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NR 511 Weekly Discussions

A 56-year-old Caucasian female presents to the office today with complaints of fatigue. Upon further questioning you discover the following subjective information regarding the chief complaint.

History of Present Illness

Onset ”about 2-3 months”

Location Generalized

Duration Constant

Characteristics Progressively worsening since onset, feels tired all of the time, sleeps 8hrs per night but does not feel well rested. ”No energy to do anything I normally can do”

Aggravating factors Exertion

Relieving factors None identified

Treatments None

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Severity Denies pain; missed 1 day of work 2 weeks ago because ”couldn’t get out of bed”

Review of Systems (ROS)

Constitutional Denies fever, chills, or recent illnesses. +5lb. weight gain since last visit 6 months ago.

Eyes No visual changes or diploplia

ENT Denies ear pain, coryza, rhinorrhea, or ST. Had tonsillectomy as child Denies snoring or history of sleep apnea.

Neck Denies lymph node tenderness or swelling

Chest Denies cough, SOB, DOE or wheezing

Heart Denies chest pain

Abdomen Denies N/V/D. + Constipation

Endocrine Denies polyuria, polydipsia. + cold intolerance. Menopause status x 5 yrs.

Skin No changes in skin, hair or nails

Psych Reports worsening of depressive symptoms but thinks it is because she is so ”unproductive” lately and tired all of the time. -Suicidal or homicidal thoughts. Sleeping 8-9hrs per night (no changes), but not feeling rested.

Musculoskeletal Generalized weakness and intermittent muscles cramping in calves

History – NR 511 Weekly Discussions

Medications Multivitamin, B-Complex, Prozac 20mg, Bisoprolol-HCTZ 2.5mg/6.25mg, Calcium 500mg + Vit D3 400IU.

PMH HTN, Depression, Postmenopausal status

PSH Tonsillectomy

Allergies Iodine dyes

Social Married; Works full time as office manager of an internal medicine office; 2 kids (grown)

Habits Denies cigarettes or drug use. +Occasional glass of wine (1-2 per month).

FH Maternal GM & GF deceased with CHF, T2DM and HTN;

Mother alive (age 82) +HTN, +Hyperlipidemia, +T2DM;

Father alive (age 84) +HTN, +Hyperlipidemia, +T2DM, +ASHD (s/p CABG 2 years ago). Also had +CVA at time of CABG (work-up revealed +DVT and +PFO; remains anticoagulated);

Oldest child (26) with seasonal allergies

Youngest child (24) with Bipolar depression and ADHD, and anxiety

Physical exam reveals the following:

Physical Exam – NR 511 Weekly Discussions

Constitutional Middle aged Caucasian female alert, oriented and cooperative

VS Temp-98.2, P-74, R-16, BP 146/95, Height: 5’7”, Weight: 180 pounds

Head Normocephalic, atraumatic

Eyes PERRLA

Ears Tympanic membranes gray and intact with light reflex noted.

Nose Nares patent. Nasal turbinates without swelling. Nasal drainage is clear.

Throat Oropharynx moist, no lesions or exudate. Surgically removed tonsils bilaterally. Teeth in good repair, no cavities.

Neck Neck supple. No lymphadenopathy. Thyroid midline, small and firm without palpable masses.

Cardiopulmonary Heart S1 and s2 noted, no murmurs, noted. Lungs clear to auscultation bilaterally. Respirations unlabored. No pedal edema

Abdomen Soft, non-tender. BS active

Skin Skin overall dry, hair coarse and thick, nails without ridging, pitting or discoloration

Psych Mood pleasant and appropriate.

Musculoskeletal Strength full throughout

Neuro DTRs 2+ at biceps, 1+ at knees and ankles

1. Briefly and concisely summarize the H&P findings as if you were presenting it to your preceptor using the pertinent facts from the case. Use shorthand where possible and approved medical abbreviations. Avoid redundancy and irrelevant information. NR 511 Weekly Discussions.

2. Provide a differential diagnosis (minimum of 3) which might explain the patient’s chief complaint along with a brief statement of pathophysiology for each.

3. Analyze the differential by using the pertinent findings from the history and physical to argue for or against a diagnosis.

