Category: Nursing

PICOT question and EBP – Opioids & Ketamine in Emergency Department (ED) Literature Review Essay

In a 3page paper:

Restate your PICOT question and its significance to nursing practice.

Summarize the findings from the articles you selected for your literature review. Describe at least one nursing practice that is supported by the evidence in the articles. Justify your response with specific references to at least 2 of the articles.

Explain how the evidence-based practice that you identified contributes to better outcomes. In addition, identify potential negative outcomes that could result from failing to use the evidence-based practice. PICOT question and EBP – Opioids & Ketamine in Emergency Department (ED) Literature Review Essay.

Outline the strategy for disseminating the evidence-based practice that you identified throughout your practice setting. Explain how you would communicate the importance of the practice to your colleagues. Describe how you would move from disseminating the information to implementing the evidence-based practice within your organization. How would you address concerns and opposition to the change in practice?

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PLEASE USE THESE REFERENCES FOR THE PAPER

1-   Ahern, T. L., Herring, A. A., Miller, S., & Frazier, B. W. (2015, July). Brief research report: Low-dose ketamine infusion for emergency department with severe pain. Pain , 16(7), 1402-1409. Retrieved from
https://eds-b-ebscohost-com.ezp.waldenulibrary.org/eds/delivery?sid=641349b8-3177-45ba-953c-c5a2d79612aa%40sessionmgr102&vid=3&ReturnUrl=https%3a%2f%2feds.b.ebscohost.com%2feds%2fpdfviewer%2fpdfviewer%3fvid%3d2%26sid%3d641349b8-3177-45ba-953c-c5a2d79612aa%2540sessionmgr102

2-  Boker, G., & Anderson, P. (2014, March 20). Ketamine: An update on its abuse. J Pharm Pract, 27(6), 582-586.
http://dx.doi.org/10.1177/0897190014525754

3.-  Ku, J., & Lei, H. (2014, October 28). Ketamine: An update on its clinical uses and abuses. CNS Neuroscience & Therapeutics, 20, 1015-1020.
http://dx.doi.org/10.1111/cns.12363

4-  Pourmand, A., Mazer-Amirshahi, M., Royall, C., Alhawas, R., & Shesser, R. (2017, March 2). American Journal of Emergency Medicine. Low dose ketamine use in the emergency department, a new direction in pain management, 35(6), 918-921.
http://dx.doi.org/10.1016/j.ajem.2017.03.005

5-  Sassano-Higgins, S., Baron, D., Juarez, G., & Esmaili, N. (2016). A review of ketamine abuse and diversion. Depression and Anxiety, 33(8), 718-727.
http://dx.doi.org/10.1002/da.22536

 

Literature Review

The literature review is intended to determine if ketamine would be a viable alternative pain management strategy to address pain control for opioid abusers in the Emergency Department (ED).  This literature review consists of 5 articles. The studies evaluated entailed use of a nonrandomized control trial and evidence from systematic or integrative reviews published by scholarly journals.  This literature review will synthesize the comparisons and contrasts of each article. The studies used different combined routes for administering ketamine primarily, as intravenously (IV).  Studies also yield in considerations of alternative routes of administration. PICOT question and EBP – Opioids & Ketamine in Emergency Department (ED) Literature Review Essay.

Comparison and Contrast

The 5 literature studies and reviews suggest, ketamine to have a correlation suggesting adequate pain management for different types of pain control.  In contrast, Boker and Anderson (2014) notes that although ketamine is an effective pain reliever it is subject to abuse.  Additionally, it alters brain function to include alterations in time, reaction, cognition, attention, memory and color perception.  Some studies have resulted in inappropriate prescribing patterns linked to knowledge deficits, safety perceptions, and inadequate pain assessment associated with under-treatment. Xu and Lei (2014) report ketamine abuse to be increasing and produce a dissociative state and hallucinations. This review confirms the alterations in the brain including; color perception, memory, attention, cognition, reaction time, and since of time, and can produce psychological addiction.  Addiction to prescription medication is considered a national wide occurrence and can be actively addressed through use of less addictive medications with comparable medications.  Sassano-Higgins et al (2016) reveal limited withdrawal symptoms reported for users of ketamine.  Pourmand et at (2017) reports the ED involvement in the opioid epidemic to be unclear although, opioids are prescribed often in the ED for pain control. This review suggests ketamine given in the ED to be a safe and effective alternative for pain control. PICOT question and EBP – Opioids & Ketamine in Emergency Department (ED) Literature Review Essay.

Patient side effects was of high importance of quality while performing the literature review. Side effects were revealed in multiple reviews. All 5 literatures state ketamine as a dissociative type of anesthetic. Ketamine is also considered a type of drug that has been used as a street drug.  Xu and Lei (2014); Boker and Anderson (2014); Sassano-Higgins et al (2016); and Pourmand et at (2017) reports the apprehension for over use of ketamine and have potential toxicity to the gastrointestinal tract and the urinary tracts.  Gastrointestinal issues revealed to have epigastric pain, hepatic dysfunction, colic like behaviors with a dilated common bile duct, abnormal liver function test, choledochal cysts.  Urinary tract side effects report ketamine users to present with dysuria, suprapubic pain, and painful hematuria. This can result in cystitis or renal failure. PICOT question and EBP – Opioids & Ketamine in Emergency Department (ED) Literature Review Essay.

In contrast, Ahern et al (2015) reports ketamine to be safe and have limited to mild side effects during a 2-hour monitoring experimental trial. The conclusion is contradictory due to the trial also added narcotics subsequently to the ketamine for assistance in pain management during the experiment. This study is based on the research hypotheses that ketamine is an alternative for pain management.  This research would not benefit the opioid abuser’s due to the relevance of using a narcotic as an adjunct. PICOT question and EBP – Opioids & Ketamine in Emergency Department (ED) Literature Review Essay.

Pourmand et al (2017) encourages nurses should be cautious when administering LDK (Low Dose Ketamine) due to the lack of experience. Suggestions for ketamine to be administered under the supervision of pain specialist or anesthesiologist. Texas Board of Nursing considers ketamine to be safe for an RN to administer by an order from a pain specialist or anesthesiologist therefore contraindicating the use for ED. If the nurse is to provide ketamine as an analgesic ensure proper protocols are in place. Ketamine when in larger doses can result in respiratory depression.

Alternative Uses and Locations

The literature reviewed combined inconsistences for multiple uses on ketamine to be effective for the use of major depression, suicidal ideations, bipolar depression, and asthmaticus attacks and was not limited to only pain. The subjects that were treated for pain were located in numerous areas including ED, postoperative, perioperative, conscious sedation, and medical floors. The limitation was only one resource with patients presenting from the ED. PICOT question and EBP – Opioids & Ketamine in Emergency Department (ED) Literature Review Essay.

Conclusion

Although the reviewed literature portrays there is high potential for opioid pain medication to be abused and even turn addictive with ketamine presenting a viable non-addictive alternative, some of the information is not based on primary data and clinical trials therefore questioning the clinical significance.  Due to lack of resources, additional limitations in the study include absence of placebos and subjectivity of pain assessment tools.  Conducting a clinical trial using patients with opioid addiction and monitor for a new development of addiction for the use of ketamine would determine if ketamine would be an effective alternative.  There is need for more clinical trials on research and data to provide enough evidence to promote ketamine as a safe alternative for opioid abusers. PICOT question and EBP – Opioids & Ketamine in Emergency Department (ED) Literature Review Essay.

PICOT Question

Pain control is a number one priority in the patient satisfaction scores for the Emergency Departments. With patient satisfaction survey scores driving how healthcare is being performed many physicians feel pressured to prescribe to customer satisfaction instead of medical necessity.  (Zgierska, Miller, Rabago, &, 2013) Prescribing opioids in this manner has caused an epidemic of opioid dependence. The deaths from narcotics are superseding the deaths from suicide and motor vehicle accidents. (Manchikanti et al., 2012) The government is now monitoring prescriptions of opioid prescribing and more patients are coming to the Emergency Department (ED) due to the need for pain control and due to opioid addiction.  Physicians are looking for a non-opioid pain relief.  Ketamine has started to appear in the emergency room for an alternative route for opioid abusers. PICOT question and EBP – Opioids & Ketamine in Emergency Department (ED) Literature Review Essay.

Alternative uses for non-opioid pain relief in the emergency rooms have incorporate low doses ketamine (LDK) to assist with acute pain, chronic pain, and refractory pain. Adverse effects to ketamine results in dizziness, nausea, vomiting, mild hallucinations or agitation.  (Pourmand, Mazer-Amirshahi, Royall, Alhawas, & Shesser, 2017) There are different types of psychological factors that can have detrimental effects on patients being given ketamine for pain control.  According to Bokor and Anderson, “ketamine can alter numerous functions in the brain including color perception, memory, attention, cognition, reaction time, and sense of time can produce psychological addiction” (Boker & Anderson, 2014) Ketamine is a scheduled class III drug which potentiates the likely increase for abuse and addiction. (American Addiction Centers, 2018). Knowledge of the side effects and levels of abuse the patient can develop from ketamine are concerning for another rising type of addiction to start in the medical field.  Currently ketamine is a recreational drug on the streets known as the “date rape drug”. (American Addiction Centers, 2018) The rationale to utilize ketamine instead of opioids is in need of recurring research to ensure safe prescribing for patients. PICOT question and EBP – Opioids & Ketamine in Emergency Department (ED) Literature Review Essay.

PICO

In developing my clinical question, I utilized the formula of patient, intervention, comparison, and outcome. I then was able to develop the question, Is Ketamine a safe effective alternative to pain relief in the Emergency Department for opioid abusers?    The patient criteria of the question involve the group of opioid abuser.  The problem is the need for an alternate non-opioid pain management for patients who have history of opioid abuse.  The alternative needs to be a safe alternative to pain management and not just a cover up or another drug to start an addiction.   The intervention is giving low doses of ketamine for pain management to opioid abusers.  The comparison component is substituting opioids for low-dose ketamine.  The outcome component is highly important, are we managing patients pain safely or is being prescribed ketamine fueling another type of addiction.PICOT question and EBP – Opioids & Ketamine in Emergency Department (ED) Literature Review Essay.

Questions

Deciding on the five questions I have developed involved understanding the reasoning, safety, and effects of giving ketamine. Patient safety is the number one priority. One correlation I perceived is are we going to be seeing more people returning to the ED for ketamine?  Is this going to be another type of addiction for opioid abuser? To understand and research the problem I have developed these five questions:

What is the mechanism of action for ketamine to provide pain relief?

What are side effects of ketamine?

Is ketamine addictive?

Should ketamine be given on a patient’s own pain scale rating?

