Risk management

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Week 9 _ PRESCRIBING FOR OLDER ADULTS AND PREGNANT WOMEN

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Week 9 _ PRESCRIBING FOR OLDER ADULTS AND PREGNANT WOMEN

**THIS DISCUSSION IS DIVIDE IN TWO PARTS –

 

  1. MAIN DISCUSSION POST BY WEDNESDAY 01/25/2023 BEFORE 8:00 PM EST
  2. TWO REPLIES BY FRIDAY 01/27/2023 BEFORE 8:00 PM EST

PRESCRIBING FOR OLDER ADULTS AND PREGNANT WOMEN

 

After assessing and diagnosing a patient, PMHNPs must take into consideration special characteristics of the patient before determining an appropriate course of treatment. For pharmacological treatments that are not FDA-approved for a particular use or population, off-label use may be considered when the potential benefits could outweigh the risks.

In this Discussion, you will investigate a specific disorder and determine potential appropriate treatments for when it occurs in an older adult or pregnant woman.

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TO PREPARE:

  • Choose one of the two following specific populations: either pregnant women or older adults. Then, select a specific disorder from the DSM-5-TR to use.
  • Research evidence-based treatments for your selected disorder in your selected population (either older adults or pregnant women). You will need to recommend one FDA-approved drug, one non-FDA-approved “off-label” drug, and one non-pharmacological intervention for treating the disorder in that population. Week 9 _ PRESCRIBING FOR OLDER ADULTS AND PREGNANT WOMEN

Instructions

  • Recommend one FDA-approved drug, one off-label drug, and one non-pharmacological intervention for treating your chosen disorder in older adults or pregnant women.
  • Explain the risk assessment you would use to inform your treatment decision making. What are the risks and benefits of the FDA-approved medicine? What are the risks and benefits of the off-label drug?
  • Explain whether clinical practice guidelines exist for this disorder, and if so, use them to justify your recommendations. If not, explain what information you would need to take into consideration.
  • Support your reasoning with at least three current, credible scholarly resources, one each on the FDA-approved drug, the off-label, and a non-pharmacological intervention for the disorder.

Weekly Resources

 

Chest Pain Assignment

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Chest Pain Assignment

CP is a 64-year-old male who presents to the emergency department (ED) via ambulance for chest pain. He was out shoveling snow from his driveway when he developed left anterior chest pain, pressure-type, radiating to his jaw and shoulder. Despite the cold weather, he was sweating. He also noted palpitations and shortness of breath, although he thought it was just because he was “a little out of shape.” He was afraid that something was wrong, so he asked his wife to call 911.  Chest Pain Assignment

Past Medical History

• Hypertension

• Hyperlipidemia

• Diabetes mellitus

• Gout Medications

• Hydrochlorothiazide, 25 mg once daily

• Allopurinol, 300 mg once daily

Social History

• Retired factory worker

• Smokes one pack of cigarettes per day

• Drinks about six beers per day (sometimes more)

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Physical Examination

• Well-developed obese man in moderate distress

• Height: 69 inches; weight: 252 lbs.; blood pressure: 172/110; pulse: 92; respiration rate: 16; temperature: 98.7 °F

• Lungs: Scattered bilateral wheezes

• Heart: Regular with grade II/VI systolic murmur

• Extremities: No edema

Labs and Imaging

• Complete blood count with mild leukocytosis (WBC 12.9k)

• Potassium: Low at 2.9 mEq/L

• Glucose: 252 mg/dL

• Troponin I: 1.7 ng/L

• Uric acid: 11.1 mg/dL

• EKG: ST segment depression with T-wave inversion over lateral leads; no pathologic Q waves Next Steps

• CP’s admitting diagnoses are non-ST segment elevation acute coronary syndrome, hypertension, diabetes mellitus, obesity, alcohol abuse, hyperuricemia, and smoker

