Category: Nursing

6670 – Psychiatric Assessment of the Adult and Older Adult

Week 1: Psychiatric Assessment of the Adult and Older Adult

Many assessment principles are the same for children and adults; however, with adults/older adults, consent for participation in the assessment comes from the actual client and not parents or guardians. The exception to this is adults/older adults who have been determined incapacitated by a court of competent jurisdiction. Some adults may be easier to assess than children/adolescents as they are more psychologically minded. That is, they have better insights into themselves and their motivations than children/adolescents (although this is not universally true).

Older adults present some of their own unique assessment challenges in that they may have higher levels of stigma associated with seeking psychiatric care. Additionally, there are higher rates of neurocognitive disorders superimposed on other clinical conditions such as depression or anxiety, which creates additional diagnostic challenges. 6670 – Psychiatric Assessment of the Adult and Older Adult.

This week, you will develop your own personal format for initial interviews of mental health clients. You also will explore the restrictions and limitations for practice as a PMHNP in your home state and create a plan for passing the national certification exam.

Photo Credit: KatarzynaBialasiewicz / iStock / Getty Images Plus

6670 – Psychiatric Assessment of the Adult and Older Adult 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

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.

Section 5.1, “Psychiatric Interview, Mental Status Examination” (pp. 192–211)

Section 5.2, “The Psychiatric Report and Medical Record” (pp. 211–217)

Section 5.3, “Psychiatric Rating Scales” (pp. 217–236)

Section 5.5, “Personality Assessment: Adults and Children” (pp. 246–257)

Section 5.7, “Medical Assessment and Laboratory Testing in Psychiatry” (pp. 266–275)

Chapter 6, “Classification in Psychiatry” (pp. 290–308)

6670 – Psychiatric Assessment of the Adult and Older Adult

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

“Cautionary Statement for Forensic Use of DSM-5”

“Assessment Measures”

“Cultural Formulation”

“Glossary of Technical Terms”

“Glossary of Cultural Concepts of Distress”

Note:
You will access this book from the Walden Library databases.

Barton Associates. (2017).
Nurse practitioner scope of practice laws
. Retrieved from https://www.bartonassociates.com/locum-tenens-resources/nurse-practitioner-scope-of-practice-laws/

American Psychiatric Association. (2016).
Practice guidelines for the psychiatric evaluation of adults
. Retrieved from http://psychiatryonline.org/doi/pdf/10.1176/appi.books.9780890426760

Document:
Practicum Journal Template (Word document). 6670 – Psychiatric Assessment of the Adult and Older Adult.

Required Media

Laureate Education (Producer). (2017b).
Working with Adults and Older Adults”
[Video file]. Baltimore, MD: Author.

 

Note:
The approximate length of this media piece 3 minutes.

 

Accessible player
 
–Downloads–
Download Video w/CC
Download Audio
Download Transcript

Hagen, B. (Producer). (n.d.-a).
Conducting a mental status exam
[Video file]. Mill Valley, CA: Psychotherapy.net. 6670 – Psychiatric Assessment of the Adult and Older Adult.

 

Note:
The approximate length of this media piece is 25 minutes. You will access this video through the Walden Library databases.

Optional Resources

American Psychological Association. (2008).
Assessment of older adults with diminished capacity
. Retrieved from https://www.apa.org/pi/aging/programs/assessment/capacity-psychologist-handbook.pdf. 6670 – Psychiatric Assessment of the Adult and Older Adult.

Rosen, S. L., & Reuben, D. B. (2011). Geriatric assessment tools.
Mount Sinai Journal of Medicine, 78
(4), 489–497. doi:10.1002/msj.20277

 

Note:
You will access this article through the Walden Library databases.

Substance Abuse and Mental Health Services Administration (SAMHSA). (2015).
TIP 59: Improving cultural competence
. Retrieved from http://store.samhsa.gov/product/TIP-59-Improving-Cultural-Competence/SMA15-4849

 

Note:
This document is available as a free download.

6670 – Psychiatric Assessment of the Adult and Older Adult Discussion: Interview Format

Despite what you may believe (or may have been told), there is no such thing as one “right” way to do an interview. In fact, there are numerous books written about the various ways of conducting the clinical interview. In actual clinical practice, you will find the format that “works” best for you and addresses your unique strengths and the needs of the client. 6670 – Psychiatric Assessment of the Adult and Older Adult.

In this Discussion, you will practice finding the interview format that works for you and share those ideas with your colleagues for feedback.

6670 – Psychiatric Assessment of the Adult and Older Adult Learning Objectives

Students will:

Develop formats for initial interviews of mental health clients

Note:
 For this Discussion, you are required to complete your initial post before you will be able to view and respond to your colleagues’ postings. Begin by clicking on the “Post to Discussion Question” link and then select “Create Thread” to complete your initial post. Remember, once you click submit, you cannot delete or edit your own posts and cannot post anonymously. Please check your post carefully before clicking 
Submit
! 6670 – Psychiatric Assessment of the Adult and Older Adult.