When should ketamine be contraindicated?

Question one was developed with needing to know knowledge on how ketamine provides pain relief in the body.  This can be beneficial in knowing how the drug will affect the patient.  Question two is needing to be researched for patient safety.  Side effects can be synergistic to other diagnosis’s the patient may have. Question three is beneficial in understanding ketamine addiction could be a prevalence for patients with opioid abuse to also become addicted to ketamine.  Question 4 rational includes understanding the pain scale and when to give ketamine is being given for pain.  Should this be a common substitute for acute pain?  Should there be other factors to patient reaction when deciding when to give ketamine besides patient’s pain scale rating. Drug abusers will tell you they have a pain of 10 to try and ensure having opioids prescribed to them.  Question 5 is indicative to understanding if it is safe or not safe to given in situations when patients present with multiple diagnosis including history of addiction. PICOT question and EBP – Opioids & Ketamine in Emergency Department (ED) Literature Review Essay.

Keywords

Keywords are important in researching the best evidence reviews and practice for developing an outcome to your PICO question.  Keywords that I chose to utilize for my database search includes; low dose ketamine, opioid abuse, pain management, adverse effects, drug seekers, analgesia, addiction, acute pain, emergency department, and subdissociative dose ketamine.  The keyword chosen correlates to the significance of the PICOT question.  The low dose ketamine and subdissociative dose ketamine is the dosage that would be given to patients who need acute pain management. Opioid abuse, drug seekers, and addiction are pertinent words to understand the reasoning for the need of an alternate solution to opioids.  Pain management, analgesia, acute pain is the types of pain or synonyms for the research of pain management in the Emergency Department for opioid abusers.  The keyword Emergency Department is important in understanding the location and setting where the patient is being given ketamine. Knowledge of adverse effects of ketamine can play an important role in understanding if the medication is safe to give in an ED setting.

Knowledge of ketamine can further inquire on the safety with administration of ketamine.  Correlating side effects, adverse effects, and mechanism of action will allow for a base understanding of the scientific purpose for treating pain with ketamine.  Further investigation and research needs to be applied in relevance to the later effects of using this type of drug for pain control. PICOT question and EBP – Opioids & Ketamine in Emergency Department (ED) Literature Review Essay.

Nursing (NURS) 516 Pharmacotherapeutics and Pathophysiology for Nurse Practitioners 

Introduction

NURS 516 is part of a program of study leading to the Post-Master’s Diploma: Nurse Practitioner, or the Master of Nursing (Nurse Practitioner) degree. NURS 516 is a prerequisite course for NURS 517, NURS 518, NURS 522, NURS 524, NURS 526, NURS 527, NURS 528, NURS 530 and NURS 531. NURS 516 can be taken as an elective course by other Master of Nursing or Master of Health Studies students and by non-program students. Nursing (NURS) 516 Pharmacotherapeutics and Pathophysiology for Nurse Practitioners.

NURS 516 provides students with an integrated approach to pathophysiology and pharmacology that will support clinical decision making about the diagnosis and treatment of acute and chronic presentations commonly managed by nurse practitioners. The course is comprised of eleven units, the first three of which are foundational, covering prescriptive practices, pharmacologic and pathophysiologic principles. The remaining seven units integrate the pathophysiology of body system with the pharmacologic agents used in the management of diseases of those body systems. Using a case-based approach students apply what they have learned to clinical scenarios depicting client presentations that students are likely to encounter in their clinical placements and in their practices as entry-level nurse practitioners. Nursing (NURS) 516 Pharmacotherapeutics and Pathophysiology for Nurse Practitioners.

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NURS 516 covers a portion of the body systems with the remainder of the systems addressed in NURS 517. Together these courses provide foundational knowledge of pharmacology and pathophysiology that will be used to support clinical decision making. The content of NURS 516 is supported by other courses in the Nurse Practitioner program that teach management of common acute and chronic diseases of adult men and women, children, and older adults. Nursing (NURS) 516 Pharmacotherapeutics and Pathophysiology for Nurse Practitioners.

Nursing (NURS) 516 Pharmacotherapeutics and Pathophysiology for Nurse Practitioners Course Goals

After completing this course, students should be able to:

describe the basic principles of pharmacokinetics and pharmacodynamics, and how these principles may affect prescribing decisions;

demonstrate an understanding of the selection and use of drugs in the management and treatment of disease, including the application of pharmacokinetics and pharmacodynamics to client clinical context and the integration of client social context (age, health status, gender, concomitant therapies, cultural beliefs, financial status, etc) to the selection of drugs of choice; Nursing (NURS) 516 Pharmacotherapeutics and Pathophysiology for Nurse Practitioners.

identify and incorporate special considerations when prescribing for specific populations: pregnancy, breastfeeding, older adults, children and infants, and genetic factors;

evaluate and then apply research findings to the development of evidence-based, comprehensive client pharmaceutical plans of care;

evaluate prescribed drug regimens for safety, clinical efficacy and outcomes, in partnership with the client;

identify and incorporate strategies to address potential barriers to regimen adherence into client assessment and education;

integrate knowledge of adverse drug reactions and interactions in safe prescribing and appropriately report adverse drug reactions;

understand professional, ethical and legal considerations and responsibilities when prescribing;

recognize polypharmacy and takes appropriate interventions to optimize therapy; and

summarize the role of interdisciplinary consultation in optimizing drug therapy.

Nursing (NURS) 516 Pharmacotherapeutics and Pathophysiology for Nurse Practitioners

explain pathophysiological processes leading to clinical manifestations of common acute and chronic diseases;

utilize knowledge of pathophysiological processes to inform diagnoses of common acute and chronic diseases;

recognize variations of pathophysiological processes in pediatric and geriatric clients; and

explain factors influencing the incidence and manifestation of diseases in populations.

articulate how pathophysiological processes influence the selection of tests to diagnose common acute and chronic diseases. Nursing (NURS) 516 Pharmacotherapeutics and Pathophysiology for Nurse Practitioners.

Nursing (NURS) 516 Pharmacotherapeutics and Pathophysiology for Nurse Practitioners Course Materials

NURS 516 comprises online content and electronic course materials.

Print Materials

The textbooks listed below are used in this course.

Arcangelo, V.P. & Peterson, A.M. (2017) 
Pharmacotherapeutics for Advanced Practice: A Practical Approach
 (4
th
 edition). Philadelphia: Wolters Kluwer

McCance, K. & Huether, S. (2019). 
Pathophysiology: The biologic basis for disease in adults and children
 (8
th
 ed.). St. Louis: Elsevier Mosby. Nursing (NURS) 516 Pharmacotherapeutics and Pathophysiology for Nurse Practitioners.

Additional Recommended Material

Woo T.M. & Robinson M.V. (2016). 
Pharmacotherapeutics for Advanced Practice Nurse Prescribers.
 (4
th
 ed.). Philadelphia: FA Davis

Nursing (NURS) 516 Pharmacotherapeutics and Pathophysiology for Nurse Practitioners Course Structure

In this course, you will access health-related websites worldwide. You will also participate in email and computer conferencing with other students. Students are expected to connect to an Internet Service Provider at their own expense.

Nursing (NURS) 516 Pharmacotherapeutics and Pathophysiology for Nurse Practitioners Technical Requirements

Computer System

In order to successfully complete this course, the student must own or have ready access to certain computer hardware and software programs. For complete and up-to-date information on the minimum computer requirements required to complete the graduate nursing courses, visit the 
Faculty of Health Disciplines
 technical site.

Students are expected to connect to an Internet Service Provider at their own expense and to secure audio speaker or headphones for the required Clinical Forum events in the course. Nursing (NURS) 516 Pharmacotherapeutics and Pathophysiology for Nurse Practitioners.

Course Outline

NURS 516 consists of the following 11 units:

Unit 1: Foundations of Prescriptive Practice

Unit 2: Pharmacologic Principles

Unit 3: Foundations of Pathophysiology

Unit 4: Dermatologic Disorders

Unit 5: Cardiovascular Disorders

Unit 6: Hematologic Disorders

Unit 7: Respiratory Disorders

Unit 8: Gastrointestinal Disorders

Unit 9: Genitourinary Disorders

Unit 10: Renal/Fluids and Electrolytes

Unit 11: Consolidation

Nursing (NURS) 516 Pharmacotherapeutics and Pathophysiology for Nurse Practitioners Assessment Structure

The assessment structure for 
NURS 516 – Pharmacotherapeutics and Pathophysiology for Nurse Practitioners I
 is based on the following course activities, 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 activities. Nursing (NURS) 516 Pharmacotherapeutics and Pathophysiology for Nurse Practitioners.

Unit Tests – 4 Tests (12.5% per Test)

50%

Case Studies – 2 Case Studies (10% per Case)

20%

Case Discussion Contributor

10%

Problem Based Learning Group Activity

20%

Synchronous Case Studies (2)

Pass/Fail

Total

100%

In order to pass NURS 516 you must achieve a minimum mark of 65% on problem based Learning group Activities, a combined mark of 65% on case studies, and a combined mark of 70% on the tests.

Unit Tests

Due Dates: Week 4, Week 8, Week 10, Week 13

Value: 12.5% each

These are online exams consisting of multiple choice questions based on content from units as follows:

Test 1 covers units 1-3, test 2 covers units 4-5 test 3 covers units 6-7, Test 4 covers units 8-10

The unit tests must be written during the specified time period. Students who do not write the tests during the specified time period will not be allowed to write the test at a later date and will be awarded a mark of zero on the exam. Nursing (NURS) 516 Pharmacotherapeutics and Pathophysiology for Nurse Practitioners.

You must attain combined mark of 70% on the unit tests (see below) in order to receive a passing grade for the course. If an average mark less than 70% is received, there will be no option for writing a supplementary exam (ie, there are no rewrites of unit tests allowed). Nursing (NURS) 516 Pharmacotherapeutics and Pathophysiology for Nurse Practitioners.

Case Studies

Value: 20%

Each student will be assigned two case studies during the course (10% EACH), which will be presented on-line. Students are expected to follow a prescribed format in preparing a Powerpoint presentation and will also be expected to moderate an on-line discussion of their case.

Case Discussion Contributor

Value: 10%

Students are expected to contribute to the case study discussions and must post either an scholarly original post or response in every unit. Nursing (NURS) 516 Pharmacotherapeutics and Pathophysiology for Nurse Practitioners.

Problem Based Learning Group Activities

Value: 20%

Over the duration of the course students will be assigned weekly problem-based learning (PBL) discussion forums. Each group will respond to assigned questions and will be responsible for presenting content related to these questions.

