The comprehensive integrated psychiatric assessment of a child or adolescent consists of gathering information from not only the child but from several sources, most notably the family members, caregivers, and the child’s teacher or school counselor.

Because of this, the diagnostic assessment becomes more complicated. Issues of confidentiality, privacy, and consent must be addressed. Also, the PMHNP must take into consideration the impact of culture on the child.

In this Discussion, you review and critique the techniques and methods of a mental health professional as he or she completes a comprehensive integrated psychiatric assessment of an adolescent.

                                               To Prepare for the Assignment:

· Review the Learning Resources concerning the comprehensive integrated psychiatric assessment.

· Watch the Mental Status Examination video Comprehensive Integrated Psychiatric Assessment.

· Watch the two YMH Bostonvideos.

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                                                           Assignment 

Based on the YMH Boston Vignette 4 video, post answers to the following questions:

· What did the practitioner do well?

· In what areas can the practitioner improve?

· At this point in the clinical interview, do you have any compelling concerns? If so, what are they?

· What would be your next question, and why?

PLEASE, INCLUDE INTRODUCTION, CONCLUSION, 3 OR MORE REFERENCES LESS THAN 5 YEARS OLD, AND ANSWER ALL THE QUESTIONS AS INSTRUCTED

                                                Learning Resources

Required Readings

Sadock, B. J., Sadock, V. A., & Ruiz, P. (2014). Kaplan & Sadock’s synopsis of psychiatry: Behavioral sciences/clinical psychiatry (11th ed.). Philadelphia, PA: Wolters Kluwer.

• Chapter 5, “Examination and      Diagnosis of the Psychiatric Patient” (pp. 192–289)
• Chapter 31, “Child Psychiatry” (pp. 1082–1107)

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

• “Introduction”
• “Use of the Manual”
• “Cultural Formulation”

Kaplan, C. (2017). Ethical dilemmas. Advanced Healthcare Network. Retrieved from http://nurse-practitioners-and-physician-assistants.advanceweb.com/Article/Ethical-Dilemmas-2.aspx

Pumariega, A. J., Rothe, E., Mian, A., Carlisle, L., Toppelberg, C., Harris, T., . . .  Smith, J. (2013). Practice parameter for cultural competence in child and adolescent psychiatric practice. Journal of the American Academy of Child & Adolescent Psychiatry, 52(10), 1101–1115. Retrieved from http://www.jaacap.com/article/S0890-8567(13)00479-6/pdf

American Academy of Child & Adolescent Psychiatry (AACAP). (2012a). Practice parameter for psychodynamic psychotherapy with children. Journal of the American Academy of Child & Adolescent Psychiatry, 51(5), 541–557. Retrieved from http://www.jaacap.com/article/S0890-8567(12)00141-4/pdf

American Psychological Association. (2017). Code of Ethics. Retrieved from http://www.apa.org/ethics/code/ Comprehensive Integrated Psychiatric Assessment

Instructions

This assignment has two parts, numbered below. Write each question as a new topic area, then follow with a paragraph or two to answer the question. You may find it necessary to search for answers to the questions outside of the assigned reading. Be sure to use APA guidelines for writing style, spelling and grammar, and citation of sources.

Tasks:

1. Imagine that you are going to make a visit to your representative in Congress. Develop a one-page document that supports your position on the AHCA that you would leave with your representative or his or her aide when you make your visit. This one-pager, also called a “leave behind,” should state your position clearly in bullet points and give your reasons why your position is preferred. This “leave behind” should have 1 inch margins and utilize 14-point font throughout. If you were making this visit in person, you would present your “leave behind” to the person with whom you speak during your visit. Include a second page that describes your rationale for the position in your “leave behind” page supported by at least two journal articles. Becoming a Grassroots Advocate
2. Write a two-page brief to describe the scenario surrounding your legislative visit. Understanding the political affiliation of your representative, include answers to the following: 
   • Was your member in support or in opposition to the AHCA?
   • State three points that you would cover in support or opposition to your representative’s position.
   • How does your nursing experience influence the advocacy position that you take on the AHCA?

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Submission Details:

• Submit your response in a 4-page Microsoft Word document.
• Name your document SU_NSG4068_W3_Project_LastName_FirstInitial.doc.
• Submit your document to the Submissions Area by the due date assigned.
• Cite sources in the APA format on a separate page. Becoming a Grassroots Advocate

Consider the ethical dilemma the health care professional faces in the selected case study. Pay particular attention to details that will help you analyze the situation using the three components of the Ethical Decision Making Model (moral awareness, moral judgment, and ethical behavior).