4. Rank the differential in order of most likely to least likely. NR 511 Weekly Discussions

5. Identify any additional tests and/or procedures that you feel is necessary or needed to help you narrow your differential. All testing decisions must be supported with an evidence-based medicine (EBM) argument as to why it is necessary or pertinent in this case. If no testing is indicated or needed, you must also support this decision with EBM.

NR 511 Weekly Discussions

Week 6: Discussion Part Two

.

CBC with differential

WBC 8.6 x10E3/uL

RBC 4.44 x 10E6/uL

Hemoglobin 14.0 g/dL

Hematocrit 41.2%

MCV 93fL

MCH 31.5 pg

MCHC 34.0 g/dL

RDW 13%

Platelet 241 x 10E3/uL

Neutrophils % 67%

Lymphocytes % 22%

Monocytes % 8%

Eosinophils % 3%

Basophils % 0%

Absolute Neutrophils 5.7 x 10E3/uL

Absolute Lymphocytes 1.9 x 10E3/uL

Absolute Monocytes 0.7 x 10E3/uL

Eosinophils Absolute 0.3 x 10E3/uL

Basophile Absolute 0.0 x 10E3/uL

Immature Grans % 0%

Absolute Immature Grans 0.0 x 10E3/uL

TSH with Reflex to FT4

TSH 6.770 uIU/mL

FT4 0.62 ng/dL

PHQ-9 Depression Score=10 (previous was 5 at last visit 6 months ago)

1. What is your primary diagnosis for this patient as the cause for the CC of fatigue? (support your decision for your diagnosis with pertinent positives and negatives from the case)

2. Identify the corresponding ICD-10 code. NR 511 Weekly Discussions.

3. Provide a treatment plan for this patient’s primary diagnosis which includes:

o Medication*

o Any additional testing necessary for this particular diagnosis*

o Patient education*

o Referral

4. Provide an active problem list for this patient based on the information given in the case.

5. Are there any changes that you would make to the patient’s overall plan at this time? Must provide an evidence-based medicine (EBM) argument to support any treatments or testing decisions. NR 511 Weekly Discussions.

6. Provide an appropriate follow-up plan (include any additional testing that you feel is necessary and include an EBM argument). NR 511 Weekly Discussions.

*If part of the plan does not warrant an action, you must explain why. ALL medication and testing decisions (or decisions not to treat with medication or additional testing) MUST be supported with an EBM argument. Over-the-counter (OTC) and RXs must be written in full as if handing a script to the patient in the office.

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Developing and Simulating a Learner-Centered Teaching Plan Essay Assignment Paper

Intellectual Indebtedness and Plagiarism

Students enrolled in Athabasca University courses, including 
Health Studies 320: Teaching and Learning for Health Professionals
, are considered to be responsible scholars, and are therefore expected to adhere rigorously to the principles of intellectual integrity. Please read the policy related to this at 
http://www.athabascau.ca/studserv/inthonesty.htm
.

Plagiarism is a form of intellectual dishonesty in which another person’s work is presented as one’s own. Be certain that whenever you use a secondary source in your course work and assignments you reference your source in a consistent and logical manner. All direct quotes (quotations of any number of words from the original) and indirect quotes (paraphrased ideas) must be acknowledged. Failure to do so constitutes plagiarism, and as with any form of academic misconduct, it will be penalized. Penalties may take the form of rejection of the submitted work; expulsion from the examination, the course or the program; or legal action, depending on the specific nature of the infraction. Developing and Simulating a Learner-Centered Teaching Plan Essay Assignment Paper.

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However, dutiful citation of quotes and paraphrased materials does not mean that you can write an essay assignment by stringing together a series of quotes. You should always try to summarize or describe someone else’s ideas in your own words. When you present your own ideas or opinions in a paper, provide evidence or arguments to substantiate your position. Developing and Simulating a Learner-Centered Teaching Plan Essay Assignment Paper.

The following Web site offers information about the citation styles of the American Psychological Association 
http://www.apastyle.org
. The 
AU Library Help Centre
 also has many useful links and resources.

All written assignments in this course must

use correct spelling and grammar,

adhere to APA format, as outlined in the 
Publication Manual of the American Psychological Association (APA) (6th. ed.)
,

be your own work and be free of evidence of plagiarism,

use Microsoft Word (or Microsoft Word compatible) format, and

be submitted via the Assessment section of the course home page.