Discussion Questions

1. What medications should be instituted for CP?

2. What medications should be continued after discharge?

3. What lifestyle modifications can be recommended for CP?

PLEASE ANSWER THE 3 QUESTIONS ABOVE, AFTER DEVELOPING THE ANSWER CREATE A RATIONALE FOR EACH QUESTION

NO PLAGIO MORE THAN 10 %

2 REFERENCES NO OLDER THAN 5 YEARS. Chest Pain Assignment

Population-Focused Nurse Practitioner Competencies

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Population-Focused Nurse Practitioner Competencies

  • Refer to the “Population-Focused Nurse Practitioner Competencies” found in the Week 1 Learning Resources and consider the quality measures or indicators advanced nursing practice nurses must possess in your specialty of interest.
  • Refer to your “Clinical Skills Self-Assessment Form” you submitted in Week 1 and consider your strengths and opportunities for improvement. Population-Focused Nurse Practitioner Competencies
  • Refer to your Patient Log in Meditrek and consider the patient activities you have experienced in your practicum experience and reflect on your observations and experiences.

In 450–500 words, address the following:

Learning From Experiences 

  • Revisit the goals and objectives from your Practicum Experience Plan. Explain the degree to which you achieved each during the practicum experience.
  • Reflect on the three most challenging patients you encountered during the practicum experience. What was most challenging about each?
  • What did you learn from this experience?
  • What resources were available?
  • What evidence-based practice did you use for the patients?
  • What would you do differently?
  • How are you managing patient flow and volume?

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Communicating and Feedback 

  • Reflect on how you might improve your skills and knowledge and how to communicate those efforts to your Preceptor.
  • Answer the questions: How am I doing? What is missing?
  • Reflect on the formal and informal feedback you received from your Preceptor.  Population-Focused Nurse Practitioner Competencies

BY DAY 7

Submit your Journal.

SUBMISSION INFORMATION

Before submitting your final assignment, you can check your draft for authenticity. To check your draft, access the Turnitin Drafts from the Start Here area.

  1. To submit your completed assignment, save your Assignment as WK11Assgn+last name+first initial.
  2. Then, click on Start Assignment near the top of the page.
  3. Next, click on Upload File and select Submit Assignment for review. Population-Focused Nurse Practitioner Competencies

Nursing homework help

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Review the case study and answer the following questions.

Case Study: You are called to a postpartum room and find Michael, a two-hour-old infant, irritable and spitting up copious amounts of formula. You do not know the maternal history, so you advise the mother that you would like to return the baby to the nursery for assessment and monitoring. In the medical record, you focus on the prenatal history and find the mother had an addiction to opioids with her last pregnancy but denied drug use with this pregnancy. You witness the baby having some significant tremors, vital signs: T (axillary) – 36.0, RR- 78, HR- 166, and the infant is alert, irritable, and does not console easily. The infant is constantly moving and sucking vigorously on the pacifier.

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  • What do you think is occurring with the infant?
  • What lab test can be ordered to confirm your suspected diagnosis?
  • What interventions can be implemented to treat this infant? Nursing homework help

Transmission Based Precautions

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Transmission Based Precautions

Pandemic Precaution

Study the new requirements set up by CDC following the current COVID pandemic guidelines for healthcare workers. Watch the video provided by Medscape to learn about donning and doffing requirements for viral hemorrhagic and biohazard diseases. Post a discussion about the topic afterward. Transmission Based Precautions

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Include the following in your points in your discussion.

  1. The differences in the requirements for transmission based precaution and the requirements for those who are suspected to have or who have a pandemic disease such as SARS COVID 19.
  2. The difference in the guidelines for donning and doffing PPE procedures as well as patient care and time management.
  3. What you believe these changes have made to healthcare and may make in the future.