To prepare for this Discussion:

Review the Learning Resources.

Develop an interview format you would use for an initial interview of a client.

By Day 3

Post:

Attach the interview format document you would use for an initial interview of a client.

Describe what interview format your preceptor uses for the initial interview of a client.

Describe which element of your interview format is most helpful in your practice. 6670 – Psychiatric Assessment of the Adult and Older Adult.

By Day 6

Respond 
to at least 
two
 of your colleagues by constructively critiquing their interview format and providing feedback.

Submission and Grading Information

Grading Criteria

To access your rubric:

Week 1 Discussion Rubric

Post by Day 3 and Respond by Day 6

To participate in this Discussion:

Week 1 Discussion

6670 – Psychiatric Assessment of the Adult and Older Adult Assignment 1: Week 1 Practicum Journal Entry: Certification Plan

Psychiatric/mental health nurse practitioners currently have only one choice for certification, which is through the American Nurses Credentialing Center (ANCC). The ANCC offers the “psychiatric/mental-health nurse practitioner (across the lifespan)” board certification (PMHNP-BC). In many states, board certification is needed as a prerequisite to being granted an NP license. Even if board certification is not a requirement for state licensure, it may be a requirement to receive privileges in various hospitals and other health care facilities. It may also be required by malpractice insurance providers prior to issuing coverage to NPs.

In this Practicum Journal Assignment, you will develop a plan, which will serve as the road map for you to follow to attain your certification.

6670 – Psychiatric Assessment of the Adult and Older Adult Learning Objectives

Students will:

Analyze state restrictions or limitations for practice

Compare PMHNP practice environments in various states

Analyze clinical practice issues

Create plans for passing national certification exams

**Assigned in Week 1 but submitted in Week 4

To prepare for this Practicum Journal:

Review the interactive nurse practitioner (NP) scope of practice law guide in your Learning Resources.

Review your state regulations and a neighboring state or state in which you would like to practice.

Reflect on how to approach relocating licensure from one state to another.

Review certification exam requirements for PMHNPs. 6670 – Psychiatric Assessment of the Adult and Older Adult.

Write a 2- to 3-page paper in which you do the following:

Describe the PMHNP practice environment for your home state, highlighting restrictions or limitations for practice.

Compare the PMHNP practice environment in your home state with a neighboring state or a state in which you would like to practice.

Describe a professional and/or clinical practice issue a new PMHNP will need to consider and address with the certification, licensure, credentialing, or relocation process.

Develop a checklist for passing the national certification exam, including a detailed timeline that includes academic preparation (study plan), registration, financial preparation, etc. 6670 – Psychiatric Assessment of the Adult and Older Adult.

By Day 7

Submit
 by Day 7 of Week 4.

Making Connections

This week, you developed your own personal format for initial interviews of mental health clients. You also explored the restrictions and limitations for practice as a PMHNP in your home state and created a plan for passing the national certification exam. 6670 – Psychiatric Assessment of the Adult and Older Adult.

Next week, you will become “captain of the ship” as you take full responsibility for a client with a depressive disorder by recommending psychopharmacologic treatment and psychotherapy, identifying medical management needs and community support, and recommending follow-up plans. You will also explore how to obtain a DEA license and the responsibilities for safe prescribing and prescription monitoring.

Fitzgerald Health Education Associates (FHEA) PMHNP 150 University Exit Comprehensive Exam

Walden has selected the Fitzgerald Health Education Associates (FHEA) PMHNP 150 University Exit Comprehensive Exam to provide you with an opportunity to take practice exams and complete sample test questions. While passing your certification exam is not guaranteed, FHEA suggests that a score of 85% or higher is predictive of success on your NP board examination. The FHEA PMHNP 150 University Exit Comprehensive Exam is used in this course as an assessment in Week 3. Each exam is worth 100 points and 10% of your grade. 6670 – Psychiatric Assessment of the Adult and Older Adult.

Note:
 Your instructor receives the results and will inform you when the results are available. Do not e-mail the Fitzgerald site. 6670 – Psychiatric Assessment of the Adult and Older Adult.

Sample Workflow of Answering a Telephone in an Office

Start

Answer phone with salutation and company identification.

Identify caller and caller inquiry.

Is the call a sales call?

Politely decline offered services.

Yes

No

 

Is the caller’s requested recipient available?

Yes

Inform caller and requested recipient of impending transfer.

Transfer caller to requested recipient.

Does the caller wish to leave a message?

No

Politely ask the caller to try again at a better time.

Yes

Record the caller’s message, name, and contact information. Forward to intended recipient.