Note: The case study may not supply all of the information you may need for the assignment. In such cases, you should consider a variety of possibilities and infer potential conclusions. However, please be sure to identify any speculations that you make. Ethical Case Studies

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Open and Close Icon Reducing Hospital Readmissions

Caleb Powell was preparing the agenda for the upcoming executive leadership meeting and he shook his head ruefully. As chief executive officer for Virginia County Regional Hospital (VCRH), Caleb believes that a key piece of VCRH’s future success lies in reducing readmission rates, not only in the areas identified by federal guidelines, but across the board.

A few weeks ago, he read a piece from the National Institutes of Health discussing strategies associated with reduction in readmission rates. He decided that he wanted to discuss the issue in detail with his leadership team.

Caleb’s goal is to align the hospital’s strategic planning with the goal of reducing readmissions. The stakes are high; under provisions of the Affordable Care Act, hospitals with higher than expected 30 day readmission rates for heart failure, heart attack and pneumonia are penalized with reduced payments.

Historically, hospitals (including VCRH) have struggled to avoid the penalties, but Caleb believes that believes that a focused approach will allow them to be successful. He also believes that reducing readmission rates will improve patient satisfaction, which has become a key metric in measuring hospital quality.

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Caleb’s initial research into this issue revealed that while many facilities were incurring the Centers for Medicare and Medicaid Services (CMS) penalties, there was still significant variability in terms of hospitals implementing successful strategies for reducing their readmission rates. However, several themes have emerged.

Hospitals that established partnerships with physicians, physician groups and other local hospitals have had greater success. In addition, a clear discharge planning process and nurse driven medication reconciliation have also been associated with reducing the risk of readmissions.

At the same time, Caleb is concerned that an aggressive policy to avoid readmissions could be construed as too focused on the hospital’s bottom line and indifferent to patient needs.

The last thing he wants is to create a policy that prevents patients from seeking or receiving care. Caleb hopes that this meeting will begin a productive discussion around developing strategies to improve VCRH’s performance in this area. Ethical Case Studies

Caleb’s email to the executive leadership team with the agenda for the meeting included the following note:

“As we research the readmission rate issue for improvement, we need to be aware that we cannot add additional days to the patient’s initial stay. It’s a balancing act. We also cannot hinder a patient from coming back into the hospital for a readmission. I’ll be asking for your input about whether we should create a system to profile health care providers whose patients have high readmission rates.”

Develop a solution to a specific ethical dilemma faced by a health care professional by applying ethical principles. Describe the issues and a possible solution in a 3-5 page paper.

For this assessment, you will develop a solution to a specific ethical dilemma faced by a health care professional. Read each portion of the assessment carefully and use the suggested resources to help you complete the assessment. This assessment provides an opportunity to consider ethical principles and how they can be applied in health care situations.

Note: The requirements outlined below correspond to the grading criteria in the scoring guide. At a minimum, be sure to address each point. In addition, you are encouraged to review the performance level descriptions for each criterion to see how your work will be assessed.

For this assessment, you will develop a solution to a specific ethical dilemma faced by a health care professional. In your assessment:

1. Access the Ethical Case Studies media piece linked in the Resources to review the case studies you may use for this assessment and select the case most closely related to your area of interest and use that case study to complete the assessment.
   • Note: The case study may not supply all of the information you may need. In such cases, you should consider a variety of possibilities and infer potential conclusions. However, please be sure to identify any assumptions or speculations you make.
2. Identify which case study you selected, briefly summarize the facts surrounding the case study, and identify the problem or issue in the case study that presents an ethical dilemma or challenge and describe that dilemma or challenge.
   • Use the three components of the ethical decision-making model (moral awareness, moral judgment, and ethical behavior) found in the Ethical Decision-Making Model media piece in the Resources to analyze the ethical issues.
3. Analyze the factors that contributed to the problem or issue.
   • Identify who is involved or affected by the problem or issue.
   • Describe the factors that contributed to the problem or issue and explain how they contributed.
   • In addition to the readings provided, use the Capella library to locate at least one academic peer-reviewed journal article relevant to the problem or issue that you can use to support your analysis of the situation.
     • Cite and apply the journal article as evidence to support your critical thinking and analysis of the case.
     • Assess the credibility of the information source.
     • Assess the relevance of the information source.
4. Discuss the effectiveness of the communication approaches present in the case study.
   • Describe how the health care professional communicated with others.
   • Describe the communication and communication strategies that were applied, both in creating and in resolving the problems or issues presented.
   • Assess instances where the professional communicated effectively or ineffectively.
5. Discuss the effectiveness of the approach used by the professional related to any problems or issues involving ethical practice in the case.
   • Describe the actions taken in response to the ethical dilemma or challenge presented in the case study.
   • Summarize how well the professional managed professional responsibilities and priorities to resolve the problem or issue in the case Ethical Case Studies.
   • Discuss the key lessons this case provides for health care professionals.
6. Apply ethical principles to a possible solution to the proposed problem or issue from the case study.
   • Describe the proposed solution.
   • Discuss how the approach makes this professional more effective or less effective in building relationships across disciplines within his or her organization.
   • Discuss how likely it is the proposed solution will foster professional collaboration.
7. Write clearly and logically, with correct use of spelling, grammar, punctuation, and mechanics.
   • Determine the proper application of the rules of grammar and mechanics.
8. Write using APA style for in-text citations, quotes, and references.
   • Determine the proper application of APA formatting requirements and scholarly writing standards.
   • Apply the principles of effective composition.
   • Integrate information from outside sources into academic writing by appropriately quoting, paraphrasing, and summarizing, following APA style.