Assessment

To receive credit for HLST320, students must complete all of the required assignments and achieve a composite grade of at least “C” (60%). All assignments must follow the guidelines of the 
APA Publication Manual
 (6th ed.) (2010). Developing and Simulating a Learner-Centered Teaching Plan Essay Assignment Paper.

The assessment structure for Health Studies 320 is based on the following assignments, with the percentage weighting of each activity as indicated. Your final grade for the course will be a 
composite
 mark based on your performance on these course assignments. A composite mark of 60% is required to pass the course.

Assignments

Suggested Due Date

Weighting

Assignment 1:Development of Your Teaching-Learning Philosophy

Week 4

35%

Assignment 2: Writing Learning Objectives

Week 9

30%

Assignment 3: Developing and Simulating a Learner-Centered Teaching Plan

Week 14

35%

Total

 

100%

Assignment 1: Development of Your Teaching-Learning Philosophy (35%)

Suggested Due Date – Week 4

Your personal assessment of your philosophy of teaching and learning should be unique to you. This assignment will give you a good base for enhanced learning through the remainder of this course and will provide you the opportunity to achieve the course learning outcome: describe the complexities and realities of health teaching from a personal and theoretical perspective. Supporting information and assessment of your philosophy of teaching and learning is addressed in Units 1 – 3. Developing and Simulating a Learner-Centered Teaching Plan Essay Assignment Paper.

Developing and Simulating a Learner-Centered Teaching Plan Essay Assignment Paper must be submitted via the appropriate dropbox on the course home page.

Evaluation Criteria for Assignment 1

Articulate clear statements of your personal learning style and your professional teaching philosophy.  (3 marks)

Link at least one of the theoretical underpinning (e.g. Behaviorism, Cognitivism, Social Constructivism) to support your teaching-learning philosophy.  (10 marks)

Provide one clear and detailed example to demonstrate how your values and beliefs related to both teaching and learning affect your role as a health care professional.  (5 marks)

Provide evidence of application of course concepts from Units 1, 2, and 3 and references from external sources as needed to support your teaching-learning philosophy. (7 marks) Developing and Simulating a Learner-Centered Teaching Plan Essay Assignment Paper.

Accurate APA format including:

Title page, headings and subheadings (1 mark)

References in the body of the paper (2 marks)

Reference citations in the references list (2 marks)

Accurate scholarly format including:

3-4 pages in length, excluding title page and References list (1 mark)

Introduction (1 mark)

Scholarly language and professional tone  (1 mark)

Grammar, spelling, and punctuation (1 mark)

Conclusion (1 mark)

Total possible marks 35

Assignment 2: Writing Learning Objectives (30%)

Suggested Due Date – Week 9

Currently within the teaching and learning literature you will discover ongoing debate and confusion related to use of terms such as educational objectives, instructional objectives, behavioural objectives, learning outcomes and learning objectives. In HLST 320, the term Learning Outcomes was chosen to reflect the overall achievements of the learner upon completion of the course, and the term Learning Objectives was chosen to reflect the more specific learning that should be achieved by the learner through the completion of unit learning activities. Developing and Simulating a Learner-Centered Teaching Plan Essay Assignment Paper.

This assignment, writing of learning objectives, will allow you to gain knowledge that is foundational to the teaching learning process and provide you with the opportunity to partially achieve the course learning outcome: apply the teaching and learning process to a health-related situation in a systematic manner that reflects the principles of teaching and learning presented in this course. Supporting information to assist you in writing learner-centered objectives is addressed in the learning activities of Unit 4 and Unit 5: The Art of Writing Learner-Centered Objectives. Developing and Simulating a Learner-Centered Teaching Plan Essay Assignment Paper.

. Assignment 2 is part 1 of developing and then simulating a learner-centered teaching plan. In this component you are asked to select from one of the following teaching and learning categories:

Category 1: Health care professional/individual as client teaching and learning

Category 2: Health care professional/family as client teaching and learning

Category 3: Preceptor/student health care professional teaching and learning

Assignment 2 uses random assignments. You will pick your category and then open the correct dropbox of three choices. The case will be randomly assigned within that category. Once you select a category a case study will be sent to you. You cannot change your case study once it is received so select your category wisely as it is from this case study that you will complete both assignments 2 and 3. Based on the case study a clear, measureable objective must be written for each of the 3 domains cognitive, affective, and psychomotor.
 Assignment 2 must be submitted, marked and returned to you prior to you submitting assignment 3. 
Assignment 2 is foundational to assignment 3 so familiarize yourself with the assignment 3 requirements as you complete assignment 2, and be certain to consider your tutor’s feedback when completing assignment 3. Please contact your tutor if you require further clarification of expectations for this assignment. Developing and Simulating a Learner-Centered Teaching Plan Essay Assignment Paper.