No

End

SAMPLE_OF_WORKFLOW

Sample Workflow of Answering a Telephone in an Office

Hospital merger impact Discussion Question #1:

1)
 Imagine that you are a first-line manager of a department in a relatively small hospital located in a semi-rural area. For many months there had been rumors of a possible merger with another semi-rural hospital half again the size of yours located about 12miles away. Both administration and the board of directors had been declining to comment on the rumors although it was apparent that some kind of negotiations were underway. In about mid-November all managers were officially notified that the merger would take place effective the first of January. The two hospitals were to become a single corporate entity with two locations, and functions and services would be consolidated wherever practical. Describe in detail the possible effects of the merger and all that it entails on you and your position.

2)
It is stated in the chapter that the three ways of getting employees to implement change are: Tell them what to do; Sell them on what must be done;and Involve them in determining the substance and direction of the change. For each of the three means, describe an instance in which it is a preferred or even essential approach and an instance in which it is an inappropriate or perhaps even harmful approach.

3)
If you were hiring a new employee in your work unit, how would you rank the importance of the following qualities?  That is, how much weight would you assign to each in making your decision? Explain.

Personal values (ex. work ethic and integrity)

Individual intelligence

Conscientiousness in performing the job

Some employers use integrity tests as part of the screening process.  Are there problems with integrity tests? Can you test for integrity?

If you were a work unit supervisor, which of the following do you think is more important to improving organizational performance?  Explain.

Encouraging employees to participate in work and organizational decisions

Setting clear, challenging work goals

As a manager you realize the supervisors who report to you make errors when they rate their employees (e.g., too lenient, rate everyone the same, etc.).  You notice a consultant is offering a training session on how to avoid appraisal rating errors.  How successful do you think such a course would be in eliminating these errors?

As a supervisor, if you asked or surveyed your employees about the importance of pay as a factor in making job decisions,do you think employees would over-state or understate its value to them?

In order to receive full credit you must give complete and detailed answers for all Three

(3) questions. You should have a 
minimum of

2references

(
only

1

reference can be the textbook,the other references should be from outside credible sources
).

 Follow APAGuidelines 

please read textbook chapters attached in order to answer questions.

Safe Prescribing Essay

Practicum Journal: Safe Prescribing

There is probably no greater responsibility that the psychiatric mental health nurse practitioner assumes than the responsibility of prescribing medications. While someone can be harmed by psychotherapy, the level and intensity of the harm generally does not come to the same level of harm that can occur from improper prescribing. The PMHNP must understand his/her responsibility both at a state and federal level when it comes to prescribing medications. Safe Prescribing Essay.

NURS 6670 EXAMS, DISCUSSIONS AND ASSIGNMENTS

In this Safe Prescribing Essay Assignment, you will explore the legalities associated with prescribing controlled substances, as well as what a DEA number is, how to obtain one, and, most importantly, how to prescribe controlled substances in your state. NURS 6670 “Captain of the Ship” Project – Depressive Disorder. Safe Prescribing Essay.

NURS 6670 “Captain of the Ship” Project – Depressive Disorder Learning Objectives

Students will:

Analyze roles of the Drug Enforcement Administration

Analyze PMHNP responsibilities when issued a DEA number

Analyze DEA number application procedures

Analyze state requirements for safe prescribing and prescription monitoring

Analyze PMHNP responsibilities for safe prescribing and prescription monitoring

Analyze Schedule II-V drug levels

Safe Prescribing Essay

** Assigned in Week 2 and submitted in Week 4.

To prepare for this Practicum Journal:

Review the Learning Resources.

In 2-3 pages:

Describe the role of the Drug Enforcement Administration (DEA) as it pertains to the PMHNP.

Explain your responsibilities when having a DEA number.

Safe Prescribing Essay

Explain how you apply for a DEA number.

NURS 6670 “Captain of the Ship” Project – Depressive Disorder

Explain your state’s requirements for a safe prescribing and prescription monitoring program. Explain your responsibility as a PMHNP to follow these requirements.

Provide an example of a drug you may prescribe from each of the Schedule II-V drug levels.

“Captain of the Ship” Project – Depressive Disorder

As nurse practitioners strive to achieve full-autonomous practice across the country, it should be noted that many states grant this ability to practice independently to psychiatric mental health nurse practitioners. To that end, you will be engaging in projects this semester that assume that you are practicing in a state that allows full-practice authority for NPs, meaning that the PMHNP may be the “captain of the ship” concerning caring for a patient population. The “captain of the ship” is the one who makes referrals to specialists, coordinates care for their patients/clients, and is responsible and accountable for patient/client outcomes overall. This is a decided change from a few decades ago when physicians were the “captain of the ship” and NPs played a peripheral role. NURS 6670 “Captain of the Ship” Project – Depressive Disorder. Safe Prescribing Essay.

In this Assignment, you will become the “captain of the ship” as you provide treatment recommendations and identify medical management, community support resources, and follow-up plans for a client with a depression disorder.

NURS 6670 “Captain of the Ship” Project – Depressive Disorder Learning Objectives

Students will:

Recommend psychopharmacologic treatments based on therapeutic endpoints for clients with depression disorders. Safe Prescribing Essay.