Synchronous Case Studies

Value: Pass/Fail

There are five synchronous Clinical Seminars utilizing Adobe Connect will occur over the span of the term to discuss specific clinical cases. Students will be provided with clinical cases prior to each seminar, and will be expected to participate in an instructor-led discussion of the case. Students will be required to attend a minimum of TWO Synchronous Clinical Seminars. Nursing (NURS) 516 Pharmacotherapeutics and Pathophysiology for Nurse Practitioners.

Manage your boss essay

Executive Summary (1 page)

summarize the advice such that someone who has not listened to the podcast will be able to glean the main points. Please include the steps along with a brief explanation of each step. This section should be single-spaced. Present the summary in a format that will be easy for others that to read.

Up to 5 ref if needed but not necessary. Manage your boss essay.

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Analysis of the Advice (2-3 pages)

think like an Industrial Psychologist, reflect on the advice, and offer your opinion on the validity of the advice they give in the podcast. Are their suggestions practical? Will they work in your organization? If you do not have a job, think about a student or volunteer organization you’re in. What advice can you immediately implement? How should you change your behavior to be in line with their suggestions? You do not have to answer all of these questions – these are merely suggestions for what to write about. Do not summarize their advice in this section. This section is to analyze the advice they gave. This section should be double-spaced. 5 ref. if needed but not necessarily. Manage your boss essay.

Managing Your Boss

We had intended to cover Managing Upwards back in December, during our sessions on

writing reviews. As it turned out, while we barely scratched the surface on how to do

reviews, it nevertheless took us FOUR casts. We didn’t want to delay those casts,

obviously, in light of their time sensitivity. So, we delayed this topic until now.

Managing Upwards for the most part boils down to Creating a Good Relationship with Your

Boss. There is a lot to be said about politics in organizations, and whom you should know

and whom you should stay in touch with. We’ve found that those topics don’t lend

themselves easily to a simple cast if we want to give you actionable guidance. That IS what

we’re about, after all. Manage your boss essay.

So, we’re going to focus on some things you can do that will help you improve your

relationship with your boss.

Managing_Your_Boss_Shownotes

Managing_Your_Boss_Shownotes-2

Outline

1. A True Story

2. The Basics.

a. Boss Goals

b. Boss Communications

c. Boss Schedule/Time Management

d. Boss Work style

e. Boss Relationships

Shownotes

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1. A True Story .

Mark recently worked with an Executive Vice President of a multi billion dollar service

company who had lost her job. To give you an idea of how different life is for senior

executives, for those of you who are not in that rarefied air yet, she wasn’t going to the

office, and technically hadn’t been fired…but it had been made clear she was no longer

employed. She stayed home for 2 and a half months, until the performance compensation

she was mostly entitled to were paid. She was paid salary while she was not working.

This executive had been with her firm for 21 years. She had worked largely in the back

office, and had created a record that was so stellar even Mark was impressed. Not only

had she hit home run after home run, in TOUGH situations, but she was one of the most

loved people in a large company he’s ever known. Everyone who ever worked for her loved

her. She was pretty clearly special. Big barbecues at her and her husband’s house were so

well known that they stopped inviting people and just told people to come on along (and

got it catered). Truly, a wonderfully successful, effective executive.

She was asked to take a special assignment not long ago, to “go fix” the financial systems

of the company. She was asked by the CEO, and even though she would report to the CFO,

it was pretty clear he had a mandate from the top.

In 30 days, she was fired…and hundreds if not thousands of managers in the company

were DEVASTATED. What happened? Manage your boss essay.

What happened was that she had thought that because the CEO sent her over, she could

actually make things happen and fix things. But she didn’t know/understand/appreciate

the CFO’s position. When she suggested to the CFO that a big re-org needed to be done,

the politically minded and nervous CFO walked into the CEOs office and described her as

power hungry and backstabbing, and then put together some half truths the CEO bought

into.

This manager did the RIGHT THING.. and was fired because she didn’t understand her

boss. Didn’t know what he wanted, how we wanted it, when he wanted it, or who else he

needed to please. Manage your boss essay.

Don’t let this happen to you.

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2. The Basics.

There are FIVE areas that we recommend you focus on in your relationship with your boss.

(By the way, it’s possible you’ll hear some of these topics repeated when we cover what to

do in the first 90 days on the job. however, we’ve discovered that managers tend to

dismiss things that they think don’t apply to them, so we’ve excluded those parts of this

topic that are only about starting out. These recommendations ALWAYS work, and are

worth revisiting annually.)

We list these topics in their order of importance to you, and the order in which you ought

to go about thinking about them. It’s not a rote one at a time process, of course. You’re

going to learn about all the topics at various times. This just suggests where your focus

should be, and what will help you the soonest. Manage your boss essay.

And remember, you’re unlikely to change your boss… so be ready to change yourself.

a. Boss Goals

This is the SINGLE MOST IMPORTANT thing you should know about your boss. And, its

likely you don’t know what these things are, except for those issues that relate to you

and your team. If you learn what your boss’s goals are, and which are most important to

him, you will be more effective at getting what you want from him. he will also perceive

you as sensitive to his needs and politically savvy.

This starts with asking, what are you responsible to YOUR boss for? What are your

revenue, cost, and profitability requirements? What metrics do they use to measure

you and by extension, me and my team supporting you? Which of those is most

important to you? What does your boss ask that is above and beyond or different than

what the org wants? What are your budget responsibilities? What do you have to create

your budget, and how long does it take? May I look at your budget to get me ready for

the next cycle (if you need to scrub it before I can see it, that’s fine.) What reporting are

you required to do on your budget, and when do you have to do it?

Continuing, you’ll note that above we focused on financials. Well, DUH. The quickest

way to trouble in most places is ignoring financials. An easy way to think about

responsibilities is to break them down into financials, operations, and people.

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Remember, we’re looking for Goals and RESPONSIBIILITIES in these areas.

Once you’ve asked the financial questions, the people and operational questions are

much easier, and are much more company/industry dependent. On the other hand,

we’ve found that bosses tend to be much more forthcoming on other goals they have

once you ask, for the most part. And often, they just spill everything they’ve got as soon

as you ask.

The second part of this line of inquiry is “What’s my role in helping you achieve that?”

For each of the above questions, you can ask what your boss sees your role as being.

Now, you might be thinking, what do I DO? Just walk in and start asking away? Well, no,

not exactly. But, regardless of what time of year it is, or how long you’ve worked for

your boss, THESE FIRST QUESTIONS AROUND GOALS JUSTIFY A SEPARATE MEETINGS

WITH YOUR BOSS TO LEARN THE ANSWERS. So, schedule a meeting with him/her, email

the questions in advance, and ask for as much detail as you can.

If you’ve worked for a boss for a while, we’ve found the best way to address the fact

that you know some of this is to send both the questions and those answers which you

know in advance. Having them written out will allow her to add/change/delete/leave

alone/save time.

If you’re wondering how to preface these questions, because you’re afraid you’re going

to be thought weird/stupid/incompetent… this is the way Mark recommends to clients:

“I’m doing an annual reassessment of my roles and goals, and want to include your

guidance…” Another that I’ve seen work is, “My professional development effort this

year is around being EFFECTIVE, and that means focusing on what’s most important…”

Okay, so you’re going to set up a meeting, email the questions in advance (with answers

you think you already know), and then take great notes in the meeting. If you think

you’re going to run over, bail out and ask for more time later. (This is because we’re

cleverly assuming you don’t know what his approach to time management is yet, not

having asked. ;-))) )

We consider this important enough that if you don’t konw all of her goals now, you

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must within THRITY DAYS.

b. Boss Communications

This area seems pretty simple, and yet it is the one most often missed. We put it second

because you usually can’t ask directly, but it has BIG implications for every other area.

The sooner you start paying attention to your boss’s comm style, the sooner you’ll be

able to adapt. Manage your boss essay.

Peter Drucker has a clever way of thinking about this. In all his years of working with

managers, he discovered that they tend to learn (take in new information) with a

preference towards one of two ways: Listeners, and Readers. His simple technique for

using that bit of boss knowledge is summed up as, “if she’s a listener, brief her verbally

first, then follow up with a report. If he’s a reader, send a memo first, then follow up

with a briefing.” Manage your boss essay.

Wow simple!!!

To go a bit further. here are some questions to look for clues to.

Does he prefer voicemail or email? Do you get individual emails from him about work

that he could have just asked you about? Do you get long voicemails at night or on the

weekends? What does he choose to share in person? Is his comm channel choice

always a function of topic? Projects by email, announcements by vmail, operations in

meetings? It happens, and it’s confusing unless you know to think about it.

How does she run meetings? Tight agendas means more advance work for you. What

kind of sharing does she do from meetings she goes to? If not a lot, you’ll need to be

asking about them and their fallout.

When it comes to face to face: what are his verbal, Vocal and visual clues? Verbally, for

instance, does he tend to ask questions, or make statements? Take a seat, or would you

like to sit down? Does he tend to talk first, or a lot, or listen first, or more than talking?

Does he reserve opinions, or come right out with them?

Vocally, is her delivery steady and even? or noticeably varied? is it forceful or not (can

you see them giving a speech?) Is it lower than average volume, or up there? Is it faster

managertools.com | Managing Your Boss / p.5

©Manager Tools | Page 5

than you, or slower? (Forget about where they’re from.)

Visually, what kind of handshake – gentle or firm? Regular eye contact or intermittent?

Small gestures or big? What kind of colors in their clothes? Lots of facial expressions, or

few? Does he make contact with you or not?

It’s not necessary for you to MIMIC your boss – it will irritate her and make you look

foolish. But knowing where you’re different and moderating your differences will make

you ENORMOUSLY more effective. ENORMOUSLY. Besides smiling and being willing to

subordinate oneself to others, Mark believes that this awareness and moderation are

the most powerful interpersonal tools he uses every day.

c. Boss Schedule/Time Management

This is one that you really don’t HAVE to ask about… you’ll learn it pretty quickly if you

remind yourself to pay attention. That said, if you’re having a great meeting early on,

and want to ask about scheduling, go for it!

This is as simple as knowing what your boss’s schedule is. I bet you’ve been thinking you

know what it is. But if she doesn’t publish it, answer this: how many standing meetings

does she go to that you don’t, when are they, how often are they changed, and what

are the topics? Manage your boss essay.

See, you don’t.

Some things you should know: What, when, where and with whom are his standing

meetings? WHEN DOES HE MEET WITH HIS BOSS AS PART OF STAFF OR IN A ONE ON

ONE? And would you leave him alone during the hour before it? And would you expect

some things to change within 6 hours after it?