 

Include ample information, the post should be about 3-5 sentences. Cite any references you used to research your topic. Transmission Based Precautions

CONTROVERSY ASSOCIATED WITH DISSOCIATIVE DISORDERS

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CONTROVERSY ASSOCIATED WITH DISSOCIATIVE DISORDERS

CONTROVERSY ASSOCIATED WITH DISSOCIATIVE DISORDERS

The DSM-5-TR is a diagnostic tool. It has evolved over the decades, as have the classifications and criteria within its pages. It is used not just for diagnosis, however, but also for billing, access to services, and legal cases. Not all practitioners are in agreement with the content and structure of the DSM-5-TR, and dissociative disorders are one such area. These disorders can be difficult to distinguish and diagnose. There is also controversy in the field over the legitimacy of certain dissociative disorders, such as dissociative identity disorder, which was formerly called multiple personality disorder. CONTROVERSY ASSOCIATED WITH DISSOCIATIVE DISORDERS

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In this Assignment, you will examine the controversy surrounding dissociative disorders. You will also explore clinical, ethical, and legal considerations pertinent to working with patients with these disorders.

 

 

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  • Sadock, B. J., Sadock, V. A., & Ruiz, P. (2015). Kaplan & Sadock’s synopsis of psychiatry(11th ed.). Wolters Kluwer.
    • Chapter 12, “Dissociative Disorders”

 

Use the Library to investigate the controversy regarding dissociative disorders. Locate at least three scholarly articles that you can use to support your Assignment.

THE ASSIGNMENT (2–3 PAGES)

  • Explain the controversy that surrounds dissociative disorders.
  • Explain your professional beliefs about dissociative disorders, supporting your rationale with at least three scholarly references from the literature.
  • Explain strategies for maintaining the therapeutic relationship with a client that may present with a dissociative disorder.
  • Finally, explain ethical and legal considerations related to dissociative disorders that you need to bring to your practice and why they are important.

Rubric

This criterion is linked to a Learning Outcome In 2–3 pages, address the following:• Explain the controversy that surrounds dissociative disorders.

Explain your professional beliefs about dissociative disorders, supporting your rationale with at least three scholarly references from the literature.

Explain strategies for maintaining the therapeutic relationship with a client that may present with a dissociative disorder.

This criterion is linked to a Learning Outcome• Finally, explain ethical and legal considerations related to dissociative disorders that you need to bring to your practice and why they are important. CONTROVERSY ASSOCIATED WITH DISSOCIATIVE DISORDERS

Successful Nurse Communication: Safe Care, Healthy Workplaces, & Rewarding Careers

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Successful Nurse Communication: Safe Care, Healthy Workplaces, & Rewarding Careers

Read

Instructions

The readings for this module include chapters from Successful Nurse Communication: Safe Care, Healthy Workplaces, & Rewarding Careers.

Before navigating to the ebook, download the reading resources by selecting the arrow next to the resource link. When you are ready to begin your readings, select “Next” to go to the next page to launch the ebook in a new window. Select “View” to see all of the chapters. Locate your assigned reading and select “View eBook” to navigate to the chapter.

When you have completed your readings, close the window and select “Next” to go to the next activity.

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Overview

Listening is a key component of the communication cycle. Throughout this module, you will learn to effectively listen, collaborate as a team member, and promote client safety.

Focus Questions:

  1. Are you an active listener, or do you listen to respond?
  2. What is your role in the team?
  3. How does your communication style impact the team dynamic? Successful Nurse Communication: Safe Care, Healthy Workplaces, & Rewarding Careers

Reading Resources

Citation

Boynton, B. (2016). Successful nurse communication: Safe care, healthy workplaces, & rewarding careers. F. A. Davis Company. Successful Nurse Communication: Safe Care, Healthy Workplaces, & Rewarding Careers

Nursing homework help

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Case Study: Mark

Instructions

Read the case study provided and answer the questions in a Microsoft Word document. Each response should be a minimum of 5 sentences in length, clear and concise, and use correct grammar. Nursing homework help

Case Study

Meet Mark.

Mark is excited to begin training as an emergency department nurse. On his first day, the nurse training him makes multiple negative remarks about the physician on duty. “Don’t ever make a suggestion, or she’ll ream you out. You have to walk on eggshells around her.” Later, another nurse is showing Mark where the supplies are kept. She tells him, “If you can’t find things, don’t call Central Supply because they’ll get on your back about wasting resources. It’s better to keep a few key things like IV start kits hidden so you can grab them when you need them.”