Recommend psychotherapy based on therapeutic endpoints for clients with depression disorders

Identify medical management needs for clients with depression disorders

Identify community support resources for clients with depression disorders

Recommend follow-up plans for clients with depression disorders

To prepare for this Assignment:

Select an adult or older adult client with a depressive disorder you have seen in your practicum.

In 3–4 pages, write a treatment plan for your client in which you do the following:

Describe the HPI and clinical impression for the client.

Recommend psychopharmacologic treatments and describe specific and therapeutic endpoints for your psychopharmacologic agent. (This should relate to HPI and clinical impression.)

NURS 6670 “Captain of the Ship” Project – Depressive Disorder

Recommend psychotherapy choices (individual, family, and group) and specific therapeutic endpoints for your choices. Safe Prescribing Essay.

Identify medical management needs, including primary care needs, specific to this client.

Identify community support resources (housing, socioeconomic needs, etc.) and community agencies that are available to assist the client. NURS 6670 “Captain of the Ship” Project – Depressive Disorder.

Recommend a plan for follow-up intensity and frequency and collaboration with other providers. Safe Prescribing Essay.

Sallie Mae Fisher Health History

Ms. Fisher is an 82-year-old female with a history of chronic congestive heart failure (CHF), atrial fibrillation, and hypertension. During the last 6 months, she has been hospitalized four times for exacerbation of her CHF. She was discharged home last Saturday from the hospital after a 3-day stay to treat increased dyspnea, an 8-pound weight gain, and chest pain.

Ms. Fisher is recently widowed and lives alone. She has a daughter, Thelma Jean, who lives in town but works full time and has family issues of her own. Therefore, family support is limited. Sallie Mae Fisher Health History.

Hospital Discharge Instructions

Mountain Top Home Health to evaluate cardio-pulmonary status, medication management, and home safety.

Medical Equipment Company to deliver oxygen concentrator and instruct patient in use. O2 at 2 liters per nasal prongs PRN. Sallie Mae Fisher Health History.

Prescriptions given at discharge:

· Digoxin 0.25 mg once a day

· Lasix 80 mg twice a day

· Calan 240 mg once a day

Order written to continue other home meds.

Sallie Mae’s Home Medication List

Zocar 50 mg once a day

Minipres 1 mg once a day

Vasotec 10 mg twice a day

Prilosec 20 mg once a day

Furosemide 40 mg once a day

Effexor 37.5 mg at bedtime

Lanoxin 0.125 mg every other day

Multivitamin once a day

Potassium 40 mEq once a day

Ibuprofen 400 mg q 4 hours as needed for pain

Darvocet N 100 mg q 4 hours as needed for pain

Nitroglycerin ointment, apply 1 inch every day

Problem founded 1. Fall Risk .Polypharamacy, Depression, Dehydration ,weigh gain,Not Ovigen at home.

Utilizing the information learned from the home visit, health histories, and discharge orders, write a scripted dialogue in which you provide Sallie Mae with education that describes her problems and the interventions identified to improve her condition. Consider Sallie Mae’s physiological, psychosocial, educational, and spiritual needs when developing your dialogue. Sallie Mae Fisher Health History.

Your dialogue should resemble a script. The following is an example of a few sentences from a scripted dialogue:

Nurse: 
“Good morning, Salle Mae, my name is ______ and I will be your nurse today. I understand you are experiencing problems with ________.”

APA format is not required for this part of the assignment, but solid academic writing is expected. Sallie Mae Fisher Health History.

Decision Tree Practicum Essay Assignment Paper: Differential Diagnosis, Psychotherapy & Psychopharmacology

Practicum: Decision Tree

For this Assignment, as you examine the client case study in this week’s Learning Resources, consider how you might assess and treat adult and older adult clients presenting symptoms of a mental health disorder.

Learning Objectives

Students will:

Evaluate clients for treatment of mental health disorders

Analyze decisions made throughout diagnosis and treatment of clients with mental health disorders

Decision Tree Practicum Essay Assignment Paper: Differential Diagnosis, Psychotherapy & Psychopharmacology

NURS 6670 EXAMS, DISCUSSIONS AND ASSIGNMENTS

Examine Case 2:
 You will be asked to make three decisions concerning the diagnosis and treatment for this client. Be sure to consider co-morbid physical, as well as mental factors that might impact the client’s diagnosis and treatment.

At each Decision Point stop to complete the following:

Decision #1: Differential Diagnosis

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. Decision Tree Practicum Essay Assignment Paper: Differential Diagnosis, Psychotherapy & Psychopharmacology.

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

Decision #2: Treatment Plan for Psychotherapy

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 Tree Practicum Essay Assignment Paper: Differential Diagnosis, Psychotherapy & Psychopharmacology.

Decision #3: Treatment Plan for Psychopharmacology

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 Tree Practicum Essay Assignment Paper: Differential Diagnosis, Psychotherapy & Psychopharmacology.