When is he busiest? Morning or late afternoon? When is he NOT busy but wants to be

left alone? How tightly does he run his time? Ho much at risk will you be if you handle

time differently than he does? What nights does he go home on time, and when does

he stay late? How often does he send night and weekend emails? How in general does

he feel about the start and end of the workday?

The way you get to these is, as we said above, not necessarily by interviewing the boss.

managertools.com | Managing Your Boss / p.6

©Manager Tools | Page 6

We recommend asking your peers for insight. Ask his assistant for a printed copy of his

weekly schedule. Review YOUR calendar for meetings he’s called.

d. Boss Work style

This is one of the harder things to discern quickly if you are new. Specifically, what we’re

asking you to ask here is, “What level of involvement does he want to have, on what

topics?” This boils down to what he delegates, and how involved he stays. The issue for

you is how much you’ll have to tolerate of his interaction after you own a task (if he

thinks you EVERY own it), and what amount of reporting will help her stay out of things,

or at least give you SOME room. Manage your boss essay.

e. Boss Relationships

This is one that we don’t recommend you tackle right away. If you get the other four

areas down pat, this one will probably happen naturally. You can discern this with the

answer to one simple question, but it may take some knowledge of your company we

can’t teach you how to get.

With whom, outside of her chain of command, does this manager regularly meet? (This

could be lunch, dinner, breakfast, hanging out in each others’ offices, etc. COULD be

work related, may not be).

We’d like you to tell US why this is important to you. first one with the right answer gets

a free copy of The Effective Executive, Getting Things Done, or The World is Flat, your

choice, mailed to you.

Special Tips:

There are three other things we recommend you do in terms of managing your

relationship with your boss. (Have you picked up on the fact that we don’t say

“managing your boss”? We think that’s kinda funny… at least we would if we were your

boss.)

Weekly One on Ones with your boss. If you have to couch it as an update meeting, fine.

Ask for a half hour, and only take YOUR FIFTEEN MINUTES. If he wants to go longer, let

him take over…and you’re having something approximating a O3. Don’t do this until you

managertools.com | Managing Your Boss / p.7

©Manager Tools | Page 7

start with YOUR team, though… If he cuts you off when you’re done, and YOU WILL BE

DONE in 15 minutes if you’re smart… fine. You’re getting the best you can get.

Quarterly performance review. Ask your boss for an hour to get feedback over the

previous 3 months. If he wont’ give it to you, fine… fill out a review form and get it to

him. If he wonders why, tell him, “to make it easier for both of us to keep track of stuff

3-6-9 months from now.” You will forget just like she will. (You can do this along with

updating your resume… it’s like we know what we’re talking about!) Manage your boss essay.

Share all this about YOU with YOUR TEAM. Don’t make them ask… walk them through

all five areas. Do a Jerry Maguire… help them help you!!!

Wrap Up

1. A True Story

2. The Basics.

a. Boss Goals

b. Boss Communications

c. Boss Schedule/Time Management

d. Boss Work style

e. Boss Relationships

managertools.com | Managing Your Boss / p.8

Manage your boss essay

Nursing 519: Advanced Pathophysiology for Clinical Decision Making

Introduction

Nursing 519: Advanced Pathophysiology for Clinical Decision Making
 is a course in a program of study leading to the Master of Nursing degree or the Post Master’s Diploma: Advanced Nursing Practice. NURS 519 is a prerequisite course for NURS 518, NURS 522, NURS 524, NURS 526 and NURS 528. NURS 519 can be taken as an elective course by other Master of Nursing or Master of Health Studies students and by non-program students. Nursing 519: Advanced Pathophysiology for Clinical Decision Making.

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NURS 519 provides students with an understanding of pathophysiology that will support clinical decision making about diagnosis and treatment of acute and chronic presentations commonly managed by nurse practitioners. The course is comprised of three sections. Nursing 519: Advanced Pathophysiology for Clinical Decision Making.  In Part I: An Overview of Pathophysiological Variations, students review cellular biology and the cellular environment and the processes of inflammatory/infectious responses. Students then examine the cellular biology of cancer and cancerous metastases. In Part II: Pathophysiological Variations of Body Systems, students study the pathophysiology of alterations of each body system and apply what they have learned to clinical scenarios depicting client presentations that students are likely to encounter in their clinical placements and in their practices as entry-level nurse practitioners. Nursing 519: Advanced Pathophysiology for Clinical Decision Making.

NURS 519 is designed as an introduction to the use of pathophysiology to support clinical decision making. The content of NURS 519 is supported by other courses in the Advanced Nursing Practice program that teach management of common acute and chronic diseases of adult men and women, children, and older adults. Nursing 519: Advanced Pathophysiology for Clinical Decision Making.

Nursing 519: Advanced Pathophysiology for Clinical Decision Making Course Goals

After completing this course, students should be able to:

explain pathophysiological processes leading to clinical manifestations of common acute and chronic diseases;

apply their understanding of pathophysiological processes to support clinical decisions about the diagnosis of common acute and chronic diseases;

Nursing 519: Advanced Pathophysiology for Clinical Decision Making

recognize variations of pathophysiological processes in pediatric and geriatric clients; and

explain factors influencing the incidence and manifestation of diseases in populations.

Nursing 519: Advanced Pathophysiology for Clinical Decision Making Course Materials

NURS 519 comprises online and print-based course materials.

Nursing 519: Advanced Pathophysiology for Clinical Decision Making Online Materials

Introduction: Provides essential information about the course materials, the design of the course, and the procedures you should follow to complete the course successfully.

Schedule: Outlines the timing of course activities.

Units: There are 13 units in this course.

Nursing 519: Advanced Pathophysiology for Clinical Decision Making

Assessment: Outlines the assignments/evaluation procedures of the course.

Reference: Listing of required readings and web sites included in the units.

Nursing 519: Advanced Pathophysiology for Clinical Decision Making Print Materials

The textbooks listed below are used in this course.

McCance, K. & Huether, S. (2014). 
Pathophysiology: The biologic basis for disease in adults and children
 (7
th
 ed.). St.Louis: Elsevier Mosby.

Harold J. Bruyere (2009) 
100 Case Studies in Pathophysiology
. Login Bros. ISBN 978-0-7817-6145-1

Nursing 519: Advanced Pathophysiology for Clinical Decision Making Course Structure

In this course, you will access health-related websites worldwide. You will also participate in email and computer conferencing with other students. Students are expected to connect to an Internet Service Provider at their own expense. Nursing 519: Advanced Pathophysiology for Clinical Decision Making.

Technical Requirements

Computer System

In order to successfully complete this course, you must own or have ready access to certain computer hardware and software programs. For complete and up-to-date information on the minimum computer requirements required to complete the graduate nursing courses, visit the 
Centre for Nursing and Health Studies
 technical site.

Nursing 519: Advanced Pathophysiology for Clinical Decision Making Course Outline

NURS 519 consists of 13 units, divided into two sections:

Part I: An Overview of Pathophysiological Variations

Unit 1: Cells and Tissues

Unit 2: Mechanisms of Self Defense: Immunity and Infection

Unit 3: Cellular Proliferations: Cancer

Part II: Pathophysiological Variations of Body Systems

Unit 4: The Neurologic System

Unit 5: The Endocrine System

Unit 6: The Reproductive System

Unit 7: The Hematologic System

Unit 8: The Cardiovascular and Lymphatic Systems

Unit 9: The Pulmonary System

Unit 10: Renal and Urologic System

Unit 11: The Integumentary System

Unit 12: The Digestive System

Unit 13: The Musculoskeletal System

Nursing 519: Advanced Pathophysiology for Clinical Decision Making Assessment Structure

The assessment structure for 
NURS 519
 is based on the following course activities, 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 activities. Nursing 519: Advanced Pathophysiology for Clinical Decision Making.

Short Case Conference

10%

Learning Objective Conference

20%

Exam 1

20%

Exam 2

25%

Exam 3

25%

Total

100%

In order to pass NURS 519, you must achieve a minimum mark of 65% on the short case conference, a minimum mark of 65% on the Learning Objective Conference and a combined mark of 70% on the exams. Nursing 519: Advanced Pathophysiology for Clinical Decision Making.

Short Case Conference Participation

Value: 10%

Beginning in Unit 3 two students will be assigned cases from Bruyere (2009). Each student will be expected to prepare a brief presentation which addresses assigned learning points. Nursing 519: Advanced Pathophysiology for Clinical Decision Making.

Learning Objective Conference

Value: 20%

For each unit students are expected to post a minimum of 2 individual posts. Feedback regarding conference participation will be ongoing. Quality of input (not quantity) is the goal. Feedback will focus on the student’s ability to provide organized and original contributions that reflect analysis and synthesis of the material presented

Exams Due Dates: Week 5 (Exam 1), Week 9 (Exam 2) and Week 13 (Exam 3)

Value: Exam 1 is worth 20%, exams 2 and 3 and worth 25% each

These are online exams consisting of multiple choice questions based on content from units 1 through 4 (Exam 1), 5 through 8 (Exam 2) and 9-13 (Exam 3). Nursing 519: Advanced Pathophysiology for Clinical Decision Making.

The exams must be written during the specified time period. Students who do not write the exam during the specified time period will not be allowed to write the exam at a later date and will be awarded a mark of zero on the exam. Nursing 519: Advanced Pathophysiology for Clinical Decision Making.

Evidence-based practice guidelines and ethical considerations

You will explore evidence-based practice guidelines and ethical considerations for specific scenarios.

Scenario 1:

The parents of a 5-year-old boy have accompanied their son for his required physical examination before starting kindergarten. His parents are opposed to him receiving any vaccines. Evidence-based practice guidelines and ethical considerations.

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Scenario 2:

A 49-year-old woman with advanced stage cancer has been admitted to the emergency room with cardiac arrest. Her husband and one of her children accompanied the ambulance.

Scenario 3:

A 27-year-old man with Crohn’s disease has been admitted to the emergency room with an extreme flare-up of his condition. He explains that he has not been able to afford his medications for the last few months and is concerned about the costs he may incur for treatment. Evidence-based practice guidelines and ethical considerations.

Scenario 4:

A single mother has accompanied her two daughters, aged 15 and 13, to a women’s health clinic and has requested that the girls receive a pelvic examination and be put on birth control. The girls have consented to the exam but seem unsettled.

Scenario 5:

A 17-year-old boy has come in for a check-up after a head injury during a football game. He has indicated that he would like to be able to play in the next game, which is in 3 days.

Scenario 6:

A 12-year-old girl has come in for a routine check-up and has not yet received the HPV vaccine. Her family is very religious and believes that the vaccine would encourage premarital sexual activity. Evidence-based practice guidelines and ethical considerations.