Developing and Simulating a Learner-Centered Teaching Plan Essay Assignment Paper must be submitted via the appropriate dropbox on the course home page.

Evaluation Criteria for Assignment 2 – Writing Learning Objectives

Articulate three objectives, one for each domain. Each objective is: learner-centered and discrete; written in clear, measurable terms; reflective of your assigned case study; reasonable for a three minute teaching session

Cognitive (4 marks)

Affective (4 marks)

Psychomotor (4 marks)

Provide rationale including integration of theoretical knowledge that is, evidence-based practice to support each objective (4 marks)

Provide evidence of application of course concepts and references of external sources as needed to support each learner centered objective (4 marks)

Accurate APA format including:

Title page, headings and subheadings (1 mark)

References in the body of the paper (2 marks)

Reference citations in the references list (2 marks)

Accurate scholarly format including:

4 pages in length, excluding title page and References list (1 mark)

Introduction (1 mark)

Scholarly language and professional tone  (1 mark)

Grammar, spelling, and punctuation (1 mark)

Conclusion (1 mark)

Total possible marks 30

Assignment 3: Developing and Simulating a Learner-Centered Teaching Plan (35%)

Suggested Due Date – Week 14

Health teaching is not an optional practice component for any health care professional. This assignment, Developing and Simulating a Learner-Centered Teaching Plan, will allow you to gain knowledge that is foundational to the teaching learning process and provide you with the opportunity to achieve the course learning outcome: apply the teaching learning process to a health-related situation in a systematic manner that reflects the principles of teaching and learning presented in this course. Supporting information to assist you in assignment 3 is addressed in Units 6-8. Developing and Simulating a Learner-Centered Teaching Plan Essay Assignment Paper.

Assignments must be submitted via the appropriate dropbox on the course home page.

NOTE –
 Assignment 2 and 3 are progressive assignments; 
you will not be able to submit assignment 3 until you have completed assignment 2 and received your mark.
 Refer back to the case study you utilized to complete assignment 2, as this same case study should be used to complete assignment 3. Also be certain to consider your tutor’s feedback on assignment 2 when completing assignment 3. Please contact your tutor if you require further clarification of expectations for this Developing and Simulating a Learner-Centered Teaching Plan Essay Assignment Paper.

Assignment 3 consists of two parts:

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Part A: Complete the following table (possible 10 marks)

Learning Objective 

Teaching Strategies

Rationale For Selection of Teaching Strategy

Domain: state cognitive, psychomotor or affective.

List strategies you have chosen to utilize

Provide rationale to support your choice of each strategy. If you used Internet resources as teaching materials, please include the links so that your tutor can access and review these. If you used other materials, such as audiovisual aids, posters, print-based pamphlets, or handouts, please send as an appendix.

Part B: Complete a simulation of your implementation of your teaching plan. 
Note this is a simulation and is not to be implemented with a human subject.  Think of this simulation as your rehearsal prior to actually implementing with a client. 
You need to submit a video of your simulation. Your video simulation should be 3 minutes in length. You 
do not
 need to submit a copy of your narrative but you do need to plan carefully what you will include in your simulation. You can record your video using Adobe Connect, You Tube, Vimeo, or a platform of your choice.

Evaluation Criteria for Assignment 3– Developing and Simulating a Learner-Centered Teaching Plan

Part A: Table (maximum 10 marks)

learning objective domain is stated clearly (2 marks)

learning objective is clear, measurable, and worded using Bloom’s new taxonomy (2 marks)

teaching strategies selected are appropriate for the learning objective (2 marks)

rationale for selection of teaching strategy is clearly articulated and supported by scholarly evidence (2 marks). Developing and Simulating a Learner-Centered Teaching Plan Essay Assignment Paper.

format is professional and clear  with accurate spelling, grammar, punctuation (2 marks)