Example Assessment: You may use the assessment example, linked in the Assessment Example section of the Resources, to give you an idea of what a Proficient or higher rating on the scoring guide would look like.

Additional Requirements

1. Length: At least 3–5 typed, double-spaced pages, not including the title page and reference page.
2. Font and font size: Times New Roman, 12 point.
3. APA Template: Use the APA Style Paper Template as the paper format and the APA Style Paper Tutorial for guidance. See the Resources for these documents.
4. Written communication: Write clearly and logically, with correct use of spelling, grammar, punctuation, and mechanics.
5. References: Integrate information from outside sources to include at least two references (the case study and an academic peer-reviewed journal article) and three in-text citations within the paper.
6. APA format: Follow current APA guidelines for in-text citation of outside sources in the body of your paper and also on the reference page.
7. Turnitin: Submit your assessment to Turnitin prior to grading. Then, only submit your final assessment to faculty for grading.

Note: Read the Applying Ethical Principles Scoring Guide to fully understand how your paper will be graded.

Submit your paper for evaluation by clicking on the assessment title and uploading the paper as a Word document.

If you would like assistance in organizing your assessment, or if you simply have a question about your assessment, please do not hesitate to ask your courseroom instructor or the teaching assistants in the NHS Learner Success Lab for guidance and suggestions.

Ethics for Health Care

• American College of Healthcare Executives. (2016). ACHE code of ethics. Retrieved from https://www.ache.org/abt_ache/code.cfm
• American Nurses Association. (n.d.). Ethics topics and articles. Retrieved from http://www.nursingworld.org/MainMenuCategories/EthicsStandards/Resources
• Centers for Disease Control and Prevention. (2017). Public health ethics resources. Retrieved from https://www.cdc.gov/od/science/integrity/phethics/resources.htm
• Levitt, D. (2014). Ethical decision-making in a caring environment: The four principles and LEADS. Healthcare Management Forum, 27(2), 105–107.
• Levitt-Rosenthal, N. (2013). Ethics, values, and decision making. Frontiers of Health Services Management, 30(1), 27–32.
• Mahoney, J. S., Mulder, C., Hardesty, S., & Madan, A. (2017). Integrating caring into patient-centered care through interprofessional education and ethics: The Caring Project. Bulletin of the Menninger Clinic, 81(3), 233–246.
• Maintaining Academic Honesty Ethical Case Studies

Students will:

· Develop effective documentation skills for group therapy sessions *

· Develop diagnoses for clients receiving group psychotherapy *

· Evaluate the efficacy of cognitive behavioral therapy for groups *

· Analyze legal and ethical implications of counseling clients with psychiatric 

 disorders *

                                                           ASSIGNMENT 

Select two clients you observed or counseled this week during a group therapy session. Note: The two clients you select must have attended the same group session. Mental Health Practicum

                  Then, in your Practicum Journal, address the following:

· Using the Group Therapy Progress Note in this week’s Learning Resources, 

  document the group session.

· Describe each client (without violating HIPAA regulations), and identify any  

   pertinent history or medical information, including prescribed medications.

· Using the DSM-5, explain and justify your diagnosis for each client.

· Explain whether cognitive behavioral therapy would be effective with this group. 

  Include expected outcomes based on this therapeutic approach.

· Explain any legal and/or ethical implications related to counseling each client.

· Support your approach with evidence-based literature.

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                                                   Learning Resources

Required Readings

Yalom, I. D., & Leszcz, M. (2005). The theory and practice of group psychotherapy (5th ed.). New York, NY: Basic Books.

• Chapter      11, “In the Beginning” (pp. 309–344)

Yalom, I. D., & Leszcz, M. (2005). The theory and practice of group psychotherapy (5th ed.). New York, NY: Basic Books.