Scenario 7:

A 57-year-old man who was diagnosed with motor neuron disease 2 years ago is experiencing a rapid decline in his condition. He prefers to be admitted to the in-patient unit at a hospice to receive end-of-life care, but his wife wants him to remain at home. Evidence-based practice guidelines and ethical considerations.

To prepare:

• Select one scenarios, and reflect on the material presented.

• What necessary information would need to be obtained about the patient through health assessments and diagnostic tests?

• Consider how you would respond as a nurse. Review evidence-based practice guidelines and ethical considerations applicable to the scenarios you selected. Evidence-based practice guidelines and ethical considerations.

To complete:

Write a detailed one-page narrative (not a formal paper) explaining the health assessment information required for a diagnosis of your selected patient (include the scenario number). Explain how you would respond to the scenario as a practice nurse using evidence-based practice guidelines and applying ethical considerations. Justify your response using at least 3 different references from current evidence based literature. Evidence-based practice guidelines and ethical considerations.

Mood Disorders Essays

Week 8: Mood Disorders

“School and going out with my friends used to be fun, but not anymore. Mom keeps telling me just to go out and have fun, but I don’t see the point of trying. All my friends are better than I am. I keep having these headaches and just feel worthless. I used to get As and Bs in school, but not anymore. I can’t concentrate at school. I would rather be at home sleeping.”

Madison, age 16

Mood disorders can be particularly challenging to address in childhood and adolescence as many parents do not believe it is possible for their child to become depressed or even suicidal. The PMHNP needs to know how to diagnose these conditions and must understand the importance of integrating medication management strategies, with both individual and family therapy to optimize treatment outcomes. Mood Disorders Essays.

This week, you debate the theory that bipolar depression can or cannot be diagnosed in children and adolescents.

Photo Credit: Corbis/VCG / Corbis / Getty Images

Mood Disorders Essays 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 31, “Child Psychiatry” (pp. 1226–1253)

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

“Bipolar and Related Disorders”

“Depressive Disorders”

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

Zeanah, C. H., Chesher, T., & Boris, N. W. (2016). Practice parameter for the assessment and treatment of children and adolescents with reactive attachment disorder and disinhibited social engagement disorder.
Journal of the American Academy of Child & Adolescent Psychiatry
,
55
(11), 990–103. Retrieved from http://www.jaacap.com/article/S0890-8567(16)31183-2/pdf

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. 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. Mood Disorders Essays.

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

Review the following medications:

Seasonal affective disorder

bupropion

Bipolar depression

Bipolar disorder

amoxapine

aripiprazole

armodafinil

asenapine

bupropion

carbamazepine

fluoxetine

iloperidone

lamotrigine

lithium

lurasidone

modafinil

olanzapine

olanzapine-fluoxetine combination

quetiapine

risperidone

sertindole

valproate (divalproex)

ziprasidone

alprazolam (adjunct)

amoxapine

aripiprazole

asenapine

bupropion

carbamazepine

chlorpromazine

clonazepam (adjunct)

cyamemazine

doxepin

fluoxetine

flupenthixol

fluphenazine

gabapentin (adjunct)

haloperidol

iloperidone

lamotrigine

levetiracetam

lithium

lorazepam (adjunct)

loxapine

lurasidone

molindone

olanzapine

olanzapine-fluoxetine combination

oxcarbazepine

paliperidone

perphenazine

pipothiazine

quetiapine

risperidone

sertindole

thiothixene

topiramate (adjunct)

trifluoperazine

valproate (divalproex)

ziprasidone

zonisamide

zotepine

zuclopenthixol

Bipolar maintenance

Depression

aripiprazole

asenapine

carbamazepine

iloperidone

lamotrigine

lithium

lurasidone

olanzapine

olanzapine-fluoxetine combination

quetiapine

risperidone (injectable)

sertindole

valproate (divalproex)

ziprasidone

agomelatine

amisulpride

amitriptyline

amoxapine

amphetamine (d)

amphetamine (d,l)

aripiprazole (adjunct)

asenapine

atomoxetine

bupropion

buspirone (adjunct)

citalopram

clomipramine

cyamemazine

desipramine

desvenlafaxine

dothiepin

doxepin

duloxetine

escitalopram

fluoxetine

flupenthixol

fluvoxamine

iloperidone

imipramine

isocarboxazid

ketamine

lisdexamfetamine

lithium (adjunct)

l-methylfolate (adjunct)

lofepramine

lurasidone

maprotiline

methylphenidate (d)

methylphenidate (d,l)

mianserin

milnacipran

mirtazapine

moclobemide

modafinil (adjunct)

nefazodone

nortriptyline

olanzapine

paroxetine

phenelzine

protriptyline

quetiapine (adjunct)

reboxetine

selegiline

sertindole

sertraline

sulpiride

tianeptine

tranylcypromine

triiodothyronine

trazodone

trimipramine

venlafaxine

vilazodone

vortioxetine

Note:
 Many of these medications are FDA approved for adults only. Some are FDA approved for disorders in children and adolescents. Many are used “off label” for the disorders examined in this week. As you read the Stahl drug monographs, focus your attention on FDA approvals for children/adolescents (including “ages” for which the medication is approved, if applicable) and further note which drugs are “off label.”

Optional Resources

Thapar, A., Pine, D. S., Leckman, J. F., Scott, S., Snowling, M. J., & Taylor, E. A. (2015).
Rutter’s child and adolescent psychiatry
(6th ed.). Hoboken, NJ: Wiley Blackwell.

Chapter 62, “Bipolar Disorder in Childhood” (pp. 858–873)

Chapter 63, “Depressive Disorders in Childhood and Adolescence” (pp. 874–892)

Discussion: Pediatric Bipolar Depression Disorder Debate

Some debate in the literature exists specific to whether or not bipolar disorder can be diagnosed in childhood. While some have anecdotally argued that it is not possible for children to develop bipolar disorder (as normal features of childhood confound the diagnosis), other sources argue that pediatric bipolar disorder is a fact. Mood Disorders Essays.

In this Discussion, you engage in a debate as to whether pediatric bipolar disorder is possible to diagnose.

Learning Objectives

Students will:

Evaluate diagnosis of pediatric bipolar depression disorder

Analyze consequences to diagnosing/failing to diagnose pediatric bipolar depression disorder

To Prepare for the Mood Disorders Essays Discussion:

The instructor will assign you a position for or against the issue of diagnosing pediatric bipolar depression disorder.

Review the Learning Resources concerning the controversy over the diagnosis of pediatric bipolar depression disorder.

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
!

By Day 3

Post:

Write “for” or “against” in the subject line of your Discussion post.

Based on the position you were assigned, justify whether or not pediatric bipolar depression disorder should be diagnosed.

Support your Mood Disorders Essays position with evidence and examples.

By Day 6

Respond
 to at least 
two
 of your colleagues who argued the opposite side as you by countering their argument with evidence. Identify at least two consequences to support your position.

Submission and Grading Information

Grading Criteria

To access your rubric:

Week 8 Discussion Rubric

Post by Day 3 and Respond by Day 6

To participate in this Discussion:

Week 8 Discussion

Mood Disorders Essays Assignment: 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.

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. Mood Disorders Essays.

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 debated the theory that bipolar depression can or cannot be diagnosed in children and adolescents.

Next week, you will compare evidence-based treatment plans for adults versus children diagnosed with schizophrenia. You analyze the legal and ethical issues involved with forcing clients with early-onset schizophrenia to take medications for the disorder. You also complete a Decision Tree concerning children with psychotic disorders.

Looking Ahead 1

In Week 9, you will work with our group again to create a new Parent Guide, focusing on feeding, eating, and elimination disorders in childhood.

Looking Ahead 2

You should be working on your cover letter, resume, and portfolio that is due in Week 10. Mood Disorders Essays.

Learning and Motor Disorders in Childhood Essays

Week 7: Learning and Motor Disorders in Childhood

“I had a substitute teacher today, so it was not a good day. She thought I was goofing off, but I could not help myself. As much as I tried to hold back, knowing she would freak out, I felt like a volcano. I erupted with a sound, kinda like a bullfrog that lasted for almost 10 minutes. She kept telling me to quiet down, but I could not help myself. Then the physical stretching and flexing of my neck started. She was really mad. Finally, my friend told her about me. It was embarrassing.”

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Learning disorders represent a diagnostic challenge in that many of the features of learning disorders overlap with ADHD. Appropriate diagnosis is essential to proper treatment. Motor disorders can be a source of considerable distress for both the child and their parents. Appropriate diagnosis is required in order to initiate the most appropriate treatment to minimize the impact of these conditions on the child. Learning and Motor Disorders in Childhood Essays.

This week, you work with your group again to develop a Parent Guide for an assigned learning or motor disorder. For your practicum, you examine the practice of voluntary and involuntary commitment of children and adolescents with mental health disorders.

Learning and Motor Disorders in Childhood Essays 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 4, “Theories of Personality and Psychopathology” (pp. 151–191)

Chapter 31, “Child Psychiatry” (pp. 1181–1205)

American Psychiatric Association. (2013).
Diagnostic and statistical manual of mental disorders
(5th ed.). Washington, DC: Author. Learning and Motor Disorders in Childhood Essays.

“Neurodevelopmental Disorders”

“Specific Learning Disorder”

“Motor Disorders”

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

Murphy, T. K., Lewin, A. B., Storch, E. A., Stock, S. (2013). Practice parameter for the assessment and treatment of children and adolescents with tic disorders.
Journal of the American Academy of Child & Adolescent Psychiatry
,
52
(12), 1341–1359. Retrieved from http://www.jaacap.com/article/S0890-8567(13)00695-3/pdf

McGarvey, E. L., Leon-Verdin, M., Wancheck, T. N., & Bonnie, R. J. (2013). Decisions to initiate involuntary commitment: The role of intensive community services and other factors.
Psychiatric Services
,
64
(2), 120–126.

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

Kaltiala-Heino, R. (2010). Involuntary commitment and detainment in adolescent psychiatric inpatient care.
Social Psychiatry and Psychiatric Epidemiology
,
45
(8),785–793. doi:10.1007/s00127-009-0116-3

Note:
You will access this article from the Walden Library databases. Learning and Motor Disorders in Childhood Essays.

Lindsey, M. A., Joe, S., Muroff, J., & Ford, B. E. (2010). Social and clinical factors associated with psychiatric emergency service use and civil commitment among African-American youth.
General Hospital Psychiatry
,
32
(3)
,
300–309. doi:10.1016/j.genhosppsych.2010.01.007

Note:
You will access this article 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. 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. Learning and Motor Disorders in Childhood Essays.

