examine Case Study: Pakistani Woman with Delusional Thought Processes. You will be asked to make three decisions concerning the medication to prescribe to this client. Be sure to consider factors that might impact the client’s pharmacokinetic and pharmacodynamic processes.

At each decision point stop to complete the following:
Decision #1

Which decision did you select?

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

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

Explain any difference between what you expected to achieve with Decision #1 and the results of the decision. Why were they different?

Decision #2

Why did you select this decision? Support your response with evidence and references to the Learning Resources.
What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.
Explain any difference between what you expected to achieve with Decision #2 and the results of the decision. Why were they different?Nurs 6630 week (1-11) Discussion and Assignments.
Decision #3

Why did you select this decision? Support your response with evidence and references to the Learning Resources.
What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.
Explain any difference between what you expected to achieve with Decision #3 and the results of the decision. Why were they different?
Decision Point One
https://mym.cdn.laureate-media.com/2dett4d/Walden/NURS/6630/06/mm/delusional_disorders/img/pill-blue.pngStart Invega Sustenna 234 mg intramuscular X1 followed by 156 mg intramuscular on day 4 and monthly thereafter

RESULTS OF DECISION POINT ONE

Client returns to clinic in four weeks
A decrease in PANSS score of 25% is noted at this visit
Client seems to be tolerating medication
Client’s husband has made sure she makes her appointments for injections (one thus far)
Client has noted a 2 pound weight gain but it does not seem to be an important point for her
Client complains of injection site pain telling the PMHNP that she has trouble siting for a few hours after the injections and doesn’t like having to walk around for such a long period of time
Decision Point Two
https://mym.cdn.laureate-media.com/2dett4d/Walden/NURS/6630/06/mm/delusional_disorders/img/pill-red.pngContinue same decision made but instruct administering nurse to begin injections into the deltoid at this visit and moving forward

RESULTS OF DECISION POINT TWO

Client returns to clinic in four weeks
Client’s PANNS has reduced by a total of 50% from the initiation of Invega sustenna
When questioned about injection site pain, client states it is much better in the arm
Client’s weight has increased by an additional 2.5 pounds (total of 4.5 pounds in a 2 month period). She is somewhat bothered by the weight gain and is afraid that her husband does not like it. He is not present at this visit as she brought herself
Client likes how she feels on the Invega Sustenna but is wondering if there is another drug like it that would not cause the weight gain
Decision Point Three
https://mym.cdn.laureate-media.com/2dett4d/Walden/NURS/6630/06/mm/delusional_disorders/img/pill-red.pngContinue with the Invega Sustenna. Counsel client on the fact that weight gain from Invega Sustenna is not as much as what other drugs with similar efficacy can cause. Make appointment with a dietician and an exercise physiologist. Follow up in one month

Guidance to Student

Weight gain can occur with Invega Sustenna. It is modest in nature and can be controlled with proper nutrition and exercise. It is always a good idea to try and control a client’s weight through consultation with a dietician and exercise physiologist (life coach) before switching to another agent when a product is showing efficacy for at least 6 months.

Abilify Maintena is a good option for someone who has good response to abilify oral. Remember that Abilify does not bind to the D2 receptor for a great period of time (such as Invega) and can be less affective in certain individuals. Also, remember that akathisia can be a possible side effect. Once an IM long acting medication is given, the effects of the drug (both efficacious and untoward effects) can be maintained for a long duration (up to a month or longer). Tolerability and efficacy should be established with oral medication first before administering the first injection. Also a disadvantage to Abilify Maintena is a 2-week overlap of oral therapy is required due to effective blood levels lagging behind the induction dose.Nurs 6630 week (1-11) Discussion and Assignments.

Qsymia is a weight loss medication that is a combination of Phenteramine and Topiramate. It is only indicated to treat obesity. This client’s BMI (28.9 kg/M2) does not fit the definition of obesity (BMI >30 Kg/M2- Following from CDC website: Class 1: BMI of 30 to < 35, Class 2: BMI of 35 to < 40, Class 3: BMI of 40 or higher. Class 3 obesity is sometimes categorized as “extreme” or “severe” obesity). There are two things wrong with this therapy option. First, there are only a few occasions where add-on therapy to treat a side effect is acceptable and weight gain is not one of those scenarios. Secondly, Phenteramine has a lot of cardiovascular toxicities (such as elevated BP, HR, increased workload on the heart).