• Chapter      12, “The Advanced Group” (pp. 345–390)

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

Bjornsson, A. S., Bidwell, L. C., Brosse, A. L., Carey, G., Hauser, M., Mackiewicz Seghete, K. L., … Craighead, W. E. (2011). Cognitive-behavioral group therapy versus group psychotherapy for social anxiety disorder among college students: A randomized controlled trial. Depression and Anxiety, 28(11), 1034–1042. doi:10.1002/da.20877

Safak, Y., Karadere, M. E., Ozdel, K., Ozcan, T., Türkçapar, M. H., Kuru, E., & Yücens, B. (2014). The effectiveness of cognitive behavioral group psychotherapy for obsessive-compulsive disorder. Turkish Journal of Psychiatry, 25(4), 225–233. Retrieved from http://www.turkpsikiyatri.com/Mental Health Practicum

Document: Group Therapy Progress Note (SEE ATTACHED PROGRESS NOTE)

Consider the following case study:

Patient AO has a history of obesity and has recently gained 9 pounds. The patient has been diagnosed with hypertension and hyperlipidemia. Drugs currently prescribed include the following:

· Atenolol 12.5 mg daily

· Doxazosin 8 mg daily

· Hydralazine 10 mg qid

· Sertraline 25 mg daily

· Simvastatin 80 mg daily PHARMACOTHERAPHY FOR CARDIOVASCULAR DISORDERS

To prepare:

• Review      this week’s media presentation on hypertension and hyperlipidemia, as well      as Chapters 19 and 20 of the Arcangelo and Peterson text.
• Select      one one the following factors: genetics, gender, ethnicity, age, or      behavior factors.
• Reflect      on how the factor you selected might influence the patient’s      pharmacokinetic and pharmacodynamic processes.
• Consider      how changes in the pharmacokinetic and pharmacodynamic processes might      impact the patient’s recommended drug therapy.
• Think      about how you might improve the patient’s drug therapy plan based on the      pharmacokinetic and pharmacodynamic changes. Reflect on whether you would      modify the current drug treatment or provide an alternative treatment      option for the patient.

With these thoughts in mind:

Post an explanation of how the factor you selected might influence the pharmacokinetic and pharmacodynamic processes in the patient from the case study. Then, describe how changes in the processes might impact the patient’s recommended drug therapy. Finally, explain how you might improve the patient’s drug therapy plan.

– This work should have Introduction and conclusion

– This work should have at 3 to 5current references (Year 2012 and up)

– Use at least 2 references from class Learning Resources PHARMACOTHERAPHY FOR CARDIOVASCULAR DISORDERS

The following Resources are not acceptable:

1. Wikipedia

2. Cdc.gov- nonhealthcare professionals section

3. Webmd.com

4. Mayoclinic.com

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Required Readings

**Arcangelo, V. P., Peterson, A. M., Wilbur, V., & Reinhold, J. A. (Eds.). (2017). Pharmacotherapeutics for advanced practice: A practical approach (4th ed.). Ambler, PA: Lippincott Williams & Wilkins.

• Chapter 19, “Hypertension”      (pp. 257-272)
       This chapter examines the relationships between the cardiovascular,      nervous, and renal systems. It then describes diagnostic criteria for      hypertension patients, drugs used to treat hypertension and possible      adverse reactions, monitoring patient response, and patient education.
• Chapter 20, “Hyperlipidemia”      (pp. 275-286)
       This chapter explores causes of hyperlipidemia, treatments for      hyperlipidemia patients, and methods for monitoring patient response. It      also reviews strategies for risk assessment and patient education.
• Chapter 21, “Chronic Stable      Angina” (pp. 289-303)
       This chapter begins by exploring factors that contribute to chronic stable      angina, types of drugs used in treatment, and diagnostic criteria for      initiating drug therapy. It also examines methods for monitoring patient      response to treatment and educating patients on self-care.
• Chapter 22, “Heart Failure”      (pp. 305-322)
       This chapter examines the process of prescribing drugs to treat heart      failure and explores effects of prescribed drugs, proper dosages, and      possible adverse reactions.
• Chapter 50, “Pharmacotherapy      for Venous Thromboembolism Prevention and Treatment, Stroke Prevention in      Atrial Fibrillation, and Thromboembolism Prevention with Mechanical Heart      Valves” (pp. 863-886)

 This chapter covers drug therapy options for three disorders requiring anticoagulants: venous thromboembolism, atrial fibrillation, and ischemic stroke. It also explains the process of initiating and managing drug therapy for patients with these disorders.

**Drugs.com. (2012). Retrieved from http://www.drugs.com/

This website presents a comprehensive review of prescription and over-the-counter drugs including information on common uses and potential side effects. It also provides updates relating to new drugs on the market, support from health professionals, and a drug-drug interactions checker.

Required Media

Laureate Education, Inc. (Executive Producer). (2012). Hypertension and hyperlipidemia. Baltimore, MD: Author.

This media presentation outlines hypertension and hyperlipidemia including contributing factors, evaluation, treatment, and implications PHARMACOTHERAPHY FOR CARDIOVASCULAR DISORDERS.