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

Review the following medications:

Tourette syndrome

Pervasive developmental disorders

clonidine

haloperidol

pimozide

guanfacine

Note:
 Many of these medications are FDA approved for adults only. Some are FDA approved for disorders in children and adolescents. Many are used “off label” for the disorders examined in this week. As you read the Stahl drug monographs, focus your attention on FDA approvals for children/adolescents (including “ages” for which the medication is approved, if applicable) and further note which drugs are “off label.” Learning and Motor Disorders in Childhood Essays.

Optional Resources

Thapar, A., Pine, D. S., Leckman, J. F., Scott, S., Snowling, M. J., & Taylor, E. A. (2015).
Rutter’s child and adolescent psychiatry
(6th ed.). Hoboken, NJ: Wiley Blackwell.

Chapter 47, “Children With Specific Sensory Impairments” (pp. 612–622)

Learning and Motor Disorders in Childhood Essays Discussion: Parent Guide

Learning disorders and motor disorders can be difficult for parents to understand. They often have many questions that go unanswered and can create considerable misunderstanding. This misunderstanding can damage the child/parent relationship. The PMHNP can answer questions and provide guidance for the family in order to help reduce the uncertainty of the disorders.

For the Discussion, you will work with your group again to develop a Parent Guide for your assigned disorder.

Learning Objectives

Students will:

Analyze signs and symptoms of learning and motor disorders in childhood

Analyze pathophysiology of learning and motor disorders in childhood

Analyze diagnosis and treatment methods for learning and motor disorders in childhood

Evaluate Parent Guides

To Prepare for this Discussion:

Your Instructor will assign you to a group and a disorder by Day 1 of Week 2.

Review the resources concerning your assigned disorder.

Use your group’s Discussion Board to design and develop the Parent Guide before posting to the group wiki. For further guidance, refer to the 
Accessing Group Discussions
 instructions below.

Using evidence-based research, design and develop a Parent Guide for your assigned disorder including:

Signs and symptoms

Pathophysiology

How the disorder is diagnosed

Treatment options

Provide a minimum of three academic references.

By Day 5

One designated group member
 should post the completed Parent Guide to the Discussion.

By Day 7

Respond
 to at least 
two
 other groups’ wikis by providing at least two contributions for improving or including in their Parent Guide and at least two things that you like about their guide. Learning and Motor Disorders in Childhood Essays.

Submission and Grading Information

Accessing Group Discussions and Wikis

To access your group’s discussion
, click on the 
Parent Guide Groups
 link. Once you have clicked on the link, select your assigned team (e.g., Team A, Team B, Team C, etc.) to access your team’s home page. Select 
Group Discussion Board
 under the Group Tools menu to work on your participate in your group’s discussion.

To access your group’s wiki
, click on the 
Parent Guide Groups
 link. Once you have clicked on the link, select your assigned team (e.g., Team A, Team B, Team C, etc.) to access your team’s home page. Learning and Motor Disorders in Childhood Essays.

Creating a Wiki Page

Create the first wiki topic page by entering the group’s wiki area and selecting 
Create Wiki Page
. Use the group’s assigned disorder as the name of your wiki. Then add your Parent Guide in the Content text box. You can use the editor functions to format the text and include files, images, web links, multimedia, and mashups. Select 
Submit
 when you have completed the wiki page. Learning and Motor Disorders in Childhood Essays.

Grading Criteria

To access your rubric:

Week 7 Parent Guide Discussion Rubric

To access your group discussion / wiki:

Parent Guide Groups

Post to Discussion by Day 5 and Respond by Day 7

To participate in this Discussion:

Parent Guide Groups – Week 7

Learning and Motor Disorders in Childhood Essays Assignment 1: Practicum Journal: Voluntary and Involuntary Commitment

PMHNPs may find themselves working in a wide variety of settings—each having their own unique challenges and inherent legal issues. For instance, what do you do in your state of practice when you are providing a therapy/treatment session and a client reports active suicidal ideation? What do you do if you are covering inpatient psychiatric consults and are called to see a patient in the ICU who overdosed on prescription medication requiring intubation? What do you do if you are a PMHNP on an inpatient unit and a client who admitted themselves on a voluntary basis suddenly states that they have decided to sign themselves out of the hospital so that they can go home to kill themselves? These are just some of the legal questions that PMHNPs must know the answers to specific to their state of licensure/practice. Learning and Motor Disorders in Childhood Essays.

In this Assignment, you investigate your state’s laws concerning voluntary and involuntary commitment. You also analyze a case to determine if the client is eligible for involuntary commitment.

Scenario for Week 7 Case:

You are a PMHNP working in a large intercity hospital. You receive a call from the answering service informing you that a “stat” consult has been ordered by one of the hospitalists in the ICU. Upon arriving in the ICU, you learn that your consult is a 14 year old male who overdosed on approximately 50 Benadryl (diphenhydramine hydrochloride) tablets in an apparent suicide attempt. At the scene, a suicide note was found indicating that he wanted to die because his girlfriend’s parents felt that their daughter was too young to be “dating.” The client stated in the suicide note that he could not “live without her” and decided to take his own life. Although he has been medically stabilized and admitted to the ICU, he has been refusing to talk with the doctors or nurses. The hospital staff was finally able to get in touch with the clients parents (using contact information retrieved from the 14 year old’s cell phone). Unbeknown to the hospital staff, the parents are divorced, and both showed up at the hospital at approximately the same time, each offering their own perspectives on what ought to be done. The client’s father is demanding that the client be hospitalized because of the suicide, but his mother points out that he does not have “physical custody” of the child. The client’s mother demands that the client be discharged to home with her stating that her son’s actions were nothing more than a “stunt” and “an attempt at manipulating the situation that he didn’t like.” The client’s mother then becomes “nasty” and informs you that she works as a member of the clerical staff for the state board of nursing, and if you fail to discharge her child “right now” she will make you “sorry.” How would you proceed? Learning and Motor Disorders in Childhood Essays.

Learning Objectives

Students will:

Evaluate clients for voluntary commitment

Evaluate clients for involuntary commitment based on state laws

Recommend actions for supporting parents of clients not eligible for involuntary commitment

Recommend actions for treating clients not eligible for involuntary commitment

Learning and Motor Disorders in Childhood Essays

To Prepare for this Practicum:

Review the Learning Resources concerning voluntary and involuntary commitment.

Read the Week 7 Scenario in your Learning Resources.

Research your state’s laws concerning voluntary and involuntary commitment.

The Assignment (2–3 pages):

Based on the scenario, would you recommend that the client be voluntarily committed? Why or why not?

Based on the laws in your state, would the client be eligible for involuntary commitment? Explain why or why not.

Did understanding the state laws confirm or challenge your initial recommendation regarding involuntarily committing the client? Explain.

If the client were not eligible for involuntary commitment, explain what actions you may be able to take to support the parents for or against voluntary commitment.

If the client were not eligible for involuntary commitment, explain what initial actions you may be able to take to begin treating the client. Learning and Motor Disorders in Childhood Essays.

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 “WK7Assgn1+last name+first initial.(extension)” as the name.

Click the 
Week 7 Assignment 1 Rubric 
to review the Grading Criteria for the Assignment.

Click the 
Week 7 Assignment 1 
link. You will also be able to “View Rubric” for grading criteria from this area. Learning and Motor Disorders in Childhood Essays.

Next, from the Attach File area, click on the 
Browse My Computer
 button. Find the document you saved as “WK7Assgn1+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.

Grading Criteria

To access your rubric:

Week 7 Assignment 1 Rubric

Check Your Assignment Draft for Authenticity

To check your Assignment draft for authenticity:

Submit your Week 7 Assignment 1 draft and review the originality report.

Submit Your Assignment by Day 7

To submit your Assignment:

Week 7 Assignment 1

Assignment 2: Practicum: Week 5 Decision Tree

By Day 7

Submit 
your Assignment. Refer to Week 5 for additional guidance.

Submission and Grading Information

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

Please save your Assignment using the naming convention “WK7Assgn2+last name+first initial.(extension)” as the name. Learning and Motor Disorders in Childhood Essays.

Click the 
Week 7 Assignment 2 Rubric 
to review the Grading Criteria for the Assignment.

Click the 
Week 7 Assignment 2 
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 “WK7Assgn2+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. Learning and Motor Disorders in Childhood Essays.

Grading Criteria

To access your rubric:

Week 7 Assignment 2 Rubric

Check Your Assignment Draft for Authenticity

To check your Assignment draft for authenticity:

Submit your Week 7 Assignment 2 draft and review the originality report.

Submit Your Assignment by Day 7

To submit your Assignment:

Week 7 Assignment 2

Assignment 3: 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.

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. Learning and Motor Disorders in Childhood Essays.

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.

Practicum Reminder

Time Logs

You are required to keep a log of the time you spend related to your practicum experience 
and enter every patient you see each day
. You can access your time log from the Welcome Page in your Meditrek account. You track time individually for each patient you work with. Please make sure to continuously input your hours throughout the term. Learning and Motor Disorders in Childhood Essays.

Making Connections

This week, you worked with your group to develop a Parent Guide for an assigned learning or motor disorder. For your practicum, you examined the practice of voluntary and involuntary commitment of children and adolescents with mental health disorders.

Next week, you will debate the theory that bipolar depression can or cannot be diagnosed in children and adolescents. Learning and Motor Disorders in Childhood Essays.

Emergency Psychiatric Care in Childhood and Adolescence Essays

Week 6: Emergency Psychiatric Care in Childhood and Adolescence

“I can’t believe I am not dead. I want to be dead, but those pills did not work as fast as I expected. Dad found me and called 911. I cannot go on living after what they said about me on the Internet. My life is ruined and I cannot go back to school or even show my face around here. They all think I am that way, but I am not. Dad thinks this was a mistake, but he is wrong. When I get out of here, I am going to try something different, and this time it will work.” Emergency Psychiatric Care in Childhood and Adolescence Essays.

ORDER A PLAGIARISM-FREE PAPER HERE

When psychiatric emergencies arise, they can present many challenges to the PMHNP. While there are many approaches to emergencies that are similar, there are also significant differences when dealing with children and adolescents versus adults. This is particularly true with coordination of care, availability of resources, and legal implications of the psychiatric emergency.

This week, you examine psychiatric emergencies that arise during childhood and adolescence and compare how those emergencies are assessed and treated to those of adult clients. Emergency Psychiatric Care in Childhood and Adolescence Essays.

 

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. Emergency Psychiatric Care in Childhood and Adolescence Essays.

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 23, “Emergency Psychiatric Medicine” (pp. 785–790)

Chapter 31, “Child Psychiatry” (pp. 1226–1253)

American Psychiatric Association. (2013).
Diagnostic and statistical manual of mental disorders
(5th ed.). Washington, DC: Author. Emergency Psychiatric Care in Childhood and Adolescence Essays.