NURS 6630 Week 7 Assignment
Assignment: Assessing and Treating Clients With Pain
Case Study: A Caucasian Man With Hip Pain

Pain can greatly influence an individual’s quality of life, as uncontrolled pain negatively impacts mood, concentration, and the overall physical and mental well-being of clients. Although pain can often be controlled with medications, the process of assessing and treating clients can be challenging because pain is such a subjective experience. Only the person experiencing the pain truly knows the intensity of the pain and whether there is a need for medication therapies. Sometimes, beliefs about pain and treatments for pain can have an adverse effect on the provider-client relationship. For this Assignment, as you examine the interactive case study consider how you might assess and treat clients presenting with pain.Case Study: A Caucasian Man With Hip Pain : NURS 6630 – Psychopharmacologic Approaches to Treatment of Psychopathology Essay Assignment.

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Case Study: A Caucasian Man With Hip Pain Required Readings
Note: All Stahl resources can be accessed through the Walden Library using this link. This link will take you to a log-in page for the Walden Library. Once you log into the library, the Stahl website will appear.

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

To access the following chapters, click on the Essential Psychopharmacology, 4th ed tab on the Stahl Online website and select the appropriate chapter. Be sure to read all sections on the left navigation bar for each chapter. NURS 6630 Week 1 Discussion Discussion: Foundational Neuroscience

Chapter 10, “Chronic Pain and Its Treatment”

Stahl, S. M., & Ball, S. (2009a). Stahl’s illustrated chronic pain and fibromyalgia. New York, NY: Cambridge University Press.NURS 6630 – Psychopharmacologic Approaches to Treatment of Psychopathology Essay Assignment

To access the following chapter, click on the Illustrated Guides tab and then the Chronic Pain and Fibromyalgia tab.

Chapter 5, “Pain Drugs”

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

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

Review the following medications:

 

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

Note: Retrieved from Walden Library databases.

National Institute of Neurological Disorders and Stroke. (2016). Pain: Hope through research. Retrieved from http://www.ninds.nih.gov/disorders/chronic_pain/detail_chronic_pain.htm#3084_2

Case Study: A Caucasian Man With Hip Pain Required Media

Laureate Education (2016a). Case study: A Caucasian man with hip pain [Interactive media file]. Baltimore, MD: Author

Note: This case study will serve as the foundation for this week’s Assignment.

To prepare for this Assignment:NURS 6630 – Psychopharmacologic Approaches to Treatment of Psychopathology Essay Assignment

Review this week’s Learning Resources. Consider how to assess and treat clients requiring therapy for pain and sleep/wake disorders.

The Case Study: A Caucasian Man With Hip Pain Assignment
Examine Case Study: A Caucasian Man With Hip Pain. You will be asked to make three decisions concerning the medication to prescribe to this client. Be sure to consider factors that might impact the client’s pharmacokinetic and pharmacodynamic processes.

At each decision point stop to complete the following:

Decision #1

Which decision did you select?
Why did you select this decision? Support your response with evidence and references to the Learning Resources.
What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.
Explain any difference between what you expected to achieve with Decision #1 and the results of the decision. Why were they different?
Decision #3
NURS 6630 – Psychopharmacologic Approaches to Treatment of Psychopathology- Case Study: A Caucasian Man With Hip Pain Essay Assignment

Why did you select this decision? Support your response with evidence and references to the Learning Resources.
What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.
Explain any difference between what you expected to achieve with Decision #3 and the results of the decision. Why were they different?
Decision #2

Why did you select this decision? Support your response with evidence and references to the Learning Resources.
What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.
Explain any difference between what you expected to achieve with Decision #2 and the results of the decision. Why were they different?
Also include how ethical considerations might impact your treatment plan and communication with clients.

NURS 6630 Week 10 Assignment
Assignment: Assessing and Treating Clients With Dementia
Case study: An elderly Iranian man with Alzheimer’s disease

The Alzheimer’s Association defines dementia as “a general term for a decline in mental ability severe enough to interfere with daily life” (Alzheimer’s Association, 2016). This term encompasses dozens of cognitive disorders of impaired memory formation, recall, and communication. The care and treatment of clients with dementia is dependent on multiple factors, including the stage of dementia, comorbidities, family support, and even the care setting. In your role, as the psychiatric mental health nurse practitioner, you must be prepared to not only treat clients with these various cognitive disorders, but also the multiple behavioral issues that often accompany them. For this Assignment, as you examine the client case study in this week’s Learning Resources, consider how you might assess and treat clients presenting with dementia. NURS 6630 – Psychopharmacologic Approaches to Treatment of Psychopathology Essay Assignment.

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Reference: Alzheimer’s Association. (2016). What is dementia? Retrieved from http://www.alz.org/what-is-dementia.aspCase study: An elderly Iranian man with Alzheimer’s disease Required Readings
Note: All Stahl resources can be accessed through the Walden Library using this link. This link will take you to a log-in page for the Walden Library. Once you log into the library, the Stahl website will appear.