Also include how ethical considerations might impact your treatment plan and communication with clients and their family.

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.

By Day 7 of Week 7

Decision Tree Practicum Essay Assignment Paper: Differential Diagnosis, Psychotherapy & Psychopharmacology

“Captain of the Ship” Project – Bipolar Disorders

Bipolar disorders are severe disorders of mood that include both depressive episodes and expansive, grandiose, or manic episodes. During these times, the person may engage in activities with little awareness of the consequences because of accompanying psychosis. A diagnosis of bipolar disorder includes periods of mania or hypomania and periods of depression where the mood is down, hopeless, and suicidal. The neurovegetative symptoms of bipolar depression can be incapacitating. It is also important to differentiate the psychosis of bipolar disorder from schizophrenia. Decision Tree Practicum Essay Assignment Paper: Differential Diagnosis, Psychotherapy & Psychopharmacology.

In this Assignment, you will become the “captain of the ship” as you provide treatment recommendations and identify medical management, community support resources, and follow-up plans for a client with a bipolar disorder.

Decision Tree Practicum Essay Assignment Paper: Differential Diagnosis, Psychotherapy & Psychopharmacology Learning Objectives

Students will:

Recommend psychopharmacologic treatments based on therapeutic end points for clients with bipolar disorders

Recommend psychotherapy based on therapeutic end points for clients with bipolar disorders

Identify medical management needs for clients with bipolar disorders

Decision Tree Practicum Essay Assignment Paper: Differential Diagnosis, Psychotherapy & Psychopharmacology

Identify community support resources for clients with bipolar disorders

Recommend follow-up plans for clients with bipolar disorders

To prepare for this Assignment:

Select an adult or older adult client with a bipolar disorder that you have seen in your practicum.

In 3-4 pages, write a treatment plan for your client. In which you do the following:

Describe the HPI and clinical impression for the client.

Recommend psychopharmacologic treatments and describe specific and therapeutic end points for your psychopharmacologic agent. (This should relate to HPI and clinical impression.).

Recommend psychotherapy choices (individual, family, and group) and specific therapeutic endpoints for your choices.

Identify medical management needs, including primary care needs, specific to this client.

Identify community support resources (housing, socioeconomic needs, etc.) and community agencies that are available to assist the client. Decision Tree Practicum Essay Assignment Paper: Differential Diagnosis, Psychotherapy & Psychopharmacology

Recommend a plan for follow-up intensity and frequency and collaboration with other providers.

By Day 7

Submit
 your Assignment.

Submission and Grading Information

To submit your completed Assignment for review and grading, do the following:

Please save your Assignment using the naming convention “WK5Assgn1+last name+first initial.(extension)” as the name. Decision Tree Practicum Essay Assignment Paper: Differential Diagnosis, Psychotherapy & Psychopharmacology

Click the 
Week 5 Assignment 1 Rubric 
to review the Grading Criteria for the Assignment.

Click the 
Week 5 Assignment 1 
link. You will also be able to “View Rubric” for grading criteria from this area.

Next, from the Attach File area, click on the 
Browse My Computer
 button. Find the document you saved as “WK5Assgn1+last name+first initial.(extension)” and click 
Open
.

If applicable: From the Plagiarism Tools area, click the checkbox for 
I agree to submit my paper(s) to the Global Reference Database
.

Click on the 
Submit
 button to complete your submission.

Decision Tree Practicum Essay Assignment Paper: Differential Diagnosis, Psychotherapy & Psychopharmacology

Integrated Safety-Net Health Care System Case Study

Evaluate the cultural competence of the healthcare organization presented in the Integrated Safety-Net Health Care System case study using a population health approach. Please also read the supplemental Interpreting Services Program document to ensure that you have all of the information about the Montefiore Medical Center you will need to address the critical elements. Integrated Safety-Net Health Care System Case Study.

Specifically the following critical elements must be addressed:

I. Patient engagement activities and communication strategies

a) Critique the organization’s translation and interpretation services that may be available to non-English-speaking patients. In other words, does

the organization provide such services? How many different languages are supported? How might the organization communicate with a speaker. Integrated Safety-Net Health Care System Case Study.

of a language that is not supported? Be sure to provide evidence that supports your claims.

b) Analyze the extent to which educational resources and materials are available in languages other than English. Be sure to provide specific

examples.

c) Assess organizational staff training on patient engagement and communications for its potential to foster cultural competence. Be sure to provide evidence to support your claims. Integrated Safety-Net Health Care System Case Study.

d) Identify gaps or deficiencies that may exist in the organization’s patient engagement and communications strategies, and provide evidence to support your claims. If you feel there are none, be sure to explain your reasoning. Integrated Safety-Net Health Care System Case Study.

Decision Tree Nursing Assignment

Assignment 1: Practicum: Decision Tree

For this Decision Tree Nursing Assignment, as you examine the client case study in this week’s Learning Resources, consider how you might assess and treat adult and older adult clients presenting symptoms of a mental health disorder.