Part B: Simulation Video (maximum 25 marks)

learner objective was stated clearly and concisely (4 marks)

stated objective was attainable within the allotted three minute time frame (3 marks)

content of the presentation clearly reflected the stated objective  (3 marks)

presentation was planned to facilitate the learners’ attainment of the objective (3 marks)

presentation was logically organized from the introduction through to the conclusion (3 marks)

presentation included an appropriate evaluation strategy (3 marks)

presenter’s voice was clear and easily heard (3 marks)

presenter’s manner was interesting and positive (3 marks). Developing and Simulating a Learner-Centered Teaching Plan Essay Assignment Paper

Principles and Power in Leadership Essay

Using the famous leader, you chose BILL GATES you will evaluate the leader

Summarize the key details about your chosen leader.

o Who is s/he?

o What is the organization?

o What are one or two important points you have learned so far in your study of the leader?

o This section of your paper should only be 1 or 2 paragraphs.

• Analyze the leader’s alignment to the four universal principles: integrity, responsibility, compassion, and forgiveness, citing examples and research to support your assessment. In essence, how did the leader demonstrate (or not demonstrate) those principles in his or her leadership practice?

• Analyze the different bases of power this leader used, citing examples and research to support your assessment. In essence, how did this leader demonstrate use of power and which bases of power did s/he use to influence others? Principles and Power in Leadership Essay.

• Analyze the demonstrated beliefs of this leader, citing examples and research to support your assessment. In essence, what did the leader appear to believe about:

o people inside the organization,

o people outside the organization,

o power,

o processes and policies,

o profit (or other relevant outcomes).

• Analyze how this leader affected the culture of his or her organization, citing examples and research to support your assessment. In essence, Principles and Power in Leadership Essay.

o How did this leader’s attitudes and actions affect followers?

o Which behaviors had a strong effect on followers?

o Was this leader credible? Based on what evidence?

o How did this leader’s attitudes and actions influence the organization’s ethical practices?

o Was the leader an ethical leader? Based on what evidence?

ü USE AT LEAST 4 CURRENT REFERENCES

ü USE HEADINGS. Principles and Power in Leadership Essay

Essay – The Reality of Providing Nursing Services in a Healthcare Rationing System

The Reality of Providing Nursing Services in a Healthcare Rationing System

This assignment will help you explore how nursing leaders provide services while at the same time rationing services.

One of the areas that must be considered in the field of fiscal and resource management is the issue of rationing services to patients.

. Based on your research and understanding, create a 3- page paper that answers the following:

• How would you as a nursing leader balance the clinical needs of the patients with the fiscal sustainability of the healthcare facility? Essay – The Reality of Providing Nursing Services in a Healthcare Rationing System.

• What are the ethical issues faced by nursing leaders in a healthcare rationing environment?

• What are the internal and external forces impacting your decision making in this environment?

• How can evidence-based care help you make fiscal decisions in this environment?

• How can evidence-based leadership be used in decision making? Essay – The Reality of Providing Nursing Services in a Healthcare Rationing System

Development of a mini business plan for a new service or product within your healthcare facility

Develop a mini business plan for a new service or product within your healthcare facility or a healthcare facility you are familiar with (e.g., a hospital, a health clinic, a nursing home, or an outpatient center).

Create a 5-page business plan that:

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• Describes the need for the service,

• factors impacting the need for the service,

• fiscal planning issues, and human capital issues and needs.

• Provides an overview of the product or the service.

• Analyze the market, explaining why this product or service is necessary and how much you will get paid for selling the product or providing this service. Development of a mini business plan for a new service or product within your healthcare facility

• Provides an operational budget.

• Provides a capital budget (major purchases required).

• Provides a human resource cost budget—if you are borrowing staff from other departments, you must account for its costs in the human resource budget.

• Summarizes why this product or service should be given the green light. Development of a mini business plan for a new service or product within your healthcare facility

Alzheimer’s and Dementia – Research Critiques and PICOT Statement Final Draft Assignment Benchmark Essay Paper

Details:

Prepare this assignment as a 1,500-1,750 word paper using the instructor feedback from the Topic 1, 2, and 3 assignments and the guidelines below.

PICOT Statement

Revise the PICOT statement you wrote in the Topic 1 assignment.

The final PICOT statement will provide a framework for your capstone project (the project students must complete during their final course in the RN-BSN program of study).