Three emergency department nurses standing next to a patient bed

Toward the end of his shift, a nurse assistant tells Mark a patient is vomiting violently in one of the examination rooms. However, Mark walks in to find the patient sitting up smiling, and only a small amount of emesis in the basin. He hears muffled laughter coming from the hallway. Later in the shift, the nurse who is training Mark comments, “Hope you don’t mind a little kidding around. This job can get to you, and it’s good to laugh when we can.”

The remainder of his training is free of other incidents and, overall, goes well.

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Case Study Questions

  1. What kind of culture best describes this department based on the scenario? Support your reasoning.
  2. What appears to be the implicit rules of the emergency department of this organization?
  3. Mark used respectful communication to optimize his relationships with the Central Supply staff, the nurse assistants, and the nurse training him. What barriers might exist in building respectful dialogue?
  4. In what ways are you like Mark? In what ways are you different? Nursing homework help

Submission and Assessment Guidelines

  • Submit your Microsoft Word document with the questions clearly listed and answered. All of the questions MUST be answered in your document.
  • It is expected that your answers are free of grammatical errors and in complete sentences, where appropriate.
  • This activity will be submitted via Turnitin. For instructions on how to view this rubric, review Viewing Rubrics in Canvas on Turnitin Assignments Download Viewing Rubrics in Canvas on Turnitin Assignments.
  • Review the Case Study Rubric for grading criteria.
  • This activity is worth 100 points. Nursing homework help

 

Healthcare Information Case Study

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 Healthcare Information Case Study

Hermit’s Pediatrics is a small practice serving the health care needs of children in a small, rural community. The practice has always used paper health records. However, the practice founder, Dr. Melody Hermit, learns that under the American Recovery and Reinvestment Act (ARRA) of 2009, the Centers for Medicare and Medicaid Services (CMS) is offering significant incentives to eligible healthcare professionals who effectively adopt electronic health records (EHR). She sees an opportunity to move into the electronic age. Healthcare Information Case Study

It takes some time for Dr. Hermit and her staff to get accustomed to using the EHR instead of the paper record, but they quickly see some real advantages. Information in the EHR is always easy to find and is well-organized. Things are going smoothly until one morning when Dr. Hermit and her staff discover that all of their patient records are gone from the EHR. Inadvertently, the system upgrade that was rolled out the night before has overwritten the storage partition containing the records. Luckily, the records had been backed up just before the wipe-out, and are eventually reloaded within a few hours.

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Several months later, Dr. Hermit receives an irate phone call from a patient’s mother whose child has been diagnosed with sickle cell disease. The mother’s anger is triggered when a neighbor expresses her sympathy, although the mother has not discussed the diagnosis with anyone. Dr. Hermit questions her staff and learns that the receptionist discussed the child’s diagnosis with the mother’s neighbor after checking his medical records. Dr. Hermit is astounded that the receptionist could even view the patient information, particularly given that the EHR is supposed to be HIPAA compliant according to Planet, the software developer. She is equally surprised when she walks into the reception area only to witness that another patient’s record is in full-sight of those waiting for their appointment. To top Dr. Hermit’s frustration, the Planet software server suffers a malicious software attack. As a consequence, the EHRs of many patients have been compromised, and many others might have been made vulnerable.

Dr. Hermit is now rethinking her decision to adopt an EHR to qualify for the incentive payment after all. The clinic may be better off using paper records until she retires.

Case Study Questions

1. Hermit’s Pediatrics has experienced risks to information confidentiality, data integrity, service availability, and the business itself. Identify the consequences, the vulnerabilities exploited, and the ways these risks could have been mitigated.

2. What are some of the risks that are not addressed by HIPAA, but an EHR software subscriber may need to consider? CITE IN APA AND PLEASE ANSWER. Healthcare Information Case Study