The Assignment:

Decision Tree Nursing Assignment  Learning Objectives

Students will:

Evaluate clients for treatment of mental health disorders

Analyze decisions made throughout diagnosis and treatment of clients with mental health disorders

Examine Case 3
: You will be asked to make three decisions concerning the diagnosis and treatment for this client. Be sure to consider co-morbid physical as well as mental factors that might impact the client’s diagnosis and treatment.

At each Decision Point, stop to complete the following Decision Tree Nursing Assignment :

NURS 6670 EXAMS, DISCUSSIONS AND ASSIGNMENTS

Decision #1: Differential Diagnosis

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. Decision Tree Nursing Assignment .

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

Decision #2: Treatment Plan for Psychotherapy

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. Decision Tree Nursing Assignment .

Explain any difference between what you expected to achieve with Decision #2 and the results of the Decision. Why were they different?

Decision #3: Treatment Plan for Psychopharmacology

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 Tree Nursing Assignment .

Also include how ethical considerations might impact your treatment plan and communication with clients and their family. Decision Tree Nursing Assignment .

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. Decision Tree Nursing Assignment

Discussion: Treatment of Neurocognitive Disorders

Neurocognitive disorders (NCD) such as delirium, dementia, and amnestic disorders are more prevalent in older adults. As the population ages and as life expectancy in the United States continues to increase, the incidence of these disorders will continue to increase. Cognitive functioning such as memory, language, orientation, judgment, and problem solving are affected in clients with NCDs. Caring for someone with a neurocognitive disorder is not only challenging for the clinician, but also stressful for the family. The PMHNP needs to consider not only the client but also the “family as client.” Collaboration with primary care providers and specialty providers is essential. Anticipatory guidance also becomes extremely important.

In this Discussion, you will integrate several sources of knowledge specific to NCDs as you discuss evidenced-based therapies used to treat these disorders.

Decision Tree Nursing Assignment Discussion Learning Objectives

Students will:

Analyze diagnostic criteria for neurocognitive disorders

Analyze evidence-based psychotherapy and psychopharmacologic treatment for neurocognitive disorders

Evaluate benefits and risks of neurocognitive therapies

Compare differential diagnostic features of neurocognitive disorders

Decision Tree Nursing Assignment Discussion

Note:
 For this Discussion, you are required to complete your initial post before you will be able to view and respond to your colleagues’ postings. Begin by clicking on the “Post to Discussion Question” link and then select “Create Thread” to complete your initial post. Remember, once you click submit, you cannot delete or edit your own posts, and cannot post anonymously. Please check your post carefully before clicking Submit! NURS 6670 Discussion: Treatment of Neurocognitive Disorders.

To prepare for this Decision Tree Nursing Assignment Discussion:

By Day 5 of Week 7, your Instructor will have assigned you a neurocognitive disorder, which will be the focus for your initial post for this Decision Tree Nursing Assignment Discussion.

Review the Learning Resources. Decision Tree Nursing Assignment Discussion.

By Day 3

Post:

Explain the diagnostic criteria for your assigned neurocognitive disorder.

Explain the evidenced-based psychotherapy and psychopharmacologic treatment for your assigned neurocognitive disorder.

Identify the risks of different types of therapy and explain how the benefits of the therapy that might be achieved might outweigh the risks. Decision Tree Nursing Assignment Discussion.

Support your rationale with references to the Learning Resources or other academic resource.

By Day 6

Respond
 to at least 
two
 of your colleagues by comparing the differential diagnostic features of the disorder you were assigned to the diagnostic features of the disorder your colleagues were assigned. Decision Tree Nursing Assignment Discussion.

Mucor comment 1

Mucor is a mold that causes a serious fungal infection. Mucormycosis most commonly affects the sinuses or lungs and affects people with weakened immune systems.  It infects the sinuses or lungs after inhaling fungal spores from the air, or can enter the skin through a cut, scrape, burn, or other skin injury.  This group of fungi lives in most soil, especially decaying leaves, composite piles, or rotten wood.  People come in contact with this frequently but may do not often develop mucormycosis unless they are immune compromised, then the fungi gets into their sinuses or lungs, develops an infection and spreads to other areas of the body and they are unable to fight it off (Cdcgov. (2015)).  The infection starts with signs of a fever, cough sometimes with dark or bloody sputum, and shortness of breath, it then progresses and rapidly multiplies in blood vessel walls.  When the fungus reaches the alveoli in the lungs, it travels into the spaces between the cells and the connecting pores.  The immune system is then triggered to send the white blood cells (neutrophils) to try and fight off the invasion of the fungus.  The neutrophils then try to do their job while at the same time are releasing cytokines which activate the immune system.  This is when the pneumonia sets in and just continues to take over as the alveoli fill with fluid leaking from the surrounding blood vessels which results in impaired oxygen transportation (Wikipediaorg. (2018)). Mucor.