Research Critiques

In the Topic 2 and Topic 3 assignments you completed a qualitative and quantitative research critique. Use the feedback you received from your instructor on these assignments to finalize the critical analysis of the study by making appropriate revisions. Alzheimer’s and Dementia – Research Critiques and PICOT Statement Final Draft Assignment Benchmark Essay Paper.

The completed analysis should connect to your identified practice problem of interest that is the basis for your PICOT statement.

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

Proposed Evidence-Based Practice Change

Discuss the link between the PICOT statement, the research articles, and the nursing practice problem you identified. Include relevant details and supporting explanation and use that information to propose evidence-based practice changes.

Prepare this assignment according to the APA guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required. Alzheimer’s and Dementia – Research Critiques and PICOT Statement Final Draft Assignment Benchmark Essay Paper.

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

You are required to submit this assignment to Turnitin. Please refer to the directions in the Student Success Center.Alzheimer’s and Dementia – Research Critiques and PICOT Statement Final Draft Assignment Benchmark Essay Paper

Quantitative Study

Churchill M , et al. (n.d.).  – PubMed – NCBI. Retrieved from
https://www.ncbi.nlm.nih.gov/pubmed/10218187
. Using a therapy dog to alleviate the agitation and desocialization of people with Alzheimer’s disease. A Matched Case–Control Trial. Alzheimer’s and Dementia – Research Critiques and PICOT Statement Final Draft Assignment Benchmark Essay Paper.

Background of Study

According to the The Alzheimer’s Association there has been an  estimated number of  4 million individuals suffer from Alzheimer’s Disease, also known as AD, and by 2050, this static  will continue to grow to an estimated 14 million (Alzheimer’s Association, 1998).  These figures are an indication that the care for those affected by AD will place a burden on health resources with the burden only expected to grow over time.  To counter the expected burden, it is projected that medical care should be focused on addressing the neuropsychiatric symptoms that include anxiety, apathy, depression, and agitation. These symptoms are chronically present in all patients and only worsen over time. Previously, psychotropic medication was used to address these symptoms. Nonetheless, evaluations show that these medication have little effect on the symptoms, and no effect on the quality of life often times resulting in the patient being lethargic along with little interaction in life and or family members at all.   AD is a neurological disorder that presents as a slow, progressive disorder that over time will lead the individual to experience a decrease in cognitive function exacerbated by impairments in memory, reasoning, abstraction, and personality (Manor, 1991). Based on this awareness, pet therapy along with other alternative methods, such as music therapy is proposed as a psychosocial intervention that could achieve the desired goal of addressing the neuropsychiatric symptoms of AD and dementia while improving the quality of life. As such, the present study evaluates usefulness of proposed therapies as mentioned to show improved patient outcomes as well as quality of life.  Even though it has been considered that  AD is a disease that affects only the elderly, it has been diagnosed in younger people (Alzheimer’s Association, 1998).  The cause of AD, even in today’s time with advanced technology is still unknown.  Secondary to the effect of this disease on the normal brain activity can often times result in the patient experiencing late afternoon symptoms, referred to as Sundowners. Behavioral changes that are associated with sundown syndrome include restlessness and verbal behavior (Evans, 1987); confusion; aimless wandering; paranoia; agitation; and aggressive behavior, such as hitting, kicking, and biting directed toward staff, family, or other patients that will take place during evening hours. Agitated patients often display symptoms such as uncooperative routines, that results in difficulties for the staff caring for the patient. The tendencies of these aggressive behaviors may lead the patient to have feelings of seclusion, loneliness, and fear, resulting in increased aggressive behaviors. Alzheimer’s and Dementia – Research Critiques and PICOT Statement Final Draft Assignment Benchmark Essay Paper.

Methods of Study

An experimental and repeated measure design utilized that was used for this study. The subjects were recorded under two random ordered conditions both with and without the dog present, being aware that this research project was approved through the Institutional Review Board and the Institutional Animal Care and Use Committee. Eligibility to be involved in the study included a diagnosis of AD or a related disorder such as Dementia, residence in a special-care unit, display of agitated behavior in the evening hours, no allergies to dogs or bad experiences with them, consent from the legally authorized representative person/persons.