“Bipolar and Related Disorders”

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. Emergency Psychiatric Care in Childhood and Adolescence Essays.

 

Note:
All Stahl resources can be accessed through the Walden Library using the link. 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 the following medications, click on The Prescriber’s Guide, 5th Ed. tab on the Stahl Online website and select the appropriate medication. Emergency Psychiatric Care in Childhood and Adolescence Essays.

Review the following medications:

Reversal of benzodiazepine effects

flumazenil

Aggression

Behavioral problems

Cataplexy syndrome

clozapine

propranolol

zuclopenthixol

aripiprazole

asenapine

chlorpromazine

haloperidol

iloperidone

lurasidone

olanzapine

paliperidone

quetiapine

risperidone

ziprasidone

clomipramine

imipramine

sodium oxybate

Catatonia

Extrapyramidal side effects

Mania

alprazolam

chlordiazepoxide

clonazepam

clorazepate

diazepam

estazolam

flunitrazepam

flurazepam

loflazepate

lorazepam

midazolam

oxazepam

quazepam

temazepam

triazolam

benztropine

diphenhydramine

trihexyphenidyl

alprazolam (adjunct)

aripiprazole

asenapine

carbamazepine

chlorpromazine

clonazepam (adjunct)

iloperidone

lamotrigine

levetiracetam

lithium

lorazepam (adjunct)

lurasidone

olanzapine

quetiapine

risperidone

sertindole

valproate (divalproex)

ziprasidone

zotepine

Note:
 Many of these medications are FDA approved for adults only. Some are FDA approved for disorders in children and adolescents. Many are used “off label” for the disorders examined in this week. As you read the Stahl drug monographs, focus your attention on FDA approvals for children/adolescents (including “ages” for which the medication is approved, if applicable) and further note which drugs are “off label.” Emergency Psychiatric Care in Childhood and Adolescence Essays.

Optional Resources

Thapar, A., Pine, D. S., Leckman, J. F., Scott, S., Snowling, M. J., & Taylor, E. A. (2015).
Rutter’s child and adolescent psychiatry
(6th ed.). Hoboken, NJ: Wiley Blackwell.

Chapter 50, “Provision of Intensive Treatment: Intensive Outreach, Day Units, and In-Patient Units” (pp. 648–664)

Chapter 64, “Suicidal Behavior and Self-Harm” (pp. 893–912)

Discussion: Treatment of Psychiatric Emergencies in Children Versus Adults

The diagnosis of psychiatric emergencies can include a wide range of problems—from serious drug reactions to abuse and suicidal ideation/behaviors. Regardless of care setting, the PMHNP must know how to address emergencies, coordinate care with other members of the health care team and law enforcement officials (when indicated), and effectively communicate with family members who are often overwhelmed in emergency situations.

In this week’s Discussion, you compare treatment of adult psychiatric emergency clients to child or adolescent psychiatric emergency clients. Emergency Psychiatric Care in Childhood and Adolescence Essays.

Learning Objectives

Students will:

Compare treatment of adult psychiatric emergency clients to child or adolescent psychiatric emergency clients

Analyze legal and ethical issues concerning treatment of child or adolescent psychiatric emergency clients

To Prepare
:

Review the Learning Resources concerning emergency psychiatric medicine.

Consider a case where your adult client had a psychiatric emergency. (
Note:
 If you have not had an adult client with a psychiatric emergency, ask your preceptor to describe one of their clients with a psychiatric emergency to use as an example for this Discussion.) Emergency Psychiatric Care in Childhood and Adolescence Essays.

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
! Emergency Psychiatric Care in Childhood and Adolescence Essays.

By Day 3

Post
:

Briefly describe the case you selected.

Explain how you would treat the client differently if he or she were a child or adolescent.

Explain any legal or ethical issues you would have to consider when working with a child or adolescent emergency case.

By Day 6

Respond
 to at least 
two
 of your colleagues by recommending at least one additional way you would treat a child or adolescent client differently than you would an adult and at least one additional way you would address the legal and ethical issues involved. Emergency Psychiatric Care in Childhood and Adolescence Essays.

Submission and Grading Information

Grading Criteria

To access your rubric:

Week 6 Discussion Rubric

Post by Day 3 and Respond by Day 6

To participate in this Discussion:

Week 6 Discussion

Emergency Psychiatric Care in Childhood and Adolescence Essays Assignment 1: Midterm Exam

This exam is designed to assess how you synthesize the information from all your PMHNP courses. It draws upon the material from all the textbooks from NURS 6630, NURS 6640, NURS 6650, and NURS 6660. It is very similar to what you will experience in your certification exam.

Emergency Psychiatric Care in Childhood and Adolescence Essays Learning Objectives

Students will:

Assess knowledge of concepts and principles related to child and adolescent psychiatry

This exam will cover the following topics:

Components of a comprehensive integrated psychiatric assessment

Assessments specific to children and adolescents

Autism spectrum disorder, ADHD, ODD, ICD

Trauma and stressor-related disorders in childhood

Anxiety disorders in childhood and adolescence

Emergency psychiatric care in childhood and adolescence

Emergency Psychiatric Care in Childhood and Adolescence Essays

By Day 7

Complete the Midterm Exam. Prior to starting the exam, you should review all of your materials. There is a 2-hour time limit to complete this 76-question exam. You may only attempt this exam once. Emergency Psychiatric Care in Childhood and Adolescence Essays.

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 Quiz by Day 7

To submit your Exam:

Week 6 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.

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. Emergency Psychiatric Care in Childhood and Adolescence Essays.

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 examined psychiatric emergencies that arise during childhood and adolescence and compared how those emergencies are assessed and treated to those of adult clients.

Next week, you will develop a Parent Guide for an assigned learning or motor disorder. For your practicum, you will examine the practice of voluntary and involuntary commitment of children and adolescents with mental health disorders.

Looking Ahead

In Week 7, you will work with your group again to create a new Parent Guide, focusing on learning and motor disorders in childhood. Emergency Psychiatric Care in Childhood and Adolescence Essays.

Anxiety Disorders in Childhood and Adolescence Essays

Week 5: Anxiety Disorders in Childhood and Adolescence

“I don’t know why everyone is worried that I don’t want to go out with my friends anymore. I just like to stay home. There is nothing wrong with that. I go to school and get good grades, but I don’t know what to say to those other girls in my class. They ask why I can’t go to the mall with them on the weekend and I get all embarrassed. They don’t understand that I don’t know what to say to them. When I do say something, it is always wrong, or they laugh. I can just stay home and read my books.”

Emma, age 15

Anxiety disorders that plague many individuals in adulthood often have their origins in childhood and adolescence. By identifying those children and adolescents with anxiety disorders, the PMHNP can intervene and teach skills that the client can use to control anxiety throughout his or her life.

This week, you analyze case studies to determine the diagnosis and treatment of anxiety disorders. Anxiety Disorders in Childhood and Adolescence Essays.

ORDER A CUSTOM-WRITTEN PAPER NOW

Anxiety Disorders in Childhood and Adolescence Essays 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 31, “Child Psychiatry” (pp. 1253–1268)

American Psychiatric Association. (2013).
Diagnostic and statistical manual of mental disorders
(5th ed.). Washington, DC: Author. Anxiety Disorders in Childhood and Adolescence Essays.

“Anxiety Disorders”

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

American Academy of Child & Adolescent Psychiatry (AACAP). (2012a). Practice parameter for the assessment and treatment of children and adolescents with obsessive-compulsive disorder.
Journal of the American Academy of Child & Adolescent Psychiatry
,
51
(1), 98–113. Retrieved from http://www.jaacap.com/article/S0890-8567(11)00882-3/pdf

McClelland, M., Crombez, M-M., Crombez, C., Wenz, C., Lisius, M., Mattia, A., & Marku, S. (2015). Implications for advanced practice nurses when pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections (PANDAS) is suspected: A qualitative study.
Journal of Pediatric Health Care
,
29
(5), 442–452. doi:10.1016/j.pedhc.2015.03.005

Note:
You will access this article from the Walden Library databases. Anxiety Disorders in Childhood and Adolescence Essays.

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. 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 the following medications, click on The Prescriber’s Guide, 5th Ed. tab on the Stahl Online website and select the appropriate medication. Anxiety Disorders in Childhood and Adolescence Essays.

Review the following medications:

Generalized anxiety disorder

Social anxiety disorder

alprazolam

citalopram

desvenlafaxine

duloxetine

escitalopram

fluoxetine

fluvoxamine

mirtazapine

paroxetine

pregabalin

sertraline

tiagabine (adjunct)

venlafaxine

citalopram

clonidine

desvenlafaxine

escitalopram

fluoxetine

fluvoxamine

isocarboxazid

moclobemide

paroxetine

phenelzine

pregabalin

sertraline

tranylcypromine

venlafaxine

Obsessive-compulsive disorder

Panic disorder

citalopram

clomipramine

escitalopram

fluoxetine

fluvoxamine

paroxetine

sertraline

venlafaxine

vilazodone

alprazolam

citalopram

clonazepam

desvenlafaxine

escitalopram

fluoxetine

fluvoxamine

isocarboxazid

lorazepam

mirtazapine

nefazodone

paroxetine

phenelzine

pregabalin

reboxetine

sertraline

tranylcypromine

venlafaxine

Note:
 Many of these medications are FDA approved for adults only. Some are FDA approved for disorders in children and adolescents. Many are used “off label” for the disorders examined in this week. As you read the Stahl drug monographs, focus your attention on FDA approvals for children/adolescents (including “ages” for which the medication is approved, if applicable) and further note which drugs are “off label.”

Required Media

YMH Boston. (2013b, May 22).
Vignette 3 – Asking about depression in a preventive services visit
[Video file]. Retrieved from https://www.youtube.com/watch?v=TO8aITpMG5E

 

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

YMH Boston. (2013b, May 22).
Vignette 5 – Assessing for depression in a mental health appointment
[Video file]. Retrieved from https://www.youtube.com/watch?v=Gm3FLGxb2ZU

 

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

Laureate Education (Producer). (2017c).
Anxiety disorder, ODC, or something else?
[Multimedia file]. Baltimore, MD: Author. Anxiety Disorders in Childhood and Adolescence Essays.

Optional Resources

Thapar, A., Pine, D. S., Leckman, J. F., Scott, S., Snowling, M. J., & Taylor, E. A. (2015).
Rutter’s child and adolescent psychiatry
(6th ed.). Hoboken, NJ: Wiley Blackwell.