Medical/Nursing interventions:

1)      Educate the patient on the importance of taking their medication as prescribed and to finish the entire dose.

2)      Apply Oxygen as needed to help ease the symptoms of dyspnea

3)      Control any underlying immune compromised condition if possible. Mucor.

comment2

The attending physician will prescribe an antifungal treatment for mucormycosis. Prescription antifungals will be used such as amphotericin B, posaconazole or isavulcaonazole (CDC, 2015). Antifungal therapies can be administered IV and oral depending on the medication. Treatment can also involve surgical debridement of the infected area. The chest X-ray in the case study shows areas in the lungs that are infected and potentially necrotic, requiring surgical intervention. Lastly, appropriate treatment of any other debilitating diseases should be addressed, such as diabetes and infections, other than mucormycosis.

Assessment and Treatment of Gender Dysphoria, Paraphilic Disorders, and Sexual Dysfunction Essay Assignment Discussion Papers

Week 11: Gender Dysphoria, Paraphilic Disorders, and Sexual Dysfunction

I have been under a lot of stress lately. Between my job, the house and kids, and my wife complaining, I don’t seem to have the “staying power” I used to. Our sex life used to be perfect, but now I cannot perform as well or as often as I used to. My wife does not seem to understand and now I am feeling inadequate. I have a long life in front of me and I don’t want to live without feeling like a true man.”

Larry, age 40

This week’s topics include gender dysphoria, paraphilic disorders, and sexual dysfunction. The term gender dysphoria is the diagnosis describing those persons who experience incongruence between their gender assigned at birth and their experienced gender. Paraphilic disorders include pedophilia, exhibitionism, fetishism, and voyeurism, for example. Sexual dysfunction disorders include, most commonly, male erectile disorder, female orgasmic disorder, and other disorders. These diagnoses may be treated with pharmacologic and psychotherapy modalities. Assessment and Treatment of Gender Dysphoria, Paraphilic Disorders, and Sexual Dysfunction Essay Assignment Discussion Papers.

This week, you will explore ways to assess and care for persons with gender dysphoria, paraphilic disorders, and sexual dysfunction disorders as outlined in the DSM-5.

Photo Credit: Rick Gomez / Blend Images / Getty Images

Assessment and Treatment of Gender Dysphoria, Paraphilic Disorders, and Sexual Dysfunction Essay Assignment Discussion Papers 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

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 17, “Human Sexuality and Sexual Dysfunctions” (pp. 564–599)

Chapter 18, “Gender Dysphoria” (pp. 600–607)

Note
: This is review from the Learning Resource in Week 3.

Gabbard, G. O. (2014).
Gabbard’s treatment of psychiatric disorders
(5th ed.). Washington, DC: American Psychiatric Publications.

Chapter 37, “Sexual Dysfunctions”

Chapter 38, “Paraphilias and Paraphilic Disorders”

Chapter 39, “Gender Dysphoria”

Note
: You will access this book from the Walden Library databases.

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

“Gender Dysphoria”

“Paraphilic Disorders”

“Sexual Dysfunctions”

Note
: You will access this book from the Walden Library databases.

Stahl, S. M. (2014).
Prescriber’s Guide: Stahl’s Essential Psychopharmacology
(5th ed.). New York, NY: Cambridge University Press.

 

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

 

To access information on specific medications, click on
The Prescriber’s Guide, 5
th
Ed.
tab on the Stahl Online website and select the appropriate medication. Assessment and Treatment of Gender Dysphoria, Paraphilic Disorders, and Sexual Dysfunction Essay Assignment Discussion Papers.

Sexual dysfunction

bupropion

Johnson, L., Shipherd, J., & Walton, H. M. (2016). The psychologist’s role in transgender-specific care with U.S. veterans.
Psychological Services
,
13(
1), 69–76. doi:10.1037/ser0000030

 

Note:
You will access this article through the Walden Library databases.

Levenson, J. S., & Grady, M. D. (2016). The influence of childhood trauma on sexual violence and sexual deviance in adulthood.
Traumatology
,
22
(2), 94–103. doi:10.1037/trm0000067

 

Note:
You will access this article through the Walden Library databases.

Hawes, S. W., Boccaccini, M. T., & Murrie, D. C. (2013). Psychopathy and the combination of psychopathy and sexual deviance as predictors of sexual recidivism: Meta-analytic findings using the Psychopathy Checklist—Revised.
Psychological Assessment
,
25
(1), 233–243. doi:10.1037/a0030391

Note:
You will access this article through the Walden Library databases.

Required Media

Johnson, S. (Producer). (n.d.).
Emotionally focused therapy with same-sex couples
[Video file]. Mill Valley, CA: Psychotherapy.net.

 

Note:
You will access this video through the Walden Library databases.