There were three extended care facilities with special-care units in the Midwest that consisted of individuals with AD or a related disorder. Each of these facilities held 20 to 35 residents on the unit, and each unit had a common area (lounge) where residents congregated for the day. Those studied consisted of twenty-eight individuals to include 21 women, 7 men.  Each of those involved in the study were also noted to be caucasian with a mean age of 83 and older, all with different levels of severity of the disease. Alzheimer’s and Dementia – Research Critiques and PICOT Statement Final Draft Assignment Benchmark Essay Paper.

Results of Study

The presence of the therapy dog showed nothing less than encouraging results that included verbalizations, smiles, looks, leans, and tactile contact. The importance of looks and smiles could be considered as an indication of happiness and interest, as well as the importance of touch displaying a nonverbal approach to communication. When considering this aspect, one must consider the importance of touch even in those that do not suffer from a disease.  Companionship, touch, and the feelings of affection is necessary in all elements of physical and mental health regardless of age, race, gender, or even those suffering from disease. Alzheimer’s and Dementia – Research Critiques and PICOT Statement Final Draft Assignment Benchmark Essay Paper.

Ethical Considerations

The study mentions that ethical approval for the research was sought from all affiliated institutions after extensive consultation throughout the research process.  The approval was based upon that the study showed no harm to those that were involved in the study and adequate actions had been undertaken to ensure that the participants as well as the animals were protected. In addition, it mentions that there was a requirement for informed consent that was signed by the participants to show that they were aware of the research intentions and consented to participate. Alzheimer’s and Dementia – Research Critiques and PICOT Statement Final Draft Assignment Benchmark Essay Paper.

Conclusion

There is much to be learned about the best treatment for those that suffer from such a sad and deteriorating disease known as Alzheimer’s and Dementia especially knowing that there is rarely early detection and no know cure.  Family members are often times found to be at a loss and only searching for ways to bring their loved ones back to who they used to be.  Even in our worse state, it is simply amazing how a simple thing such as touch, feelings of love and security can make all the difference in the world to a bad day.  This study showed that the presence of a therapy dog did improve socialization and decreased agitation in persons with AD or a related disorder during sundown hours. These changes, however, were found to be unrelated to the severity of the disease process.  With this being said, the results are valuable to nursing practitioners since they show a clear correlation between those that suffer from AD and dementia and that with the use of pet and other alternative methods such as music therapy are under review so that nurses will have evidence to support proposals for development of pet, music and possible other therapy programs. Alzheimer’s and Dementia – Research Critiques and PICOT Statement Final Draft Assignment Benchmark Essay Paper

Therapy for Pediatric Clients With Mood Disorders Essay Assignment Paper

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

The 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. Therapy for Pediatric Clients With Mood Disorders Essay Assignment Paper.

SEE ATTACHED OF THE CASE STUDY DECISIONS MADE FOR POINTS # 1, 2 AND 3.

• At each decision point stop to complete the following:

o Decision #1

 Which decision did you select?

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 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. Therapy for Pediatric Clients With Mood Disorders Essay Assignment Paper.

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

o 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?

o 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? Therapy for Pediatric Clients With Mood Disorders Essay Assignment Paper.

• 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. Therapy for Pediatric Clients With Mood Disorders Essay Assignment Paper

Therapy for Pediatric Clients with Mood Disorders

An African American Child Suffering From Depression

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)

 

RESOURCES

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

Therapy for Pediatric Clients with Mood Disorders

An African American Child Suffering From Depression

Decision Point One

Begin 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. Therapy for Pediatric Clients With Mood Disorders Essay Assignment Paper.

Decision Point One

 
Select what the PMHNP should do:

Begin Zoloft 25mg orally daily

RESULTS OF DECISION POINT ONE

Client returns to clinic in four weeks

No change in depressive symptoms at all

Decision Point Two

Begin Zoloft 25 mg orally daily

Begin Paxil 10 mg orally daily

Begin Wellbutrin 75 mg orally BID

Therapy for Pediatric Clients With Mood Disorders Essay Assignment Paper.

 

Week 2: Therapy for Pediatric Clients With Mood Disorders

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.

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.

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.

 

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.

 

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.

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. Therapy for Pediatric Clients With Mood Disorders Essay Assignment Paper.

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.

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. Therapy for Pediatric Clients With Mood Disorders Essay Assignment Paper.

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). 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. Therapy for Pediatric Clients With Mood Disorders Essay Assignment Paper.