Stahl, S. M. (2013). Stahl’s essential psychopharmacology: Neuroscientific basis and practical applications (4th ed.). New York, NY: Cambridge University Press.NURS 6630 – Psychopharmacologic Approaches to Treatment of Psychopathology Essay Assignment

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

Chapter 13, “Dementia and Its Treatment”

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

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

Review the following medications:

For insomnia

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

Note: Retrieved from from the Walden Library databases.

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

Case study: An elderly Iranian man with Alzheimer’s disease Required Media

Laureate Education. (2016h). Case study: An elderly Iranian man with Alzheimer’s disease [Interactive media file]. Baltimore, MD: Author.NURS 6630 – Psychopharmacologic Approaches to Treatment of Psychopathology Essay AssignmentNurs 6630 week (1-11) Discussion and Assignments.

Note: This case study will serve as the foundation for this week’s Assignment.

To prepare for this Assignment:

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

The Case study: An elderly Iranian man with Alzheimer’s disease Assignment
Examine Case Study: An Elderly Iranian Man With Alzheimer’s Disease. You will be asked to make three decisions concerning the medication to prescribe to this client. Be sure to consider factors that might impact the client’s pharmacokinetic and pharmacodynamic processes. NURS 6630 – Psychopharmacologic Approaches to Treatment of Psychopathology Essay Assignment

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At each decision point stop to complete the following:

Decision #1

Which decision did you select?
Why did you select this decision? Support your response with evidence and references to the Learning Resources.
What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.
Explain any difference between what you expected to achieve with Decision #1 and the results of the decision. Why were they different?Nurs 6630 week (1-11) Discussion and Assignments.
Decision #2

Why did you select this decision? Support your response with evidence and references to the Learning Resources.
What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.
Explain any difference between what you expected to achieve with Decision #2 and the results of the decision. Why were they different?
Decision #3

Why did you select this decision? Support your response with evidence and references to the Learning Resources.
What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.
Explain any difference between what you expected to achieve with Decision #3 and the results of the decision. Why were they different?
Also include how ethical considerations might impact your treatment plan and communication with clients.

NURS 6630 Week 11 Psychopharmacologic Approaches to Treatment of Psychopathology Syllabus
NURS 6630 – Psychopharmacologic Approaches to Treatment of Psychopathology

Syllabus
Student Support and Calendar Information
So you have all key information available to you off-line, it is highly recommended that you print the following items for your reference:

This Syllabus, including the Course Schedule that is linked on this page as a PDF
Course Calendar
Student Support
Credit Hours

11 weeks
Walden University assigns credit hours based on the number and type of assignments that enable students to achieve the course learning objectives. In general, each semester credit equals about 42 hours of total student work and each quarter credit equals about 28 hours of total student work. This time requirement represents an approximate average for undergraduate work and the minimum expectations for graduate work. The number and kind of activities estimated to fulfill time requirements will vary by degree level and student learning style and by student familiarity with the delivery method and course content.

Course Description
At times, psychotherapy is not enough to alleviate the emotional difficulties that some patients face. To that end, psychopharmacologic approaches are needed. Psychiatric mental health nurse practitioners (PMHNPs) must have a strong basis in psychopharmacology, extending from a prior education in pharmacology, to make appropriate medication choices for their patients. Learners in this course consider psychopharmacologic approaches to major mental health disorders including but not limited to major depressive disorders, bipolar disorder, anxiety disorders, as well as psychotic disorders. Learners explore key considerations associated with medication selection, monitoring of efficacy, and long-term management. NURS 6630 – Psychopharmacologic Approaches to Treatment of Psychopathology

Course Prerequisites
PMHNP Program Core Coures & NURS-6521

Course Outcomes
By the end of this course, students will:

Evaluate foundational neuroscience as it relates to caring for clients with psychiatric disorders across the lifespan
Assess mechanisms of action of medications used to treat a variety of psychiatric conditions
Compare evidence-based practices to select appropriate psychopharmacologic agents
Synthesize pathophysiology and health assessment concepts in the psychopharmacologic treatment of psychiatric mental health disorders
Evaluate ethical and legal implications of prescribing psychotropic medications across the lifespan
Evaluate the efficacy and adverse reactions of psychotropic medications
Recommend strategies to become a social change agent for individuals with psychiatric mental health issues
Click on the following link to view the Outcomes/Alignment map for NURS 6630:Nurs 6630 week (1-11) Discussion and Assignments. NURS 6630 Week 1 Discussion Discussion: Foundational Neuroscience