Discussion: Assessment and Treatment of Gender Dysphoria, Paraphilic Disorders, and Sexual Dysfunction

Sexuality is an important part of each person’s quality of life. Research indicates that awareness of sexual identity and its importance may begin as early as age 3. However, individuals with varying diagnoses, disorders, or dysfunctions may grapple with issues related to their sexuality in their teen years, as well as into adulthood.

In this Discussion, you will explore the assessment and treatment of gender dysphoria, paraphilic disorders, and sexual dysfunction. Assessment and Treatment of Gender Dysphoria, Paraphilic Disorders, and Sexual Dysfunction Essay Assignment Discussion Papers.

Learning Objectives

Students will:

Analyze diagnostic criteria for gender dysphoria, paraphilic disorders and sexual dysfunction

Analyze evidence-based psychotherapy and psychopharmacologic treatments for gender/sexual disorders

Compare differential diagnostic features of gender/sexual disorders

Note:
 For this Discussion, you are required to complete your initial post before you will be able to view and respond to your colleagues’ postings. Begin by clicking on the “Post to Discussion Question” link and then select “Create Thread” to complete your initial post. Remember, once you click submit, you cannot delete or edit your own posts, and cannot post anonymously. Please check your post carefully before clicking 
Submit
!

To prepare for this Discussion:

Select a gender dysphoria, paraphilic disorder, or sexual dysfunction that interests you.

Review the Learning Resources.

By Day 3

Post:

Explain the diagnostic criteria for the gender dysphoria, paraphilic disorder, or sexual dysfunction you selected.

Explain the evidenced-based psychotherapy and psychopharmacologic treatment for the gender dysphoria, paraphilic disorder, or sexual dysfunction you selected.

Support your rationale with references to the Learning Resources or other academic resource.

By Day 6

Respond
 to at least 
two
 of your colleagues by comparing the differential diagnostic features of the disorder you selected to the diagnostic features of the disorder your colleagues were assigned. Assessment and Treatment of Gender Dysphoria, Paraphilic Disorders, and Sexual Dysfunction Essay Assignment Discussion Papers.

Submission and Grading Information

Grading Criteria

To access your rubric:

Week 11 Discussion Rubric

Post by Day 3 and Respond by Day 6

To participate in this Discussion:

Week 11 Discussion

NURS 6670 EXAMS, DISCUSSIONS AND ASSIGNMENTS

Assessment and Treatment of Gender Dysphoria, Paraphilic Disorders, and Sexual Dysfunction Essay Assignment Discussion Papers Assignment 1: Final Exam

This exam is designed to assess how well you have synthesized the information from all your PMHNP courses. It draws upon the material from all the textbooks from NURS 6630, NURS 6640, NURS 6670, NURS 6660, and NURS 6670. It is very similar to what you will experience in your certification exam.

Learning Objectives

Students will:

Assess knowledge of adult and older adult psychotherapy concepts and principles (E)

This exam will cover the following topics:

Obsessive-Compulsive Disorders

Neurocognitive Disorders

Schizophrenia Spectrum and Other Psychotic Disorders

Sleep/Wake Disorders, Parasomnias

Gender Dysphoria, Paraphilic Disorders, & Sexual Dysfunction

By Day 7

Complete the Final Exam by. Prior to starting the exam, you should review all of your materials. There is a 2-hour time limit to complete this 75-question exam. You may only attempt this exam once. Assessment and Treatment of Gender Dysphoria, Paraphilic Disorders, and Sexual Dysfunction Essay Assignment Discussion Papers.

This exam is a test of your knowledge in preparation for your certification exam. 
No outside resources
 including books, notes, websites, or any other type of resource are to be used to complete this exam. You are expected to 
comply with Walden University’s Code of Conduct
.

Submission and Grading Information

Submit Your Exam by Day 7

To submit your Exam:

Week 11 Final Exam

Assignment 2: Board Vitals

This week you will be responding to twenty Board Vitals questions that cover a broad review of your Nurse Practitioner program courses up to this point. Assessment and Treatment of Gender Dysphoria, Paraphilic Disorders, and Sexual Dysfunction Essay Assignment Discussion Papers.

These review questions will provide practice that is critical in your preparation for the national certification exam that’s required to certify you to practice as a nurse practitioner. These customized test questions are designed to help you prepare for your Nurse Practitioner certification exam. It is in your best interest to take your time, do your best, and answer each question to the best of your ability.

You can access Board Vitals through the link sent to you in email or by following the link below:

https://www.boardvitals.com/

By Day 7

Complete the Board Vitals questions.

Making Connections

This week, you explored ways to assess and care for persons with gender dysphoria, paraphilic disorders, and sexual dysfunction disorders as outlined in the DSM-5.

Congratulations! After you have finished all of the assignments for this week, you have completed the course. Please submit your Course Evaluation by Day 7. Assessment and Treatment of Gender Dysphoria, Paraphilic Disorders, and Sexual Dysfunction Essay Assignment Discussion Papers.