Analyzing Ethical Decisions Essay Assignment Paper

For this Assignment, you review the literature and discover the various ethical dilemmas PMHNPs encounter and how these issues are typically addressed in your state.Analyzing Ethical Decisions Essay Assignment Paper

Students will:

Analyze salient ethical issues in psychiatric mental health practice

Compare ethical dilemmas with state health laws and regulations

Analyze ethical decision-making processes

ORDER A PLAGIARISM-FREE PAPER

To prepare:

Review literature for moral/ethical issues encountered by a PMHNP.

Select one of the articles you found that was published within the last 5 years to use as a focus for this assignment.

Write a 2-page paper in which you do the following: Analyzing Ethical Decisions Essay Assignment Paper

QUESTIONS:

Summarize the moral/ethical issue in the article (no more than 1 paragraph).

Describe the moral and ethical dilemmas surrounding the issue. Analyzing Ethical Decisions Essay Assignment Paper.

Analyze the ethical issue and compare them to the state health laws and regulations in your state. ( MY STATE IS NEW JERSEY )

Outline the process of ethical decision making you would use to address this ethical dilemma. Analyzing Ethical Decisions Essay Assignment Paper

Special Problems and Challenges and the Future of Policing In America Essay Assignment paper

Assignment 4: Special Problems and Challenges and the Future of Policing In America

Due Week 10 and worth 200 points

Modern law enforcement operations and strategies are driven by best practices in the areas of data collection and manipulation, addressing special populations, and preventing organized criminal activities. A tremendous amount of specialization has evolved in today’s sphere of policing, especially among federal, state, and local agencies. Perhaps, what is most evident is how the law enforcement agencies of the federal government have retooled to meet today’s challenge of terrorism. Use your textbook, the Internet, and / or Strayer library to research credible sources on the aforementioned issues as they relate to law enforcement operations and management. Special Problems and Challenges and the Future of Policing In America Essay Assignment paper.

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Write a five to seven (5-7) page Special Problems and Challenges and the Future of Policing In America Essay Assignment paper in which you:

Identify and describe the major functions of the four (4) agencies of the Department of Justice. Of the four agencies, provide a rationale for which agency you feel has the greatest responsibility as it relates to federal law enforcement.

Explain the purposes of the Uniform Crime Reports (UCR) and the National Crime Information Center (NCIC). Identify and discuss the various weaknesses related to the accuracy of the Uniform Crime Report (UCR).

Describe the major roles of police executives using the Mintzberg model of chief executive officers. Of the executive roles described in the model, provide a rationale for which role you feel is the most important for a chief executive officer’s success.

Examine two (2) legislative enactments that are in place to help combat terrorism. Provide your opinion on the effectiveness of these enactments in regards to combatting terrorism.

Analyze the problems related to determining the actual numbers of hate crimes and what makes hate crimes different from other crimes.

Use at least four (4) quality references including the textbooks. Note: Wikipedia and other Websites do not qualify as academic resources.

Your Special Problems and Challenges and the Future of Policing In America Essay Assignment paper must follow these formatting requirements:

Be typed, double spaced, using Times New Roman font (size 12), with one-inch margins on all sides; citations and references must follow APA or school-specific format. Check with your professor for any additional instructions.

Include a cover page containing the title of the assignment, the student’s name, the professor’s name, the course title, and the date. The cover page and the reference page are not included in the required assignment page length.

The specific course learning outcomes associated with this Special Problems and Challenges and the Future of Policing In America Essay Assignment paper are:

Contrast the organization and administration of federal law enforcement agencies with that of state agencies.

Contrast the organization and administration of municipal law enforcement agencies with that of county agencies.

Visualize the future of policing in America and identify some of the forces and technologies shaping that future.

Use technology and information resources to research issues in law enforcement operations and management.

Write clearly and concisely about law enforcement operations and management using proper writing mechanics. Special Problems and Challenges and the Future of Policing In America Essay Assignment paper.

Comprehensive Integrated Psychiatric Assessment

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

This is the video from Youtube

Address the following 4 points

1 What did the practitioner do well?

2 In what areas can the practitioner improve?

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

4 What would be your next question, and why?

These are the resources other resources

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. Comprehensive Integrated Psychiatric Assessment.

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”

Comprehensive Integrated Psychiatric Assessment