Chapter 60, “Anxiety Disorders” (pp. 822–840)

Chapter 61, “Obsessive Compulsive Disorder” (pp. 841–857)

Anxiety Disorders in Childhood and Adolescence Essays Discussion: Clinical Supervision

Clinical Supervision is an essential component of your development as a psychiatric mental health nurse practitioner. It provides an opportunity for professional collaboration as you share experiences with and gain insights from colleagues. For this Clinical Supervision, consider a client whom you do not think is adequately progressing according to expected clinical outcomes.

Anxiety Disorders in Childhood and Adolescence Essays Learning Objectives

Students will:

Analyze clients presenting for treatment of anxiety disorders

Evaluate effectiveness of therapeutic approaches for clients diagnosed with an anxiety disorder

To Prepare
:

Review this week’s Learning Resources concerning treating patients with anxiety disorders.

Reflect on a child or adolescent client you are currently counseling or have previously counseled at your practicum site who has been diagnosed with an anxiety disorder. Anxiety Disorders in Childhood and Adolescence Essays.

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
!

By Day 3

Post
 a 3- to 5-minute Kaltura video in which you do the following:

Describe the client. 
Note:
 Do not use the client’s actual name.

Explain your therapeutic approach with the client, including the perceived effectiveness of your approach.

Identify any additional information about this client that may potentially impact expected outcomes.

Note:
 Nurse practitioners must have strong oral communication skills. This Discussion is designed to help you hone these skills. When filming your Kaltura video, be sure to dress and speak in a professional manner. Anxiety Disorders in Childhood and Adolescence Essays.

View
 a selection of your colleagues’ responses.

By Day 6

Respond
 to at least 
two
 of your colleagues by suggesting an alternate therapeutic approach. Support your feedback with evidence-based literature and/or your own experiences with clients.

Submission and Grading Information

Grading Criteria

To access your rubric:

Week 5 Discussion Rubric

Post by Day 3 and Respond by Day 6

To participate in this Discussion:

Week 5 Discussion

Assignment 1: 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 pediatric clients presenting symptoms of a mental health disorder.

Anxiety Disorders in Childhood and Adolescence Essays 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

The Assignment:

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. Anxiety Disorders in Childhood and Adolescence Essays.

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.

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? Anxiety Disorders in Childhood and Adolescence Essays.

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?

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

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. Anxiety Disorders in Childhood and Adolescence Essays.

By Day 7 of Week 7

Submit your Assignment.

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.

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. Anxiety Disorders in Childhood and Adolescence Essays.

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 analyzed case studies to determine the diagnosis and treatment of anxiety disorders.

Next week, you examine psychiatric emergencies that arise during childhood and adolescence and compare how those emergencies are assessed and treated to those of adult clients.

Looking Ahead

You should be working on your cover letter, resume, and portfolio that is due in Week 10. Anxiety Disorders in Childhood and Adolescence Essays.

Trauma and Stressor-Related Disorders in Childhood essays

Week 4: Trauma and Stressor-Related Disorders in Childhood

“He was drunk again, so I should have known better. I should have stayed away from the house, but that would have made him madder. He has done this before, but not nearly this bad. He broke my wrist as I was protecting my mom. The neighbor heard the screaming and called the cops. They hauled him away, but I know he will be back. She always lets him come back.”

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In August of 2005, thousands of children lost their homes in Hurricane Katrina. On December 14, 2012, the students at Sandy Hook Elementary School experienced the death of 20 of their classmates and six of their teachers. Every day, children experience physical and sexual abuse and neglect by their parents or caregivers. These types of trauma have a lifelong impact on the children involved and those witnessing the events. As much as we try to prevent unwanted childhood trauma and stressors, the phenomena are present in our culture. Childhood trauma is a significant contributor to both physical and mental health problems in children and adults. Trauma and Stressor-Related Disorders in Childhood essays.

This week, you examine several cases of child abuse and neglect, and you recommend strategies for assessing for abuse. You analyze influences of media and social media on mental health and evaluate the need for mandatory reporting of abuse. You also submit your Practicum Journal and Assignments.

Trauma and Stressor-Related Disorders in Childhood essays 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 31, “Child Psychiatry” (pp. 1216–1226)

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

“Trauma- and Stressor-related Disorders”

Note:
You will access this book from the Walden Library databases. Trauma and Stressor-Related Disorders in Childhood essays.

Pfefferbaum, B., & Shaw, J. A. (2013). Practice parameter on disaster preparedness.
Journal of the American Academy of Child & Adolescent Psychiatry
,
52
(11), 1224–1238. Retrieved from http://www.jaacap.com/article/S0890-8567(13)00550-9/pdf

American Psychiatric Nurses Association. (2017).
Childhood and adolescent trauma.
Retrieved from http://www.apna.org/i4a/pages/index.cfm?pageID=4545

Document:
Childhood Abuse Case Study (PDF)

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. 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. Trauma and Stressor-Related Disorders in Childhood essays.

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

Review the following medications:

Posttraumatic stress disorder

citalopram

clonidine

desvenlafaxine

escitalopram

fluoxetine

fluvoxamine

mirtazapine

nefazodone

paroxetine

prazosin (nightmares)

propranolol (prophylactic)

sertraline

venlafaxine

Note:
 Many of these medications are FDA approved for adults only. Some are FDA approved for disorders in children and adolescents. Many are used “off label” for the disorders examined in this week. As you read the Stahl drug monographs, focus your attention on FDA approvals for children/adolescents (including “ages” for which the medication is approved, if applicable) and further note which drugs are “off label.”

Optional Resources

Thapar, A., Pine, D. S., Leckman, J. F., Scott, S., Snowling, M. J., & Taylor, E. A. (2015).
Rutter’s child and adolescent psychiatry
(6th ed.). Hoboken, NJ: Wiley Blackwell.

Chapter 50, “Provision of Intensive Treatment: Intensive Outreach, Day Units, and In-Patient Units” (pp. 648–664)

Chapter 58, “Disorders of Attachment and Social Engagement Related to Deprivation” (pp. 795–805)

Chapter 59, “Post Traumatic Stress Disorder” (pp. 806–821)

Chapter 64, “Suicidal Behavior and Self-Harm” (pp. 893–912)

Trauma and Stressor-Related Disorders in Childhood essays Discussion: Treating Childhood Abuse

In 2012, statistics in the United States indicated that state CPS agencies received 3.4 million referrals for child abuse and neglect. Of these, nearly 700,000 children were found to be victims of maltreatment: 18% were victims of physical abuse and 78% were victims of neglect (CDC, 2014). Child sexual abuse makes up roughly 10% of child maltreatment cases in the United States (CDC, 2014). The CDC considers sexual abuse at any age a form of violence. Child abuse of any kind can lead to an increased state of inflammatory markers in adulthood, as well as multiple physical illnesses and high-risk behavior such as alcoholism and drug abuse. If a PMHNP identifies child abuse, there may be a need to report the abuse to authorities. Once able to provide treatment, the PMHNP can be instrumental in reducing the long-term effects of child abuse. Trauma and Stressor-Related Disorders in Childhood essays.

In this Discussion, you recommend strategies for assessing for abuse and analyze influences of media and social media on mental health. You also evaluate the need for mandatory reporting of abuse.

Trauma and Stressor-Related Disorders in Childhood essays Learning Objectives

Students will:

Recommend strategies for assessing for abuse

Analyze influences of media and social media on mental health

Evaluate the need for mandatory reporting of abuse

To Prepare
 
for this Discussion:

Read the Learning Resources concerning treating childhood abuse.

Read the Child Abuse Case Study in the Learning Resources.

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
!

By Day 3

Post:

What strategies would you employ to assess the patient for abuse? Explain why you selected these strategies.

How might exposure to the media and/or social media affect the patient?

What type of mandatory reporting (if any) is required in this case? Why?

Trauma and Stressor-Related Disorders in Childhood essays

By Day 6

Respond
 to at least 
two
 of your colleagues by providing at least two ways that their strategies may be expanded or improved.

Submission and Grading Information

Grading Criteria

To access your rubric:

Week 4 Discussion Rubric

Post by Day 3 and Respond by Day 6

To participate in this Discussion:

Week 4 Discussion

Trauma and Stressor-Related Disorders in Childhood essays Assignment 1: Practicum: Week 1 Practicum Journal

By Day 7

Submit
 your Assignment. Refer to Week 1 for additional guidance.

Submission and Grading Information

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

Please save your Assignment using the naming convention “WK4Assgn1+last name+first initial.(extension)” as the name.

Click the 
Week 4 Assignment 1 Rubric 
to review the Grading Criteria for the Assignment.

Click the 
Week 4 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 “WK4Assgn1+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.

Grading Criteria

To access your rubric:

Week 4 Assignment 1 Rubric

Check Your Assignment Draft for Authenticity

To check your Assignment draft for authenticity:

Submit your Week 4 Assignment 1 draft and review the originality report.

Submit Your Assignment by Day 7

To submit your Assignment:

Week 4 Assignment 1

Trauma and Stressor-Related Disorders in Childhood essays Assignment 2: Practicum: Week 3 Decision Tree

By Day 7

Submit
 your Assignment. Refer to Week 3 for additional guidance.

Submission and Grading Information

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

Please save your Assignment using the naming convention “WK4Assgn2+last name+first initial.(extension)” as the name.

Click the 
Week 4 Assignment 2 Rubric 
to review the Grading Criteria for the Assignment.

Click the 
Week 4 Assignment 2 
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 “WK4Assgn2+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.

Trauma and Stressor-Related Disorders in Childhood essays

Grading Criteria

To access your rubric:

Week 4 Assignment 2 Rubric

Check Your Assignment Draft for Authenticity

To check your Assignment draft for authenticity:

Submit your Week 4 Assignment 2 draft and review the originality report.

Submit Your Assignment by Day 7

To submit your Assignment:

Week 4 Assignment 2

Assignment 3: 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.

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. Trauma and Stressor-Related Disorders in Childhood essays.

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.

Practicum Reminder

Time Logs

You are required to keep a log of the time you spend related to your practicum experience 
and enter every patient you see each day
. You can access your time log from the Welcome Page in your Meditrek account. You track time individually for each patient you work with. Please make sure to continuously input your hours throughout the term. Trauma and Stressor-Related Disorders in Childhood essays.

Making Connections

This week, you examined several cases of child abuse and neglect and recommended strategies for assessing for abuse. You analyzed influences of media and social media on mental health and evaluated the need for mandatory reporting of abuse. You also submitted your Practicum Journal and Assignments.

Next week, you analyze case studies to determine the diagnosis and treatment of anxiety disorders. Trauma and Stressor-Related Disorders in Childhood essays.